Publications by authors named "Inger-Lise Aamot"

18 Publications

  • Page 1 of 1

Adherence to a Long-Term Physical Activity and Exercise Program After Stroke Applied in a Randomized Controlled Trial.

Phys Ther 2019 01;99(1):74-85

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology.

Background: Persistent physical activity is important to maintain motor function across all stages after stroke.

Objective: The objective of this study was to investigate adherence to an 18-month physical activity and exercise program.

Design: The design was a prospective, longitudinal study including participants who had had a stroke randomly allocated to the intervention arm of a randomized controlled trial.

Methods: The intervention consisted of individualized monthly coaching by a physical therapist who motivated participants to adhere to 30 minutes of daily physical activity and 45 minutes of weekly exercise over an 18-month period. The primary outcome was the combination of participants' self-reported training diaries and adherence, as reported by the physical therapists. Mixed-effect models were used to analyze change in adherence over time. Intensity levels, measured by the Borg scale, were a secondary outcome.

Results: In total, 186 informed, consenting participants who had had mild-to-moderate stroke were included 3 months after stroke onset. Mean age was 71.7 years (SD = 11.9). Thirty-four (18.3%) participants withdrew and 9 (4.8%) died during follow-up. Adherence to physical activity and exercise each month ranged from 51.2% to 73.1%, and from 63.5% to 79.7%, respectively. Adherence to physical activity increased by 2.6% per month (odds ratio = 1.026, 95% CI = 1.014-1.037). Most of the exercise was performed at moderate-to-high intensity levels, ranging from scores of 12 to 16 on the Borg scale, with an increase of 0.018 points each month (95% CI = 0.011-0.024).

Limitations: Limitations included missing information about adherence for participants with missing data and reasons for dropout.

Conclusions: Participants with mild and moderate impairments after stroke who received individualized regular coaching established and maintained moderate-to-good adherence to daily physical activity and weekly exercise over time.
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http://dx.doi.org/10.1093/ptj/pzy126DOI Listing
January 2019

[Exercise as medicine].

Tidsskr Nor Laegeforen 2018 08 21;138(12). Epub 2018 Aug 21.

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http://dx.doi.org/10.4045/tidsskr.17.1033DOI Listing
August 2018

Ventilatory efficiency and aerobic capacity in people with multiple sclerosis: A randomized study.

SAGE Open Med 2017 12;5:2050312117743672. Epub 2017 Dec 12.

Clinic of Clinical Services, St. Olav's University Hospital, Trondheim, Norway.

Objectives: To assess ventilatory efficiency and aerobic capacity in people with multiple sclerosis and whether treadmill walking or progressive strength training has an effect on these parameters in this population.

Methods: In all, 24 adults with multiple sclerosis with an Expanded Disability Status Scale score of ≤6 completed a cardiopulmonary exercise test before and after 8 weeks of exercise. They were randomized to treadmill walking of low-to-moderate intensity (50%-70% of peak heart rate) or progressive strength training (six repetitions × two at 80% of one repetition maximum). Both groups exercised for 30 min three times per week. Primary outcome measure was ventilatory efficiency measured as the minute ventilation/carbon dioxide production (VE/VCO) ratio and oxygen uptake efficiency slope. Secondary outcome was aerobic capacity, measured as peak oxygen uptake (VO).

Results: Despite low aerobic capacity, ventilatory efficiency was found to be within normal range. After 8 weeks of exercise, no significant between-group differences emerged in (1) VE/VCO ratio (26 ± 2.2 to 26 ± 2.0, 29 ± 2.0 to 28 ± 2.3, = 0.66), (2) oxygen uptake efficiency slope (2697 ± 442 to 2701 ± 577, 2473 ± 800 to 2481 ± 896, = 0.71), or (3) VO in mL/kg/min (28 ± 4.4 to 30 ± 4.3, 29 ± 6.7 to 29 ± 6.4, = 0.38) in treadmill walking and progressive strength training, respectively. There were no significant within-group differences either. No adverse events occurred during cardiopulmonary exercise test or exercise training.

