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Effects of aerobic or aerobic and resistance training on cardiorespiratory and skeletal muscle function in heart failure: a randomized controlled pilot trial

Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada, mandic.sandra{at}gmail.com, School of Physical Education, University of Otago, Dunedin, New Zealand

Wayne Tymchak

Faculty of Medicine, Division of Cardiology, University of Alberta, Edmonton, Canada

Daniel Kim

Faculty of Medicine, Division of Cardiology, University of Alberta, Edmonton, Canada

Bill Daub

Northern Alberta Cardiac Rehabilitation Program, Glenrose Hospital, Capital Health, Edmonton, Canada

H Arthur Quinney

School of Physical Education, University of Otago, Dunedin, New Zealand

Dylan Taylor

Faculty of Medicine, Division of Cardiology, University of Alberta, Edmonton

Suhaib Al-Kurtass

Faculty of Medicine, Division of Cardiology, University of Alberta, Edmonton

Mark J Haykowsky

Faculty of Medicine, Division of Cardiology and Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

Objective: To examined the effects of different training modalities on exercise capacity (Vo _2peak), systolic function, muscular strength and endurance and quality of life in heart failure patients.

Design: Randomized controlled trial.

Setting: Cardiac rehabilitation centre in Canada.

Subjects: Forty-two individuals with heart failure (62 ± 12 years; New York Heart Association (NYHA) classes I—III).

Interventions: Aerobic training (n = 14), combined aerobic and resistance training (n = 15) or usual care (n = 13) three times per week for 12 weeks.

Main measures: (1) Vo _2peak measured by symptom-limited graded exercise test on cycle ergometer; (2) systolic function assessed by two-dimensional echocardiography; (3) muscular strength and muscular endurance measured by one-repetition maximum procedure; and (4) quality of life assessed by questionnaires.

Results: In the intention-to-treat analysis, neither aerobic nor combined aerobic and resistance training significantly improved Vo_2peak, systolic function or quality of life compared with usual care. However, combined aerobic and resistance training significantly improved upper extremity strength (40.7 (14.0)—48.5 (16.0) kg, P<0.05) and muscular endurance (5.7 (2.7)—11.6 (7.6) reps, P<0.05) compared with aerobic training or usual care. In compliant participants (exercise adherence 80%), Vo_2peak increased in the aerobic group (16.9 (6.0)—19.0 (6.8), P= 0.026) and tended to increase in the combined training group (15.9 (5.0)—17.6 (5.6), P= 0.058) compared with usual care. Quality of life was improved in the aerobic group only.

Conclusions: Both aerobic and combined aerobic and resistance training are effective interventions to improve Vo_2peak in compliant heart failure patients. Combined training may be more effective in improving muscle strength and endurance.

Clinical Rehabilitation, Vol. 23, No. 3, 207-216 (2009)
DOI: 10.1177/0269215508095362


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