title: Hydrotherapy in advanced heart failure: the cardio-HKT pilot study.
abstract: BACKGROUND
  In-water exercise, hydrotherapy, may offer an attractive alternative to conventional training in markedly compromised patients with advanced HF. This Pilot Study evaluates the safety and efficacy of Cardio-Hydrokinesitherapy (Cardio-HKT) in patients with advanced HF on optimal medical therapy. Cardio-HKT is a novel rehabilitation program that includes training sessions in warm water (31 degrees C), integrated by educational and psycho-behavioural sessions to promote healthy life style modifications.
  
  
  METHODS
  We studied 18 adult patients with advanced HF, LVEF < 35%, NYHA functional class > II and peak oxygen uptake (peak VO2) < 18 ml/kg/min. Cardio-HKT consisted of a 3 weeks daily in-water training, combined to educational and psycho-behavioural sessions. Patients underwent a six-minute-walking-test (6mWT), a cardiopulmonary exercise test at baseline and after 3 weeks of Cardio-HKT. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHF).
  
  
  RESULTS
  All patients completed the Cardio-HKT rehabilitation program without complications. The 6mWT improved from 453 +/- 172 m to 571 +/- 120 m (p < 0.01), peak VO2 from 13.0 +/- 3.1 to 14.5 +/- 2.9 ml/kg/min (p = 0.03), whereas VE/ CO2 slope declined from 37 +/- 10 to 33 +/- 9 (p = 0.01). MLHF markedly improved from 56 (68-27) to 18 (40-7) (p < 0.01).
  
  
  CONCLUSIONS
  Our results support the safety and efficacy of the innovative Cardio-HKT rehabilitation program in patients with advanced HF.
authors.affiliation: Struttura Complesso di Cardiologia, A.O. Ospedale Santa Corona, Pietra Ligure SV, Italy. am072003@yahoo.it
authors.forename: Annamaria
authors.initials: A
authors.lastname: Municinó
authors.forename: Annamaria
authors.initials: A
authors.lastname: Nicolino
authors.forename: Manlio
authors.initials: M
authors.lastname: Milanese
authors.forename: Edoardo
authors.initials: E
authors.lastname: Gronda
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreuzzi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarella
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D006875:Hydrotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010865:Pilot Projects; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires