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Exploring Differences in Cardiorespiratory Fitness Response Rates Across Varying Doses of Exercise Training: A Retrospective Analysis of Eight Randomized Controlled Trials

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Abstract

Objective

This study tested the hypothesis that greater mean changes in cardiorespiratory fitness (CRF), in either the absence or presence of reduced interindividual variability, explain larger CRF response rates following higher doses of exercise training.

Methods

We retrospectively analyzed CRF data from eight randomized controlled trials (RCT; n = 1590 participants) that compared at least two doses of exercise training. CRF response rates were calculated as the proportion of participants with individual confidence intervals (CIs) placed around their observed response that lay above 0.5 metabolic equivalents (MET). CIs were calculated using no-exercise control group-derived typical errors and were placed around each individual’s observed CRF response (post minus pre-training CRF). CRF response rates, mean changes, and interindividual variability were compared across exercise groups within each RCT.

Results

Compared with lower doses, higher doses of exercise training yielded larger CRF response rates in eight comparisons. For most of these comparisons (7/8), the higher dose of exercise training had a larger mean change in CRF but similar interindividual variability. Exercise groups with similar CRF response rates also had similar mean changes.

Conclusion

Our findings demonstrate that larger CRF response rates following higher doses of exercise training are attributable to larger mean changes rather than reduced interindividual variability. Following a given dose of exercise training, the proportion of individuals expected to improve their CRF beyond 0.5 METs is unrelated to the heterogeneity of individual responses.

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Author information

Authors and Affiliations

  1. School of Kinesiology and Health Studies, Queen’s University, Kingston, ON, Canada

    Jacob T. Bonafiglia, Nicholas Preobrazenski, Hashim Islam, Robert Ross & Brendon J. Gurd

  2. Department of Kinesiology, McMaster University, Hamilton, ON, Canada

    Jeremy J. Walsh

  3. Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada

    Jeremy J. Walsh & Gary S. Goldfield

  4. School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA

    Neil M. Johannsen

  5. Pennington Biomedical Research Center, Baton Rouge, LA, USA

    Neil M. Johannsen, Corby K. Martin & Timothy S. Church

  6. Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA

    Cris A. Slentz, Leanna M. Ross & William E. Kraus

  7. Division of Cardiology, Duke University School of Medicine, Durham, NC, USA

    William E. Kraus

  8. School of Human Kinetics, Faculty of Healthy Sciences, University of Ottawa, Ottawa, ON, Canada

    Glen P. Kenny, Gary S. Goldfield, Denis Prud’homme & Ronald J. Sigal

  9. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Glen P. Kenny & Ronald J. Sigal

  10. Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada

    Gary S. Goldfield

  11. School of Psychology, University of Ottawa, Ottawa, ON, Canada

    Gary S. Goldfield

  12. Institut du Savoir Montfort, Ottawa, ON, Canada

    Denis Prud’homme

  13. Departments of Medicine, Cardiac Sciences and Community Health Sciences Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Ronald J. Sigal

  14. Health and Kinesiology, Texas A & M University, College Station, TX, USA

    Conrad P. Earnest

Authors
  1. Jacob T. Bonafiglia
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  2. Nicholas Preobrazenski
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  3. Hashim Islam
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  4. Jeremy J. Walsh
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  5. Robert Ross
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  6. Neil M. Johannsen
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  7. Corby K. Martin
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  8. Timothy S. Church
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  9. Cris A. Slentz
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  12. Glen P. Kenny
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  17. Brendon J. Gurd
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Corresponding author

Correspondence to Brendon J. Gurd.

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Funding

J. T. B., N. P., H. I., and B. J. G. were supported by the Natural Sciences and Engineering Research Council of Canada: Vanier Canada Graduate Scholarship, Canada Graduate Scholarship (Master’s), Post-graduate scholarship (Doctoral), and Discovery Grant (#402635), respectively. L.M.R. was supported by a NHLBI fellowship (T32-FL-007101). The DREW, E-MECHANIC, and HART-D trials were supported by the National Institutes of Health (NIH) with Grant numbers: HL66262; R01: HL102166, P30: DK072476, and U54: GM104940; and DK068928, respectively. The HEARTY and Queen’s trials were supported by the Canadian Institutes of Health Research (CIHR) with Grant numbers MCT-71979 and OHN-63277, respectively. STRRIDE I (NCT00200993) and STRRUDE AT/RT (NCT00275145) were funded by a NHLBI Grant (HL-057354). STRRIDE-PD (NCT00962962) was funded by a NIDDK Grant (DK081559).

Conflicts of interest

The authors declare no conflicts of interest.

Ethics approval

Each trial was granted ethics approval at their respective institutions.

Consent to participate

All participants from each trial provided written informed consent to participate prior to data collection.

Consent to publication

Not applicable.

Availability of data and material

The datasets generated during and/or analysed during the current study are available upon reasonable request.

Code availability

Not applicable.

Author contributions

All authors, unless otherwise noted (see note regarding Dr. CPE): (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Dr. CPE made substantial contributions to the conception, design, and data collection of the trials conducted at the Pennington Biomedical Research Center. Dr. CPE was unable to edit or approve the final version of the manuscript.

Additional information

Conrad P. Earnest: Deceased.

Dr. Earnest made substantial contributions to the conception, design, and data collection of the trials conducted at the Pennington Biomedical Research Center. Dr. Earnest was unable to edit or approve the final version of the manuscript.

Supplementary Information

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40279_2021_1442_MOESM1_ESM.tif

Supplemental Figure 1. Flow chart for secondary analysis. * As determined in steps in 1A or 1B of primary analysis. † Unpaired t-tests were only performed if ANOVAs with three groups (e.g. ANOVAs for DREW, HART-D, and HEARTY) revealed significant group × time interaction effects. These unpaired t-tests were used as post-hoc tests to determine which groups had significantly different mean changes in CRF (TIF 566 KB)

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Bonafiglia, J.T., Preobrazenski, N., Islam, H. et al. Exploring Differences in Cardiorespiratory Fitness Response Rates Across Varying Doses of Exercise Training: A Retrospective Analysis of Eight Randomized Controlled Trials. Sports Med 51, 1785–1797 (2021). https://doi.org/10.1007/s40279-021-01442-9

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