Original ArticleEffect of exercise training on quality of life in patients with chronic heart failure
Introduction
Chronic heart failure (CHF) is a major health problem, with an increasing incidence and a gloomy prognosis, that is often accompanied by restricted physical activity and severe complaints in several areas of quality of life [1]. The beneficial effects of physical activity and training on psychological functioning in healthy individuals and several patient groups have been documented extensively 2, 3, 4, 5, 6, 7, 8, 9, 10, 11.
For patients with chronic heart failure (CHF), however, avoidance of strenuous physical activity has been advocated for a long time, often resulting in further disablement and a decrease in quality of life [12].
Recently, exercise training has been recognized as a valuable therapeutic modality in CHF, resulting in an improvement in exercise capacity, muscular function and neurohormonal balance 13, 14, 15, 16, 17, 18. Very little attention has been paid, however, to the clinically more relevant consequences for everyday activities and quality of life. The purpose of this study was to determine whether exercise training, by itself, can improve quality of life and to what extent physical improvement and improvement in quality of life are related.
Section snippets
Study design
This study comprises a single-center, prospective, randomized comparison of 12 weeks of exercise training with 12 weeks of usual medical care in CHF patients. Assessment of quality of life measures and exercise testing were performed in both the training and the control group at entry and after 12 weeks. The study was performed in accordance with the Declaration of Helsinki and the protocol was approved by the local hospital medical ethics committee. Informed consent was obtained from all
Patients
Of the 41 patients randomized to the training (TR) group, 35 completed the program. The six dropouts were one sudden cardiac death not related to exercise, three because of lack of motivation, one due to ventricular tachycardia (not related to exercise) requiring hospital admission, and one due to progression of claudication.
Of the 39 patients randomized to the control (CO) group, 32 completed the study period. The seven dropouts were two sudden cardiac deaths, one noncardiac death, one who
Discussion
The present study confirms that exercise training can be performed safely by patients with mild to moderate chronic heart failure (CHF). After 12 weeks of physical training an increase in general well-being and a reduction in feelings of disability, related to the increase in exercise performance, were observed. These results support the concept that exercise training is an important modality to increase quality of life in CHF.
Coats et al. [13] performed the first controlled study in 17 CHF
Acknowledgements
Acknowledgments—This study was supported by a grant from The Netherlands Heart Foundation.
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