M. Javaherian1, N. Dabbaghipour1, E. Ahmadi2, Z. Mohammadpour3, B. Attarbashi Moghaddam1
1Tehran University of Medical Sciences, Physiotherapy, Tehran, Iran, 2University of Antwerp, Antwerp, Belgium, 3Tehran University of Medical Sciences, Tehran, Iran
Background: Cardiovascular diseaes (CVDs) are the important causes of increased mortality, morbidity, and physical disability. Lipid profiles (LP) includes serum total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total triglycerides (TG) parameters, which their modifications should be considered in any treatment of CVDs. It is suggested that HDL serum level and TC/HDL and TG/HDL ratios are associated with all-cause mortality and risk of hospitalization in patients with CVD.
Purpose: The current study aimed at updating prior systematic review and meta-analysis in order to determine the effects of supervised exercise-based cardiac rehabilitation (EBCR) and introduce proper exercise protocol for LP changes in patients with CVD.
Methods: PubMed, Scopus, and Web of Science databases were searched from 1980 to December 2018. All published, randomized controlled trials (RCTs) reporting the efficacy of supervised EBCR in patients with CVD and measuring at least one component of LP were included. The quality of articles was assessed based on the PEDro scale. Random effect model was used to calculate the effect size of post-intervention data.
Results: Initially 774 RCTs were reviewed, 14 of them were finally included. In comparison with the control group, supervised EBCR was associated with higher serum levels of HDL (weight mean difference (WMD): 1.297; 95% confidence interval (CI): -1.620, 4.214) and lower serum level of LDL (WMD: -7.797; 95%CI: -14.005, -1.588), total cholesterol (TC) (WMD: -11.029; 95%CI: -20.716, -1.342), and TG (WMD: -14.602; 95%CI: -28.992, -0.212).
Conclusion(s): It seems EBCR is associated with insignificant HDL serum level increase and significant LDL, TC, and TG serum levels decrease. The subgroup analysis suggested using long duration, moderate exercise volume (EV), and combination of aerobic exercise (AE) and resistance exercise (RE) to improve HDL and TG serum levels. Short duration, high EV, and AE+RE seem to significantly reduce LDL serum level. Moderate EV seems to be associated with significant reduction of TC level.
Implications:
- Exercise-based cardiac rehabilitation can improve all components of lipid profile
- Combination of aerobic and resistance exercises improves lipid profile
- Long duration and moderate exercise are suggested for HDL and TG levels improvement
- Short duration and high volume are suggested for decrease of LDL serum level.
Funding, acknowledgements: There was not any funding sources for this study.
Keywords: Cardiac Rehabilitation, Cardiovascular Disease, Lipid
Topic: Cardiorespiratory
Did this work require ethics approval? No
Institution: Tehran University of Medical Sciences
Committee: Vice-Chancellor in Research Affairs-Tehran University of Medical Sciences
Reason: This study was a systematic review and meta-analysis.
All authors, affiliations and abstracts have been published as submitted.
