Effects of combined high-intensity aerobic interval training program and Mediterranean diet recommendations after myocardial infarction (INTERFARCT Project): study protocol for a randomized controlled trial

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Abstract

Background

Exercise therapy has long been used for rehabilitation purposes after myocardial infarction (MI) and the benefit of regular physical exercise is also well-established. High-intensity interval training (HIIT) has been proposed to be more effective than continuous exercise for improving exercise capacity and health-related adaptations to low-volume (LV) and HIIT are also known. Furthermore, the Mediterranean diet (Mediet) has been widely reported to be a model of healthy eating for its contribution to a favorable health status and a better quality of life, reducing overall mortality. This study will investigate the effects of different HIIT programs (high-volume [HV] vs LV) and Mediet recommendations in clinical condition, cardiorespiratory fitness, biomarkers, ventricular function, and perception of quality of life after MI, and compared to an attention control group that is recommended to Mediet and physical activity without supervision sessions.

Methods/Design

In this randomized controlled trial, cardiorespiratory fitness, anthropometry, central and peripheral cardiovascular variables, biochemical and nutritional condition, and quality of life will be assessed before and after 16 weeks of intervention in 177 participants diagnosed with MI type 1. All participants will be randomly (1:1:1) assigned to the attention control group or two exercise groups (Mediet recommendations plus supervised aerobic exercise two days/week: (1) HV (40 min) HIIT group and (2) LV (20 min) HIIT group.

Discussion

This study will be the first clinical trial comparing the effects of two different volumes of HIIT programs with Mediet recommendations for people after MI. The results of this study will provide good evidence for physical rehabilitation in this population.

Trial registration

ClinicalTrials.gov, NCT02876952. Registered on 24 August 2016.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-2529-3) contains supplementary material, which is available to authorized users.

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Most cited references 25

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The aim was to develop a standardised and externally paced field walking test, incorporating an incremental and progressive structure, to assess functional capacity in patients with chronic airways obstruction. The usefulness of two different shuttle walking test protocols was examined in two separate groups of patients. The initial 10 level protocol (group A, n = 10) and a subsequent, modified, 12 level protocol (group B, n = 10) differed in the number of increments and in the speeds of walking. Patients performed three shuttle walking tests one week apart. Then the performance of patients (group C, n = 15) in the six minute walking test was compared with that in the second (modified) shuttle walking test protocol. Heart rate was recorded during all the exercise tests with a short range telemetry device. The 12 level modified protocol provided a measure of functional capacity in patients with a wide range of disability and was reproducible after just one practice walk; the mean difference between trial 2 v 3 was -2.0 (95% CI -21.9 to 17.9) m. There was a significant relation between the distance walked in the six minute walking test and the shuttle walking test (rho = 0.68) but the six minute walking test appeared to overestimate the extent of disability in some patients. The shuttle test provoked a graded cardiovascular response not evident in the six minute test. Moreover, the maximal heart rates attained were significantly higher for the shuttle walking test than for the six minute test. The shuttle walking test constitutes a standardised incremental field walking test that provokes a symptom limited maximal performance. It provides an objective measurement of disability and allows direct comparison of patients' performance.

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The European Society of Cardiology heart failure guidelines firmly recommend regular physical activity and structured exercise training (ET), but this recommendation is still poorly implemented in daily clinical practice outside specialized centres and in the real world of heart failure clinics. In reality, exercise intolerance can be successfully tackled by applying ET. We need to encourage the mindset that breathlessness may be evidence of signalling between the periphery and central haemodynamic performance and regular physical activity may ultimately bring about favourable changes in myocardial function, symptoms, functional capacity, and increased hospitalization-free life span and probably survival. In this position paper, we provide practical advice for the application of exercise in heart failure and how to overcome traditional barriers, based on the current scientific and clinical knowledge supporting the beneficial effect of this intervention.

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A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population

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Author and article information

Contributors

Sara Maldonado-Martín: +34 945013534 , sara.maldonado@ehu.eus

Jon Ander Jayo-Montoya: jonanderjayo@gmail.com

Tatiana Matajira-Chia: tatianamatajira@yahoo.com

Beatriz Villar-Zabala: beaviza@hotmail.com

Juan José Goiriena: juanjose.goirienagandarias@ehu.eus

G. Rodrigo Aispuru: graispuru@gmail.com

Journal

Journal ID (nlm-ta): Trials

Journal ID (iso-abbrev): Trials

Title: Trials

Publisher: BioMed Central (London )

ISSN (Electronic): 1745-6215

Publication date (Electronic): 2 March 2018

Publication date PMC-release: 2 March 2018

Publication date Collection: 2018

Volume: 19

Electronic Location Identifier: 156

Affiliations

[1 ]ISNI 0000000121671098, GRID grid.11480.3c, Department of Physical Education and Sport, Faculty of Education and Sport, Physical Activity and Sport Sciences Section, , University of the Basque Country (UPV/EHU), ; Portal de Lasarte, 71, 01007 Vitoria-Gasteiz, Araba/Álava, Basque Country Spain

[2 ]Cardiology Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos, Spain

[3 ]Primary Care Administration of Burgos, Miranda de Ebro, Burgos, Spain

[4 ]ISNI 0000000121671098, GRID grid.11480.3c, Department of Physiology, Faculty of Medicine, , University of the Basque Country (UPV/EHU), ; Leioa, Bizkaia, Basque Country Spain

Article

Publisher ID: 2529

DOI: 10.1186/s13063-018-2529-3

PMC ID: 5834904

PubMed ID: 29499766

SO-VID: cc021db9-a86c-4478-a995-59e4e567d391

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 21 September 2017

Date accepted : 5 February 2018

Funding

Funded by: Santiago Apostol Hospital

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: exercise design,cardiorespiratory fitness,low-volume training,health status

Data availability:

ScienceOpen disciplines: Medicine

Keywords: exercise design, cardiorespiratory fitness, low-volume training, health status

Effects of combined high-intensity aerobic interval training program and Mediterranean diet recommendations after myocardial infarction (INTERFARCT Project): study protocol for a randomized controlled trial

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Abstract

Background

Methods/Design

Discussion

Trial registration

Electronic supplementary material

Related collections

Herbal Medicines Journal (Herb Med J)

Most cited references 25

Development of a shuttle walking test of disability in patients with chronic airways obstruction.

Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation.

A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population

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