Resistance training for chronic heart failure patients on beta blocker medications. Effects of aerobic or aerobic and resistance training on cardiorespiratory and skeletal muscle function in heart failure: a randomized controlled pilot trial Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness. Group-based Aerobic Interval Training in Patients With Chronic Heart Failure: Norwegian Ullevaal Model Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure. The Health Benefits of a 12-Week Home-Based Interval Training Cardiac Rehabilitation Program in Patients With Heart Failure. Effects of group-based high-intensity aerobic interval training in patients with chronic heart failure. Long-term effects of a group-based high-intensity aerobic interval-training program in patients with chronic heart failure. Physical Exercise Improves The Functional Capacity and Quality of Life in Patients With Heart Failure [Physical training as interval or continuous training in chronic heart failure for improving functional capacity, hemodynamics and quality of life--a controlled study]. Quality of life, psychological and physiological changes following exercise training in patients with chronic heart failure. Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease. Quality of life and cardiorespiratory function in chronic heart failure: effects of 12 months' aerobic training. Benefits of combined aerobic/resistance/inspiratory training in patients with chronic heart failure. A complete exercise model? A prospective randomised study. Effects of combined exercise training and electromyostimulation treatments in chronic heart failure: A prospective multicentre study The effect of physical training in chronic heart failure. Impact of a home-based walking and resistance training program on quality of life in patients with heart failure. Effect of physical exercise training on muscle strength and body composition, and their association with functional capacity and quality of life in patients with atrial fibrillation: a randomized controlled trial. Graduated exercise training and progressive resistance training in adolescents with chronic fatigue syndrome: a randomized controlled pilot study Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients: A Randomized Study Moderate exercise training improves functional capacity, quality of life, and endothelium-dependent vasodilation in chronic heart failure patients with implantable cardioverter defibrillators and cardiac resynchronization therapy Effect of aerobic vs combined aerobic-strength training on 1-year, post-cardiac rehabilitation outcomes in women after a cardiac event. Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy
BACKGROUND Resistance training increases the skeletal muscle strength and functional ability of chronic heart failure patients . However , there is limited data regarding the effect of resistance training on the hemodynamic responses and peak oxygen consumption ( peak VO(2 ) ) of chronic heart failure patients treated with beta-blocker . This study examined the effect of resistance training on hemodynamics , peak aerobic capacity , muscle strength and quality of life of chronic heart failure patients on beta-blockers medication . METHODS Fifteen men diagnosed with chronic heart failure were matched to either a resistance training program or non-training control group . At baseline and after 8 weeks of resistance training patients performed both Balke incremental and maximal strength tests and completed quality of life question naires . RESULTS The resistance training group demonstrated a significant increase of walking time and peak VO(2 ) by 11.7 % ( p=0.002 ) and approximately 19 % ( p<0.05 ) , respectively . Peak VO(2 ) was significantly correlated with both walking time ( r=0.54 , p=0.038 ) and change in total weight lifted ( r=0.55 , p=0.034 ) . Quality of life significantly increased by 87 % ( p=0.030 ) . The improvement in quality of life was correlated with post training peak VO(2 ) ( r=0.58 , p=0.025 ) and total weight lifted during the post maximal strength test ( r=-0.52 , p=0.047 ) . CONCLUSIONS The benefits from resistance training for chronic heart failure patients on beta-blocker medication included an increased aerobic and exercise capacity , skeletal muscle strength and most importantly , an improvement in the quality of life , which is the main goal of cardiac rehabilitation programs . Furthermore , with appropriate supervision , it is recommended that resistance exercise be added to the exercise rehabilitation program of these patients when possible Objective : To examined the effects of different training modalities on exercise capacity ( Vo 2peak ) , systolic function , muscular strength and endurance and quality of life in heart failure patients . Design : R and omized controlled trial . Setting : Cardiac rehabilitation centre in Canada . Subjects : Forty-two individuals with heart failure ( 62 ± 12 years ; New York Heart Association ( NYHA ) classes I — III ) . Interventions : Aerobic training ( n = 14 ) , combined aerobic and resistance training ( n = 15 ) or usual care ( n = 13 ) three times per week for 12 weeks . Main measures : ( 1 ) Vo 2peak measured by symptom-limited grade d exercise test on cycle ergometer ; ( 2 ) systolic function assessed by two-dimensional echocardiography ; ( 3 ) muscular strength and muscular endurance measured by one-repetition maximum procedure ; and ( 4 ) quality of life assessed by question naires . Results : In the intention-to-treat analysis , neither aerobic nor combined aerobic and resistance training significantly improved Vo2peak , systolic function or quality of life compared with usual care . However , combined aerobic and resistance training significantly improved upper extremity strength ( 40.7 (14.0)—48.5 ( 16.0 ) kg , P<0.05 ) and muscular endurance ( 5.7 (2.7)—11.6 ( 7.6 ) reps , P<0.05 ) compared with aerobic training or usual care . In compliant participants ( exercise adherence 80 % ) , Vo2peak increased in the aerobic group ( 16.9 (6.0)—19.0 ( 6.8 ) , P= 0.026 ) and tended to increase in the combined training group ( 15.9 (5.0)—17.6 ( 5.6 ) , P= 0.058 ) compared with usual care . Quality of life was improved in the aerobic group only . Conclusions : Both aerobic and combined aerobic and resistance training are effective interventions to improve Vo2peak in compliant heart failure patients . Combined training may be more effective in improving muscle strength and endurance OBJECTIVES The health benefits of high-intensity interval training in cardiac rehabilitation warrant further research . We compared the effectiveness of low-volume high-intensity interval training vs continuous aerobic exercise training in chronic heart failure . DESIGN / SETTING S Unblinded , two arm parallel design with r and om assignment to exercise interventions in out-patient hospital rehabilitation gym . METHODS Patients with signs of chronic heart failure and ejection fraction < 45 % , ( mean age : 59.1 years ( st and ard deviation ( SD ) 8.6 ) ; 3 women ) completed 6 months of exercise using continuous aerobic exercise training ( n = 9 ) or high-intensity interval training ( n = 8) . Cardiorespiratory fitness was determined during cycle ergometry using respiratory gas exchange analysis .  Functional capacity was assessed via sit-to-st and and gait speed . Quality of life was assessed using the MOS Short-Form 36 and Minnesota living with heart failure question naires . Cardiac autonomic regulation was assessed using Heart Rate Variability . RESULTS Analysis of Covariance revealed significant time effects but no group × time interactions for exercise and functional capacity outcomes . Peak oxygen uptake ( VO2peak ) improved by a mean of 14.9 % ( SD 16.3 % ) from baseline and by 22 % ( SD 28.3 ) at ventilatory threshold in both groups . Sit-to-st and ( 11.9 ( SD 11 % ) ) and gait speed ( 16.0 ( SD 19 % ) ) improved similarly in both groups . No changes in quality of life or heart rate variability were noted . Training adaptations in high-intensity interval training were achieved despite a significantly reduced time commitment and total work volume compared to continuous aerobic exercise training . CONCLUSION Low-volume high-intensity interval training is a feasible and well tolerated training modality in cardiac rehabilitation setting s , but is not more effective than continuous aerobic exercise training Background and Purpose : The purpose of this case report is to describe the responses of 4 patients with chronic heart failure ( CHF ) to a novel rehabilitation program : a group-based , high-intensity , interval-training program that includes aerobic , resistance , flexibility , and balance activities . Case Descriptions : Four patients ( 55–71 years of age ) with CHF ( New York Heart Association class III ) participated in the rehabilitation program twice per week for 16 weeks . Outcome measures included a 6-minute walk test ( 6MWT ) , a cycle ergometer test ( aerobic capacity ) , and a quality -of-life question naire . Outcomes : Patients 1 , 2 , and 3 increased their aerobic capacity ( 17 % , 25 % , and 52 % , respectively ) . Patient 4 did not complete the cycle ergometer test because of limitations associated with his pacemaker . All patients increased their 6MWT distance ( 117 , 66 , 135 , and 143 m for patients 1 , 2 , 3 , and 4 , respectively ) . No adverse events were reported . Discussion : The Norwegian Ullevaal Model of cardiac rehabilitation is a novel high-intensity , interval-training program . The 4 patients with CHF in this case series who participated in this program experienced improvements in physical capacity and quality of life and had no adverse events . These results are consistent with recent evidence supporting the efficacy of high-intensity interval training in people with CHF . R and omized clinical trials are needed to evaluate the clinical efficacy of this group-based , high-intensity , aerobic interval-training program for patients with CHF BACKGROUND Beneficial training outcomes have been reported in patients with chronic heart failure ( CHF ) following leg exercise training .  However , data from more comprehensive training programs are limited . The aim of this study was to test the hypothesis that exercise training applying the concept of comprehensive local muscle training can improve aerobic and functional working capacity as well as quality of life in patients with CHF . METHODS Twenty-four men and women [ age 63+/-9 years ( mean+/-S.D. ) ] with stable , moderate chronic heart failure ( left ventricular ejection fraction 30+/-10 % ) , were investigated in a r and omized controlled study with a training group of 16 patients and a  control group of 8 patients . The training was performed as an aerobic resistance training by activating all the main muscle groups , one at a time . The patients exercised for 1 h , three times per week for 8 weeks . RESULTS Patient groups did not differ at baseline . Peak oxygen uptake ( 8 % , P<0.03 ) , the distance walked in a 6-min walking