Conclusion: In people with mild-to-moderate multiple sclerosis, 8 weeks of treadmill walking of low-to-moderate intensity or progressive strength training did not have any effect on ventilatory efficiency or aerobic capacity. Although aerobic capacity was lower than reference values, ventilatory efficiency was not reduced.
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http://dx.doi.org/10.1177/2050312117743672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734440PMC
December 2017

High Intensity Interval Training for Maximizing Health Outcomes.

Prog Cardiovasc Dis 2017 Jun - Jul;60(1):67-77. Epub 2017 Apr 3.

K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway; Norwegian National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Conditions, St. Olav's Hospital, Trondheim, Norway. Electronic address:

Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT.
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http://dx.doi.org/10.1016/j.pcad.2017.03.006DOI Listing
April 2017

Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial.

SAGE Open Med 2015 16;3:2050312115580799. Epub 2015 Apr 16.

Department of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Objectives: To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain.

Methods: A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life.

Results: Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (-17.6, 95% confidence interval: -30.5, -4.7; p < 0.01), and the reduction was persistent at 3 months' follow-up (-15.2, 95% confidence interval: -28.5, -1.8; p = 0.03). Health-related quality of life improved in all three domains in patients with no significant difference between groups.

Conclusion: Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.
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http://dx.doi.org/10.1177/2050312115580799DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679239PMC
January 2016

Safety of the CO-Rebreathing Method in Patients with Coronary Artery Disease.

Med Sci Sports Exerc 2016 Jan;48(1):33-8

1K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, NORWAY; 2Department of Cardiology, St. Olav's University Hospital, NORWAY; 3Clinical Services, St. Olav's University Hospital, NORWAY; 4Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Norway; and 5Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, NORWAY.

Purpose: To address and study the safety concerns with the improved carbon monoxide (CO) rebreathing method for measuring total blood volume in patients with coronary artery disease to implement the use of the methodology in this patient group.

Methods: Eighteen patients with stable coronary artery disease (age 62 ± 7 yr, 24 ± 5 months since diagnosis) were investigated using the improved CO-rebreathing test. Before, during, and up to 2 h after the test, ECG, blood pressure, arterial oxygen saturation, carbon monoxide bound to hemoglobin (HbCO%), and cardiac function were measured. At 24 h, HbCO% and troponin-T were measured.

Design: Cross-over.

Results: Six minutes after the CO-rebreathing test, HbCO increased from 1.5% ± 0.4% to 6.0% ± 0.6%, with a subsequent decrease to 4.5% ± 0.4% and 1.4% ± 0.4% at 2 h and 24 h after the test, respectively. Resting heart rate, stroke volume, cardiac output, and ejection fraction were 64 ± 11 bpm, 93.9 ± 16.5 mL per beat, 5.84 ± 0.99 L, and 48.5% ± 5.7% and remained unchanged during and 10 min after the rebreathing. All patients were in sinus rhythm during the 2-h observation period, without ST- or T-wave changes, with low numbers of premature beats and normal rate variability. Systolic and diastolic blood pressure gradually decreased during the observation period. Troponin-T was below the 99th percentile for all the participants 24 h after the test.

Conclusion: Cardiovascular function and safety indices remained unchanged after exposure to approximately 6% HbCO, indicating that the method is safe to perform in patients with stable coronary artery disease.
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http://dx.doi.org/10.1249/MSS.0000000000000729DOI Listing
January 2016

Upper arm venous compliance and fitness in stable coronary artery disease patients and healthy controls.

Clin Physiol Funct Imaging 2017 Sep 15;37(5):498-506. Epub 2015 Dec 15.

K.G. Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Objectives: Arteries have been examined extensively in coronary artery disease (CAD), while less attention has been paid to veins.

Aims: (1) To determine whether venous compliance or venous outflow in the upper arm is reduced in CAD patients compared to healthy age- and fitness-matched controls; and (2) to examine the association between upper arm venous compliance and total blood volume.

Design: Fifteen patients with stable CAD (age 62·1 ± 5·7 years, body mass index 26·5 ± 3·2 kg·m , fat-free mass 59·3 ± 7·6 kg, mean arterial pressure 98·9 ± 8·0 mmHg, VO : 2·92 ± 0·53 l min ) were compared to twelve healthy age- and fitness-matched controls (age 62·2 ± 3·7 years, body mass index 26·2 ± 2·3 kg m , fat-free mass 61·0 ± 9·2 kg, mean arterial pressure 96·5 ± 9·1 mmHg, VO : 3·24 ± 0·48 l min ). Venous compliance was examined using high-resolution ultrasound and Doppler in the basilic vein. Blood volumes were measured by the optimized CO rebreathing method.

