Published date: Nov 16 2017

Journal Title: Arab Journal of Nutrition and Exercise

Issue title: AJNE: Vol 2, No 2 (2017)

Pages: 74-90

DOI: 10.18502/ajne.v2i2.1247

Irene C. Themistocleous

Manos Stefanakismanos.stefanakis.gr@gmail.comDepartment of Life & Health Sciences, University of Nicosia, 46, Makedonitissas Avenue, Nicosia, 1700, Cyprus

Objectives: To determine the effects of high intensity interval training (HIIT) or moderate intensity continuous exercise (MICE) in patients with myocardial infarction (MI). 

Background: Cardiovascular diseases are the leading cause of mortality and morbidity globally causing a significant reduction in the quality of life of these patients. Participation of these patients in rehabilitation programs which involve a significant component of exercise seems to help by improving functional capacity and quality of life (QoL). Despite the beneficial effect of exercise, the type of exercise that yields the best results is yet to be determined.

Methods: Three databases (MEDLINE, CINHAL and SportDirect) were searched in May-June 2017 for original articles regarding the effect of two types of exercise in patients with myocardial infarction. Randomized control trial studies which enrolled patients with myocardial infarction and studied the effects of HIIT and/or MICE, were included in this review. Data were extracted and summarised and all studies were assessed for bias.

Results: Both forms of exercise seem to improve the relevant outcome measures such as functional capacity, QoL, walking distance, fatigue and function of the left heart. However HIIT seemed to be better in comparison with MICE in improving these outcomes. Several limitations and risk of bias have been identified and reported.

Conclusion: Both HIIT and MICE are recommended for patients with MI. Further research is required to conclusively support the superiority of HIIT over other types of exercise.

[1] A. Alwan, (2014). Global status report on noncommunicable diseases 2010. World Health Organization.

[2] A. E. Bauman, “Updating the evidence that physical activity is good for health: an epidemiological review 2000–2003,” Journal of Science and Medicine in Sport, vol. 7, no. 1, pp. 6–19, 2004.

[3] S. N. Blair, H. W. Kohl III, C. E. Barlow, R. S. Paffenbarger Jr., L. W. Gibbons, and C. A. Macera, “Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men,” Journal of the American Medical Association, vol. 273, no. 14, pp. 1093–1098, 1995.

[4] M. Lee, C. C. Hsieh, and R. S. Paffenbarger, “Exercise Intensity and Longevity in Men: The Harvard Alumni Health Study,” Journal of the American Medical Association, vol. 273, no. 15, pp. 1179–1184, 1995.

[5] M. Hulens, G. Vansant, A. L. Claessens, R. Lysens, E. Muls, and R. Rzewnicki, “Healthrelated quality of life in physically active and sedentary obese women,” American Journal of Human Biology, vol. 14, no. 6, pp. 777–785, 2002.

[6] C. E. I. Lebrun, Y. T. van der Schouw, F. H. de Jong, H. A. P. Pols, D. E. Grobbee, and S. W. J. Lamberts, “Relations between body composition, functional and hormonal parameters and quality of life in healthy postmenopausal women,” Maturitas, vol. 55, no. 1, pp. 82–92, 2006.

[7] M. L. Pollock, G. A. Gaesser, J. D. Butcher et al., “ACSM position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, andflexibility in healthy adults,” Medicine Science in Sports Exercise, vol. 30, no. 6, pp. 975–991, 1998.

[8] C. A. Barboza, L. Y. Rocha, C. T. Mostarda et al., “Ventricular and autonomic benefits of exercise training persist after detraining in infarcted rats,” European Journal of Applied Physiology, vol. 113, no. 5, pp. 1137–1146, 2013.

[9] R. S. Taylor, A. Brown, S. Ebrahim et al., “Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials,” American Journal of Medicine, vol. 116, no. 10, pp. 682–692, 2004.

[10] J. Perk, G. De Backer, H. Gohlke, I. Graham, and Ž. Reiner, “European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives
of nine societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention Rehabilitation (EACPR,” European Heart Journal, p. s092, 2012.

[11] J. Kruk, “Physical activity in the prevention of the most frequent chronic diseases: An analysis of the recent evidence,” Asian Pacific Journal of Cancer Prevention, vol. 8, no. 3, pp. 325–338, 2007.

[12] L. Azevedo and M. Santos, “High-Intensity Intermittent Exercise Training for Cardiovascular Disease,” Journal of Novel Physiotherapies, vol. 4, p. 1, 2014.

[13] P. D. Thompson, “Exercise prescription and proscription for patients with coronary artery disease,” Circulation, vol. 112, no. 15, pp. 2354–2363, 2005.

[14] B. B. Nilsson, A. Westheim, and M. A. Risberg, “Long-Term Effects of a GroupBased High-Intensity Aerobic Interval-Training Program in Patients With Chronic Heart Failure,” American Journal of Cardiology, vol. 102, no. 9, pp. 1220–1224, 2008.