test ( 11 % , P<0.002 ) , the health-related quality of life ( P<0.001 ) and plasma norepinephrine levels at rest ( 32 % , P<0.003 ) and at submaximal intensities ( P<0.03 ) improved after training . No changes were found in the control group , except for decreased peak oxygen uptake ( P<0.02 ) and quality of life scores ( P<0.03 ) . CONCLUSIONS Since comprehensive physical training activating a minor muscle mass at a time markedly improves exercise capacity and quality of life and reduces catecholamine levels , it can be recommended for the rehabilitation of patients with CHF under supervision of a physical therapist BACKGROUND Recently , high-intensity interval training has been advocated for the rehabilitation of persons living with heart failure ( HF ) . Home-based training is more convenient for many patients and could augment compliance . However , the safety and efficacy of home-based interval training remains unclear . METHODS We evaluated the safety and efficacy of a supervised home-based exercise program involving a combination of interval and resistance training . Measures of aerobic power , endurance capacity , ventilatory threshold , and quality of life in 40 patients with HF , were taken at baseline and after 12 weeks . Patients were matched and r and omized to either control ( CTL ; n = 20 ) or experimental ( EXP ; n = 20 ) conditions . The EXP group underwent a 12-week high-intensity interval and resistance training program while the CTL group maintained their usual activities of daily living . RESULTS In the EXP group , we found a significant improvement in aerobic power , endurance capacity , ventilatory threshold , and quality of life . There were no significant changes in the CTL group . CONCLUSIONS We have shown that a home-based cardiac rehabilitation program involving interval and resistance training is associated with improved aerobic capacity and quality of life in patients with HF . This research has important implication s for the treatment of HF The aim of this study was to evaluate the effectiveness of a novel group-based aerobic interval training of high intensity on functional capacity and quality of life in patients with chronic heart failure ( CHF ) and examine the relation between changes in functional capacity and quality of life .  Eighty patients with stable CHF ( 63 men , 17 women ; mean age 70.1 + /- 7.9 [ SD ] years ; left ventricular ejection fraction 30 + /- 8.5 % ) on optimal medical treatment were r and omly assigned to either a 16-week group-based aerobic high-intensity interval training model twice weekly for 65 to 80 minutes/day ( n = 40 ) or a control group ( n = 40 ) that received st and ard care .  Functional capacity was measured using the 6-minute walk test and cycle ergometer test . Quality of life was measured using the Minnesota Living with Heart Failure Question naire . After 16 weeks , functional capacity improved significantly in the exercise group compared with the control group measured using the 6-minute walk test ( + 58 vs -15 meters ; p < 0.001 ) and for both workload and time measured using the bicycle ergometer test ( + 10 vs -1 W ; p < 0.001 ; + 57 vs -8 seconds ; p < 0.001 ) . Quality of life improved significantly in the exercise group compared with the control group ( p = 0.03 ) , and a significant inverse correlation was found between quality of life and functional capacity ( r = -0.49 , p < 0.05 ) . In conclusion , our exercise model significantly improved functional capacity and quality of life compared with the control group in patients with CHF . Improvements in quality of life were significantly related to functional capacity Studies on the long-term effects of exercise training programs on functional capacity and the quality of life in patients with chronic heart failure ( CHF ) are sparse . The aim of this study was to evaluate the long-term effects of group-based , high-intensity interval training on functional capacity and the quality of life in 80 patients with stable CHF ( mean age 70.1 + /- 7.9 years ) in New York Heart Association classes II to IIIB . Patients were r and omized to either an  exercise group ( n = 40 ) or a control group  ( n = 40 ) . The  mean ejection fractions  at baseline were 31 + /- 8 % in the exercise group and 31 + /- 1 % in the control group . The exercise group exercised twice a week for 4 months in addition to 4 consultations with a CHF nurse .  Six-minute walking distance , workload and exercise time on a cycle ergometer test , and the quality of life were measured at baseline and 4 and 12 months after enrollment . After 4 months , functional capacity ( 6-minute walking distance + 58 vs -15 m , p < 0.001 ) and the quality of life ( Minnesota Living With Heart Failure Question naire score + 10 vs -1 point , p < 0.005 ) improved significantly in the exercise group compared with the control group . After 12 months , the improvements were still significant in the exercise group compared with the control group for all parameters ( 6-minute walking distance + 41 vs -20 m , p < 0.001 ; workload + 10 vs -1 W , p = 0.001 ; exercise time + 53 vs -6 seconds , p = 0.003 ; quality of life + 10 vs -6 points , p = 0.003 ) . In conclusion , the results support the implementation of a group-based aerobic interval training program to improve long-term effects on functional capacity and the quality of life in patients with CHF OBJECTIVE The purpose of this study was to investigate the effects of physical exercise on the functional capacity and quality of life in