Effects of aerobic or aerobic and resistance training on cardiorespiratory and skeletal muscle function in heart failure: a randomized controlled pilot trial Resistance training for chronic heart failure patients on beta blocker medications. A Combined Aerobic and Resistance Exercise Program Improves Physical Functional Performance in Patients With Heart Failure: A Pilot Study Effects of combined aerobic and resistance training versus aerobic training alone in cardiac rehabilitation. Combined aerobic and resistance exercise program improves task performance in patients with heart failure. Effect of resistance training on physical disability in chronic heart failure. Effect of exercise training on quality of life in patients with chronic heart failure. Benefits of combined aerobic/resistance/inspiratory training in patients with chronic heart failure. A complete exercise model? A prospective randomised study. Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD. Resistance Exercise Training Improves Heart Function and Physical Fitness in Stable Patients With Heart Failure The effect of physical training in chronic heart failure. The effects of resistance training on functional outcomes in patients with chronic obstructive pulmonary disease Effect of aerobic vs combined aerobic-strength training on 1-year, post-cardiac rehabilitation outcomes in women after a cardiac event. Superior Cardiovascular Effect of Aerobic Interval Training Versus Moderate Continuous Training in Heart Failure Patients: A Randomized Study Resistance exercise training improves heart rate variability and muscle performance: a randomized controlled trial in coronary artery disease patients. The Impact of Exercise Training on Conduit Artery Wall Thickness and Remodeling in Chronic Heart Failure Patients Effects of exercise training on aerobic capacity and quality of life in individuals with heart failure.
Objective : To examined the effects of different training modalities on exercise capacity ( Vo 2peak ) , systolic function , muscular strength and endurance and quality of life in heart failure patients . Design : R and omized controlled trial . Setting : Cardiac rehabilitation centre in Canada . Subjects : Forty-two individuals with heart failure ( 62 ± 12 years ; New York Heart Association ( NYHA ) classes I — III ) . Interventions : Aerobic training ( n = 14 ) , combined aerobic and resistance training ( n = 15 ) or usual care ( n = 13 ) three times per week for 12 weeks . Main measures : ( 1 ) Vo 2peak measured by symptom-limited grade d exercise test on cycle ergometer ; ( 2 ) systolic function assessed by two-dimensional echocardiography ; ( 3 ) muscular strength and muscular endurance measured by one-repetition maximum procedure ; and ( 4 ) quality of life assessed by question naires . Results : In the intention-to-treat analysis , neither aerobic nor combined aerobic and resistance training significantly improved Vo2peak , systolic function or quality of life compared with usual care . However , combined aerobic and resistance training significantly improved upper extremity strength ( 40.7 (14.0)—48.5 ( 16.0 ) kg , P<0.05 ) and muscular endurance ( 5.7 (2.7)—11.6 ( 7.6 ) reps , P<0.05 ) compared with aerobic training or usual care . In compliant participants ( exercise adherence 80 % ) , Vo2peak increased in the aerobic group ( 16.9 (6.0)—19.0 ( 6.8 ) , P= 0.026 ) and tended to increase in the combined training group ( 15.9 (5.0)—17.6 ( 5.6 ) , P= 0.058 ) compared with usual care . Quality of life was improved in the aerobic group only . Conclusions : Both aerobic and combined aerobic and resistance training are effective interventions to improve Vo2peak in compliant heart failure patients . Combined training may be more effective in improving muscle strength and endurance BACKGROUND 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 . METHODS 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 question naires . RESULTS The resistance training group demonstrated a significant increase of walking time and peak VO(2 ) by 11.7 % ( p=0.002 ) and approximately 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 ) . CONCLUSIONS 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 Background : Recent guidelines for exercise in patients with heart failure ( HF ) recommended aerobic and resistance exercise as being safe and effective ; however , the clinical and functional significance of these combined training modalities has not been established . In this pilot study , combined aerobic and resistance training was hypothesized to improve physical function , muscle strength , and health-related quality of life ( HRQOL ) compared with an attention control wait list ( ACWL ) . Methods : The 10-item Continuous Scale Physical Functional Performance Test ( CS-PFP10 ) , which