Low dose therapeutic exercise in patients with chronic heart failure - impact on physical performance and quality of life
M. Quittan, B. Sturm, G.F. Wiesingcr, R. Pacher(*)
Univ. Hospital Vienna- Dept. of PM&R, (*) - Dept. of Int. Med.II (Cardiology)
26 Patients (23 men, 3 women, mean age (54±9) with stable chronic heart failure due to idiopathic cardiomyopathy were randomly allocated to a control group and a training group. Training consisted of aerobic exercises set at an intensity of 50% of VO2 max and took place 3 times a week for 3 months. The control group continued usual activities of daily living.
Results: Maximal Oxygen uptake (ml/min/kg) and maximal physical performance increased significantly in the exercise group: 15.9±0 to 18.5±0.8; p<0.01 vs. 17.8±+0.7 to 18.5±1.0; n.s. Quality of life (MOS SF-36), expecially subscales of physical functioning and role limitation and social functioning improved significantly. No adverse events were registered.
Conclusion: Low dose exercise training of patients with stable chronic heart failure is effective in improving functional capacity and quality of life perception.
A NON-AEROBIC CARDIAC REHABILITATION (CR) PROGRAM
Anil Mital (University of Cincinnati, Cincinnati, U.S.A.), Donald E. Shrey, Majorkumar Govindaraju, Thomas M. Broderick, Kathryn Colon-Brown, and Byron W. Gustin
Abstract: The traditional Phase II CR process has involved putting coronary heart disease (CHD) victims through an aerobic exercise program involving exercises on treadmill, bicycle and arm ergometers, and arm and leg resistance equipment. These exercises are designed to enhance a CHD victim's aerobic capacity and, in no way, replicate day-to-day industrial work or prepare him/her for return to work. In fact, the metabolic energy requirements for most industrial jobs are less than 25% of an average person' s aerobic capacity. It is our belief that a lack of realistic job-simulation during the CR process is the reason why the return to work rate of CHD victims in the United States has not changed in the last 35 years.
In order to test the significance of the above statement, we designed a non-aerobic phase II CR program that included components of non-repetitive and non-endurance activities such as weight lifting and carrying, and flexibility and dexterity activities The results indicated that, in contrast to traditional phase II CR program, this new program was significantly better (p<0.01) as indicated by CHD victims returning to work (100% for the new program vs. 62% for traditional program). Furthermore, even though aerobic conditioning was not the goal of this new program, it resulted in a significant post-training enhancement of aerobic capacity (p<0.05). The gain in aerobic capacity was comparable to that of the traditional CR program; differences were insignificant (p>0.10).
It is concluded that a CR program that simulates actual job conditions is far superior to traditional CR programs as far as the return to work is concerned. Furthermore, the aerobic conditioning advantage of the proposed CR program is as good as traditional CR programs that only emphasize aerobic conditioning.