OBJECTIVE: To determine the importance of the duration and intensity of "warm up" exercise for reducing ischaemia during second exercise in patients with exertional angina. DESIGN: Randomised crossover comparison of three warm up exercise protocols. PATIENTS: 18 subjects with stable ischaemic heart disease and > 0.1 mV ST segment depression on treadmill exercise testing. INTERVENTIONS: The warm up protocols were 20 minutes of slow exercise at 2.7 km/h, symptom limited graded exercise for a mean of 7.4 (range 5.0 to 10.5) minutes, and three minutes of symptom limited fast exercise of similar maximum intensity. MAIN OUTCOME MEASURES: ST segment depression during graded treadmill exercise undertaken 10 minutes after each warm up protocol or no warm up exercise. RESULTS: Compared with exercise with no warm up, the duration of graded exercise after earlier slow warm up increased by 4.9% (95% confidence interval (CI), -3.3% to 13.7%), after graded warm up by 10.3% (95% CI, 5.6% to 15.2%), and after fast warm up by 16% (95% CI, 6.2% to 26.7%). ST segment depression at equivalent submaximal exercise decreased after slow warm up by 27% (95% CI, 5% to 44%), after graded warm up by 31% (95% CI, 17% to 44%), and after fast warm up by 47% (95% CI, 27% to 61%). Compared with slow warm up exercise, the more intense graded and fast warm up protocols significantly increased the duration of second exercise (p = 0.0072) and reduced both peak ST depression (p = 0.0026) and the rate of increase of ST depression (p = 0.0069). CONCLUSIONS: In patients with exertional angina the size of the warm up response is related to the maximum intensity rather than the duration of first exercise.
RCT Entities:
OBJECTIVE: To determine the importance of the duration and intensity of "warm up" exercise for reducing ischaemia during second exercise in patients with exertional angina. DESIGN: Randomised crossover comparison of three warm up exercise protocols. PATIENTS: 18 subjects with stable ischaemic heart disease and > 0.1 mV ST segment depression on treadmill exercise testing. INTERVENTIONS: The warm up protocols were 20 minutes of slow exercise at 2.7 km/h, symptom limited graded exercise for a mean of 7.4 (range 5.0 to 10.5) minutes, and three minutes of symptom limited fast exercise of similar maximum intensity. MAIN OUTCOME MEASURES: ST segment depression during graded treadmill exercise undertaken 10 minutes after each warm up protocol or no warm up exercise. RESULTS: Compared with exercise with no warm up, the duration of graded exercise after earlier slow warm up increased by 4.9% (95% confidence interval (CI), -3.3% to 13.7%), after graded warm up by 10.3% (95% CI, 5.6% to 15.2%), and after fast warm up by 16% (95% CI, 6.2% to 26.7%). ST segment depression at equivalent submaximal exercise decreased after slow warm up by 27% (95% CI, 5% to 44%), after graded warm up by 31% (95% CI, 17% to 44%), and after fast warm up by 47% (95% CI, 27% to 61%). Compared with slow warm up exercise, the more intense graded and fast warm up protocols significantly increased the duration of second exercise (p = 0.0072) and reduced both peak ST depression (p = 0.0026) and the rate of increase of ST depression (p = 0.0069). CONCLUSIONS: In patients with exertional angina the size of the warm up response is related to the maximum intensity rather than the duration of first exercise.
Authors: J Niebauer; R Hambrecht; T Velich; K Hauer; C Marburger; B Kälberer; C Weiss; E von Hodenberg; G Schlierf; G Schuler; R Zimmermann; W Kübler Journal: Circulation Date: 1997-10-21 Impact factor: 29.690
Authors: Y Okazaki; K Kodama; H Sato; M Kitakaze; A Hirayama; M Mishima; M Hori; M Inoue Journal: J Am Coll Cardiol Date: 1993-06 Impact factor: 24.094
Authors: R Hambrecht; J Niebauer; C Marburger; M Grunze; B Kälberer; K Hauer; G Schlierf; W Kübler; G Schuler Journal: J Am Coll Cardiol Date: 1993-08 Impact factor: 24.094
Authors: Fiona J Collinson; Walter M Gregory; Chris McCabe; Helen Howard; Catherine Lowe; DrBarbara Potrata; Sandy Tubeuf; Pat Hanlon; Lucy McParland; T Wah; Peter J Selby; Jenny Hewison; Julia Brown; Janet Brown Journal: BMC Cancer Date: 2012-12-14 Impact factor: 4.430
Authors: Linda Long; Lindsey Anderson; Alice M Dewhirst; Jingzhou He; Charlene Bridges; Manish Gandhi; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2018-02-02