Issues in cardiovascular nursingEffects of exercise training on aerobic capacity and quality of life in individuals with heart failure
Introduction
During the past decade, researchers have demonstrated that patients with heart failure (HF) can improve exercise and functional capacity through physical training.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 However, results have been equivocal as to the effect of exercise training on overall quality of life (QOL) in patients with HF.12, 13, 14, 15, 16, 17 In addition, it is not known whether improving physical capacity during treadmill exercise tests translates into reduced symptoms and increased physical activity in daily life.
The objectives of this investigation were to determine whether subjects with chronic HF, who completed a 12-week program of cardiopulmonary training, would have significantly greater QOL, better aerobic fitness, less difficulty with symptoms secondary to HF, greater self-efficacy for exercise, and higher daily activity levels when compared with subjects who met bi-weekly with an investigator but did not undergo cardiopulmonary training. An additional objective was to determine whether subjects randomized to the exercise program would continue to show improvement at 24 and 36 weeks and with less frequently scheduled supervised exercise training sessions. This study was approved by the Hospital Human Studies Subcommittee, and all procedures were performed in accordance with institutional guidelines.
Section snippets
Research design
In this randomized controlled clinical trial, subjects were screened for eligibility, and written consent was obtained. After eligibility for participation in the study was established, each subject completed a health-related QOL questionnaire and underwent a symptom-limited Naughton treadmill test (TMT). The TMT was repeated to establish a stable baseline, and the subject began completing the baseline 3-day physical activity diary. After baseline testing, the subject was randomized to an
Subjects
Fifty-one subjects met the inclusion criteria and gave their written informed consent. Of these 51 volunteers, 31 males completed baseline testing and were randomized into one of 2 experimental groups (n = 15 exercise, n = 16 control). Of the 20 subjects not randomized, 12 had a left ventricular ejection fraction greater than 40%, 3 had positive stress tests precluding participation, 3 failed to keep scheduled appointments, 1 had unstable HF, and 1 had uncontrolled blood pressure. A summary of
Discussion
After 12 weeks, there was a significant difference in the change score between the exercise and control group on the physical function subscale of the SF-36. A moderate-to-large improvement in physical function was observed in the exercise group accompanied by a small decline in the control group. The present study is one of only a few studies that have demonstrated an improvement in QOL in a randomized controlled trial.13, 16, 17, 31 Austrian investigators observed significant improvements in
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