heart failure patients . METHODS Forty-two patients of both sexes with heart failure of NYHA class II and III with different etiologies were r and omly divided into  untrained or trained groups . The six-month exercise program consisted of aerobic training , muscle strength training , agility and joint flexibility activities . Physical fitness was evaluated by testing the performance on these trained components . Quality of life was evaluated by scored answers to a st and ardized question naire involving multiple domains . RESULTS Baseline values did not differ between groups . Improvement in the trained group was identified in all components of functional capacity when compared to the untrained group ( p < 0.001 ) . Quality of life improved in the trained patients concerning physical , psychological , social and environmental domains ( p < 0.001 ) , whereas no significant change was found in the untrained patients . CONCLUSIONS Guided and monitored physical exercise is safe and has the potential to improve functional capacity and quality of life in heart failure patients with multiple etiologies We conducted a three-week r and omized trial comparing the improvement of functional capacity by exercise training in chronic heart failure by the steady-state ( EF 27.3 % , n = 20 ) and the interval modus ( EF 29.3 % , n = 20 ) with a control group ( EF = 26.6 % , n = 10 ) . Minimal EF was 10 % , the lowest maximal oxygen consumption was 9.3 ml/kg/min and the lowest cardiac output was 1.9 l/min ; 9 patients had been evaluated for HTX .  VO2 at the anaerobic threshold and at maximal exercise increased in the continuous exercise group by 1.4 or 1.6 ml/kg/min , respectively , corresponding to an increase of 13.7 % ( p < 0.05 ) and 9.3 % ( p < 0.05 ) . In the interval training group the increase was 1.3 and 1.5 ml/kg/min corresponding to 14 % ( p < 0.05 ) and 8.1 % ( p < 0.05 ) . Continuous short-term exercise had no impact to central hemodynamics as pulmonary artery pressure ( PA ) , capillary wedge pressure ( pc ) , cardiac index ( CI ) or stroke volume index ( SVI ) , whereas after interval training a significant increase at maximal exercise could be seen in CI ( p < 0.05 ) and SVI ( p < 0.01 ) with a concomitant drop in systemic peripheral resistance ( p < 0.05 ) compared to the steady-state modus . Interval training was further characterized by a higher short-term but lower mean work load with a significantly smaller increase in lactate . Quality of life was improved according to the SF-36 question naire in both training groups but the psychologic sum factor was three times as high , increasing to 24.2 % in the steady-state exercise group . It can be concluded that clinical ly stable patients with heart failure and even those already having been evaluated for cardiac transplantation profit from short-term physical training . Both training modalities seem equally suited to improve functional capacity . However interval training leads to more pronounced improvement in hemodynamics compared to the steady-state exercise , whereas the later had a greater impact on psychological well-being and quality of life .  Patients with heart failure and severe peripheral deconditioning tolerate higher workloads with more peripheral stress by an interval training modus . Long-term training modalities need to be established to further improve and stabilize functional status OBJECTIVE To assess the physiological and psychosocial effects of exercise training in chronic heart failure . SUBJECTS/ PATIENTS Twenty-six men with heart failure ( New York Heart Association functional classes II and III ) aged 52.5 ( SD 9.8 ) years , were studied . METHODS The subjects were r and omized either to rehabilitation group ( Group A : 16 patients ) , participating in a 6-month exercise training program , or to control group ( Group B : 10 patients ) . A psychosocial assessment , which included affective ( Beck Depression Inventory and Hospital Anxiety and Depression Scale ) , quality of life ( Quality of Life Index , Minnesota Living with Heart Failure Question naire and the Scale of Life Satisfaction ) and personality ( Eysenck Personality Question naire ) parameters , was performed at the beginning and the end of the study . RESULTS After training VO2 peak increased by 36 % and exercise time by 35 % , p < 0.05 . A significant decrease in anxiety and depression was also observed . Moreover , trained patients demonstrated a significant improvement in quality of life . No significant correlations were found between deltaVO2 peak and all psychosocial parameter gains . However , the more depressed patients showed the largest physiological responses . CONCLUSION An exercise rehabilitation program in patients with chronic heart failure is useful for improving their work capacity and psychosocial status . Improvements in psychological status seem to be independent of the aerobic gains Cardiopulmonary exercise training is beneficial to people with coronary artery disease ( CAD ) . Nevertheless , the correlation between aerobic capacity , and functional mobility and quality of life in elderly CAD patients is less addressed . The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD , integrating exercise stress testing , functional mobility , h and grip strength , and health-related quality of life .  Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center . Participants were assigned to the  exercise training group ( N = 21 ) or the usual care group ( N = 15 ) . A total of 36 sessions of exercise training , completed in 12 weeks , was prescribed . Echocardiography , exercise stress testing , the 6-minute walking test , Timed Up and Go test , and h and  grip strength testing were performed , and the Short-Form 36 question naire ( SF-36 ) was administered at baseline and at 12-week follow-up . Peak oxygen consumption improved significantly after training . The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training . Functional mobility and h and grip strength also improved after training . Significant improvements were found in SF-36 physical function , social function , role limitation due to emotional problems , and mental health domains . A significant correlation between dynamic cardiopulmonary exercise testing parameters , the 6-minute walking test , Timed Up and Go test , h and grip strength , and SF-36 physical function and general health domains was also detected . Twelve-week , 36-session exercise training , including moderate-intensity cardiopulmonary exercise training , strengthening exercise , and balance training , is beneficial to elderly patients with CAD , and cardiopulmonary exercise testing parameters correlate well with balance and quality of life OBJECTIVE : To examine the long-term benefits and safety of aerobic training in patients with chronic heart failure . DESIGN : Non-r and omised control trial with 52 weeks follow up . SETTING : Outpatient cardiac rehabilitation referral centre . PATIENTS : Patients with compensated chronic heart failure ( mean ( SD ) age 62 ( 6 ) years , New York Heart Association stage III , initial resting ejection fraction 22 (7)% ) . Experimental group of 17 men , 4 women ; control group 8 men , 1 woman . INTERVENTIONS : Experimental group : progressive , supervised aerobic walking programme for 52 weeks . Control group : st and ard medical treatment . MAIN OUTCOME MEASURES : Six-minute walk distance , progressive cycle ergometer test to subjective exhaustion , disease-specific quality of life question naire , and st and ard gamble test , all measured at entry , 4 , 8 , 12 , 16 , 26 , and 52 weeks . RESULTS : Control data showed no changes except a small trend to improved emotional function ( P = 0.02 at 12 weeks only ) . Fifteen of the 21 patients completed all 52 weeks of aerobic training ; two withdrew for non-cardiac reasons ( 16 , 52 weeks ) . Three were withdrawn because of worsening cardiac failure unrelated to their exercise participation ( 4 , 4 , 8 weeks ) , and one had a non-fatal cardiac arrest while shopping ( 16 weeks ) . Gains of cardiorespiratory function plateaued at 16 - 26 weeks , with 10 - 15 % improvement in six-minute walk , peak power output , and peak oxygen intake linked to gains in oxygen pulse and ventilatory threshold and reductions in resting heart rate . Marked improvements in quality of life followed a parallel course . CONCLUSIONS : Aerobic training is safe and beneficial in compensated chronic heart failure . Gains in aerobic function and quality of life persisted over a programme lasting 52 weeks BACKGROUND We hypothesised that combined aerobic training ( AT ) with resistance training ( RT ) and inspiratory muscle training ( IMT ) could result in additional benefits over AT alone in patients with chronic heart failure ( CHF ) . METHODS Twenty-seven patients , age 58 ± 9 years , NYHA II/III and LVEF 29 ± 7 % were r and omly assigned to a 12-week AT ( n=14 ) or a combined AT/RT/IMT ( ARIS ) ( n=13 ) exercise program . AT consisted of bike exercise at 70 - 80 % of max heart rate . ARIS training consisted of AT with RT of the quadriceps at 50 % of 1 repetition maximum ( 1RM ) and upper limb exercises using dumbbells of 1 - 2 kg as well as IMT at 60 % of sustained maximal inspiratory pressure ( SPI(max ) ) . At baseline and after intervention patients underwent cardiopulmonary exercise testing , echocardiography , evaluation of dyspnea , muscle function and quality of life ( QoL ) scores . RESULTS The ARIS program as compared to AT alone , result ed in additional improvement in quadriceps muscle strength ( 1RM , p=0.005 ) and endurance ( 50%1 RM × number of max repetitions , p=0.01 ) , SPI(max ) ( p<0.001 ) , exercise time ( p=0.01 ) , circulatory power ( peak oxygen consumption × peak systolic blood pressure , p=0.05 ) , dyspnea ( p=0.03 ) and QoL ( p=0.03 ) . CONCLUSIONS ARIS training was safe and result ed in incremental benefits in both peripheral and respiratory muscle weakness , cardiopulmonary function and QoL compared to that of AT . The present findings may add a new prospect i ve to cardiac rehabilitation programs of heart failure patients whilst the clinical significance of these outcomes need to be addressed in larger r and omised studies Background Exercise training as part of a comprehensive cardiac rehabilitation is recommended for patients with cardiac heart failure . It is a valuable method for the improvement of exercise tolerance . Some studies reported a similar improvement with quadricipital electrical myostimulation , but the effect of combined exercise training and electrical myostimulation in cardiac heart failure has not been yet evaluated in a large prospect i ve multicentre study . Purpose The aim of this study was to determine whether the addition of low frequency electrical myostimulation to exercise training may improve exercise capacity and /or muscular strength in cardiac heart failure patients . Methods Ninety-one patients were included ( mean age : 58 ± 9 years ; New York Heart Association II/III : 52/48 % , left ventricular ejection