simulates common household chores ; muscle strength ( h and grip and knee extension ) ; and HRQOL ( Kansas City Cardiomyopathy Question naire ) were evaluated at baseline ( T1 ) and at 12 weeks ( T2 ) . The home-based moderate-intensity walking and resistance training program was performed 5 days a week . Results : Twenty-four New York Heart Association class II to III HF patients ( mean [ SD ] age , 60 [ 10 ] years ; mean [ SD ] left ventricular ejection fraction , 25 % [ 9 % ] ) were r and omized to a combined aerobic and resistance exercise program or to an ACWL group . Of the total group , 58 % were New York Heart Association class III HF patients , 50 % were white , and 50 % were female . The CS-PFP10 total scores were significantly increased in the exercise group , from 45 ( 18 ) to 56 ( 16 ) . The Kansas City Cardiomyopathy Question naire overall summary score was significantly improved ( P < .001 ) at T2 in the exercise intervention group compared with the ACWL group . Conclusions : Participants provided the home-based , combined aerobic and resistance exercise program had significantly improved physical function , muscle strength , symptom severity , and HRQOL compared with the ACWL group . The findings of this study must be interpreted cautiously owing to the limitations of a small sample , data collection from a single center , and differences between control and interventions groups at baseline . A combined aerobic and resistance exercise approach may improve physical function in stable HF patients , but further study in a larger , more diverse population is recommended . However , in this study , the CS-PFP10 instrument demonstrated its ability to identify functional health status in HF patients and thus warrants further testing in a larger sample for possible use in clinical practice PURPOSE This study examined the effects of performing combined resistance and aerobic training , versus aerobic training alone , in patients with coronary artery disease . METHODS Thirty-six patients with coronary artery disease were r and omized to either an aerobic-only training group ( AE ) or a combined aerobic and resistance training group ( AE + R ) . Both groups performed 30 minutes of aerobic exercise 3 days/week for 6 months . In addition , AE + R group performed two sets of resistance exercise on seven different Nautilus machines after completion of aerobic training each day . Twenty patients ( AE : n = 10 ; AE + R : n = 10 ) completed the training protocol with > 70 % attendance . RESULTS Strength gains for AE + R group were greater than for AE group on six of seven resistance machines ( P < 0.05 ) . VO2peak increased after training for both AE and AE + R ( P < 0.01 ) with no difference in improvement between the groups . Resting and submaximal exercise heart rates and rate-pressure product were lower after training in the AE + R group ( P < 0.01 ) , but not in the AE group . AE + R increased lean mass in arm , trunk , and total body regions ( P < 0.01 ) , while AE increased lean mass in trunk region only ( P < 0.01 ) . Percent body fat was reduced for AE + R after training ( P < 0.05 ) with a between group trend toward reduced body fat ( P = 0.09 ) . Lean mass gain significantly correlated with strength increase in five of seven resistance exercises for AE + R. CONCLUSIONS Resistance training adds to the effects of aerobic training in cardiac rehabilitation patients by improving muscular strength , increasing lean body mass , and reducing body fat OBJECTIVES To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association ( NYHA ) class II and III patients and systolic heart failure ( HF ) . DESIGN R and omized controlled trial . SETTING Home based . PARTICIPANTS Stable patients ( N=24 ; mean age , 60 ± 10 y ; left ventricular ejection fraction , 25 % ± 9 % ; 50 % white ; 50 % women ) with New York Heart Association ( NYHA ) classes II and III ( NYHA class III , 58 % ) systolic heart failure ( HF ) . INTERVENTION A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise . Attention control wait list participants performed light stretching and flexibility exercises . MAIN OUTCOME MEASURES A 10-item performance-based physical function measure , the Continuous Scale Physical Functional Performance test ( CS-PFP10 ) , was the major outcome variable and included specific physical activities measured in time to complete a task , weight carried during a task , and distance walked . Other measures included muscle strength , HRQOL ( Minnesota Living With Heart Failure Question naire , Epworth Sleepiness Scale ) , functional capacity ( Duke Activity Status Index ) , and disease severity ( brain natriuretic peptide ) levels . RESULTS After the exercise intervention , 9 of 10 specific task activities were performed more rapidly , with increased weight carried by exercise participants compared with the attention control wait list group . Exercise participants also showed significant improvements in CS-PFP10 total score ( P<.025 ) , upper and lower muscle strength , and HRQOL ( P<.001 ) compared with the attention control wait list group . Adherence rates were 83 % and 99 % for the aerobic and resistance training , respectively . CONCLUSIONS Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach . Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify . Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population PURPOSE Patients with chronic heart failure ( CHF ) report difficulty performing activities of daily living . To our knowledge , however , no study has directly measured performance in activities of daily living in these patients to systematic ally assess their level of physical disability . Moreover , the contribution of skeletal muscle weakness to physical disability in CHF remains unclear . Thus , we measured performance in activities of daily living in CHF patients and controls , its relationship to aerobic capacity and muscle strength , and the effect of resistance exercise training to improve muscle strength and physical disability . METHODS Patients and controls were assessed for performance in activities of daily living , self-reported physical function , peak aerobic capacity , body composition , and muscle strength before and after an 18-wk resistance training program . To remove the confounding effects of several disease-related factors ( muscle disuse , hospitalization , acute illness ) , we recruited controls with similar activity levels as CHF patients and tested patients > 6 months after any disease exacerbation/hospitalization . RESULTS Performance in activities of daily living was 30 % lower ( P < 0.05 ) in CHF patients versus controls and was related to both reduced aerobic capacity ( P < 0.001 ) and muscle strength ( P < 0.01 ) . Moreover , resistance training improved ( P < 0.05 to P < 0.001 ) physical function and muscle strength in patients and controls similarly , without altering aerobic capacity . CONCLUSIONS CHF patients are characterized by marked physical disability compared with age- and physical activity-matched controls , which is related to reduced aerobic capacity and muscle strength . CHF patients respond to resistance training with normal strength/functional adaptations . Our results support muscle weakness as a determinant of physical disability in CHF and show that interventions that increase muscle strength  ( resistance training ) reduce physical disability The effect of exercise training on quality of life and exercise capacity was studied in 67 patients with mild to moderate chronic heart failure ( CHF ; age : 65.6+/-8.3 years ; left ventricular ejection fraction : 26.5+/-9.6 % ) . Patients were r and omly allocated to either a training group or to a control group . After intervention a significantly larger decrease in Feelings of Being Disabled ( a subscale of the Heart Patients Psychological Question naire ) and a significantly larger increase in the Self- Assessment of General Well-Being ( SAGWB ) were observed in the training group . Exercise time and anaerobic threshold were increased in the training group only . The increase in exercise time was related to both Feelings of Being Disabled and SAGWB . We conclude that supervised exercise training improves both quality of life and exercise capacity and can be safely performed by chronic heart failure patients BACKGROUND We hypothesised that combined aerobic training ( AT ) with resistance training ( RT ) and inspiratory muscle training ( IMT ) could result in additional benefits over AT alone in patients with chronic heart failure ( CHF ) . METHODS Twenty-seven patients , age 58 ± 9 years , NYHA II/III and LVEF 29 ± 7 % were r and omly assigned to a 12-week AT ( n=14 ) or a combined AT/RT/IMT ( ARIS ) ( n=13 ) exercise program . AT consisted of bike exercise at 70 - 80 % of max heart rate . ARIS training consisted of AT with RT of the quadriceps at 50 % of 1 repetition maximum ( 1RM ) and upper limb exercises using dumbbells of 1 - 2 kg as well as IMT at 60 % of sustained maximal inspiratory pressure ( SPI(max ) ) . At baseline and after intervention patients underwent cardiopulmonary exercise testing , echocardiography , evaluation of dyspnea , muscle function and quality of life ( QoL ) scores . RESULTS The ARIS program as compared to AT alone , result ed in additional improvement in quadriceps muscle strength ( 1RM , p=0.005 ) and endurance ( 50%1 RM × number of max repetitions , p=0.01 ) , SPI(max ) ( p<0.001 ) , exercise time ( p=0.01 ) , circulatory power ( peak oxygen consumption × peak systolic blood pressure , p=0.05 ) , dyspnea ( p=0.03 ) and QoL ( p=0.03 ) . CONCLUSIONS ARIS training was safe