Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure.
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 randomized 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.
Tyni-Lenné
R
R
Department of Physical Therapy, Karolinska Institutet and Huddinge University Hospital, Stockholm, Sweden. raija.tyni-lenne@physio.hs.sll.se
Dencker
K
K
Gordon
A
A
Jansson
E
E
Sylvén
C
C
D000704:Analysis of Variance; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D008771:Nordefrin / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D010807:Physical Endurance; D011788:Quality of Life; D018709:Statistics, Nonparametric; D016138:Walking / Q000502:physiology
D008771:Nordefrin