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      Training, Detraining and Retraining Effects after a Water-Based Exercise Program in Patients with Coronary Artery Disease

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          Objective: The aim of this study was to investigate the adaptations of a water-based training program as well as the detraining and retraining effects on physiological parameters in patients with coronary artery disease (CAD). Methods: Twenty-one patients were separated in an exercise group (n = 11) and a control group (n = 10). The exercise group followed three periods: training, detraining and retraining. Each period lasted 4 months. During the training and the retraining periods, the patients performed four sessions of water exercise (not swimming) per week. Results: The water-based program was well-accepted and no adverse effects were observed. The exercise group improved (p < 0.05) their stress-test time (+11.8%), VO<sub>2 peak</sub> (+8.4%) and total body strength (+12.2%) after the training period; detraining tended to reverse these positive adaptations. Resumption of training increased the beneficial effects obtained after the initial training period (exercise stress: +4.5%; VO<sub>2 peak</sub>: +6.6%; total strength: +7.0%). The patients in the control group did not show any significant alterations throughout the study. Conclusion: Water-based exercise is safe and induces positive physiological and muscular adaptations in low-risk patients with CAD. These could be reversed, however, after the cessation of exercise. This is why uninterrupted exercise throughout life is a must.

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          Most cited references 11

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          Effects of exercise training and activity restriction on 6-minute walking test performance in patients with chronic heart failure.

          Eighteen hospitalized patients with severe chronic heart failure (ejection fraction [mean +/- SEM] 21% +/- 1%) underwent 3 weeks of exercise training (interval bicycle ergometer and treadmill walking training exercises) and 3 weeks of activity restriction in a random-order crossover trial. Before and after exercise training and after activity restriction, a 6-minute walking test was performed to determine the maximum distance walked, hemodynamic and cardiopulmonary responses, norepinephrine levels, and ratings of leg fatigue and dyspnea while walking. A ramp test on bicycle ergometer (increments of 12.5 W/min) was performed before and after exercise training and activity restriction to determine peak oxygen uptake. After training, the maximum distance walked was increased by 65% (from 232 +/- 21 m at baseline to 382 +/- 20 m; p < 0.001), whereas after activity restriction (253 +/- 19 m) there was no significant difference compared with baseline. No significant differences in hemodynamic and cardiopulmonary parameters (with the exception of the ventilatory equivalent for carbon dioxide and perceived exertion) or norepinephrine levels were observed during walking tests. Improvement in maximum distance walked correlated significantly with training-induced increase in peak oxygen uptake measured during bicycle ergometry (r = 0.47, p < 0.05). The lower the maximum distance walked at baseline, the more pronounced the training-induced prolongation of maximum distance (r= -0.73; p < 0.001). These data support the value of exercise training in patients with severe chronic heart failure for improving maximum distance walked, as documented by the 6-minute walking test. The impairment of walking test performance during activity restriction suggests a need for long-term exercise training programs.
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            Land versus water exercise in patients with coronary artery disease: effects on body composition, blood lipids, and physical fitness.

            We examined the effects of combined resistance and aerobic training on land versus combined resistance and aerobic training in water in patients with coronary artery disease. Thirty-four patients were randomly assigned to land exercise (LE, n = 12), water exercise (WE, n = 12), and control (n = 10) groups. The LE group trained 4 times per week, twice with aerobic exercise and twice with resistance training. The WE program included aquatic aerobic activities 2 times per week and resistance exercise at the same frequency carried out in water. The duration of the training programs was 4 months. Body composition measurements, blood lipids, exercise stress testing, and muscular strength were obtained at the beginning and at the end of the training period. After 4 months of training, analysis of covariance revealed that body weight and sum of skinfolds were lower for WE and LE groups than for the control group. Patients who trained in water improved exercise time (+11.7% vs +8.1%) and maximum strength (+12.8% vs +12.9%) in a similar manner compared to the patients who trained on land. Total cholesterol (WE -4.4%, LE -3.3%) and triglycerides (WE -10.2%, LE -11.8%) decreased significantly for both exercise groups but not for the control group. Exercise programs that combine resistance and aerobic exercise performed either on land or in water can both improve exercise tolerance and muscular strength in patients with coronary artery disease. Furthermore, both programs induce similar favorable adaptations on total cholesterol, triglycerides, and body composition.
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              • Abstract: not found
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              Training and Detraining Effects of a Combined-strength and Aerobic Exercise Program on Blood Lipids in Patients With Coronary Artery Disease


                Author and article information

                S. Karger AG
                October 2008
                23 April 2008
                : 111
                : 4
                : 257-264
                Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
                127737 Cardiology 2008;111:257–264
                © 2008 S. Karger AG, Basel

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                Page count
                Figures: 3, Tables: 3, References: 29, Pages: 8
                Original Research


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