Effects of Different Exercise Interventions on Cardiorespiratory Fitness, as Measured by Peak Oxygen Consumption in Patients with Coronary Heart Disease: An Overview of Systematic Reviews,Sports Medicine

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Effects of Different Exercise Interventions on Cardiorespiratory Fitness, as Measured by Peak Oxygen Consumption in Patients with Coronary Heart Disease: An Overview of Systematic Reviews
Sports Medicine ( IF 9.3 ) Pub Date : 2024-07-22 , DOI: 10.1007/s40279-024-02053-w
Mansueto Gomes-Neto _{1,

2,

3,

4,

5} , Andre Rodrigues Durães ₄ , Lino Sérgio Rocha Conceição ₁ , Michelli Bernardone Saquetto _{2,

3,

4} , Iura Gonzalez Alves ₃ , Neil A Smart ₆ , Vitor Oliveira Carvalho _{1,

3}

Affiliation

Background

Exercise is an important component of rehabilitation care for people with coronary heart disease (CHD).

Objectives

The aim of this study was to critically analyze and summarize the existing evidence from published systematic reviews (SRs) and meta-analyses of randomized controlled trials (RCTs) that have evaluated the effects of different types of exercise interventions on cardiorespiratory fitness, as measured by peak oxygen consumption in people with CHD.

Methods

Electronic databases (Cochrane Library, Medline/PubMed, EMBASE, and PEDro) were searched for SRs of exercise interventions of people with CHD. Two reviewers assessed the quality of SRs using the AMSTAR-2 tool and evaluated the strength of evidence quality with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system for relevant outcome measures. Mean difference (MD) and 95% confidence intervals (CIs) were calculated.

Results

Thirty-one SRs (with 125 RCTs) met the study criteria, including 33,608 patients. Compared with usual care, continuous aerobic exercise produced an improvement in peak oxygen consumption, MD of 3.8 mL kg⁻¹ min⁻¹ (95% CI: 3.204.4, I² = 67%); high-intensity interval training, MD 6.1 mL kg⁻¹ min⁻¹ (95% CI: 0.4–11.8, I² = 97%); resistance training, MD of 2.1 mL kg⁻¹ min⁻¹ (95% CI: 0.98–3.2, I² = 60%); combined aerobic and resistance training, MD of 3.0 mL kg⁻¹ min⁻¹ (95% CI: 2.5–3.4, I² = 0%); and water-based exercise, MD of 4.4 mL kg⁻¹ min⁻¹ (95% CI, 2.1–6.7; I² = 2%).

Conclusion

Exercise interventions improve peak oxygen consumption in people with CHD. However, there was moderate to very-low certainty for the evidence found.

中文翻译：

不同运动干预措施对冠心病患者心肺健康的影响（通过峰值耗氧量测量）：系统评价概述

背景

运动是冠心病 (CHD) 患者康复护理的重要组成部分。

目标

本研究的目的是批判性地分析和总结已发表的系统评价 (SR) 和随机对照试验 (RCT) 的荟萃分析中的现有证据，这些证据评估了不同类型的运动干预措施对心肺健康的影响，测量方法为CHD 患者的峰值耗氧量。

方法

在电子数据库（Cochrane Library、Medline/PubMed、EMBASE 和 PEDro）中搜索了 CHD 患者运动干预的 SR。两名评审员使用 AMSTAR-2 工具评估 SR 的质量，并使用相关结果指标的建议分级、评估、制定和评价 (GRADE) 系统评估证据质量的强度。计算平均差 (MD) 和 95% 置信区间 (CI)。

结果

31 项 SR（其中 125 项随机对照试验）符合研究标准，包括 33,608 名患者。与常规护理相比，持续有氧运动使峰值耗氧量有所改善，MD为3.8 mL kg ^-1 min ^-1 （95% CI：3.204.4， I ² = 67%）；高强度间歇训练，MD 6.1 mL kg ⁻¹ min ⁻¹ (95% CI: 0.4–11.8, I ² = 97%)；阻力训练，MD为2.1 mL kg ⁻¹ min ⁻¹ (95% CI: 0.98–3.2, I ² = 60%)；有氧运动和阻力训练相结合，MD为3.0 mL kg ⁻¹ min ⁻¹ (95% CI: 2.5–3.4, I ² = 0%)；和基于水的运动，MD为4.4 mL kg ⁻¹ min ⁻¹ (95% CI, 2.1–6.7; I ² = 2%)。