Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients.

Background: We aimed to compare: (1) two different periodized aerobic training protocols (linear (LP) versus non-linear (NLP)) on the cardiopulmonary exercise response in patients with coronary heart disease; (2) the proportion of responders between both training protocols.

Design: A randomized controlled trial.

Methods: A total of 39 coronary heart disease patients completed either LP ( = 20, 65 ± 10 years) or NLP ( = 19, 66 ± 5 years). All patients completed a cardiopulmonary exercise testing with gas exchange measurements. Patients underwent a 12-week supervised exercise program including an isoenergetic aerobic periodized training and a similar resistance training program, 3 times/week. Weekly energy expenditure was constantly increased in the LP group for the aerobic training, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. Peak oxygen uptake (peak V̇O), oxygen uptake efficiency slope, ventilatory efficiency slope (V̇E/V̇CO slope), V̇O at the first (VT) and second (VT) ventilatory thresholds, and oxygen pulse (O pulse) were measured. Responders were determined according the median value of the Δpeak V̇O (mL.min.kg).

Results: We found similar improvement for peak V̇O (LP: +8.1%, NLP: +5.3%, interaction:  = 0.37; time:  < 0.001) and for oxygen uptake efficiency slope, VT, VT and O pulse in both groups (interaction:  > 0.05; time:  < 0.05) with a greater effect size in the LP group. The proportion of non-, low and high responders was similar between groups ( = 0.29).

Conclusion: In contrast to the athletes, more variation (NLP) does not seem necessary for greater cardiopulmonary adaptations in coronary heart disease patients.