Elsevier

Heart & Lung

Volume 33, Issue 3, May–June 2004, Pages 154-161
Heart & Lung

Issues in cardiovascular nursing
Effects of exercise training on aerobic capacity and quality of life in individuals with heart failure

https://doi.org/10.1016/j.hrtlng.2003.12.009Get rights and content

Abstract

Purpose

The purpose of this study was to determine whether subjects with chronic heart failure, who completed a 12-week rehabilitation program, would have significantly greater quality of life, better aerobic fitness, less difficulty with symptoms of heart failure, greater self-efficacy for exercise, and higher daily activity levels when compared with subjects in a control group.

Methods

Thirty-one males, aged 64 ± 10 years with left ventricular ejection fraction of 29 ± 7%, were randomized to a moderate intensity supervised aerobic exercise program (n = 15) or a control group (n = 16). Twenty-seven subjects completed at least 1 follow-up assessment.

Results

After 12 weeks there were significant differences in the change scores for perceived physical function (using RAND Corporation's 36-item short form) (P = .025) and peak oxygen uptake (P = .019) between the exercise and control groups with the exercise group experiencing improved physical function and fitness.

Conclusions

Exercise training in adults with heart failure increases exercise tolerance and perceived physical function. Improved heart failure symptoms, self-efficacy for exercise, or increased physical activity may not be associated with enhancement of exercise tolerance.

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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