scholarly journals Exercise training in patients with chronic heart failure: A new challenge for Cardiac Rehabilitation Community

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Francesco Giallauria ◽  
Lucrezia Piccioli ◽  
Giuseppe Vitale ◽  
Filippo M. Sarullo
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Inspiratory Muscle ◽  
Moderate Intensity ◽  
Frailty Status ◽  
Training Modality

Exercise training (ET) is strongly recommended in patients with chronic stable heart failure (HF). Moderate-intensity aerobic continuous ET is the best established training modality in HF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. In HF patients, HIIT exerts larger improvements in exercise  capacity compared to moderate-continuous ET. Since better functional capacity translates into symptoms relief and improvement in quality of life in patients with HF, this training modality is collecting growing interest and consensus, not revealing major safety issues. HIIT should not replace other training modalities in HF but should rather complement them. Inspiratory muscle training, another promising training modality in patients with HF, exerts beneficial effect on inspiratory muscle strength and inspiratory endurance, on exercise capacity and quality of life. In conclusion, taking into consideration the complecity of HF syndrome, combining and tailoring different ET modalities according to each patient’s baseline clinical characteristics (i.e. exercise capacity, comorbidity, frailty status, personal needs, preferences and goals) seem the most wily approach for exercise prescription.

scholarly journals Home-Based Exercise Training for Heart Failure Patients: a Systematic Review

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 155
Author(s):  
Roby Aji Permana ◽  
Wikan Purwihantoro Sudarmaji ◽  
Wahyu Sukma Samudera ◽  
Agostinha Soares ◽  
Yanuar Aga Nugraha
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Search Algorithm ◽  
Rehabilitation Program ◽  
Heart Failure Patients ◽  
Home Based

Exercise training is one of the recommendations for a cardiac rehabilitation program to increase exercise capacity and thus quality of life, decreasing both readmission and mortality in terms of heart failure. In spite of the evidence on the benefits and safety of cardiac rehabilitation, the uptake and participation of cardiac rehabilitation by patients with heart failure is currently poor. This study aimed to systematically review the effect of home-based exercise training on heart failure patients. The studies were systematically identified by searching through the chosen electronic databases (Scopus, Science Direct, Proquest, Pubmed, and CINAHL) for articles from the 5 last years. The search algorithm identified a total 164 articles and 15 articles were selected based on the inclusion and exclusion criteria. For the 15 articles, 13 were RCTs, 1 was quasi-experimental and 1 was a retrospective study. The major result of this review shows that home-based exercise has an effect on functional and exercise capacity, quality of life and a decreased rate of readmission within 2-12 months follow up. Home-based exercise has a long-term effect that is more effective than exercise that is hospital-based.

Exercise Capacity in Chronic Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
Positive Impact ◽  
Pharmacologic Therapy ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

Exercise training and cardiac rehabilitation in patients with implantable cardioverter defibrillators: a review of current literature focusing on safety, effects of exercise training, and the psychological impact of programme participation

2011 ◽  
Vol 19 (4) ◽  
pp. 804-812 ◽  
Author(s):  
Kjetil Isaksen ◽  
Ingvild Margreta Morken ◽  
Peter Scott Munk ◽  
Alf Inge Larsen
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Current Literature ◽  
Control Group ◽  
Implantable Cardioverter Defibrillators ◽  
Increased Risk ◽  
Cardioverter Defibrillators

Background: Indications for implantable cardioverter defibrillators (ICDs) have been widened considerably during the last decade due to the well-documented effect in the heart failure population. Exercise training (ET) has a 1 A recommendation in heart failure. However, data on safety and efficacy of ET in patients with ICDs is sparse. ICD shocks are associated with reduced quality of life and increased mortality. Whether ET may have a beneficial effect in heart failure patients with an ICD is not well documented. Methods: This review is based on a systematic search in the Pub Med database using the terms ‘exercise training’, ‘implantable cardioverter defibrillator’, and ‘cardiac rehabilitation’. Results: Nine studies were identified, comprising 1889 patients. The average duration of exercise-based cardiac rehabilitation (CR) was 9.6 weeks. Ten ICD therapies (seven shocks) were reported in the 834 patients with ICD during ET. Between exercise sessions and during follow up 182 events were recorded including 166 shocks. Three studies (2 randomized) showed that the control group representing sedentary patients were more prone to ICD discharge than patients undergoing CR/ET. In all studies the ICD patients improved their aerobic fitness following ET. Few studies report data on the effect of ET on anxiety and depression. Conclusion: Based on the current literature, ET in patients with an ICD seems to be safe and is not associated with increased risk of shocks. ET improves aerobic capacity in ICD patients, while effects on anxiety, depression and quality of life are still under debate.

scholarly journals Are the group-based interventions improving the functional exercise capacity and quality of life of frail subjects with chronic heart failure?

