IJCS | Volume 31, Nº4, July / August 2018

402 Macedo et al. Periodized model for prescribed exercises Int J Cardiovasc Sci. 2018;31(4)393-404 Original Article Studies have shown that moderate AT promotes an improvement in body composition. 29,30 This was important because obesity is considered to be an important modifiable cardiovascular risk factor. 31 A simple improvement in food habits is not sufficient for a rapid and appropriate decrease in fat mass. Therefore, the physical exercise association was fundamental for body weight decrease and long-term maintenance of these changes. 31 Studies 28,32,33 have recognized aerobic exercise as the most suitable form of training by providing positive effects on glucose and lipids and decrease on body fat and the strength exercises. Inoue et al. 24 have shown that the association of strength and AT was more effective than only AT to improve lipid profile and insulin resistance sensitivity on obese adolescents. The improvement in aerobic capacity or exercise tolerance results in a greater consumption of calories to maintain the activity and, consequently, burning more fat. 24 Lira et al. 34 have studied the effects of intensity and type of exercise on lipoprotein profiles and highlighted the higher energy expenditure achieved by associating volume and intensity. This fact justifies the finding that the PG, with its greater cardiopulmonary evolution and tolerance to exercise, presented greater body fat decrease. This is because improving the aerobic capacity increases the caloric expenditure per session, since the patient is walking more within a same time interval. Skeletal muscle function Both training groups presented a significant improvement in strength after the training period. In this case, the PG showed no advantage. During MAD the patients worked with loads equivalent to 30% of the maximum determined in the 1RM test, in the MFU, with 40%, and in the MSP, with 50%. This organized progression of the loadwas not more effective than the randomprogression used for the NPG. This could be attributed to the fact that these low training loads did not recruit different energy sources and/or types of muscle fibers. In addition, in the first 12 weeks of training, the increase in strength occurs due to neural adaptation and not to hypertrophy, which is independent of the load. 8,11 The increase in strength noted in both groups could have contributed to the improvement in the VO 2 peak, in the walking speed and in the inclination reached during the treadmill test. 27 Therefore, the training study is extremely important to both athletes, to reach high performance, and patients, such as those with heart disease, to reduce the risk of mortality, which has great social relevance. Conclusion The present study showed that, within the cardiac rehabilitation programs for coronary disease patients, periodization of the training can improve the results as compared to the conventional model, when considering the following variables: VO 2 peak, VO 2 for the VT2, VO 2 for the VT1, %fat and body weight. These findings are very important for future studies involving physical training and cardiac rehabilitation. We believe that, at the present moment, before evolving into comparative studies between continuous exercises of moderate intensity versus high intensity exercises with intervals, periodization should be included as a prescription tool aimed at improving the results of the intervention or treatment of those with coronary disease with physical exercise. Study limitations Some of the study limitations were the small size of the sample and not using the Faulkner protocol to evaluate body composition. In addition, inflammatory biomarkers, oxidative stress analysis and drug reduction for hypertension were not performed. Author contributions Conception and design of the research and analysis and interpretation of the data: Macedo RM; Acquisition of data: Macedo RM, SebastiãoNeto F; Statistical analysis: Macedo RM, Macedo ACB, Olandoski M; Obtaining financing:Macedo RM, Guarita-Souza LC, Silveira RP; Writing of the manuscript: Macedo RM, Macedo ACB, Faria-Neto JR, Costantini CR, Costantini CO, Guarita- Souza LC, Carvalho KAT; Critical revision of the manuscript for intellectual content: Macedo RM, Macedo ACB, Faria-Neto JR, Guarita-Souza LC. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study.