title: The effect of physical training on workload, upper leg muscle function and muscle areas in patients with chronic heart failure.
abstract: OBJECTIVE
  To investigate the effect of physical training (PTr) on upper leg muscle area, muscle strength and muscle endurance expressed as upper leg muscle function (ULMF) in relation to exercise performance in CHF.
  
  
  METHODS
  Randomised to a training (TG) or control group (CG).
  
  
  METHODS
  Outpatient cardiac rehabilitation centre of community hospital.
  
  
  METHODS
  77 CHF patients (59 men and 18 women), NYHA class II/III, age 59.8+/-9.3 years, LVEF 27+/-8%. Sixteen patients dropped out during the intervention period, 61 patients (M/F:46/15) completed the study.
  
  
  METHODS
  PTr (combined strength and endurance exercises) four times per week, twice supervised and twice at home, during 26 weeks.
  
  
  METHODS
  LVEF, body composition, daily physical activity, exercise performance, upper leg muscle area and isokinetic leg muscle variables.
  
  
  RESULTS
  Workload and peak oxygen consumption decreased in the CG (-4.1% and -4%) but increased in the TG (+5% and +4%) following PTr (p<0.05, ANOVA repeated measures). Hamstrings area decreased in the CG and did not change in the TG (p<0.05, ANOVA repeated measures). ULMF improved in the TG, but remained unchanged in the CG (+13.0% and 0.0, respectively, p<0.05; ANOVA repeated measures). At baseline and after intervention nearly 60% of the variance in maximal workload was explained by ULMF and quadriceps muscle area (multiple regression analysis).
  
  
  CONCLUSIONS
  In CHF patients, home-based training in conjunction with a supervised strength and endurance training program is safe, feasible and effective and does not require complex training equipment. Physical training prevented loss of hamstrings muscle mass and improved exercise performance by enhancing muscle strength and endurance.
authors.affiliation: Meander Medical Centre, Cardiology, Amersfoort, The Netherlands. P.Senden@meandermc.nl
authors.forename: P Jeff
authors.initials: PJ
authors.lastname: Senden
authors.forename: Louise W
authors.initials: LW
authors.lastname: Sabelis
authors.forename: Maria L
authors.initials: ML
authors.lastname: Zonderland
authors.forename: Erik H
authors.initials: EH
authors.lastname: Hulzebos
authors.forename: Eduard
authors.initials: E
authors.lastname: Bol
authors.forename: Willem L
authors.initials: WL
authors.lastname: Mosterd
mesh_terms: D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D018737:Hand Strength; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D007537:Isometric Contraction; D007866:Leg; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000502:physiology*; D010807:Physical Endurance