fraction : 30 ± 7 % ) in a prospect i ve French study . The patients were r and omised into two groups : 41 patients in exercise training and 50 in exercise training + electrical myostimulation . All patients underwent 20 exercise training sessions . In addition , in the exercise training + electrical myostimulation group , patients underwent 20 low frequency ( 10 Hz ) quadricipital electrical myostimulation sessions . Each patient underwent a cardiopulmonary exercise test , a six-minute walk test , a muscular function evaluation and a quality of life question naire , before and at the end of the study . Results A significant improvement of exercise capacity ( Δ peak oxygen uptake+15 % in exercise training group and + 14 % in exercise training + electrical myostimulation group ) and of quality of life was observed in both groups without statistically significant differences between the two groups . Mean creatine kinase level increased in the exercise training group whereas it remained stable in the combined group . Conclusions This prospect i ve multicentre study shows that electrical myostimulation on top of exercise training does not demonstrate any significant additional improvement in exercise capacity in cardiac heart failure patients BACKGROUND Supervised cardiac rehabilitation programs have been offered to patients following myocardial infa rct ( MI ) , coronary artery bypass graft surgery ( CABG ) and percutaneous coronary intervention ( PCI ) for many years . However , limited information is available on the usefulness of rehabilitation programs in chronic heart failure ( CHF ) . The aim of our study was to evaluate the outcome of supervised physical training on CHF patients by measuring both central and peripheral factors . METHODS This was a prospect i ve r and omized study , including 43 patients with CHF , New York Heart Association ( NYHA ) class II or III , mean age 68 years . After initial measurements of VO2 peak , 6 min walk distance , muscle strength , plasma levels of atrial natriuretic peptide ( ANP ) and brain natriuretic peptide ( BNP ) , echocardiogram , measurements of pulmonary function and quality of life question naire , patients were r and omized to either a training group ( n = 21 ) or a control group ( n = 22 ) . The training group had supervised aerobic and resistance training program twice a week for five months . After the training program was completed , all measurements were repeated in both groups . RESULTS No training related adverse events were reported . Significant improvement was found between groups in the six minute walk test ( + 37.1 m vs. + 5.3 m , p = 0.01 ) , work load on the bicycle exercise test ( + 6.1 W vs. + 2.1 W , p = 0.03 ) , time on the bicycle exercise test ( + 41 s vs. + 0 s , p = 0.02 ) and quadriceps muscle strength test ( + 2.8 kg . vs. + 0.2 kg . , p = 0.003 ) . Quality of life factors that reflect exercise tolerance and general health , improved significantly in the training group compared to the control group . No other significant changes were found between the two groups . CONCLUSION Supervised physical training as used in this study appears safe for CHF patients in NYHA class II or III . The improvement in functional capacity observed in the training group seems to be related to peripheral factors rather than in central cardiovascular performance Patients with heart failure ( HF ) often have profound activity limitations and diminished quality of life ( QOL ) due to symptoms of dyspnea and fatigue . Although recent studies demonstrate positive physiologic and psychological benefits of low to moderate intensity , supervised , aerobic exercise training performed 3 to 5 days/ week for 20 to 40 minutes ' duration , in a monitored setting , the efficacy of a home-based exercise program combining endurance and resistance exercise on symptoms and QOL , are unknown . This r and omized controlled study examined the efficacy , safety , and adherence rates of a 3-month home-based combined walking and resistance exercise program on symptoms and QOL in 40 women and men aged 30 to 76 years with New York Heart Association class II to III HF . Baseline and 3-month evaluations consisted of a chronic HF question naire to assess symptoms and QOL and exercise capacity by symptom-limited treadmill exercise test with respiratory gas analysis . The exercise intervention improved fatigue ( p = 0.02 ) , emotional function ( p = 0.01 ) , and mastery ( p = 0.04 ) . Overall exercise adherence was excellent ( 90 % ) and there were no reported adverse events . A moderate intensity home-based combined walking and resistance program for patients with class II to III HF is safe and effective in reducing symptoms and improving QOL OBJECTIVE Atrial fibrillation diminishes cardiac function , exercise tolerance and quality of life . The objective of this study was to determine whether exercise training in atrial fibrillation affects muscle strength , body composition , maximal exercise capacity and walking capacity positively , thus improving quality of life . DESIGN R and omized clinical trial . Twelve weeks of physical exercise training or control . PATIENTS Forty-nine patients in permanent atrial fibrillation were r and omized to training or control . METHODS Intervention consisted of aerobic training for 1 h 3 times per week at 70 % of maximal exercise capacity vs control . Muscle strength , exercise capacity , 6-minute walk test , lean body mass , fat percentage , and quality of life were assessed . RESULTS Muscle