Resistance training (RT) has been shown to improve chronic heart failure (CHF) patients' functional ability and quality of life. Despite these benefits RT has not always been recommend as a form of ...exercise principally because of a concern for acceleration of the left ventricular (LV) remodeling process. This study investigated the effects of 8 weeks RT on the LV structure and function of patients with CHF.
Fifteen men who suffered from CHF were divided into either a RT program or non-training control group. Before and after 8 weeks of training patients underwent resting echocardiography to assess their end-diastolic and end-systolic dimensions (EDD and ESD, respectively), ejection fraction (EF), fractional shortening (FS) and stroke volume (SV).
A repeated measured ANOVA showed that 8 weeks of RT had no significant effect on the LV measurements (group×time,
p>0.05). Post training comparison, however, revealed that the EF and FS of the training group was significantly higher than in the control group (40.9±10.5% vs. 30.3±4.6%,
p=0.029 and 25.0±7.0% vs. 17.4±3.1%,
p=0.020 respectively).
RT is a suitable method of training for CHF patients since it does not cause a reduction of LV contractility function or enhance myocardial deterioration as measured by EF and FS.
Resistance training increases the skeletal muscle strength and functional ability of chronic heart failure patients. However, there is limited data regarding the effect of resistance training on the ...hemodynamic responses and peak oxygen consumption (peak VO
2) of chronic heart failure patients treated with beta-blocker. This study examined the effect of resistance training on hemodynamics, peak aerobic capacity, muscle strength and quality of life of chronic heart failure patients on beta-blockers medication.
Fifteen men diagnosed with chronic heart failure were matched to either a resistance training program or non-training control group. At baseline and after 8 weeks of resistance training patients performed both Balke incremental and maximal strength tests and completed quality of life questionnaires.
The resistance training group demonstrated a significant increase of walking time and peak VO
2 by 11.7% (
p=0.002) and ~19% (
p<0.05), respectively Peak VO
2 was significantly correlated with both walking time (
r=0.54,
p=0.038) and change in total weight lifted (
r=0.55,
p=0.034). Quality of life significantly increased by 87% (
p=0.030). The improvement in quality of life was correlated with post training peak VO
2 (
r=0.58,
p=0.025) and total weight lifted during the post maximal strength test (
r=−0.52,
p=0.047).
The benefits from resistance training for chronic heart failure patients on beta-blocker medication included an increased aerobic and exercise capacity, skeletal muscle strength and most importantly, an improvement in the quality of life, which is the main goal of cardiac rehabilitation programs. Furthermore, with appropriate supervision, it is recommended that resistance exercise be added to the exercise rehabilitation program of these patients when possible.
Despite the unequivocal benefits from regular physical activity many obese people continue to live sedentary lifestyles which may be attributed to negative perceptions about exercising. This study ...investigated the acute psychological response of obese individuals to a single self-selected paced aerobic exercise session using the Subjective Exercise Experience Scale (SEES) and the relationship with Body Mass Index (BMI). Six obese volunteers, mean age 43.8 (range 38-50) years and mean BMI of 38.5 (range 30-44) walked 2 km outdoors at a self-selected speed wearing a heart rate monitor. Immediately pre and post a bout of walking, participants completed the SEES, measuring Positive Well Being (PWB), Psychological Distress (PD) and Fatigue. The walking intensity (114.5 plus or minus 17.4bpm) corresponded to 65% of the participant's predicted maximal HR. Walking time was 26.5 plus or minus 3.4 minutes. Wilcoxon Signed-Rank Test showed no significant change post exercise in PWB (18.2 plus or minus 5.4 to 20.3 plus or minus 4.0, p=0.07), PD (5 plus or minus 1.7 to 4.2 plus or minus 0.4, p=0.29) and Fatigue (7.7 plus or minus 3.0 to 9.8 plus or minus 3.3, p=0.14). Spearmans Rho demonstrated significant correlations between BMI and HR (r=0.94, p=0.01), BMI and Walk Time (r=0.89, p=0.02), BMI and Fatigue Pre (r=0.93, p=0.01), BMI and Fatigue Post (r=0.88, p=0.02) and BMI and PD Pre (r=0.85, p=0.03). PD Pre was also significantly correlated with Fatigue Post (r=0.84, p=0.04). Physicians should be aware of greater apprehension and possible psychological stress leading to increased feelings of fatigue after exercise with increasing BMI when encouraging walking for exercise. The levels of PD and Fatigue however were not high suggesting obese individuals generally did not have negative feelings regarding a single exercise session.
Obesity is associated with impaired respiratory function. As a significant correlation exists between respiratory function, muscle strength and lean body mass, the aim of this study was to examine ...the effects of low intensity resistance training as an initial intervention, on respiratory function in obese individuals. Both resistance bands and free weights were used to examine the effectiveness of resistance bands as a training mode. Fifteen obese individuals, ten female and five male (mean age 53.9, range 27-75; mean BMI 38.0, range 30.4 to 46.2) volunteered for the study. Participants allocated to resistance band (n=9) or weights groups (n=6) trained twice a week with intensity monitored by HR and RPE. Measurements include: Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) (spirometer) and quadriceps strength (cybex). A repeated measure MANOVA with planned contrasts was used to examine differences within and between groups and Spearman rho was used to assess the relationship between muscle strength and FVC and FEV. No significant differences were found within group or between groups (all variables p>0.05) after training. Correlation was found between quadriceps strength and FVC and FEV1 both before and after training (r between 0.78 and 0.85, p<0.01). Therefore, low intensity resistance training at this frequency is insufficient to induce significant strength changes in this population. The correlation between muscle strength and respiratory function suggests that higher training intensity and/or frequency which will increase strength and lean body mass is needed in order to enhance respiratory changes.