2020 ◽  
Vol 05 (04) ◽  
pp. 102-108
Author(s):  
Jannis Vasileios Papathanasiou
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Capacity ◽  
Perceived Exertion ◽  
Moderate Intensity ◽  
Walking Capacity ◽  
Functional Exercise ◽  
Functional Exercise Capacity

Objectives: Frail subjects with chronic heart failure (CHF) often demonstrate limited tolerance of exertion, shortness of breath, and reduced walking capacity resulting poor quality of life (QoL). The aim of this study was to quantify the improvements in functional exercise capacity (FEC) and QoL among Bulgarian frail subjects with CHF performed group-based high-intensity aerobic interval training (HIAIT)/m-Ullevaal intervention and to compare it with moderate intensity continuous training (MICT) protocol. Methods: One hundred and twenty (n=120) frail subjects with mean age of 63.73±6.68 years, in CHF and NYHA class II-IIIB, were enrolled in the single-center, prospective, two-arm randomized controlled clinical trial conducted at the Medical Center for Rehabilitation and Sports Medicine-I-Plovdiv. The baseline assessment included 6-minute walk test (6ΜWT), peak oxygen uptake (VO2peak), modified Borg Perceived Exertion Scale (mBPES), and Minnesota living with the Heart Failure Questionnaire (MLHFQ). Results: The improvement in 6MWT (P<0.001), VO2peak (P<0.001), mBPES (P<0.001), and MLHFQ (P<0.001) observed among frail subjects performed HIAIT/m-Ullevaal intervention was significantly greater compared to the improvement observed in the subjects performed MICT protocol (P<0.001). Conclusions: The group-based HIAIT/m-Ullevaal intervention is a new perspective and challenge for both, Bulgarian cardiac rehabilitation (CR), and frail patients with CHF.

Abstract 3403: Heart Failure Patients Improve their Exercise Capacity after Cardiac Rehabilitation Irrespective of having a Preserved or Depressed Ejection Fraction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Veronica Franco ◽  
Todd M Brown ◽  
Jose A Tallaj ◽  
Bonnie Sanderson ◽  
Vera A Bittner
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Depressive Symptoms ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Left Ventricular Ejection ◽  
Physical Component Score ◽  
Component Score

Background: Whether exercise training reduces morbidity and mortality in heart failure (HF) patients is unknown. The objective of this study was to determine if cardiac rehabilitation (CR) outcomes differ in HF patients with and without systolic dysfunction. Methods: We included the 152 patients completing CR from 1996 to 2006 with HF listed as the primary diagnosis or as a co-morbidity. Based on left ventricular ejection fraction (LVEF) at enrollment, we divided patients into 2 groups: those with LVEF ≥ 45% (51/152, 34%) and those with LVEF < 45% (101/152, 66%). At baseline, we compared distance, perceived exertion (Borg Scale), shortness of breath (Dyspnea Scale), and maximum heart rate (MHR) during a 6 minute walk test (MWT);self reported physical activity (total metabolic hours); depressive symptoms (Beck Depression Inventory [BDI]); and quality of life (physical component score [PCS] and mental component score [MCS] of the SF-36) between the 2 groups. Within each group, we compared changes from baseline to CR completion for each parameter. We compared differences between groups with multivariate linear regression to assess the association between LVEF classification and changes in each parameter, controlling for age, race, gender, and baseline value of the parameter. Results: Mean age (61 vs. 62 years), race (43% vs. 43% non-white), and gender (36% vs. 37% women) were similar in the 2 groups. At baseline, both groups had similar 6 MWT values, depressive symptoms, and quality of life, although Borg scores were higher in the LVEF ≥ 45% group. At CR completion, the 2 groups showed improvement in all parameters (all p<0.05) except MHR on 6 MWT, which was unchanged in both groups. After adjusting for age, race, gender, and baseline value of each parameter, there was no difference in the magnitude of the improvement between the 2 groups (table ). Conclusions: Patients with clinical heart failure symptoms, regardless of ejection fraction, benefit from exercise training.

