Eccentric training in chronic heart failure: feasibility and functional effects. Results of a comparative study.
OBJECTIVE
To evaluate, in chronic heart failure (CHF) patients, feasibility, safety, compliance and functional improvements of an eccentric (ECC) cycle training protocol personalized by the rate of perceived exertion (RPE; 9-11 Borg Scale), compared to concentric (CON) training at workload corresponding to the first ventilatory threshold.


METHODS
Thirty patients were randomly allocated to ECC or CON training (20 sessions). Compliance was evaluated with RPE, visual analog scale for muscle soreness and monitoring of heart rate (HR). Functional parameters were measured by the distance walked and the VO(2) uptake during the 6-minute walk test (6MWT) before and after training.


RESULTS
Two patients were excluded due to adverse effects in each group. RPE was 9-11 in ECC training while it reached 12-14 in CON training. HR remained stable in ECC group during exercise whereas it increased during CON exercise. 6MWT distance improved in both group (ECC: +53 m; CON: +33 m). 6MWT VO(2) uptake remained stable in ECC group whereas it increased in CON group.


CONCLUSIONS
ECC training tailored by RPE appears to be an efficient and safe alternative for CHF patients. Indeed, it induces functional improvement similar to conventional CON training with lower demand on the cardiovascular system during exercise.
CIC-P Inserm 803, plateforme d'investigation technologique, CHU de Dijon, 23, rue Gaffarel, 21079 Dijon, France.
D
D
Besson
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C
Joussain
V
V
Gremeaux
C
C
Morisset
Y
Y
Laurent
J-M
JM
Casillas
D
D
Laroche
D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D005082:Physical Exertion / Q000502:physiology