Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial
Introduction: Exercise training with well-known health benefits is a key element in the self-management of coronary artery disease (CAD). Although current guidelines for patients with CAD recommend daily exercise training, most of the patients do not follow the guidelines. We tested the hypothesis t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2024.1319907/full |
| _version_ | 1797346143985729536 |
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| author | Essi O. Saarikoski Elina T. M. Roiha Antti M. Kiviniemi Jose Cerdán-De-las-Heras Juha Perkiömäki Kari S. Kaikkonen Mikko P. Tulppo |
| author_facet | Essi O. Saarikoski Elina T. M. Roiha Antti M. Kiviniemi Jose Cerdán-De-las-Heras Juha Perkiömäki Kari S. Kaikkonen Mikko P. Tulppo |
| author_sort | Essi O. Saarikoski |
| collection | DOAJ |
| description | Introduction: Exercise training with well-known health benefits is a key element in the self-management of coronary artery disease (CAD). Although current guidelines for patients with CAD recommend daily exercise training, most of the patients do not follow the guidelines. We tested the hypothesis that an exercise training program guided by a novel technology used at home will improve adherence to exercise training.Methods: One to three weeks after percutaneous coronary intervention (PCI), acute coronary syndrome patients (n = 50) were randomized into traditional (age 65 ± 8 years) and novel technology-guided (age 60 ± 8 years) exercise rehabilitation groups. The novel technology included a tablet computer with a virtual autonomous physiotherapy agent (VAPA group) for every patient at home; it was used to guide exercise training time, volume, and intensity. Traditional rehabilitation was performed by exercise training prescriptions, phone calls, and diaries (control group). The duration of the rehabilitation program was 6 months for both groups. Exercise capacity and 24-h heart rate variability were measured at baseline and at the end of the program. Adherence to exercise was measured over 6 months as the percentage of realized training.Results: None of the patients dropped out from the VAPA group, while three patients dropped out from the control group. Adherence to exercise was higher in the VAPA group than in the control group for resistance training (141% ± 56% vs. 50% ± 20%, p < 0.0001), and there were no differences between the groups for aerobic training (144% ± 45% vs. 119% ± 65%, p = 0.22). Exercise capacity increased in both the groups (time p < 0.001, time × group interaction p = ns). High-frequency power of R-R intervals (lnHF) increased in the VAPA group but remained unchanged in the control group (natural logarithm of lnHF power from 5.5 ± 0.7 to 5.8 ± 0.9 ms2 and from 5.3 ± 0.8 to 5.2 ± 0.7 ms2, respectively, time × group interaction p = 0.014).Conclusion: Compared with the use of traditional methods, the use of novel technology at home results in better adherence to exercise, particularly in resistance training, in acute coronary syndrome patients. Second, the VAPA group showed improved cardiac vagal regulation, documented by increased vagally mediated R-R interval fluctuation, compared with the traditional training group (ClinicalTrials.gov identifier: NCT03704025). |
| first_indexed | 2024-03-08T11:28:40Z |
| format | Article |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-08T11:28:40Z |
| publishDate | 2024-01-01 |
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| spelling | doaj.art-1b6a73cd8f494545bc2222ca82ed2f792024-01-26T04:37:46ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2024-01-011510.3389/fphys.2024.13199071319907Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trialEssi O. Saarikoski0Elina T. M. Roiha1Antti M. Kiviniemi2Jose Cerdán-De-las-Heras3Juha Perkiömäki4Kari S. Kaikkonen5Mikko P. Tulppo6Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandDepartment of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, DenmarkResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandResearch Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FinlandIntroduction: Exercise training with well-known health benefits is a key element in the self-management of coronary artery disease (CAD). Although current guidelines for patients with CAD recommend daily exercise training, most of the patients do not follow the guidelines. We tested the hypothesis that an exercise training program guided by a novel technology used at home will improve adherence to exercise training.Methods: One to three weeks after percutaneous coronary intervention (PCI), acute coronary syndrome patients (n = 50) were randomized into traditional (age 65 ± 8 years) and novel technology-guided (age 60 ± 8 years) exercise rehabilitation groups. The novel technology included a tablet computer with a virtual autonomous physiotherapy agent (VAPA group) for every patient at home; it was used to guide exercise training time, volume, and intensity. Traditional rehabilitation was performed by exercise training prescriptions, phone calls, and diaries (control group). The duration of the rehabilitation program was 6 months for both groups. Exercise capacity and 24-h heart rate variability were measured at baseline and at the end of the program. Adherence to exercise was measured over 6 months as the percentage of realized training.Results: None of the patients dropped out from the VAPA group, while three patients dropped out from the control group. Adherence to exercise was higher in the VAPA group than in the control group for resistance training (141% ± 56% vs. 50% ± 20%, p < 0.0001), and there were no differences between the groups for aerobic training (144% ± 45% vs. 119% ± 65%, p = 0.22). Exercise capacity increased in both the groups (time p < 0.001, time × group interaction p = ns). High-frequency power of R-R intervals (lnHF) increased in the VAPA group but remained unchanged in the control group (natural logarithm of lnHF power from 5.5 ± 0.7 to 5.8 ± 0.9 ms2 and from 5.3 ± 0.8 to 5.2 ± 0.7 ms2, respectively, time × group interaction p = 0.014).Conclusion: Compared with the use of traditional methods, the use of novel technology at home results in better adherence to exercise, particularly in resistance training, in acute coronary syndrome patients. Second, the VAPA group showed improved cardiac vagal regulation, documented by increased vagally mediated R-R interval fluctuation, compared with the traditional training group (ClinicalTrials.gov identifier: NCT03704025).https://www.frontiersin.org/articles/10.3389/fphys.2024.1319907/fullcoronary artery diseaseexercise trainingheart rate variabilityaerobic trainingresistance training |
| spellingShingle | Essi O. Saarikoski Elina T. M. Roiha Antti M. Kiviniemi Jose Cerdán-De-las-Heras Juha Perkiömäki Kari S. Kaikkonen Mikko P. Tulppo Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial Frontiers in Physiology coronary artery disease exercise training heart rate variability aerobic training resistance training |
| title | Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial |
| title_full | Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial |
| title_fullStr | Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial |
| title_full_unstemmed | Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial |
| title_short | Adherence to exercise after an acute coronary syndrome: a 6-month randomized controlled trial |
| title_sort | adherence to exercise after an acute coronary syndrome a 6 month randomized controlled trial |
| topic | coronary artery disease exercise training heart rate variability aerobic training resistance training |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2024.1319907/full |
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