A cardiac rehabilitation programme based on neuromuscular training improves the functional capacity of patients with acute coronary syndrome: a preliminary randomised controlled trial

Objectives To evaluate the effects of a cardiac rehabilitation programme based on neuromuscular training (NMT) compared with classic rehabilitation strength training (CRST) in patients diagnosed with acute coronary syndrome (ACS). Design Preliminary randomised, double-blinded, parallel clinical trial. Setting University health clinic in Valencia, Spain. Participants Thirty patients with ACS. Interventions Patients were assigned to one of two groups at random: the NMT group (n = 15) and the CRST group (n = 15). All patients attended the 20 sessions of the exercise programme. Main outcome measures The primary outcome was the Incremental Shuttle Walk Test (ISWT). The secondary outcomes were the Chester Step Test (CST), the 30-Second Chair Stand Test (30CST), and hip flexor dynamometry. Assessments were made at baseline, immediately post-treatment, and at 6-month follow-up. Results The NMT group showed a greater improvement in the ISWT than the CRST group, both at post-treatment {mean 648 [standard deviation (SD) 197] vs 493 (SD 219), mean difference 155, 95% confidence interval (CI) -1 to 310} and at follow-up [732 (SD 183) vs 518 (SD 222), mean difference 214, 95% CI 61 to 367]. The secondary outcomes showed significant between-group differences in favour of the NMT group at 6-month follow-up, except for the 30CST. Conclusions These preliminary findings indicate that a cardiac rehabilitation programme based on NMT may improve functional capacity in terms of patient performance, cardiorespiratory fitness and muscle strength. Moreover, the improvements were maintained at medium- term follow-up. This could help improve the design of rehabilitation sessions, considering factors associated with performing everyday activities in patients affected by ACS. Clinical Trial Registration number NCT04246008. Contribution of the Paper center dot This study provides insight into new modalities of strength interventions in patients with acute coronary syndrome. center dot Neuromuscular training is a novel exercise modality in cardiac rehabilitation patients that has been shown to improve functional capacity. (c) 2024 The Authors. Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).