Evaluation of the Effects of Eccentric Training on a Cycle Ergometer, Versus Conventional Concentric Training

The research will take place in 3 phases:

PHASE 1 :

30 healthy volunteers will be included to test tolerance to personalized exercise on an eccentric cycle ergometer.

PHASE 2 :

15 patients suffering from coronary artery disease (CAD) and 15 patients suffering from chronic obstructive pulmonary disease (COPD) will be included to test the same protocol.

PHASE 3 :

A total of 169 patients split into 2 parallel groups will be included: a group receiving conventional rehabilitation (group A) and the other group receiving eccentric exercise combined to conventional rehabilitation (group B).

Coronary patients: 93 patients will be included (62 patients in group A and 31 in group B).

COPD patients: 76 patients will be included (38 patients per group).

Inclusion criteria

• Persons who have provided written informed consent

Healthy volunteers:

• Men or women aged between 40 and 75 years.

Patients with CAD:

• Men or women aged between 40 and 75 years, with coronary artery disease without heart failure referred for a rehabilitation program.
• Left ventricular ejection fraction on echocardiography (Simpson methode) > 45 %

Patients with Chronic obstructive pulmonary disease:

• Men or women aged between 40 and 75 years
• Severe Chronic obstructive pulmonary disease (post-bronchodilatator FEV1/FVC < 0.70 and FEV1 ≤ 60% of predicted value)
• Patient not on oxygen therapy (24h/24)

Exclusion criteria

• Person without national health insurance cover
• Severe, obstructive cardiopathy
• Severe aortic valve stenosis,
• Severe progressive heart rhythm or conduction disorders not corrected by a pacemaker and detected during the initial effort test
• Cardiac intracavitary thrombus,
• Severe pulmonary artery hypertension (PAHT systolic >70mmHg),
• Recent history of venous thromboembolism (previous 3 months),
• Impaired executive functions making it impossible to understand and adhere to a rehabilitation program (Mini Mental Test < 24),
• Heart transplant,
• Associated medical condition that could substantially affect functional capacities (examples: non-stabilized metabolic disorders such as progressive renal insufficiency, major asthenia linked to a severe non-stabilized disorder such as neoplasia, systemic disease…).
• Physical incapacity of the lower limbs that could impair rehabilitation, whether they are neurological (central or peripheral), arterial (in particular, peripheral artery disease with a systolic index < 0.6) or orthopedic (degenerative or inflammatory rheumatism).
• Patients who have taken part (within the previous 6 months) or a currently taking part in a rehabilitation program.