# Exercise as it relates to Disease/The Effect of Training Types on Heart Failure Patients

This is an analysis of the article "Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients." This wikipage has been created by U3099759 as an assignment for the University of Canberra.

## Background

Physical activity is defined as movement by the skeletal muscle system which requires energy to be completed. The Australian physical activity guidelines for adults are;
-Any physical activity is better than none
-Be active on most days
-150-300 minutes of moderate exercise or 75-150minutes of high intensity exercise
-Muscle strengthening activities 2 times per week
Physical activity has been found to reduce the symptoms of chronic heart failure. Although exercise is known to help with the symptoms of chronic heart failure it is controversial which exercise intensity yields the greatest beneficial adaptations. Peak aerobic exercise, know as VO2 max, has been identified as the single best predictor of death in cardiovascular disease patients.

## Where was this research from?

This study was conducted in St. Olav's Hospital, Trondheim, Norway by an extensive group of researchers who have published a comprehensive number of articles within the science and exercise community. The article was approved by the regional medical research ethics committee and there was no conflict of interest, as the funding organisations had no role in the design or conduct of the research article.

## What kind of research was this?

The research conducted in this article was as a randomised study. Randomised controlled trials have several features that differentiate them from different studies. One feature is that groups are randomly allocated a treatment, which they remain unaware of until the end of the trial. Another feature is all the groups are treated identical and are analysed within their allocated group.

## What did the research involve?

The research for this study involved 27 patients with post infarction heart failure and who had not had a myocardial infarction 12 months leading up to the commencement of the study. All participants performed an individualised VO2 max test after a 10min warm up and work economy was determined from these results. The participants were then randomly selected into 2 different exercise groups and 1 control group.
Table 1.
| | Aerobic Interval Training | Moderate Continuous Training | Control |
| Exercise | Treadmill Walking 2 times a week | Treadmill Walking 2 times a week | Exercise once every 3 weeks |
| Intensity | 4x 4min intervals at 90-95% max HR | 47mins of 70-75% max HR | 47mins of 70% max HR |
Multiple tests were conducted on the patients in this trial after the 12 weeks of exercise as well as heart rate monitors being worn throughout the exercise sessions. Some of the other tests which were undertaken were; blood analyses, muscle biopsy, quality of life and echocardiography. All of these tests were necessary to the study and to positively identify which exercise intensity was the most beneficial for heart failure patients.

## Results

This article observed the effect that exercise has on different parts and functions of the body. The results from the study found that the aerobic interval training group had a 46% increase in VO2 max whereas the moderate continuous group only has a 14% increase. Left ventricle end-diastolic and end-systolic decreased in the interval group by 18% and 25% respectively whereas no significant change was seen in the other two groups. Quality of life was also a component assessed in this study through the MacNew global score. Both the continuous training group and the interval training group had an increase in score from 4.4 to 5.2 and 4.41 to 5.73 respectively whereas the control group had no change.

## Conclusions from this research

The conclusion from this study is that patients with post infarction heart failure should participate in some form of physical activity. The most beneficial type of exercise to reduce symptoms of heart failure as described in this study is aerobic interval training. This study found that aerobic interval training created the highest increase in VO2 max which has been identified as the single best predictor of cardiac and all cause deaths. All exercise should be completed under the supervision of a trained exercise professional and patients should consult their doctor for a pre screen assessment to identify some of the possible risks in completing an exercise program.

## Practical advice

The results produced in this study show that exercise is beneficial in heart failure patients. For patients who are recovering from heart failure, their rehabilitation process should consist of aerobic interval training. Exercise should always be undertaken with close supervision to achieve the best outcome for the patient.

## Further information

Information on Heart Diseases
Health benefits of Physical Activity

## References

* 1 2 3 4 5 Wisloff U, Stoylen A, Loennechen J, Bruvold M, Rognmo o, Haram P et al. Superior Cardiovascular Effect Of Aerobic Interval-training Versus Moderate Continuous Training In Elderly Heart Failure Patients. Medicine & Science in Sports & Exercise. 2007;39(Supplement):S32.
* ↑ WHO | Physical activity [Internet]. Who.int. 2016 [cited 20 September 2016]. Available from: http://www.who.int/topics/physical_activity/en/
* ↑ Department of Health | Australia's Physical Activity and Sedentary Behaviour Guidelines [Internet]. Health.gov.au. 2016 [cited 20 September 2016]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines
* 1 2 Sibbald BRoland M. Understanding controlled trials: Why are randomised controlled trials important?. BMJ. 1998;316(7126):201-201.
* ↑ Heart disease in Australia [Internet]. The Heart Foundation. 2016 [cited 18 September 2016]. Available from: https://heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia
* ↑ Warburton D. Health benefits of physical activity: the evidence. Canadian Medical Association Journal. 2006;174(6):801-809.