Jansen Jemima, Marshall Paul W, Benatar Jocelyne R, Cross Rebecca, Lindbom Tia K, Kingsley Michael
Department of Exercise Sciences, University of Auckland, Auckland 1010, New Zealand.
Greenlane Cardiovascular Service, Auckland City Hospital, Auckland 1023, New Zealand.
J Clin Med. 2024 Dec 2;13(23):7338. doi: 10.3390/jcm13237338.
Cardiac rehabilitation, a multi-component intervention designed to mitigate the impact of cardiovascular disease, often underutilises low-intensity resistance exercise despite its potential benefits. This narrative review critically examines the mechanistic and clinical evidence supporting the incorporation of low-intensity resistance exercise into cardiac rehabilitation programmes. Research indicates that low-intensity resistance exercise induces hypertrophic adaptations by maximising muscle fibre activation through the size principle, effectively recruiting larger motor units as it approaches maximal effort. This activation promotes adaptation in both type I and II muscle fibres, resulting in comparable increases in myofibrillar protein synthesis and phosphorylation of key signalling proteins when compared to high-intensity resistance exercise. Low-intensity resistance exercise provides equivalent improvements in muscular strength and hypertrophy compared to high-intensity protocols while addressing barriers to participation, such as concerns about safety and logistical challenges. By facilitating engagement through a more accessible exercise modality, low-intensity resistance exercise might improve adherence rates and patient outcomes in cardiac rehabilitation. Additionally, the ability of low-intensity resistance exercise to address sarcopenia and frailty syndrome, significant determinants of cardiovascular disease progression, can enhance the recovery and overall quality of life for patients. This review establishes evidence-based recommendations for the inclusion of low-intensity resistance exercise in cardiac rehabilitation, offering a promising pathway to enhance the effectiveness of these programmes.
心脏康复是一种旨在减轻心血管疾病影响的多组分干预措施，尽管低强度抗阻运动有潜在益处，但在心脏康复中其应用常常不足。本叙述性综述批判性地审视了支持将低强度抗阻运动纳入心脏康复计划的机制和临床证据。研究表明，低强度抗阻运动通过大小原则使肌肉纤维激活最大化来诱导肥大适应性变化，在接近最大努力时有效地募集更大的运动单位。这种激活促进I型和II型肌纤维的适应性变化，与高强度抗阻运动相比，肌原纤维蛋白合成和关键信号蛋白磷酸化有类似增加。与高强度方案相比，低强度抗阻运动在肌肉力量和肥大方面提供了同等程度的改善，同时解决了参与障碍，如对安全性的担忧和后勤挑战。通过更易进行的运动方式促进参与，低强度抗阻运动可能提高心脏康复中的依从率和患者结局。此外，低强度抗阻运动解决肌肉减少症和衰弱综合征（心血管疾病进展的重要决定因素）的能力，可以提高患者的恢复能力和总体生活质量。本综述为在心脏康复中纳入低强度抗阻运动建立了基于证据的建议，为提高这些计划的有效性提供了一条有前景的途径。