[15] B. B. Nilsson, A. Westheim, and M. A. Risberg, “Effects of Group-Based HighIntensity Aerobic Interval Training in Patients With Chronic Heart Failure,” American Journal of Cardiology, vol. 102, no. 10, pp. 1361–1365, 2008.

[16] K. Meyer, C. Foster, N. Georgakopoulos et al., “Comparison of left ventricular function during interval versus steady- state exercise training in patients with chronic congestive heart failure,” American Journal of Cardiology, vol. 82, no. 11, pp. 1382–1387, 1998.

[17] D. O’Connor, S. Green, and J. P. T. Higgins, “Defining the review question and developing criteria for including studies. In,” in Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. [Updated March 2011]: The Cochrane Collaboration, 2011, Chapter 5, Retrieved from: www.cochrane handbook.org, J. P. T.
Higgins and S. Green, Eds., 2011.

[18] J. P. T. Higgins and J. J. Deeks, “Chapter 7: Selecting studies and collecting data,” in Cochrane Handbook for Systematic Reviews of InterventionsVersion 5.1.0. [Updated March 2011]: The Cochrane Collaboration, 2011, J. P. T. Higgins and S. Green, Eds., 2011, Retrieved from http://www.cochrane-handbook.org.

[19] C. Cooper, A. Selwood, M. Blanchard, Z. Walker, G. Blizard, and G. Livingston, “Abuse of people with dementia by family carers: representative cross sectional survey,” British Medical Journal, vol. 339, no. 7694, pp. 155–157, 2009.

[20] A. R. Jadad, R. A. Moore, D. Carroll et al., “Assessing the quality of reports of randomized clinical trials: Is blinding necessary?” Controlled Clinical Trials, vol. 17, no. 1, pp. 1–12, 1996.

[21] V. M. Conraads, N. Pattyn, C. De Maeyer et al., “Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: the SAINTEX-CAD study,” International Journal of Cardiology, vol. 179, pp. 203–210, 2015.

[22] K. D. Currie, J. B. Dubberley, R. S. McKelvie, and M. J. MacDonald, Low-Volume, Highintensity Interval Training in Patients with Coronary Artery Disease. Medicine and science in sports and exercise,.

[23] K. D. Currie, L. M. Rosen, P. J. Millar, R. S. McKelvie, and M. J. MacDonald, “Heart rate recovery and heart rate variability are unchanged in patients with coronary artery disease following 12 weeks of highintensity interval and moderate-intensity endurance exercise training,” Applied Physiology, Nutrition, and Metabolism, vol. 38,
no. 6, pp. 644–650, 2013.

[24] G. G. Cardozo, R. B. Oliveira, and P. T. V. Farinatti, “Effects of high intensity interval versus moderate continuous training on markers of ventilatory and cardiac efficiency in coronary heart disease patients,” The Scientific World Journal, vol. 2015, Article ID 192479, 8 pages, 2015.

[25] T. Guiraud, A. Nigam, V. Gremeaux, P. Meyer, M. Juneau, and L. Bosquet, “Highintensity interval training in cardiac rehabilitation,” Sports Medicine, vol. 42, no. 7, pp. 587–605, 2012.

[26] T. T. Moholdt, B. H. Amundsen, L. A. Rustad et al., “Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life,” American Heart Journal, vol. 158, no. 6, pp. 1031–1037, 2009.

[27] T. Moholdt, I. L. Aamot, I. Granøien et al., “Aerobic interval training increases peak oxygen uptake more than usual care exercise training in myocardial infarction patients: a randomized controlled study,” Clinical Rehabilitation, vol. 26, no. 1, pp. 33–44, 2012.

[28] T. Moholdt, E. Madssen, Ø. Rognmo, and I. L. Aamot, “The higher the better? Interval training intensity in coronary heart disease,” Journal of Science and Medicine in Sport, vol. 17, no. 5, pp. 506–510, 2014.

[29] Ø. Rognmo, E. Hetland, J. Helgerud, J. Hoff, and S. A. Slørdahl, “High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease,” European Journal of Cardiovascular Prevention and Rehabilitation, vol. 11, no. 3, pp. 216–222, 2004.

[30] D. E. R. Warburton, D. C. McKenzie, M. J. Haykowsky et al., “Effectiveness of highintensity interval training for the rehabilitation of patients with coronary artery disease,” American Journal of Cardiology, vol. 95, no. 9, pp. 1080–1084, 2005.

[31] U. Wisløff, A. Støylen, J. P. Loennechen et al., “Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study,” Circulation, vol. 115, no. 24, pp. 3086–3094, 2007.

[32] J. A. C. Sterne, M. Egger, and D. Moher, “Addressing reporting biases,” in Cochrane Handbook for Systematic Reviews of Interventions, Chapter 10, J. P. T. Higgins and S. Green, Eds., 2011.