Results: Equal upper arm venous compliance normalized to blood volume (patients: 0·28 ± 0·26 mm  mmHg  l , healthy controls: 0·16 ± 0·11 mm mmHg  l ) and peak venous outflow normalized to blood volume (patients: 10·4 ± 3·9 cm s  l , healthy controls: 8·3 ± 0·8 cm s  l ) were found in patients with CAD and healthy age- and fitness-matched controls. Additionally, no difference was found in blood volume (patients: 6·06 ± 0·79 l, healthy controls: 6·68 ± 1·27 l) or VO .

Conclusion: Comparable upper arm venous compliance and venous outflow in CAD patients and healthy age- and fitness-matched controls might indicate that high VO and blood volume could prevent possible disease-induced reductions in venous compliance in CAD.
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http://dx.doi.org/10.1111/cpf.12324DOI Listing
September 2017

Treadmill Training or Progressive Strength Training to Improve Walking in People with Multiple Sclerosis? A Randomized Parallel Group Trial.

Physiother Res Int 2016 Dec 25;21(4):228-236. Epub 2015 Jun 25.

Clinical Services, St. Olavs University Hospital, Trondheim, Norway.

Background And Purpose: The most effective treatment approach to improve walking in people with multiple sclerosis (MS) is not known. The aim of this trial was to assess the efficacy of treadmill training and progressive strength training on walking in people with MS.

Methods: A single blinded randomized parallel group trial was carried out. Eligible participants were adults with MS with Expanded Disability Status Scale score ≤6. A total of 29 participants were randomized and 28 received the allocated exercise intervention, treadmill (n = 13) or strength training (n = 15). Both groups exercised 30 minutes, three times a week for 8 weeks. Primary outcome was The Functional Ambulation Profile evaluated by the GAITRite walkway. Secondary outcomes were walking work economy and balance control during walking, measured by a small lightweight accelerometer connected to the lower back. Testing was performed at baseline and the subsequent week after completion of training.

Results: Two participants were lost to follow-up, and 11 (treadmill) and 15 (strength training) were left for analysis. The treadmill group increased their Functional Ambulation Profile score significantly compared with the strength training group (p = .037). A significant improvement in walking work economy (p = .024) and a reduction of root mean square of vertical acceleration (p = .047) also favoured the treadmill group.

Discussion: The results indicate that task-specific training by treadmill walking is a favourable approach compared with strength training to improve walking in persons with mild and moderate MS. Implications for Physiotherapy practice, this study adds knowledge for the decision of optimal treatment approaches in people with MS. Copyright © 2015 John Wiley & Sons, Ltd.
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http://dx.doi.org/10.1002/pri.1636DOI Listing
December 2016

Long-term Exercise Adherence After High-intensity Interval Training in Cardiac Rehabilitation: A Randomized Study.

Physiother Res Int 2016 Mar 16;21(1):54-64. Epub 2015 Feb 16.

Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.

Background And Purpose: Exercise adherence in general is reported to be problematic after cardiac rehabilitation. Additionally, vigorous exercise is associated with impaired exercise adherence. As high-intensity interval training (HIT) is frequently used as a therapy to patients with coronary artery disease in cardiac rehabilitation, the objective was to assess long-term exercise adherence following an HIT cardiac rehabilitation programme.

Methods: A multicentre randomized study was carried out. Eligible participants were adults who had previously attended a 12-week HIT cardiac rehabilitation programme, as either a home-based or hospital-based HIT (treadmill exercise or group exercise). The primary outcome was change in peak oxygen uptake; secondary outcomes were self-reported and objectively measured physical activity.

