title: Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT).
abstract: BACKGROUND
  The purpose of this study was to examine the effects of exercise training on functional capacity in patients with heart failure.
  
  
  METHODS
  One hundred eighty-one patients in New York Heart Association class I to III, with ejection fraction <40% and 6-minute walk distance <500 meters, were recruited into a randomized, controlled, single-blind trial comparing 3 months of supervised training, then 9 months of home-based training with usual care.
  
  
  RESULTS
  There was a significant increase in 6-minute walk distance at 3 and 12 months but no between-group differences. Incremental peak oxygen uptake increased in the exercise group compared with the control group at 3 months (0.104 +/- 0.026 L/min vs 0.025 +/- 0.023 L/min; P =.026) and 12 months (0.154 +/- 0.074 L/min vs 0.024 +/- 0.027 L/min; P =.081). Compared with the control group, significant increases were observed in the exercise group for arm and leg strength. No significant changes were observed in cardiac function or quality of life. Adherence to exercise was good during supervised training but reduced during home-based training.
  
  
  CONCLUSIONS
  Exercise training improves peak oxygen uptake and strength during supervised training. Over the final 9 months of the study, there was little further improvement, suggesting that some supervision is required for these patients. There were no adverse effects on cardiac function or clinical events.
authors.affiliation: Division of Cardiology and Preventive Cardiology and Therapeutic Program, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada. mckelrob@hhsc.on.ca
authors.forename: Robert S
authors.initials: RS
authors.lastname: McKelvie
authors.forename: Koon K
authors.initials: KK
authors.lastname: Teo
authors.forename: Robin
authors.initials: R
authors.lastname: Roberts
authors.forename: Neil
authors.initials: N
authors.lastname: McCartney
authors.forename: Dennis
authors.initials: D
authors.lastname: Humen
authors.forename: Terence
authors.initials: T
authors.lastname: Montague
authors.forename: Katie
authors.initials: K
authors.lastname: Hendrican
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010349:Patient Compliance; D011788:Quality of Life; D016037:Single-Blind Method; D016138:Walking