Eccentric exercise in ischemic cardiac patients and functional capacity: A systematic review and meta-analysis of randomized controlled trials

Background: Eccentric (ECC) exercise is an "economical'' type of exercise with low energy requirements and does not cause early fatigue. Therefore, it is used for cardiac patients, who have low physical activity and exercise intolerance, as an easier kind of training. Objective: This systematic review aimed to investigate the efficacy of ECC exercise for functional capacity (FC) in patients with ischemic heart disease. Design: Systematic review. Methods: MEDLINE via PubMed and EBSCO databases were searched for articles of randomized controlled trials of adults with ischemic heart disease who underwent ECC training as compared with other forms of exercise (concentric exercise) or no exercise and assessed FC. The methodologic quality of studies was assessed by the PEDro scale. A meta-analysis was performed with sufficient homogeneity between at least 2 studies in the pre-defined comparisons. Results: Four studies, investigating a total of 99 subjects, met the inclusion criteria. The results of the studies did not clearly indicate whether ECC exercise could improve FC better than traditional forms of exercise. However, the small number of studies and their methodologic weaknesses do not allow for drawing firm conclusions. Conclusions: We found contradictory results about the effectiveness of ECC as compared with concentric exercise in terms of FC in ischemic cardiac patients. Further investigation with well-designed randomized trials is needed to determine the effectiveness of this kind of exercise for FC in such patients. (C) 2016 Elsevier Masson SAS. All rights reserved.