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The impact of high-calorie-expenditure exercise on quality of life in older adults with coronary heart disease
Pope L, Harvey-Berino J, Savage P, Bunn J, Ludlow M, Oldridge N, Ades P
Journal of Aging and Physical Activity 2011 Apr;19(2):99-116
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000 to 3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700 to 800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 +/- 4 versus. 3.7 +/- 5 kg, p < 0.001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < 0.05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = 0.05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.

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