Continuous Versus Interval Training in Patients With Coronary Artery Disease: FRAXIO Study
Condition: Acute Coronary Syndrome
MeSH terms: Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Acute Coronary Syndrome
Study type: Interventional

Summary: 
      The benefits of cardiac rehabilitation have been clearly demonstrated. In particular exercise
      training is recognized to be part of modern management after coronary artery disease. However
      methods of prescribing exercise-training programs and the exercise intensity are difficult to
      determine. The objective of this randomised clinical trial is to determine whether
      appropriate endurance exercise training improves the ventilatory threshold, the exercise
      tolerance and the quality of life in patients with coronary artery disease. Patients are
      randomized to continuous training or aerobic interval training respectively: 80%-versus
      maximal-workload at the ventilatory threshold. For each patient, the intensity of exercise
      training is determined by a first exercise test with gas analysis using parameters of sub
      maximal exercise capacity such as ventilatory threshold. Others parameters of functional
      capacity are also considered. Duration of the rehabilitation stage is between 7 to 10 weeks.
      Dyspnoea assessment at maximal intensity, quality of life measurement by SF36, drugs and
      events are reported. Maximal exercise tests with gas exchange measurements are performed
      after training program and at 6 months follow-up to compare the different cardio respiratory
      parameters in the two groups before and after exercise training and to evaluate the more
      effective endurance training program.
    

Detailed description: 
      -  Outline of the training program: Duration of the rehabilitation course is 7 or 10 weeks,
           2 or 3 training sessions a week, 21 sessions altogether. Each training session consist
           in cycling on an ergometer. In the interval training group, the training session
           alternates one minute at 100% workload at the ventilatory threshold and one minute
           active pause at 50% workload at the ventilatory threshold; total exercise time is 20
           minutes. In continuous training, the training session lasts 20 minutes at 80% workload
           at the ventilatory threshold.

        -  Exercise testing: Exercise capacity is measured before and at the end of the exercise
           training program and at 6 month follow-up. A first exercise test with respiratory gas
           exchange is performed 2 weeks after hospitalization: this is the baseline exercise test.
           The protocol consists of 3-min warm up at a workload of 30 watts. At each stage, the
           workload is increased by 10 or 15 watts per min. Patients are instructed to maintain a
           speed of 55 to 65 rotations per min. Four exercise tests with gas analysis are
           programmed during cardiac rehabilitation: three maximal tests (before exercise training
           program to precise exercise intensity during the sessions, after training program to
           evaluate the primary end point and at 6 months) and one sub maximal exercise test during
           the tenth session to adjust the intensity of training exercises (this test is stopped
           when the ventilatory threshold is obtained).
    

Intervention name(s): Continuous versus interval training
Intervention type(s): Other
Intervention description(s): Influence of different exercise training programs
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: cardiac rehabilitation; coronary heart disease; interval training; continuous training; ventilatory threshold