Effective endurance and strength training for patients with chronic musculoskeletal disorders
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BACKGROUND: Peak oxygen uptake (VO2peak), maximal strength (measured as one-repetition maximum (1RM)), and walking economy (Cw) have a great impact on physical work capacity, disability and mortality. The study aimed to compare the effects of aerobic high intensity interval training and maximal strength training versus moderate intensity training on VO2peak, 1RM and Cw in the rehabilitation of patients with musculoskeletal disorders aiming to return to work. METHODS: Fifty-eight patients with musculoskeletal disorders (mean age 45 years) were either randomized to high intensity training at 85-95% of maximum heart rate (HRmax) and 85-95% 1RM or moderate intensity training, 5 days/week, for 4 weeks at Hokksund rehabilitation centre. Primary outcomes were VO2peak, 1RM and Cw at baseline and after rehabilitation. RESULTS: VO2peak, 1RM and Cw improved in the high intensity group (33.8±8.1 vs. 37.3±8.4 mL.kg-1.min-1, 92.9±25.6 vs. 127.2±28.0 kg, 16.0±2.2 vs. 14.4±1.8 mL.kg-1.min-1, p < .001) and the moderate intensity group (33.0±7.0 vs. 34.6±7.5 mL.kg-1.min-1, 108.0±37.7 vs. 125.8±39.1 kg, 15.3±2.1 vs. 14.0±1.4 mL.kg-1.min-1, p <0 .001), with a significance group difference (p < 0.001) in VO2peak and 1RM. Systolic and diastolic blood pressure decreased significantly in both groups (p < 0.01 and p <0.001), with no significant difference between groups. CONCLUSION: Four weeks of intensive endurance and strength training improved VO2peak, 1RM and Cw significantly after both high intensity training and moderate intensity training. The results show that high intensity training was twice as effective in increasing VO2peak and 1RM after 4 weeks rehabilitation. Increased physical work capacity could lead to increased quality of life and perhaps return to work.