strength increased in the training group ( p = 0.01 ) , but no change was observed in controls . Lean body mass was unchanged in both groups . Fat percentage decreased in both groups , but there was no significant difference between the groups . Exercise capacity improved in the training group ( p < 0.001 ) , with no change in the control group . There was a significant difference after the training period between the training and control groups in terms of exercise capacity . ( p = 0.001 ) . Six-min walk test improved in the training group compared with controls ( p < 0.01 ) . Overall quality of life score , as measured by the Minnesota Living with Heart Failure Question naire , improved in the training group ( p = 0.03 ) . Quality of life , measured by Short Form-36 , improved in the training group in 3 out of 8 subscales : physical functioning ( p = 0.02 ) , general health perceptions ( p = 0.001 ) and vitality ( p = 0.02 ) . CONCLUSION Muscle strength , exercise capacity and quality of life increased with exercise training in subjects with atrial fibrillation . Lean body mass was unchanged Objective : To investigate the differential effects of aerobic grade d exercise and progressive resistance training on exercise tolerance , fatigue and quality of life in adolescent patients with chronic fatigue syndrome ( CFS ) . Design : Single-blind , r and omized controlled pilot trial . Setting : A major metropolitan hospital in Melbourne , Australia . Subjects : Twenty-two adolescents aged 13—18 years diagnosed with CFS and admitted to the inpatient chronic fatigue rehabilitation programme . Intervention : Patients were r and omized to either grade d aerobic exercise training or a progressive resistance training programme , for five days/week for four weeks . The grade d aerobic training consisted of 20—40 minutes of stationary cycling and treadmill exercise . The progressive resistance training involved 16 exercises performed with single set , moderate load and high repetitions . Main measures : Exercise tolerance ( time to fatigue ) measured on a grade d sub-maximal treadmill test , metabolic equivalents and quality of life , along with muscular strength ( maximium push-ups ) and endurance ( sit-to-st and ) and question naires evaluating depressive symptoms and fatigue severity . Results : No intervention was significantly better than the other for any outcome . However , physical capacity and quality of life significantly improved in both groups , while fatigue severity and symptoms of depression improved only with aerobic training . Conclusions : Resistance and aerobic training result ed in similar changes to physical capacity , quality of life and fatigue severity . Generally , patients who completed resistance training or aerobic training experienced significant improvements in outcomes from baseline when they entered the programme . Whether these improvements can be attributed to the treatment is unknown Background — Exercise training reduces the symptoms of chronic heart failure . Which exercise intensity yields maximal beneficial adaptations is controversial . Furthermore , the incidence of chronic heart failure increases with advanced age ; it has been reported that 88 % and 49 % of patients with a first diagnosis of chronic heart failure are > 65 and > 80 years old , respectively . Despite this , most previous studies have excluded patients with an age > 70 years . Our objective was to compare training programs with moderate versus high exercise intensity with regard to variables associated with cardiovascular function and prognosis in patients with postinfa rct ion heart failure . Methods and Results — Twenty-seven patients with stable postinfa rct ion heart failure who were undergoing optimal medical treatment , including & bgr;-blockers and angiotensin-converting enzyme inhibitors ( aged 75.5±11.1 years ; left ventricular [ LV ] ejection fraction 29 % ; & OV0312;o2peak 13 mL · kg−1 · min−1 ) were r and omized to either moderate continuous training ( 70 % of highest measured heart rate , ie , peak heart rate ) or aerobic interval training ( 95 % of peak heart rate ) 3 times per week for 12 weeks or to a control group that received st and ard advice regarding physical activity . & OV0312;o2peak increased more with aerobic interval training than moderate continuous training ( 46 % versus 14 % , P<0.001 ) and was associated with reverse LV remodeling . LV end-diastolic and end-systolic volumes declined with aerobic interval training only , by 18 % and 25 % , respectively ; LV ejection fraction increased 35 % , and pro-brain natriuretic peptide decreased 40 % . Improvement in brachial artery flow-mediated dilation ( endothelial function ) was greater with aerobic interval training , and mitochondrial function in lateral vastus muscle increased with aerobic interval training only . The MacNew global score for quality of life in cardiovascular disease increased in both exercise groups . No changes occurred in the control group . Conclusions — Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity , endothelial function , and quality of life in patients with postinfa rct ion heart failure . These findings may have important implication s for exercise training in rehabilitation programs and future studies Background The objective of this study was to determine the effects of a moderate exercise training program on functional capacity , quality of life , and hospital readmission rate in chronic heart failure patients with implantable cardioverter defibrillators and cardiac resynchronization therapy . Methods and results We studied 52 men ( mean age 55 ± 10 years , ejection fraction 31 ± 7 % ) in chronic heart failure II ( n = 29 ) and III ( n = 23 ) NYHA functional class with ischemic cardiomyopathy who received implantable cardioverter defibrillators with or without cardiac resynchronization therapy .  