The Rating of Perceived Exertion (RPE) has been used as a supplementary tool for prescription of exercise training intensity for healthy and special populations. Despite the wide use of the RPE ...scale, there is an inconsistency regarding the accuracy of that scale for chronic heart failure (CHF) patients treated with beta-blockers. The study examined the correlation between RPE and heart rate (HR), percentage of maximal HR (%MHR), ventilation (VE) and oxygen consumption (VO2) during graded treadmill testing and examined the RPE scale as a guideline for training intensity for CHF patients treated with beta-blockers. Fourteen men age 57.7 ± 10.2 yrs diagnosed with CHF and treated with beta-blockers participated in the study. During a Balke treadmill test the subjects RPE, HR, VE and VO2 ml·kg(-1)·min(-1) were monitored. Low to moderate significant correlations were found between RPE and HR, %MHR, VE and VO2 ml·kg(-1)·min(-1) (r = 0.44, 0.43, 0.55 and 0.69 respectively, all p < 0.001). Some subjects exhibited clinical symptoms (e.g. fall of systolic blood pressure, ST depression/elevation) despite relatively low RPE. The RPE may be used to indicate the level of exercise intensity; however it may not represent the HR responses in CHF patients on beta-blocker medication. Therefore, it is recommended to monitor the HR in combination with RPE when prescribing exercise intensity for CHF patients on beta blocker medication. Key PointsRPE correlated with HR, VE and VO2 in CHF patients on beta blockers.There was a large RPE inter-individual variability during graded treadmill tests.RPE can be used as an exercise intensity indicator for patients on beta-blockers, however, it must be taken with caution.
In the past resistance training was forbidden for people with heart failure (HF) because of the concern from increases in rate pressure product due to elevation in blood pressure and afterload. The ...purpose of this paper was to examine the effects of one repetition maximum (1-RM) testing compared to a Balke walking treadmill test. Five males age 56, range 42-68 who were diagnosed with HF (mean EF 37%, range 33-41) performed the Balke walking treadmill test and a 1-RM test (in 8 different exercises). Paired t-tests showed a significant difference in the peak heart rate, peak systolic blood pressure and rate pressure product between the Balke test and the 1-RM test (100.2 plus or minus 3.9 bpm vs. 80.9 plus or minus 8.2 bpm; p=0.01, 143.2 plus or minus 21.2 mmHg vs. 117.5 plus or minus 17.7 mmHg; p=0.02 and 143.8 plus or minus 24.3 vs. 94.6 plus or minus 12.5; p= 0.01 respectively). No significant difference was found in diastolic blood pressure (p=0.14). Additionally, no injuries, muscle soreness or other adverse effect were recorded during and for 24 hours after the tests. The results demonstrate that the physiological responses to a 1-RM test are not as severe as those reported in an incremental Balke test to 60% age predicted max HR. To the contrary, the lower hemodynamic responses during the 1-RM test reduce the myocardial oxygen consumption and the risk for myocardial ischemia during strength testing, in comparison to the aerobic exercise. 1-RM test appears to be a safe method to assess the maximal strength in selected heart failure patients.
The Rated Perceived Exertion (RPE) has been used as an indicator for work intensity. An RPE of 15 or greater has been used to indicate that the anaerobic threshold has been crossed and for the ...termination of exercise testing in cardiac patients (ACSM, 2000). The purpose of this paper was to examine the RPE 15 ("hard") as an indicator for stopping stress test in patients with heart failure (HF) treated with beta-blockers. Five males mean age 56, range 42-68 who were diagnosed with HF (mean EF 37%, SD 4%) and were treated with beta-blockers, performed the Balke walking treadmill test. The mean peak VO2, RPE and heart rate as % of maximal predicted heart rate during the last minutes of exercise were 13.9 mL/kg/min, SD 4.5 mL/kg/min, 12.6, SD 2 and 62%, SD 4% respectively. Criteria for terminating the tests were, fall of systolic blood pressure more than 10 mmHg, ST depression, and no increase of VO2 despite an increase of workload. The preliminary results indicate that a RPE of 15 may be an overestimation of the cardiac metabolic stress experienced by cardiac patients. Therefore the use of a RPE of 15 for terminating stress test in HF patients on beta-blockers may be inappropriate.
It has been demonstrated that resistance exercises may improve chronic heart failure (CHF) patients' functional ability and quality of life, however, physicians do not recommend this form of exercise ...because of a concern for reported increases in afterload and blood pressure (BP) during the exercise. This study compared the heart rate (HR), BP and rate pressure product (RPP) of CHF patients for a Balke incremental test and a maximal strength test (MS). Fifteen men diagnosed with CHF participated in the study. All subjects performed both a Balke incremental test and MS test for eight different resistance exercises. The subjects' HR and BP were monitored during the incremental test and immediately after each resistance exercise. HR, systolic BP and RPP were significantly lower during the MS test than during both the peak Balke incremental test and during exercise at 80% of peak VO2 (p < 0.05). No significant RPP differences were found between upper and lower body resistance exercises (p > 0.05). The physiological responses in this study were less severe during a MS test than those reported during an incremental Balke treadmill test. Also the finding suggests that MS tests may be an acceptable method to assess the maximal strength of patients with moderate heart failure. Key PointsThe physiological responses of CHF patients to maximal strength test were less severe than those reported during a walking incremental test.There were similar hemodynamic responses during upper and lower resistance exercises.Maximal strength test appears to be an acceptable method to assess the maximal strength of patients with moderate CHF.
