Different Endurance Training Protocols in Cardiac Rehabilitation

Study Overview
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Brief Summary
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It is the aim of the study to compare the effects of 6 weeks of either high-intensity interval training (HIT; carried out at correctly assessed 85-95% of maximal heart rate), pyramid, or continuous endurance training, on changes of physical exercise capacity in cardiac patients. The three exercise arms (isocaloric) are composed as follows: Endurance training (n=15): 31min at 65-75% HRmax; HIT (n=15): 4x4min intervals at 85-95% HRmax divided by 3x3min of active recovery at 60-70% HRmax, making it a total of 25min; Pyramids (n=15): One Pyramid consists of 8 one-minute blocks. Those are grouped starting with one block of 70-75% HRmax, followed by one block at 75-80% HRmax and another one at 80-85% HRmax. The top of the pyramid are 2 blocks of 85-90% HRmax. Intensity is lowered afterwards with one block at 80-85% HRmax, followed by one block at 75-80% HRmax and last one at 70-75% HRmax. Two more pyramids follow, each divided by 2min of active recovery at 65-70% HRmax, making it a total of 28min. All protocols are initiated by 5min of warm-up and end with 5min of cool-down, both at 60-70% HRpeak. Primary Outcome: Individual maximum power output in watt (Pmax). Secondary Outcome: Change of power output in watt at lactate thresholds at 2 and 4 mmol/l.

Official Title
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Effects of Different Endurance Training Protocols on Physical Performance in Cardiac Patients

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Other: Endurance training with constant work load
* Other: Pyramid-Training
* Other: High-intensity interval training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least one of the following diagnoses within the previous 3 months: acute coronary syndrome (STEMI) acute coronary syndrome (NSTEMI) aortocoronary bypass surgery PCI stable coronary heart disease Exclusion Criteria: Unstable angina pectoris Heart failure (NYHA IV) Acute endomyocarditis or other acute infections Pulmonary artery embolism or phlebothrombosis within the previous 6 months Hemodynamically unstable arrhythmia Hypertrophic cardiomyopathy participation in another study within the previous 6 months Medical conditions which prevent patients from complying with the exercise program

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Endurance training with constant work load<br> | Other: Endurance training with constant work load<br>* Endurance training with constant work load(n=15): 31min at 65-75% HRmax<br>|
| Experimental: Pyramid-Training<br> | Other: Pyramid-Training<br>* Pyramid-Training (n=15): One Pyramid consists of 8 one-minute blocks. Those are grouped starting with one block of 70-75% HRmax, followed by one block at 75-80% HRmax and another one at 80-85% HRmax. The top of the pyramid are 2 blocks of 85-90% HRmax. Intensity is lowered afterwards with one block at 80-85% HRmax, followed by one block at 75-80% HRmax and last one at 70-75% HRmax. Two more pyramids follow, each divided by 2min of active recovery at 65-70% HRmax, making it a total of 28min.<br>|
| Experimental: High-intensity interval training<br> | Other: High-intensity interval training<br>* HIT (n=15): 4x4min intervals at 85-95% HRmax divided by 3x3min of active recovery at 60-70% HRmax, making it a total of 25min<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Individual maximum power output in watt (Pmax) | Change of individual maximum power output in watt (Pmax) on a bicycle ergometer after the training intervention of controlled physical activity within 6 weeks | 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Power output in watt at lactate threshold of 2 and 4 mmol/l | Change of power output in watt at lactate thresholds at 2 and 4 mmol/l | 6 weeks |