Combined Aerobic and Resistance Exercise Program Improves Task Performance in Patients With Heart Failure

Abstract

Objectives To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association (NYHA) class II and III patients and systolic heart failure (HF). Design Randomized controlled trial. Setting Home based. Participants Stable patients (N=24; mean age, 60±10y; left ventricular ejection fraction, 25%±9%; 50% white; 50% women) with New York Heart Association (NYHA) classes II and III (NYHA class III, 58%) systolic heart failure (HF). Intervention A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise. Attention control wait list participants performed light stretching and flexibility exercises. Main Outcome Measures A 10-item performance-based physical function measure, the Continuous Scale Physical Functional Performance test (CS-PFP10), was the major outcome variable and included specific physical activities measured in time to complete a task, weight carried during a task, and distance walked. Other measures included muscle strength, HRQOL (Minnesota Living With Heart Failure Questionnaire, Epworth Sleepiness Scale), functional capacity (Duke Activity Status Index), and disease severity (brain natriuretic peptide) levels. Results After the exercise intervention, 9 of 10 specific task activities were performed more rapidly, with increased weight carried by exercise participants compared with the attention control wait list group. Exercise participants also showed significant improvements in CS-PFP10 total score (P<.025), upper and lower muscle strength, and HRQOL (P<.001) compared with the attention control wait list group. Adherence rates were 83% and 99% for the aerobic and resistance training, respectively. Conclusions Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach. Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify. Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population.

Significance of Low Plasma Levels of Brain-Derived Neurotrophic Factor in Patients With Heart Failure

“…25,26 In addition to aerobic training, resistance training, which increases muscle strength, endurance, and blood flow, 27 improves heart function and performance of routine physical activities. 28,29 Pereira et al 30 reported that not aerobic exercises but muscle strength exercises increased plasma BDNF levels irrespective of improvement of depressive symptoms in older women without HF symptoms. As mentioned earlier, we developed an interest in whether BDNF levels can increase by resistance training and whether high BDNF levels correlate with improvement in HF symptoms in patients with HF.…”

Health-Related Quality of Life, Functional Status, and Cardiac Event-Free Survival in Patients With Heart Failure

“…Gary and colleagues 22 tested the effects of a home-based exercise program, and found that the exercise group had improved HRQOL. In a subsequent aerobic and resistance exercise intervention study, Gary and colleagues 23, 24 found that exercise participants had significant improvement in physical function, muscle strength, and HRQOL compared with those in the attention control group. Similarly, Servantes and colleagues 54 found that a home-based exercise training intervention improved both HRQOL (as assessed by MLHFQ) and functional status (as measured by exercise testing, peak oxygen consumption) in patients with HF.…”

Aerobic exercise effect on prognostic markers for systolic heart failure patients: a systematic review and meta-analysis

“…Figure 4 shows Included patients are primary atrial fibrillation diagnoses Passino et al [60] Baseline NTproBNP was lower than 300 pg/ml Brehm et al [61] Study did not report the exercise protocol Conraads et al [62] It is a non-randomized study Gary et al [63] The peptide marker is BNP and not NTproBNP NTproBNP Jonsdóttir et al [64] The peptide marker is BNP and not NTproBNP…”