Results: Out of 83 eligible participants, 76 were available for assessment (68 men/8 women, mean age 59 (8) years) at a one-year follow-up. Peak oxygen uptake was significantly elevated above baseline values, (treadmill exercise: 35.8 (6.4) vs. 37.4 (7.4) ml kg(-1)  min(-1) , group exercise: 32.7 (6.5) vs. 34.1 (5.8) ml kg(-1)  min(-1) and home-based exercise: 34.5 (4.9) vs. 36.7 (5.8) ml kg(-1)  min(-1) at baseline and follow-up, respectively), with no significant differences between groups. The majority of the participants (>90%) met the recommended daily level of 30 minutes of moderate physical activity. The home-based group showed a strong trend towards increased physical activity compared with the hospital-based groups.

Discussion: The results from this study have shown that both home-based and hospital-based HIT in cardiac rehabilitation induce promising long-term exercise adherence, with maintenance of peak oxygen uptake significantly above baseline values at a one-year follow-up. The implication for physiotherapy practice is that HIT in cardiac rehabilitation induces satisfactory long-term exercise adherence.
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http://dx.doi.org/10.1002/pri.1619DOI Listing
March 2016

High-intensity aerobic interval training for patients 3-9 months after stroke: a feasibility study.

Physiother Res Int 2014 Sep 4;19(3):129-39. Epub 2013 Dec 4.

Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Physiotherapy, Faculty of Health Education and Social Work, Sør-Trøndelag University College, Trondheim, Norway.

Background And Purpose: High-intensity aerobic interval training (AIT) has shown to be beneficial in patients with cardiac and pulmonary diseases. Presumably, patients with stroke also benefit from such treatment. However, the feasibility and potential efficacy of high-intensity AIT should be investigated for patients early after stroke.

Methods: This was a single-group, pre-test-post-test, intervention study. The intervention consisted of a 6-week high-intensity AIT programme, performed twice a week. The AIT comprised 4 × 4-minute intervals, at 85-95% of peak heart rate, interrupted by 3-minute active breaks. Adherence to the protocol, compliance and adverse events were registered to assess feasibility. Cardiorespiratory fitness and functional outcomes were assessed before and after the intervention and at 6 and 12 weeks follow-up.

Results: Ten men and five women (mean age 70.0 ± 7.7; range 61-85 years) with mild to moderate stroke were included, 3-9 months after onset. One patient was diagnosed with cancer during follow-up. There were three minor events, but no serious adverse events occurred. All patients accomplished all training sessions and reached the 85% intensity level, except one patient who discontinued the last session. The mean peak oxygen uptake showed no significant improvement from pre-treatment, 28.7 ± 3.8 ml kg(-1)  min(-1), to post-treatment, 29.6 ± 3.6 ml kg(-1)  min(-1), p = 0.189, whereas the mean 6-minute walk test improved from 410.7 ± 101.4 m to 461.0 ± 99.6 m, p = 0.001, and the median (interquartile range) Rivermead Motor Assessment Scale improved from 12.0 (11.0-13.0) to 13.0 (11.0-13.0) points, p = 0.100. These improvements continued after the intervention was concluded.

Conclusions: This study has shown that high-intensity AIT is feasible for a selected group of stroke patients. However, the training should be accomplished in line with the American College of Sports Medicine guidelines for high-risk populations to ensure safety. The participants achieved a clinically highly significant improvement in walking distance. This intervention should be tested out in a randomized controlled trial to assess if it is superior to other interventions.
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http://dx.doi.org/10.1002/pri.1573DOI Listing
September 2014

Does rating of perceived exertion result in target exercise intensity during interval training in cardiac rehabilitation? A study of the Borg scale versus a heart rate monitor.

J Sci Med Sport 2014 Sep 8;17(5):541-5. Epub 2013 Aug 8.

Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Norway; Department of Cardiology, St. Olav's University Hospital, Norway.

Objectives: To assess whether rating of perceived exertion using the Borg 6-20 scale is a valid method for achieving target exercise intensity during high-intensity interval training in cardiac rehabilitation.

Design: A single-group cross-over design.

Methods: Ten participants (56 (6.5) years) who were enrolled in a high-intensity interval training cardiac rehabilitation program were recruited. A target exercise intensity of Borg 17 (very hard) was used for exercise intensity guidance in the initial four exercise sessions that took place before a cardiopulmonary exercise test, as in usual care rehabilitation. The heart rate was recorded and blinded to the participants. After performing the test, the participants were then instructed using heart rate monitors openly for exercise guidance in four subsequent exercise sessions, at an intensity corresponding to 85-95% of peak heart rate.

