Purpose: The optimal approach to prescribing resistance training (RT) combined with aerobic training (AT) for cardiac rehabilitation is unclear with respect to patient oriented outcomes. The purpose of this study was to compare the effects of RT (1 vs 3 sets) combined with AT versus AT alone on quality-of-life, mood and self-efficacy parameters in persons with coronary artery disease.

Methods: Subjects (n = 72) were randomized to AT (5 d [middle dot] wk^-1) or combined AT (3 d [middle dot] wk^-1) with either 1 set (AT/RT1) or 3 sets (AT/RT3) of RT performed 2 d [middle dot] wk^-1. A variety of quality-of-life parameters were assessed before and after 29 weeks of training.

Results: Fifty-one subjects (mean +/- SEM age 61 +/- 2, 12% female) completed training. The decrease from baseline in depression score (Center for Epidemiologic Studies Depression Scale questionnaire) averaged 5% for AT (P = .71), 37% for AT/RT1 (P = .02), and 40% for AT/RT3 (P = .04), however the difference between groups was not significant. The mean self-efficacy score for walking increased by 19.4% for AT (P = .1), 32% for AT/RT1 (P = .01), and 46.7% for AT/RT3 (p < .001). Mean self-efficacy score for lifting increased by 30.8% for AT (P = .1), 24.3% for AT/RT1 (P = .01), and 46.7% for AT/RT3 (P < .001). The mean self-efficacy score for push-ups increased by 14.8% for AT (P = .1), 31.5% for AT/RT1 (P = .01) and 55.8% for AT/RT3 (P = .03). The difference in self-efficacy score for walking approached significance between AT and AT/RT3 (P = .08) but no other between-group differences were observed. The greatest between-group difference in Profile of Mood States dimensions was the fatigue/inertia score which deteriorated for the AT group but improved for the AT/RT3 group (-47.6% vs +16.3% respectively, P = .06). The Medical Outcome Survey Short Form 36 physical component summary score improved significantly for both AT/RT3 (12%, P = .004) and AT/RT1 (10%, P = .006) but not for AT (6%, P = .13). The mental component summary score increased by 11% for AT/RT3 (P = .07), 3% for AT/RT1 (P = .52), 8% for AT (P = .9).

Conclusion: Combined AT+RT yields more pronounced improvements in patient oriented parameters than AT alone. The data supports the use of multiple-set RT for patients desiring an increased RT stimulus which may further augment parameters that affect quality-of-life in a cardiac population.