An alternative approach for exercise prescription and efficacy testing in patients with chronic heart failure

Meyer, Tim; Görge, Günter; Schwaab, Bernhard; Hildebrandt, Kristof; Walldorf, Jens; Schäfer, Christine; Kindermann, Ingrid; Scharhag, Jürgen; Kindermann, Wilfried

doi:10.1016/j.ahj.2004.12.006

Cited by 50 publications

(45 citation statements)

References 32 publications

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“…Hydrotherapy is a new and well-tolerated method of exercise rehabilitation that was first proposed as an alternative for elderly and impaired patients with heart failure, but which showed important improvements in neurohormonal attenuation because of the hydrostatic pressure and warming. 19 Independent of the method of exercise rehabilitation, the prescription of adequate aerobic effort is crucial to obtain both an acceptable training stimulus and a reasonable control of the exercise-related risk. 1 Despite there being no consensus about which exercise intensity is the best for heart failure patients, a submaximal level (between the anaerobic threshold and respiratory compensation point) seems to have the best security-efficacy relationship.…”

Section: Discussionmentioning

confidence: 99%

“…1,7 Despite the lack of consensus about which exercise method and intensity are the best to improve heart failure patients, a submaximal level (ie, between the anaerobic threshold and respiratory compensation point) seems to have the best security/efficacy relationship. 19 Higher exercise intensities are associated with displeasure 20 and reduced adherence. 21 Hydrotherapy (ie, exercise in warm water) has been considered potentially dangerous for heart failure patients because of the increased venous return caused by the hydrostatic pressure.…”

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confidence: 99%

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The Borg Scale as an Important Tool of Self-Monitoring and Self-Regulation of Exercise Prescription in Heart Failure Patients During Hydrotherapy

Carvalho

Bocchi

Guimarães

2009

Circ J

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Background:The Borg Scale may be a useful tool for heart failure patients to self-monitor and self-regulate exercise on land or in water (hydrotherapy) by maintaining the heart rate (HR) between the anaerobic threshold and respiratory compensation point. Methods and Results: Patients performed a cardiopulmonary exercise test to determine their anaerobic threshold/respiratory compensation points. The percentage of the mean HR during the exercise session in relation to the anaerobic threshold HR (%EHR-AT), in relation to the respiratory compensation point (%EHR-RCP), in relation to the peak HR by the exercise test (%EHR-Peak) and in relation to the maximum predicted HR (%EHR-Predicted) was calculated. Next, patients were randomized into the land or water exercise group. One blinded investigator instructed the patients in each group to exercise at a level between "relatively easy and slightly tiring". The mean HR throughout the 30-min exercise session was recorded. The %EHR-AT and %EHR-Predicted did not differ between the land and water exercisegroups, but they differed in the %EHR-RCP (95±7 to 86±7, P<0.001) and in the %EHR-Peak (85±8 to 78±9, P=0.007). Conclusions: Exercise guided by the Borg scale maintains the patient's HR between the anaerobic threshold and respiratory compensation point (ie, in the exercise training zone). (Circ J 2009; 73: 1871 -1876

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Borg Scale as an Important Tool of Self-Monitoring and Self-Regulation of Exercise Prescription in Heart Failure Patients During Hydrotherapy

Carvalho

Bocchi

Guimarães

2009

Circ J

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“…cycling, walking, rowing) is the most investigated training modality in CHF patients, and is recommended as baseline activity [Vanhees et al 2012;Davies et al 2010;Flynn et al 2009;O'Connor et al 2009]; cycling is usually preferred because of the reproducible power output, the possible low workloads and reduced injury rate. Traditionally, the first ventilatory anaerobic threshold (VAT) (50-60% of VO 2 peak) was identified as the maximum training intensity for HF patients, avoiding exercise-related risks and adverse events [Myers, 2008;Meyer et al 2005aMeyer et al , 2005b]. …”

Section: Prescription Of a Training Programme: Types Of Exercisementioning

confidence: 99%

Exercise training in chronic heart failure

Maeyer

Beckers

Vrints

et al. 2013

Therapeutic Advances in Chronic Disease

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Abstract:The syndrome of heart failure (HF) is a growing epidemic that causes a significant socio-economic burden. Despite considerable progress in the management of patients with HF, mortality and morbidity remain a major healthcare concern and frequent hospital admissions jeopardize daily life and social activities. Exercise training is an important adjunct nonpharmacological treatment modality for patients with HF that has proven positive effects on mortality, morbidity, exercise capacity and quality of life. Different training modalities are available to target the problems with which HF patients are faced. It is essential to tailor the prescribed exercise regimen, so that both efficiency and safety are guaranteed. Electrical implanted devices and mechanical support should not exclude patients from exercise training; however, particular precautions and a specialized approach are advised. At least 50% of patients with HF, older than 65 years of age, present with HF with preserved ejection fraction (HFPEF). Although the study populations included in studies evaluating the effect of exercise training in this population are small, the results are promising and seem to support the idea that exercise training is beneficial for HFPEF patients. Both the short-and especially longterm adherence to exercise training remain a major challenge that can only be tackled by a multidisciplinary approach. Efforts should be directed towards closing the gap between recommendations and the actual implementation of training programmes.

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“…15 Both VO 2peak and AT determined by the ventilatory method are considered valid and reproducible in healthy subjects 1,5,14,16 . However, as the determination of maximum stress can be subjective in individuals with HF 1,16 , AT can be an alternative option comparable to the VO 2peak to predict aerobic performance 1,8,13,[16][17][18] . Moreover, AT may be useful in determining the intensity of the training prescription in rehabilitation programs, in evaluating the effects of training, and in assessing the prognosis of patients with HF 4,8 .…”

Section: Introductionmentioning

confidence: 99%

Reprodutibilidade da determinação do limiar anaeróbico em pacientes com insuficiência cardíaca

Vieira

Ribeiro-Samora

Lopes

et al. 2010

Arq. Bras. Cardiol.

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An alternative approach for exercise prescription and efficacy testing in patients with chronic heart failure

Cited by 50 publications

References 32 publications

The Borg Scale as an Important Tool of Self-Monitoring and Self-Regulation of Exercise Prescription in Heart Failure Patients During Hydrotherapy

The Borg Scale as an Important Tool of Self-Monitoring and Self-Regulation of Exercise Prescription in Heart Failure Patients During Hydrotherapy

Exercise training in chronic heart failure

Reprodutibilidade da determinação do limiar anaeróbico em pacientes com insuficiência cardíaca

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