Results: The mean exercise intensity during high-intensity bouts was 82% (6%) of peak heart rate for the rating of perceived exertion and 85% (6%) using heart rate monitors (p=0.005). Bland-Altman limits of agreement analysis with a mean bias showed a bias of 2.97 (-2.08, 8.02) percentage points for the two methods. Exercise intensity was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86-0.99, p<0.001) and 0.96 (95% CI 0.88-0.99, p<0.001) in the exercise sessions using rating of perceived exertion and percentage of peak heart rate for intensity control, respectively.

Conclusions: Rating of perceived exertion results in an exercise intensity below target during high-intensity interval training bouts in cardiac rehabilitation. Heart rate monitoring should be used for accurate intensity guidance.
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http://dx.doi.org/10.1016/j.jsams.2013.07.019DOI Listing
September 2014

The higher the better? Interval training intensity in coronary heart disease.

J Sci Med Sport 2014 Sep 12;17(5):506-10. Epub 2013 Aug 12.

K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Clinical Services, St. Olav University Hospital, Trondheim, Norway.

Objectives: Peak oxygen uptake (VO2 peak) increases more after high intensity interval training compared to isocaloric moderate exercise in patients with coronary heart disease (CHD). We assessed the impact of exercise intensity during high intensity intervals on the increase in VO2 peak.

Design/methods: We included 112 patients with coronary heart disease who had participated in randomized trials of interval training consisting of four times four minutes intervals at 85-95% of heart rate maximum (HRmax) for 12 weeks. Exercise intensity was calculated for each patient using HR during the two last minutes of each interval, expressed as percentage of HRmax. We used a univariate general linear model with VO2 peak increase as the dependent variable and percentage of HRmax, age, number of exercise sessions, and baseline VO2 peak as covariates. Exercise intensity was also divided into three categories; <88%, 88-92%, and >92% of HRmax, and these categories were used as a fixed factor in the model.

Results: VO2 peak increased by 3.9 (SD 3.1) mL kg(-1)min(-1), equal to 11.9% after 23.4 exercise sessions. Percentage of HRmax had a significant effect on increase in VO2 peak, both as a continuous (p=0.019) and categorical variable (p=0.020). The estimated marginal means and 95% confidence intervals of the increase in VO2 peak for the three intensity categories were 3.1 (2.0, 4.2), 3.6 (2.8, 4.4), and 5.2 (4.1, 6.3) for the <88%, the 88-92%, and the >92% category, respectively.

Conclusions: Even within the high intensity training zone, exercise intensity was an important determinant for improving VO2 peak in patients with coronary heart disease.
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http://dx.doi.org/10.1016/j.jsams.2013.07.007DOI Listing
September 2014

Home-based versus hospital-based high-intensity interval training in cardiac rehabilitation: a randomized study.

Eur J Prev Cardiol 2014 Sep 23;21(9):1070-8. Epub 2013 Apr 23.

Norwegian University of Science and Technology, Trondheim, Norway St. Olav's University Hospital, Trondheim, Norway.

Background: High-intensity interval training (HIT) as exercise therapy is gradually implemented in cardiac rehabilitation as the cardiovascular benefits from exercise is intensity dependent. However, in previous studies, HIT has been performed with strict supervision. The aim of the study was to assess the feasibility and effectiveness of different modes of HIT in cardiac rehabilitation.

Design: a randomized clinical study.

Methods: Ninety participants with coronary artery disease (80 men/10 women, mean age 57 ± 8 years) were randomly assigned to one of three exercise modes: group exercise (GE), treadmill exercise (TE), or home-based exercise (HE). HIT was performed twice a week for 12 weeks with an exercise intensity of 85-95% of peak heart rate. The primary outcome measure was change in peak oxygen uptake (peak VO2).

Results: Eighty-three participants (92%) completed the intervention without any severe adverse events. Peak VO2 increased from 34.7 ± 7.3 to 39.0 ± 8.0 ml/kg/min, 32.7 ± 6.5 to 36.0 ± 6.2 ml/kg/min, and 34.4 ± 4.8 to 37.2 ± 5.2 ml/kg/min in TE, GE, and HE, respectively. Mean group difference for TE vs. HE was 1.6 ml/kg/min (95% confidence interval, CI, 0.7 to 3.1, p = 0.02), TE vs. GE 1.1 ml/kg/min (95% CI-0.5 to 2.5, p = 0.27), and GE vs. HE 0.6 ml/kg/min (95% CI -1.0 to 2.1, p = 1). However, on-treatment analysis showed no significant difference between groups.

