Quality of life and psychosocial measures influenced by exercise modality in patients with coronary artery disease

Background. The optimal approach to prescribing resistance training (RT) combined with aerobic training (AT) for psychosocial and health-related quality of life (HRQOL) is unclear. Aim. To compare the effects of AT combined with RT (1 versus 3 sets) versus AT alone on HRQOL and psychosocial outcomes. Design. Subjects (N.=72) were randomized to AT (5 d.wk(-1)) or AT (3 d.wk(-1)) with either 1 set (AT/RT1) or 3 sets (AT/RT3) of RT performed 2 d.wk(-1). Setting. Outpatient Cardiac Rehabilitation Program. Population. Subjects with coronary artery disease. Methods. HRQOL and psychosocial parameters were assessed before and after 29 weeks of training by questionnaire. Results. Fifty-three subjects (mean +/- SD age 60.6 +/- 10.6 years) completed training. There was a group effect for change in self-efficacy of lower body physical activity tasks (P=0.03) with significantly greater improvement for AT/RT3 than AT alone (17.5 +/- 16.6% vs. 3.2 +/- 12.8% respectively, p=0.04). Lower body self-efficacy improved for AT/RT1 (15.5 +/- 13.8%, p<0.001) but not for AT alone (P=0.2). Self-efficacy for upper body tasks improved with AT/RT3 (18.2 +/- 19.9%, P=0.003) and AT/RT1 training (12.6 +/- 15.8%, P=0.005) but not with AT alone (8.3 +/- 16.1%, P=0.1). AT/RT3 and AT/RT1 training yielded improvements in depression score (-4.0 +/- 7.7, P=0.04 and -3.0 +/- 5.1, P=0.02 respectively) but not with AT alone (-0.5 +/- 4.7, P=0.71). The improvement from baseline in physical HRQOL score (MOS, SF-36) averaged 8.2 +/- 11.2% for AT (P=0.04), 10.4 +/- 11.9% for AT/RT1 (P=0.006) and 12.0 +/- 12.9% for AT/RT3 (P=0.004). Conclusions. Both AT+RT groups with either 1 or 3 sets (AT 3 d.wk(-1) and RT 2 d.wk(-1)) each yield more pronounced psychosocial and HRQOL adaptations than AT alone (5 d.wk(-1)). RT prescription beyond 1 set may further augment selected parameters in cardiac patients. Clinical Rehabilitation Impact. These results provide further rationale to develop combined AT+RT regimens for individuals with coronary artery disease.