Insulin resistance, lipids and body composition in patients with coronary artery disease after combined aerobic training and resistance training: a randomised, controlled trial.

BACKGROUND: The effect of resistance training (RT) in cardiac rehabilitation (CR) on insulin resistance remains elusive. We examined whether the addition of high-load (HL) or low loads (LL) RT has any effect on the levels of insulin resistance and lipids versus aerobic training (AT) alone in patients with coronary artery disease (CAD). METHODS: Seventy-nine CAD patients were randomised to HL-RT [70-80% of one repetition maximum (1-RM)] and AT, LL-RT (35-40% of 1-RM) and AT or AT (50-80% of maximal power output), and 59 patients [75% males, 15% diabetics, age: 61 (8) years, left ventricular ejection fraction: 53 (9) %] completed the study. Plasma levels of glucose, insulin, blood lipids [total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL)] cholesterol and body composition were measured at baseline and post-training (36 training sessions). RESULTS: Training intervention had only time effect on lean mass (p = 0.002), total and LDL cholesterol levels (both p < 0.001), and no effects on levels of glucose and insulin resistance (homeostatic assessment 2-insulin resistance). Total and LDL cholesterols levels decreased following AT [mean difference (95% confidence interval); total cholesterol: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.013; LDL: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.006] and HL-RT [total cholesterol: - 0.5 mmol/l (- 0.8 mmol/l, - 0.2 mmol/l), p = 0.002; LDL: - 0.5 mol/l (- 0.7 mmol/l, - 0.2 mmol/l), p = 0.002]. No associations were observed between post-training change in body composition and post-training change in blood biomarkers. CONCLUSIONS: RT when combined with AT had no additional effect beyond AT alone on fasting glucose metabolism, blood lipids and body composition in patients with CAD. Trial registration number NCT04638764.

Physical activity and sedentary behaviour following combined aerobic and resistance training in coronary artery disease patients: A randomised controlled trial.

BACKGROUND: Effective training modalities and potential determinants to induce favourable changes in physical activity (PA) and sedentary behaviour (SB) remains elusive in patients with coronary artery disease. AIMS: This study aimed to investigate the effects of high-load resistance training and low-load RT combined with aerobic training in comparison to aerobic training alone on PA and SB, and whether baseline level of SB modifies PA outcomes in coronary artery disease patients. METHODS: We randomised 79 patients to aerobic training, low-load resistance training and aerobic training or high-load resistance training and aerobic training. PA and SB were measured using triaxial accelerometer at baseline and post-training for 8 days. RESULTS: There was no difference between training modalities in post-training PA and SB. When stratified by baseline SB, the very sedentary patients improved SB (-52 min/day, p = 0.001) and light intensity PA (+27 min/day, p = 0.009) following intervention. The improvement in PA was greater in the very sedentary patients (SB: +27%, p = 0.002; light intensity PA: +24%, p = 0.004) and in sedentary patients (SB: +24%, p = 0.009) compared to the very active patients. CONCLUSIONS: Post-training improvement in PA and SB was determined by baseline SB, while the addition of low-load or high-load resistance training provided no further benefits in coronary artery disease patients. CLINICAL TRIALS REGISTRATION NUMBER: NCT04638764.

Biomechanical Adjustments of the Basketball Jump Shot Performed Over Differently High Opponents.

Biomechanical adjustments of the jump shot in presence of an opponent and their associations with shooting efficiency remain to be determined in elite basketball. The aim of this research was to examine the selected biomechanical determinants of the jump shot when shooting over opponents of different height. Nineteen elite basketball players, age 22 ± 3 years, performed three trials of 20 basketball shots in a crossover, randomised manner: over an obstacle of the height of standing reach (RH), over reach height with additional 20 cm (RH+20 cm), over reach height with additional 40 cm (RH+40 cm), and the maximum height jump shot without an obstacle (JSmax). Jump height, the ball entry angle, and shooting efficiency were measured on each trial. Jump height when shooting over RH+40 cm was significantly higher than RH+20 cm (+0.022 m, p = 0.030) and RH (+0.023 m, p = 0.029). Similarly, the ball entry angle was greater at RH+40 cm compared to RH (+7.19 °, p < 0.001) and RH+20 cm (+2.90°, p < 0.001). In contrast, shooting efficiency decreased significantly when shooting over RH+40 cm compared to RH (-10.79%, p = 0.048) and RH+20 cm (-8.95%, p = 0.015). We recorded the highest jump height (0.35 ± 0.08m, p < 0.001) and the lowest angle of entry (39.16 ± 1.19°, p < 0.001) when participants performed JSmax. Shooting over higher opponents should be prioritised in training to significantly improve shooting efficiency. Future research is needed to determine additional potential biomechanical determinants of a successful jump shot in elite basketball.

