IJCS | Volume 31, Nº4, July / August 2018

401 Macedo et al. Periodized model for prescribed exercises Int J Cardiovasc Sci. 2018;31(4)393-404 Original Article Table 5 - Intra & intergroup comparison of muscle strength Group PG p NPG p Pre Post Pre Post Extensor chair (kg) 13.5 ± 5.5 24.0 ± 8.3 0.00* 10.4 ± 5 20.6 ± 8.4 0.00* Leg curl (kg) 7.9 ± 3.3 14.1 ± 4.3 0.00* 6.5 ± 3 11 ± 6.5 0.00* Bench press 12.6 ± 4.5 21.2 ± 6.5 0.00* 9.7 ± 5 18.2 ± 6.9 0.00* Triceps 8.9 ± 3.6 15.5 ± 4.4 0.00* 7.2 ± 3.5 12.3 ± 3.5 0.00* Biceps 8.4 ± 2.5 13.3 ± 3.4 0.00* 7.2 ± 3.1 11.4 ± 3.6 0.00* High pulley rear 15.5 ± 5.7 28.5 ± 7.9 0.00* 11.8 ± 7.2 23.9 ± 11.4 0.00* * Intra-group difference (Student t test for dependent samples, p < 0.05) guidelines for cardiac patients, 6,8 but has never been compared to non-periodized training in this population. Linear periodized training has superior cardiac and musculoskeletal function as compared to non-periodized training for athletes and healthy subjects 10,23 and with respect to cardiometabolic risk in obese adolescents. 24 Ribeiro et al. 25 have described that, for beginners, walking programs remain the most prescribedmodality for CAD patients because they are safe, controlled, and can be performed anywhere. The intensity of the AT of the NPG was moderate, between VT1 and VT2, that is, between the minimum and maximum stable phases of lactate production. 19 Therefore, they trained during almost the whole period (36 sessions) predominantly using the aerobic system as their energy source, without generating acidosis, and metabolic recovery was not necessary during the session, allowing for the maintenance of continuous training. Jolliffe et al. 1 have carried out a meta-analysis involving 8,440 patients with 32 randomized and controlled studies. They concluded that AT was safe, improved the aerobic capacity and reduced mortality, confirming the findings of the present study for PG. The volunteers in the PG trained in the same interval of intensity as the NPG (between the HRVT1 and HRVT2). A training TZ was created for both groups corresponding to the HR interval for VT1 and VT2, but a load progressionwas organized for the PG. The intensity of AT was limited to the AHR up to the 18th session and this interval training was defined as the ideal to improve aerobic performance. 22 The improvement of the VO 2 of the VT2 in the PG was attributed to this specificity of the training, which did not occur in NPG. As from the 19 th session (half of the fundamental macrocycle), the volunteers started training above the AHR up to the HR corresponding to the VT2. Due to the increased intensity of training, interval training started in PG. From the 5 th minute of walking on the treadmill, the patient trained 2 minutes close to the HRVT1 followed by 1 minute close to the HRVT2, and maintained this alternating scheme until completing 30 minutes of workout. Due to its specificity, this training intensity promoted a greater increase in the VO 2 of the VT2, a fact confirmed by the findings of the present study. It is important to highlight that this AT with intervals, limited by the maximum stable lactate phase, has already been proven. Cornish et al. 26 have published a meta-analysis involving 213 patients with seven randomized studies, which demonstrated the need for more studies in order to determine the risks and benefits of interval training above the VT2. In addition, the authors have noted different prescription methodologies, with the patients starting the exercise programwith sets of high intensity training with intervals in the majority of cases. 27 We believe that periodization allows for a greater chance of standardizing the prescriptions. Body composition The volunteers in the PG showed reductions in their fat mass, weight of fat above the ideal value and in their body weight. Increments in body mass and body fat are associatedwith several chronic diseases, such as diabetes and cardiovascular disease. 28