[Utilization of heart rate at the ventilatory threshold for the prescription of intensity of exercise training in cardiac failure].
Physical exercise is a treatment for cardiac failure but a large range of intensities of exercise is proposed. The aims of this study were to determine the range of intensities of effort used and to individualize the intensities used. Thirty patients with stable cardiac failure (NYHA Classes II-III, age: 53 +/- 2.1 years, ejection fraction: 31 +/- 1.4%) underwent a cardiorespiratory exercise stress test before and after individualized training at the ventilatory threshold. However, before and after the training period, standard methods of calculation of the intensities at the ventilatory threshold showed individual differences greater than +/- 2 standard deviations, indicating different metabolic stimulations. After the individualized training programme, peak oxygen consumption on exercise (1679 +/- 100 vs 1487 +/- 89 ml.min-1, p = 0.0001) and at ventilatory threshold increased (1365 +/- 85 vs 1133 +/- 65 ml.min-1, p = 0.0001), the ventilatory threshold/peak exercise ratio increased (81.2 +/- 1.3 vs 76.7 +/- 1.4%, p = 0.0008), and there was a decrease in heart and ventilatory rates at submaximal metabolic levels (p = 0.0001). The authors conclude that protocols using intensity of effort at the ventilatory threshold give similar results with respect to improvement of aerobic capacity as other methods of indirect calculation, based on maximal heart rate of oxygen consumption. The value of this particular method lies in the adequation between aerobic capacity of the patient and the intensity of training. The results obtained attain the physiopathological aims of rehabilitation.
Curnier
D
D
Clinique de réadaptation cardiovasculaire et pulmonaire de St-Orens, 12 avenue de Revel, 31650 Saint-Orens-de-Gameville.
Galinier
M
M
Fourcade
J
J
Bousquet
M
M
Bovéda
S
S
Delay
M
M
Sénard
J M
JM
Fauvel
J M
JM
Bounhoure
J P
JP
Montastruc
J L
JL
D002138:Calibration; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010347:Patient Care Planning; D012123:Pulmonary Ventilation; D012016:Reference Values