Combined resistance training with aerobic training improves physical performance in patients with coronary artery disease: A secondary analysis of a randomized controlled clinical trial.

Background: The efficacy of combined resistance training (RT) and aerobic training (AT) compared with AT alone is well established in cardiac rehabilitation (CR); however, it remains to be elucidated whether RT load (high load [HL] vs. low load [LL]) modifies the outcomes. The aim of our study was to investigate the effects of HL-RT and LL-RT combined with AT in comparison to AT alone on body composition and physical performance in patients with coronary artery disease (CAD) enrolled in phase II CR. Methods: We randomized 79 patients with a stable CAD to 12 weeks of lower limb LL-RT + AT (35-40% of one repetition maximum [1-RM]; n = 28), HL-RT + AT (70-80% of 1-RM; n = 26), or AT (n = 25). Fifty-nine patients (75% men) with mean (standard deviation) age 61 (8) years and left ventricular ejection fraction 53 (9)% completed LL-RT (n = 19), HL-RT (n = 21) and AT (n = 19). Body composition and physical performance (upper and lower submaximal muscle strength, flexibility, balance, and mobility) were measured at baseline and post-training. Results: Training intervention had no significant impact on time × group interaction in the body composition measures. There was a significant time × group interaction for the gait speed test, chair sit-and-reach test, arm curl test, Stork balance test, up and go test, STS-5, and 6-min walk distance (p-values ≤ 0.001-0.04) following the training intervention. After the training intervention, HL-RT improved gait speed (+12%, p = 0.044), arm curl (+13%, p = 0.037), and time of Up and Go test (+9%, p < 0.001) to a greater extent compared with AT group, while there was a greater improvement in time of Up and Go test (+18%, p < 0.001) and time of five sit-to-stand tests (+14%, p = 0.016) following LL-RT when compared with AT. There were no differences between HL-RT and LL-RT in post-training improvement in any of the physical performance measures. Conclusion: The combination of AT with HL-RT or LL-RT promoted similar improvements in physical performance, which were superior to AT. Therefore, both types of combined AT and RT can be applied to patients with CAD. Clinical trial registration: [https://clinicaltrials.gov/ct2/show/NCT04638764] Identifier [NCT04638764].

High-Load and Low-Load Resistance Exercise in Patients with Coronary Artery Disease: Feasibility and Safety of a Randomized Controlled Clinical Trial.

Resistance exercise (RE) remains underused in cardiac rehabilitation; therefore, there is insufficient evidence on safety, feasibility, and hemodynamic adaptations to high-load (HL) and low-load (LL) RE in patients with coronary artery disease (CAD). This study aimed to compare the safety, feasibility of HL-RE and LL-RE when combined with aerobic exercise (AE), and hemodynamic adaptations to HL and LL resistance exercise following the intervention. Seventy-nine patients with CAD were randomized either to HL-RE (70−80% of one-repetition maximum [1-RM]) and AE, LL-RE (35−40% of 1-RM) and AE or solely AE (50−80% of maximal power output) as a standard care, and 59 patients completed this study. We assessed safety and feasibility of HL-RE and LL-RE and we measured 1-RM on leg extension machine and hemodynamic response during HL- and LL-RE at baseline and post-training. The training intervention was safe, well tolerated, and completed without any adverse events. Adherence to RE protocols was excellent (100%). LL-RE was better tolerated than HL-RE, especially from the third to the final mesocycle of this study (Borgs' 0−10 scale difference: 1−2 points; p = 0.001−0.048). Improvement in 1-RM was greater following HL-RE (+31%, p < 0.001) and LL-RE (+23%, p < 0.001) compared with AE. Participation in HL-RE and LL-RE resulted in a decreased rating of perceived exertion during post-training HL- and LL-RE, but in the absence of post-training hemodynamic adaptations. The implementation of HL-RE or LL-RE combined with AE was safe, well tolerated and can be applied in the early phase of cardiac rehabilitation for patients with stable CAD.