Effects of exercise prescription on daily physical activity and maximal exercise capacity in coronary artery disease patients with and without type 2 diabetes

Background Promotion of and adherence to increased physical activity (PA) is an important part of the prevention and treatment of coronary artery disease (CAD). We hypothesized that individually tailored home-based exercise prescriptions will increase long-term PA and maximal exercise capacity among CAD patients without and with type 2 diabetes (CAD+T2D). Methods Physical activity of patients with CAD (n = 44) and CAD+T2D (n = 39), matched by age, sex and ejection fraction, was measured over 5 days with an accelerometer pre- and postexercise prescription. PA was assessed as the average time per day of moderate (METs = 25) and high (METs > 5) intensities. Six-month exercise prescriptions were introduced based on individual maximal heart rate reserve. Results At the baseline, patients with CAD+T2D engaged in less moderate-intensity PA (2:40 +/- 1:23 versus 3:24 +/- 1:17 h, P = 0.014) and exhibited a non-significant trend to reduced high-intensity PA (2:08 +/- 2:57 versus 5:02 +/- 9:19 min, P = 0.091) compared with patients with CAD. High-intensity PA increased markedly in CAD (5:02 +/- 9:19 versus 9:59 +/- 15:03 min) and patients with CAD+T2D (2:08 +/- 2:57 versus 6:14 +/- 10:18 min) after exercise prescription (main effect for time P = 0.001). Also maximal exercise capacity increased in both groups (main effect for time P<0.001). Conclusion Patients with CAD with T2D are physically less active than CAD patients without diabetes in their daily life. Individually tailored home-based exercise prescriptions are an effective way to promote more active lifestyles and improve fitness in both patient groups.