One of the coauthors (Uraiwan Chatchawan) with expertise in epidemiology and biostatistics analyzed the data and was completely blinded to the patients’ group assignment. All analyses were performed on the basis of the intention-to-treat principle. All outcome measures are presented as means ± standard deviations (SD). The independent samples t-test was used for comparisons between the groups, and the dependent samples t-test was used for comparisons between before and after the intervention. Interaction effect were assessed by the ordinary least squares (OLS) method13). We used a cross analysis (Student’s t-test) to compare the mean change in score (post-pre) because the primary outcomes(VO2 max) was normally distributed (Shapiro-Wilk W test; p>0.05)14, 15). In case of significant period × treatment interaction, the second-period data were not used for the analysis16).