Some types of exercise interventions are more effective than others in people with coronary heart disease: systematic review and network meta-analysis


Author: Mansueto Gomes-Neto1, Andre Rodrigues Durães2, Lino Sérgio Rocha Conceição3, Michelli Bernardone Saquetto2, Iura Gonzalez Alves4, Neil A Smart5, Vitor Oliveira Carvalho3

Affiliation: <sup>1</sup> Postgraduate Program in Health Science, Federal University of Sergipe, Aracaju, Brazil; Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil. Electronic address: mansueto.neto@ufba.br.

<sup>2</sup> Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil.

<sup>3</sup> Postgraduate Program in Health Science, Federal University of Sergipe, Aracaju, Brazil.

<sup>4</sup> Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil.

<sup>5</sup> Department of Exercise and Sports Science, University of New England, Armidale, Australia.
Conference/Journal: J Physiother
Date published: 2024 Mar 18
Other:
  Pages: S1836-9553(24)00019-5   ,  Special Notes: doi: 10.1016/j.jphys.2024.02.018.   ,  Word Count: 262  
    Question:

What are the effects of different types of exercise treatments on oxygen consumption, quality of life and mortality in people with coronary heart disease?



Design:

Systematic review with network meta-analysis of randomised controlled trials.



Participants:

Adults with coronary heart disease.



Intervention:

Exercise interventions including aerobic (continuous or high-intensity interval) training, resistance training, respiratory muscle exercises, water-based exercises, yoga, Tai chi, Qigong exercises and a combination of different types of exercise.



Outcome measures:

Oxygen consumption, quality of life and mortality.



Results:

This review included 178 randomised controlled trials with 19,143 participants. Several exercise interventions improved peak oxygen consumption (mL/kg/min): high-intensity interval training (MD 4.5, 95% CI 3.7 to 5.4); combined water-based exercises and moderate-intensity continuous training (MD 3.7, 95% CI 1.3 to 6.0); combined aerobic and resistance exercise (MD 3.4, 95% CI 2.5 to 4.3); water-based exercises (MD 3.4, 95% CI 0.6 to 6.2); combined respiratory muscle training and aerobic exercise (MD 3.2, 95% CI 0.6 to 5.8); Tai chi (MD 3.0, 95% CI 1.0 to 5.0); moderate-intensity continuous training (MD 3.0, 95% CI 2.3 to 3.6); high-intensity continuous training (MD 2.7, 95% CI 1.6 to 3.8); and resistance training (MD 2.2, 95% CI 0.6 to 3.7). Quality of life was improved by yoga (SMD 1.5, 95% CI 0.5 to 2.4), combined aerobic and resistance exercise (SMD 1.2, 95% CI 0.6 to 1.7), moderate-intensity continuous training (SMD 1.1, 95% CI 0.6 to 1.6) and high-intensity interval training (SMD 0.9, 95% CI 0.1 to 1.6). All-cause mortality was reduced by continuous aerobic exercise (RR 0.67, 95% CI 0.53 to 0.86) and combined aerobic and resistance exercise (RR 0.58, 95% CI 0.36 to 0.94). Continuous aerobic exercise also reduced cardiovascular mortality (RR 0.56, 95% CI 0.42 to 0.74).



Conclusion:

People with coronary heart disease may use a range of exercise modalities to improve oxygen consumption, quality of life and mortality.



Registration:

PROSPERO CRD42022344545.



Keywords: Coronary heart disease; Exercise; Network meta-analysis; Physical therapy; Systematic review.



PMID: 38503676 DOI: 10.1016/j.jphys.2024.02.018