The Effect of Exercise Training Intensity on Quality of Life in Heart Failure Patients: A Systematic Review and Meta-Analysis

Cardiology ◽  
2016 ◽  
Vol 136 (2) ◽  
pp. 79-89 ◽  
Author(s):  
Cecilia Ostman ◽  
Daniel Jewiss ◽  
Neil A. Smart
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Resistance Training ◽  
Exercise Training ◽  
Left Ventricular ◽  
Moderate Intensity ◽  
Training Intensity ◽  
Medline Search ◽  
Intensity Training

Objectives: To establish if exercise training intensity produces different effect sizes for quality of life in heart failure. Background: Exercise intensity is the primary stimulus for physical and mental adaptation. Methods: We conducted a MEDLINE search (1985 to February 2016) for exercise-based rehabilitation trials in heart failure using the search terms ‘exercise training', ‘left ventricular dysfunction', ‘peak VO2', ‘cardiomyopathy', and ‘systolic heart dysfunction'. Results: Twenty-five studies were included; 4 (16%) comprised high-, 10 (40%) vigorous-, 9 (36%) moderate- and 0 (0%) low-intensity groups; two studies were unclassified. The 25 studies provided a total of 2,385 participants, 1,223 exercising and 1,162 controls (36,056 patient-hours of training). Analyses reported significant improvement in total Minnesota living with heart failure (MLWHF) total score [mean difference (MD) -8.24, 95% CI -11.55 to -4.92, p < 0.00001]. Physical MLWHF scorewas significantly improved in all studies (MD -2.89, 95% CI -4.27 to -1.50, p < 0.00001). MLWHF total score was significantly reduced after high- (MD -13.74, 95% CI -21.34 to -6.14, p = 0.0004) and vigorous-intensity training (MD -8.56, 95% CI -12.77 to -4.35, p < 0.0001) but not moderate-intensity training. A significant improvement in the total MLWHF score was seen after aerobic training (MD -3.87, 95% CI -6.97 to -0.78, p = 0.01), and combined aerobic and resistance training (MD -9.82, 95% CI -15.71 to -3.92, p = 0.001), but not resistance training. Conclusions: As exercise training intensity rises, so may the magnitude of improvement in quality of life in exercising patients. Aerobic-only or combined aerobic and resistance training may offer the greatest improvements in quality of life.

scholarly journals Inspiratory Muscle Training in Patients with Heart Failure

2020 ◽  
Vol 9 (6) ◽  
pp. 1710
Author(s):  
Hugo Fernandez-Rubio ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
David Rodríguez-Sanz ◽  
César Calvo-Lobo ◽  
Davinia Vicente-Campos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Trials ◽  
Exercise Training ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Inspiratory Muscle ◽  
Muscle Training ◽  
Patients With Heart Failure

Background: Prior systematic reviews and meta-analysis addressed that inspiratory muscle training (IMT) improved inspiratory muscle weakness, cardiorespiratory fitness and quality of life similar to conventional exercise training as a first alternative in deconditioned patients with heart failure (HF) lead to a better adaptation to posterior exercise training. The heterogeneity and variability in a wide range of new studies about this topic led to the necessity of an updated and comprehensive narrative review. The present review aimed to analyze and update the most relevant studies about IMT in patients who suffer from HF. Methods: A narrative review was carried out about IMT in HF patients including 26 experimental studies divided into 21 clinical trials and 5 quasi-experimental studies identified through database searching in PubMed, Cochrane and PEDro. Results: There is enough evidence to state that IMT produces improvements in functional capacity of patients with HF. Nevertheless, there is not enough evidence to support that IMT could improve cardiovascular parameters, blood biomarkers or quality of life in these patients. Conclusions: Thus, IMT may be recommended to improve functional capacity in patients who suffer from HF; nevertheless, more evidence is needed regarding cardiovascular parameters, biomarkers and quality of life. Furthermore, mortality or HF hospitalization was not evaluated and most studies were not longer than 3 months. According to IMT protocols and study designs heterogeneity and mid-term follow-up, further investigations through high-quality long-term randomized clinical trials should be performed to achieve systematic reviews and meta-analysis to support strong evidence for IMT in HF patients.

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