{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T19:38:03Z","timestamp":1767901083462,"version":"3.49.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Exercise is a valuable intervention modality for patients post-myocardial infarction (MI). Aerobic and resistance training are both commonly used separately in cardiac rehabilitation. However, the effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac electrophysiologic and anthropometric measures had not been thoroughly investigated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>The primary objective of this study was to compare the effectiveness of moderate-intensity continuous-aerobic training (CAT) vs. SCT on cardiac electrical measures (resting electrocardiographic, ECG; a nd heart rate variability, HRV) in patients\u2019 post-MI presenting reduced left ventricular function. Second, to examine its effect on anthropometric measures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Material and methods<\/jats:title>\n<jats:p>Twenty-nine men post-MI with reduced left ventricular function were assigned randomly to either 12 weeks of CAT (n = 15) or SCT (n = 14). CAT group performed moderate-intensity activity. SCT group performed high-intensity exercise, alternating between resistance and aerobic training. Differences between CAT and SCT groups were done using independent t-tests, paired t-tests and effect size (ES).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Participants in both groups improved their HRV measures (increase in HFnu; p &lt; 0.05; ES &gt; 0.51) and ECG (reduction in QT-dispersion; p &lt; 0.05; ES &gt; 0.51). Only the SCT group had significant improvements in waist circumference (p &lt; 0.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Exercise improves cardiac electrical measures post-MI. However, in comparison to CAT, SCT may yield greater anthropometric changes. In order to have improvements in cardiac electrical stability, clinicians working with post-MI patients may use both CAT and SCT. However, SCT might result in greater improvements.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267888","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T17:24:35Z","timestamp":1651598675000},"page":"e0267888","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intermittent aerobic-resistance interval training versus continues aerobic training: Improvement in cardiac electrophysiologic and anthropometric measures in male patients post myocadiac infarction, a randomized control trial"],"prefix":"10.1371","volume":"17","author":[{"given":"Horesh","family":"Dor-Haim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Horowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eldad","family":"Yaakobi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Katzburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-4798","authenticated-orcid":true,"given":"Sharon","family":"Barak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"pone.0267888.ref001","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1161\/01.CIR.0000151788.08740.5C","article-title":"Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation","volume":"111","author":"American Heart Association","year":"2005","journal-title":"Circulation"},{"key":"pone.0267888.ref002","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/eurjhf\/hfq056","article-title":"Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis","volume":"12","author":"EJ Davies","year":"2010","journal-title":"European Journal of Heart Failure"},{"key":"pone.0267888.ref003","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1093\/oxfordjournals.eurheartj.a014715","article-title":"Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction?","volume":"17","author":"H Adachi","year":"1996","journal-title":"European Heart Journal"},{"key":"pone.0267888.ref004","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/0735-1097(93)90231-O","article-title":"Physical training improves skeletal muscle metabolism in patients with chronic heart failure","volume":"21","author":"S Adamopoulos","year":"1993","journal-title":"Journal of the American College of Cardiology"},{"key":"pone.0267888.ref005","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.cger.2005.12.002","article-title":"Exercise in the Elderly: Research and Clinical Practice","volume":"22","author":"JE Frankel","year":"2006","journal-title":"Clinics in Geriatric Medicine"},{"key":"pone.0267888.ref006","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1177\/1741826711430926","article-title":"Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II)","volume":"19","author":"L Vanhees","year":"2012","journal-title":"Eur J Prev Cardiolog"},{"key":"pone.0267888.ref007","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/01.hjr.0000137692.36013.27","article-title":"Recommendations for resistance exercise in cardiac rehabilitation. 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A potential mechanism predisposing to body weight gain","volume":"92","author":"M Spraul","year":"1993","journal-title":"J Clin Invest"},{"key":"pone.0267888.ref015","doi-asserted-by":"crossref","first-page":"e0188551","DOI":"10.1371\/journal.pone.0188551","article-title":"Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial","volume":"13","author":"H Dor-Haim","year":"2018","journal-title":"PLoS ONE"},{"key":"pone.0267888.ref016","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1161\/01.CIR.93.5.1043","article-title":"Heart rate variability: standards of measurement, physiological interpretation and clinical use. 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Cohen","year":"1977"},{"key":"pone.0267888.ref030","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1037\/1082-989X.7.1.105","article-title":"Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs","volume":"7","author":"SB Morris","year":"2002","journal-title":"Psychological Methods"},{"key":"pone.0267888.ref031","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.tips.2010.05.001","article-title":"New pharmacological targets and treatments for atrial fibrillation","volume":"31","author":"L Carlsson","year":"2010","journal-title":"Trends in Pharmacological Sciences"},{"key":"pone.0267888.ref032","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.tips.2010.12.001","article-title":"Cardiac electrical remodeling in health and disease","volume":"32","author":"MJ Cutler","year":"2011","journal-title":"Trends in Pharmacological 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