Conclusion: HIT was efficiently performed in three settings of cardiac rehabilitation, with respect to target exercise intensity, exercise attendance, and increase in peak VO2. Exercise mode was not essential for exercise capacity.
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http://dx.doi.org/10.1177/2047487313488299DOI Listing
September 2014

Aerobic interval training compensates age related decline in cardiac function.

Scand Cardiovasc J 2012 Jun 20;46(3):163-71. Epub 2012 Feb 20.

Department of Circulation and Medical Imaging, K.G. Jebsen Center of Exercise in Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

Objectives: To study the effect of aerobic interval training (AIT) on myocardial function in sedentary seniors compared to master athletes (MA) and young controls.

Design: Sixteen seniors (72 ± 1 years, 10 men) performed AIT (4 × 4 minutes) at ≈ 90% of maximal heart rate three times per week for 12 weeks. Results were compared with 11 male MA (74 ± 2 years) and 10 young males (23 ± 2 years).

Results: Seniors had an impaired diastolic function compared to the young at rest. AIT improved resting diastolic parameters, increased E/A ratio (44%, p <0.01), early diastolic tissue Doppler velocity (e') (11%, p <0.05) and e' during exercise (11%, p <0.01), shortened isovolumic relaxation rate (IVRT) (13%, p <0.01). Left ventricle (LV) systolic function (S') was unaffected at rest, whereas S' during stress echo increased by 29% (p <0.01). Right ventricle (RV) S' and RV fractional area change (RFAC) increased (9%, p <0.01, 12%, p =0.01, respectively), but not RV e'. MA had the highest end-diastolic volume, stroke volume, diastolic reserve and RV S'.

Conclusion: AIT partly reversed the impaired age related diastolic function in healthy seniors at rest, improved LV diastolic and systolic function during exercise as well as RV S' at rest.
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http://dx.doi.org/10.3109/14017431.2012.660192DOI Listing
June 2012

Aerobic interval training increases peak oxygen uptake more than usual care exercise training in myocardial infarction patients: a randomized controlled study.

Clin Rehabil 2012 Jan 21;26(1):33-44. Epub 2011 Sep 21.

KG Jebsen Center of Exercise in Medicine, Norwegian University of Science and Technology, Department of Circulation and Medical Imaging, Trondheim, Norway.

Objective: Exercise capacity strongly predicts survival and aerobic interval training (AIT) increases peak oxygen uptake effectively in cardiac patients. Usual care in Norway provides exercise training at the hospitals following myocardial infarction (MI), but the effect and actual intensity of these rehabilitation programmes are unknown.

Design: Randomized controlled trial.

Setting: Hospital cardiac rehabilitation.

Subjects: One hundred and seven patients, recruited two to 12 weeks after MI, were randomized to usual care rehabilitation or treadmill AIT.

Interventions: Usual care aerobic group exercise training or treadmill AIT as 4 × 4 minutes intervals at 85-95% of peak heart rate. Twice weekly exercise training for 12 weeks.

Main Measures: The primary outcome measure was peak oxygen uptake. Secondary outcome measures were endothelial function, blood markers of cardiovascular disease, quality of life, resting heart rate, and heart rate recovery.

Results: Eighty-nine patients (74 men, 15 women, 57.4 ± 9.5 years) completed the programme. Peak oxygen uptake increased more (P = 0.002) after AIT (from 31.6 ± 5.8 to 36.2 ± 8.6 mL·kg(-1)·min(-1), P < 0.001) than after usual care rehabilitation (from 32.2 ± 6.7 to 34.7 ± 7.9 mL·kg(-1)·min(-1), P < 0.001). The AIT group exercised with significantly higher intensity in the intervals compared to the highest intensity in the usual care group (87.3 ± 3.9% versus 78.7 ± 7.2% of peak heart rate, respectively, P < 0.001). Both programmes increased endothelial function, serum adiponectin, and quality of life, and reduced serum ferritin and resting heart rate. High-density lipoprotein cholesterol increased only after AIT.

