Abstract
ContextHeart failure (HF) is a common and costly condition. Reduced endurance is the main limiting factor of exercise capacity in HF patients. Cardiopulmonary exercise testing (CPX) is considered the most objective method to assess exercise capacity in HF patients.AimTo study the degree of improvement among patients with chronic stable left ventricular HF with low and average functional capacity after functional capacity-based rehabilitation program.Settings and designRehabilitation was done at department of cardiology, department of physical medicine and rehabilitation, Ain Shams university. CPX was done at the National institute of research.Patients and methodsA total of 40 patients with chronic heart failure were randomized to either a control (received their medical treatment with no specific rehabilitation program) or a rehabilitation group. Symptom-limited CPX was performed at baseline and at discharge from the program. Rehabilitation group was further divided according to their functional capacity measures obtained from CPX into group 1 and group 2. Minnesota Living with Heart Failure Questionnaire was obtained from all participants. Group 1 received electric muscle stimulation (EMS) of both lower limbs 5 days/week for 5 weeks. Group 2 received a conventional aerobic rehabilitation program 2 or 3 times/week for ~40 sessions. VO2peak, VO2-VT, VE/VCO2, peak load, heart rate recovery, and Minnesota Living with Heart Failure Questionnaire values were compared before and after the treatment period.Statistical analysis usedStatistical presentation and analysis of the present study was conducted using the mean, SD, Student’s t-test, paired t-test, χ2, linear correlation coefficient, and analysis of variance tests by SPSS, version 17.ResultsEMS produced significant improvement of functional capacity measures in addition to quality of life. It was comparable to the aerobic rehabilitation in group 2. Both rehabilitation protocols caused significant improvement when compared with the control group.ConclusionFunctional capacity and quality of life were improved after either EMS or aerobic rehabilitation protocol when applied to selected patients with chronic heart failure when compared with control patients who did not receive any rehabilitation program.
Highlights
The syndrome of chronic heart failure (CHF) has become one of the most common cardiovascular disorders throughout the world, placing a heavy financial and social burden on public health funding [1].muscle besides central hemodynamics disturbance
Our aim is to study the degree of improvement in patients with chronic stable left ventricular HF with low and average functional capacity after functional capacity-based rehabilitation program
Patients and methods This study was conducted on 40 participants with chronic stable left-sided heart failure (LHF) with ejection fraction up to 40%
Summary
The syndrome of chronic heart failure (CHF) has become one of the most common cardiovascular disorders throughout the world, placing a heavy financial and social burden on public health funding [1].muscle besides central hemodynamics disturbance. In symptomatic patients with CHF, maximal exercise capacity is often less than 50% of normal. Exercise intolerance is a widespread and serious problem in patients with CHF [2]. Recent evidence examining the underlying pathophysiology of fatigue and dyspnea, the two main symptoms in heart failure (HF), points to structural and functional abnormalities in skeletal. Cardiopulmonary exercise testing (CPX) proved to be the most accurate way for quantification of cardiorespiratory fitness, grading of the etiology and severity of impairment, and an objective assessment of the response to intervention [3,4].
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