Patients were r and omized into two groups . Group T ( n = 30 patients , 15 implantable cardioverter defibrillator , 15 implantable cardioverter defibrillator + cardiac resynchronization therapy ) underwent a supervised exercise training program at 60 % of peak Vo2 three times a week for 8 weeks . Group C ( n = 22 patients , 12 implantable cardioverter defibrillator , 10 implantable cardioverter defibrillator + cardiac resynchronization therapy ) avoided physical training . At 8 weeks , only trained patients had improvements in peak Vo2 ( P < 0.01 versus C ) , endothelium-dependent dilatation of the brachial artery ( P < 0.001 versus C ) and quality of life ( P < 0.001 versus C ) . Among trained patients , those with cardiac resynchronization therapy had greater improvements in peak Vo2 and quality of life . During the follow-up ( 24 ± 6 months ) , eight controls had sustained ventricular tachycardia requiring hospital readmission , while no trained patients had adverse events ( log rank 8.56 ; P < 0.001 ) . The improvement in peak Vo2 was correlated with the improvement in endothelium-dependent dilatation ( r=0.65 ) . Conclusion Moderate exercise training is safe and has beneficial effects after implantable cardioverter defibrillator implantation , especially when cardiac resynchronization therapy is present . These effects are associated with improvement in quality of life and outcome OBJECTIVE To compare the effect and sustainability of 6 months combined aerobic/strength training vs aerobic training alone on quality of life in women after coronary artery by-pass graft surgery or myocardial infa rct ion . DESIGN Prospect i ve , 2-group , r and omized controlled trial . PARTICIPANTS Ninety-two women who were 8 - 10 weeks post-coronary artery by-pass graft surgery or myocardial infa rct ion , able to attend supervised exercise , and fluent in English . METHODS The aerobic training alone group had supervised exercise twice a week for 6 months . The aerobic/strength training group received aerobic training plus upper and lower body resistance exercises . The amount of active exercise time was matched between groups . The primary outcome , quality of life , was measured by the MOS SF-36 ; secondary outcomes were self-efficacy , strength and exercise capacity . RESULTS After 6 months of supervised exercise training both groups showed statistically significant improvements in physical quality of life ( p = 0.0002 ) , peak VO2 ( 19 % in aerobic/strength training vs 22 % in aerobic training alone ) , strength ( p < 0.0001 ) and self-efficacy for stair climbing ( p = 0.0024 ) , lifting ( p < 0.0001 ) and walking ( p = 0.0012 ) . However , by 1-year follow-up there was a statistically significant difference in physical quality of life in favor of the aerobic/strength training group ( p = 0.05 ) . CONCLUSION Women with coronary artery disease st and to benefit from both aerobic training alone and aerobic/strength training . However , continued improvement in physical quality of life may be achieved through combined strength and aerobic training Chronic heart failure ( CHF ) is a complex syndrome characterized by progressive decline in left ventricular function , low exercise tolerance and raised mortality and morbidity . Left ventricular diastolic dysfunction plays a major role in CHF and progression of most cardiac diseases . The current recommended goals can theoretically be accomplished via exercise and pharmacological therapy so the aim of the present study was to evaluate the impact of cardiac rehabilitation program on diastolic dysfunction and health related quality of life and to determine the correlation between changes in left ventricular diastolic dysfunction and domains of health-related quality of life ( HRQoL ) .  Forty patients with chronic heart failure were diagnosed as having dilated cardiomyopathy ( DCM ) with systolic and diastolic dysfunction . The patients were equally and r and omly divided into training and control groups . Only 30 of them completed the study duration . The training group participated in rehabilitation program in the form of circuit-interval aerobic training adjusted according to 55–80 % of heart rate reserve for a period of 7 months . Circuit training  improved both diastolic and systolic dysfunction in the training group . On the other h and , only a significant correlation was found between improvement in diastolic dysfunction and health related quality of life measured by Kansas City Cardiomyopathy Question naire . It was concluded that improvement in diastolic dysfunction as a result of rehabilitation program is one of the important underlying mechanisms responsible for improvement in health-related quality of life in DCM patients
Resistance training increased 6-minute walk distance compared to no training , but had no other benefits on cardiac function , exercise capacity , or quality of life if used alone or as an adjunct to aerobic training in people with chronic heart failure .
QUESTION Does resistance training , either alone or as an adjunct to aerobic training , improve cardiac function , exercise capacity and quality of life in people with chronic heart failure ?