Effect of Different Endurance Training Protocols During Cardiac Rehabilitation on Quality of Life

Am J Med. 2021 Jun;134(6):805-811. doi: 10.1016/j.amjmed.2020.10.048. Epub 2021 Feb 6.


Background: This study aimed to assess the effect of different types of endurance training during outpatient cardiac rehabilitation on patients' health-related quality of life (HRQL).

Methods: The MacNew Heart Disease HRQL questionnaire and the Hospital Anxiety and Depression Scale were used to assess changes in HRQL in 66 patients before and after 6 weeks of cardiac rehabilitation. Patients were randomized to 1 of 3 types of supervised endurance training: continuous endurance training, high-intensity interval training, and pyramid training. Two-way analysis of variance for repeated measure and chi-square test were used to analyze changes before and after rehabilitation.

Results: Attendance rate during the 6 weeks of exercise training was 99.2%. Physical work capacity increased from 136.1 to 165.5 watts (+22.9%; P < .001), and there were no statistical differences between training protocols. Fully completed questionnaires at both time points were available in 46 patients (73.9%; 61.3±11.6 years, 34 males, 12 females). Regardless of the type of supervised endurance training, there was significant improvement during rehabilitation in each of the categories of the MacNew questionnaire (ie, emotion, physical, social, global; all P < .05) and the Hospital Anxiety and Depression Scale (anxiety: P = .05; depression: P = .032), without significant differences between protocols.

Conclusions: All 3 types of endurance training led to significant and well comparable increases in physical work capacity, which was associated with an increase in HRQL independent of the type of training. Our findings support further individualization of training regimes, which could possibly lead to better compliance during life-long home-based exercise training.

Keywords: Anxiety; cardiac rehabilitation; continuous exercise training; depression; high-intensity interval training; pyramid training.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Cardiac Rehabilitation / methods*
  • Cardiac Rehabilitation / standards
  • Cardiac Rehabilitation / statistics & numerical data
  • Chi-Square Distribution
  • Endurance Training / methods
  • Endurance Training / standards*
  • Endurance Training / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life / psychology*
  • Surveys and Questionnaires