Does eccentric endurance training improve walking capacity in patients with coronary artery disease? A randomized controlled pilot study.

OBJECTIVE

To examine the effect of eccentric endurance training on exercise capacities in patients with coronary artery disease.

DESIGN

Randomized parallel group controlled study.

SETTING

Cardiac rehabilitation unit, Dijon University Hospital.

PARTICIPANTS

Fourteen patients with stable coronary artery disease after percutaneous coronary intervention.

INTERVENTION

Patients followed 15 sessions of training (1 session per day, 3 days a week), either in the concentric group, following a standard programme, or in the eccentric group, performing eccentric resistance exercises using both lower limbs on a specifically designed ergometer.

MAIN OUTCOMES MEASURED

Symptom-limited Vo2, peak workload, isometric strength of leg extensor and ankle plantar flexors, distance covered during the 6-minute walk test and time to perform the 200-m fast walk test in both groups, before and after the training period.

RESULTS

Patients did not report any adverse effects and were highly compliant. All measured parameters improved in eccentric and concentric group, except for 200-m fast walk test: symptom-limited Vo2 (+14.2% versus +4.6%), peak workload (+30.8% versus +19.3%), 6-minute walk test distance walked (+12.6% versus +10.1%) and leg extensor strength (+7% versus +13%) improved to a similar degree in both groups (P < 0.01); ankle plantar flexor strength improved in both groups with a significantly greater increase in the eccentric group (+17% versus +7%, P < 0.05).

CONCLUSION

Patients with stable coronary artery disease can safely engage in eccentric endurance training, which appears to be as efficient as usual concentric training, with reduced oxygen consumption.