title: Upper-extremity exercise training in heart failure.
abstract: OBJECTIVE
  Aerobic exercise training (ExTR), predominantly performed with lower extremities, has been used to reverse heart failure (HF)-related exercise intolerance. The present study determined the safety and efficacy of upper-extremity exercise in HF subjects because daily activities are performed using both upper and lower extremities and there is little cross-training effects between extremities.
  
  
  METHODS
  Seven subjects underwent 36 sessions (40 minutes, 3 times per week for 12 weeks) of upper-extremity ExTR (ARM ExTR) using arm ergometers, the arm function of a NuStep device, and an Airdyne stationary cycle. Exercise intensity and duration during weeks 1 to 4 were gradually increased to achieve a 75% to 85% peak heart rate. Pre- and post-ExTR tests included arm ergometer cardiopulmonary testing with echocardiography and quality of life self-administered surveys.
  
  
  RESULTS
  After ARM ExTR test duration increased by 22% (P = .008), respiratory exchange ratio increased by 10% (P = .02), whereas peak oxygen consumption was not improved. Echocardiographic parameters were not altered by ARM ExTR. The total scores of both the Minnesota Living With Heart Failure Questionnaire (P = .02) and the Medical Outcomes Study-36 questionnaire (P = .05) were improved, but the Functional Status Questionnaire scores were not improved.
  
  
  CONCLUSIONS
  Although this study was limited in the number of subjects and lacked a control group, results indicate that ARM ExTR is safe and well-tolerated by persons diagnosed with HF, a finding that is relevant for individuals with HF who cannot exercise with lower extremities.
authors.affiliation: Brooks College of Health, University of North Florida, Jacksonville, FL 32224, USA. cnyquist@unf.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Nyquist-Battie
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Fletcher
authors.forename: Barbara
authors.initials: B
authors.lastname: Fletcher
authors.forename: Joan M
authors.initials: JM
authors.lastname: Carlson
authors.forename: Ramon
authors.initials: R
authors.lastname: Castello
authors.forename: Keith
authors.initials: K
authors.lastname: Oken
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation; D004452:Echocardiography; D016552:Ergometry; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010807:Physical Endurance; D011659:Pulmonary Gas Exchange; D011788:Quality of Life; D012107:Research Design; D018434:Sickness Impact Profile; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*