Conclusions: AIT increased peak oxygen uptake more than the usual care rehabilitation provided to MI patients by Norwegian hospitals.
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http://dx.doi.org/10.1177/0269215511405229DOI Listing
January 2012

Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients.

Eur J Prev Cardiol 2012 Apr 4;19(2):151-60. Epub 2011 Mar 4.

Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Olav Kyrres veg 3, Trondheim, Norway.

Aims: Exercise is recommended as prevention, management, and control of all stages of hypertension. There are still controversies about the optimal training dose, frequency, and intensity. We aimed to study the effect of aerobic interval training on blood pressure and myocardial function in hypertensive patients.

Methods And Results: A total of 88 patients (52.0 ± 7.8 years, 39 women) with essential hypertension were randomized to aerobic interval training (AIT) (>90% of maximal heart rate, correlates to 85-90% of VO(2max)), isocaloric moderate intensity continuous training (MIT) (~70% of maximal heart rate, 60% of VO(2max)), or a control group. Exercise was performed on a treadmill, three times per week for 12 weeks. Ambulatory 24-hour blood pressure (ABP) was the primary endpoint. Secondary endpoints included maximal oxygen uptake (VO(2max)), mean heart rate/24 hour, flow mediated dilatation (FMD), total peripheral resistance (TPR), and myocardial systolic and diastolic function by echocardiography. Systolic ABP was reduced by 12 mmHg (p < 0.001) in AIT and 4.5 mmHg (p = 0.05) in MIT. Diastolic ABP was reduced by 8 mmHg (p < 0.001) in AIT and 3.5 mmHg (p = 0.02) in MIT. VO(2max) improved by 15% (p < 0.001) in AIT and 5% (p < 0.01) in MIT. Systolic myocardial function improved in both exercise groups, diastolic function in the AIT group only. TPR reduction and increased FMD were only observed in the AIT group.

Conclusions: This study indicates that the blood pressure reducing effect of exercise in essential hypertension is intensity dependent. Aerobic interval training is an effective method to lower blood pressure and improve other cardiovascular risk factors.
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http://dx.doi.org/10.1177/1741826711400512DOI Listing
April 2012

Onset of exercise training 14 days after uncomplicated myocardial infarction: a randomized controlled trial.

Eur J Cardiovasc Prev Rehabil 2010 Aug;17(4):387-92

Clinical Services, St. Olav University Hospital, 7006 Trondheim, Norway.

Background: Exercise training is an important part of cardiac rehabilitation to reduce morbidity and mortality. Low-intensity exercise training can start as soon as the myocardial infarction (MI) patient is stable. Our objective was to evaluate the effect of an early start of exercise training in MI patients.

Design: A randomized controlled trial.

Methods: Thirty-nine MI patients were randomized to either an early start of exercise training group (EG) or to a delayed start control group (CG). The EG participated in an outpatient low-intensity EG (phase 2a) two times a week for 4 weeks before entering ordinary exercise training of moderate-to-high intensity (phase 2b). CG entered phase 2b directly after 4 weeks of delay. Primary outcome measure was peak oxygen consumption (VO2peak), measured at baseline, after 4 weeks and after 16 weeks. Secondary outcome measure was health-related quality of life.

Results: VO2peak did not change from baseline to 4 weeks, either in EG [30.6+/-6.7 ml/kg/min vs. 30.7+/-6.2 ml/kg/min, not significant (NS)] or CG (29.8+/-6.1 ml/kg/min vs. 30.7+/-6.2 ml/kg/min, NS). After 16 weeks VO2peak increased in both groups to 33.1+/-7.1 ml/kg/min in EG (P<0.005) and 33.0 ml/kg/min+/-8.6 in CG (P<0.005), group differences NSH. Health-related quality of life increased in every domain but physical functioning for both groups (group differences NS).

Conclusion: An early start of exercise training did not increase VO2peak compared to 4 weeks of delay. For low-risk patients with high motivation for exercise training, home-based walking is an option as a moderate start of cardiac rehabilitation the first weeks after MI.
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http://dx.doi.org/10.1097/HJR.0b013e328333edf9DOI Listing
August 2010
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