and result ed in incremental benefits in both peripheral and respiratory muscle weakness , cardiopulmonary function and QoL compared to that of AT . The present findings may add a new prospect i ve to cardiac rehabilitation programs of heart failure patients whilst the clinical significance of these outcomes need to be addressed in larger r and omised studies PURPOSE Aerobic exercise training is a recognized approach for improving functional capacity in COPD . People with greater disease severity often have difficulty achieving higher aerobic exercise training intensity . The effects of resistance training prior to aerobic training were examined to determine if this sequential approach was associated with greater gains in functional status than aerobic training alone or concurrent aerobic and resistance training . METHODS Patients were r and omized to : 1 ) sequential resistance then aerobic training ( RT-then-AT ) ( 8 weeks resistance training followed by 8 weeks aerobic exercise training ) , 2 ) control group ( CE-then-AT + RT ) ( 8 weeks of ' sham ' training followed by 8 weeks concurrent aerobic and resistance training ) , 3 ) control group ( CE-then-AT ) ( 8 weeks ' sham ' training followed by 8 weeks aerobic training ) . Outcomes were assessed at study entry , after week 8 , and after week 16 : aerobic exercise performance ; muscle strength and endurance . RESULTS 75 patients completed training :  FEV1 % pred 40 ± 10 , V˙O(2peak ) % predicted , 71 ± 22 , fat-free mass index 19.5 ± 3.1 . RT-then-AT had greater acquisition of peripheral muscle endurance than CE-then-AT + RT and CE-then-AT , but improvements in aerobic exercise performance were similar . Improvements in muscle strength were similar between RT-then-AT and CE-then-AT + RT . Sarcopenia was associated with poorer attendance , and lower aerobic and resistance training volumes . CONCLUSION Although the sequential approach to resistance and aerobic training yielded a greater increase in muscle endurance and higher resistance training volume compared to concurrent resistance and aerobic training , other training outcomes were similar between the two groups , thus the sequential approach is not clearly superior to the concurrent approach in severe COPD . Clinical Trials.gov Identifier : NCT01058213 PURPOSE This study determined the effect of a structured isotonic strength training ( ST ) program on left ventricular ( LV ) function ( ejection fraction , stroke volume , and end-diastolic and end-systolic volumes ) and physical fitness ( 6-minute walk test , upper body strength , lower body strength , and body composition ) in patients with New York Heart Association class II and III heart failure . METHODS Sixteen patients were r and omized into 2 groups , ST and usual care . The ST group ( 10 patients ) performed 24 ST exercise sessions ( 3 per week , 8 weeks ) , while the usual care ( 6 patients ) group followed routine medical care . The structured isotonic ST program involved 12 different exercises on circuit weight machines .  LV function ( 3D echocardiography ) and physical fitness were assessed at baseline and 8 weeks . RESULTS Modest improvements ( P < .05 ) in resting ejection fraction ( 0.32–0.37 ) and stroke volume ( 46 to 53 mL/beat ) , as well as in muscular strength and 6-minute walk distance , were found after training . CONCLUSIONS A short-term structured isotonic ST program appears to improve selected measures of resting LV function and fitness in patients with mild congestive heart failure . Additional studies utilizing larger numbers of subjects , including women , are needed BACKGROUND Supervised cardiac rehabilitation programs have been offered to patients following myocardial infa rct ( MI ) , coronary artery bypass graft surgery ( CABG ) and percutaneous coronary intervention ( PCI ) for many years . However , limited information is available on the usefulness of rehabilitation programs in chronic heart failure ( CHF ) . The aim of our study was to evaluate the outcome of supervised physical training on CHF patients by measuring both central and peripheral factors . METHODS This was a prospect i ve r and omized study , including 43 patients with CHF , New York Heart Association ( NYHA ) class II or III , mean age 68 years . After initial measurements of VO2 peak , 6 min walk distance , muscle strength , plasma levels of atrial natriuretic peptide ( ANP ) and brain natriuretic peptide ( BNP ) , echocardiogram , measurements of pulmonary function and quality of life question naire , patients were r and omized to either a training group ( n = 21 ) or a control group ( n = 22 ) . The training group had supervised aerobic and resistance training program twice a week for five months . After the training program was completed , all measurements were repeated in both groups . RESULTS No training related adverse events were reported . Significant improvement was found between groups in the six minute walk test ( + 37.1 m vs. + 5.3 m , p = 0.01 ) , work load on the bicycle exercise test ( + 6.1 W vs. + 2.1 W , p = 0.03 ) , time on the bicycle exercise test ( + 41 s vs. + 0 s , p = 0.02 ) and quadriceps muscle strength test ( + 2.8 kg . vs. + 0.2 kg . , p = 0.003 ) . Quality of life factors that reflect exercise tolerance and general health , improved significantly in the training group compared to the control group . No other significant changes were found between the two groups . CONCLUSION Supervised physical training as used in this study appears safe for CHF patients in NYHA class II or III . The improvement in functional capacity observed in the training group seems to be related to peripheral factors rather than in central cardiovascular performance Aerobic exercise training is used for rehabilitation in patients with chronic obstructive pulmonary disease ( COPD ) , although it has little effect on muscle weakness and atrophy . Resistance training may be a useful addition to aerobic programs for these patients . The purpose of the present study was to investigate the effects of resistance training in addition to aerobic training on functional outcomes in patients with COPD . Seventeen COPD patients enrolled in an aerobic-based program that met twice a week were assigned to a 12-week control/aerobic [ CON : n=8 ; 63 ( 8) years ; mean ( SD ) ] or a resistance/aerobic group [ RES : n=9 ; 61 ( 7 ) years ] . RES trained an additional twice a week on 12 resistance machines , performing three sets of 8–12 repetitions at 32–64 % of their one-repetition maximum ( 1-RM ) lifts . RES ( P<0.05 ) increased upper ( 36 % ) and lower ( 36 % ) body strength , as well as lean body mass ( 5 % ) , while CON showed little to no change . The 12-min walk distance increased ( P<0.05 ) in only the RES [ 676 ( 219 ) to 875 ( 172 ) m ] . Measurements of three of the eight tasks of activities of daily living improved in RES ( P<0.05 ) compared to CON . This study demonstrated that progressive resistance training was well tolerated and improved functional outcomes in COPD patients that were currently involved in an aerobic training program OBJECTIVE To compare the effect and sustainability of 6 months combined aerobic/strength training vs aerobic training alone on quality of life in women after coronary artery by-pass graft surgery or myocardial infa rct ion . DESIGN Prospect i ve , 2-group , r and omized controlled trial . PARTICIPANTS Ninety-two women who were 8 - 10 weeks post-coronary artery by-pass graft surgery or myocardial infa rct ion , able to attend supervised exercise , and fluent in English . METHODS The aerobic training alone group had supervised exercise twice a week for 6 months . The aerobic/strength training group received aerobic training plus upper and lower body resistance exercises . The amount of active exercise time was matched between groups . The primary outcome , quality of life , was measured by the MOS SF-36 ; secondary outcomes were self-efficacy , strength and exercise capacity . RESULTS After 6 months of supervised exercise training both groups showed statistically significant improvements in physical quality of life ( p = 0.0002 ) , peak VO2 ( 19 % in aerobic/strength training vs 22 % in aerobic training alone ) , strength ( p < 0.0001 ) and self-efficacy for stair climbing ( p = 0.0024 ) , lifting ( p < 0.0001 ) and walking ( p = 0.0012 ) . However , by 1-year follow-up there was a statistically significant difference in physical quality of life in favor of the aerobic/strength training group ( p = 0.05 ) . CONCLUSION Women with coronary artery disease st and to benefit from both aerobic training alone and aerobic/strength training . However , continued improvement in physical quality of life may be achieved through combined strength and aerobic training Background — Exercise training reduces the symptoms of chronic heart failure . Which exercise intensity yields maximal beneficial adaptations is controversial . Furthermore , the incidence of chronic heart failure increases with advanced age ; it has been reported that 88 % and 49 % of patients with a first diagnosis of chronic heart failure are > 65 and > 80 years old , respectively . Despite this , most previous studies have excluded patients with an age > 70 years . Our objective was to compare training programs with moderate versus high exercise intensity with regard to variables associated with cardiovascular function and prognosis in patients with postinfa rct ion heart failure . Methods and Results — Twenty-seven patients with stable postinfa rct ion heart failure who were undergoing optimal medical treatment , including & bgr;-blockers and angiotensin-converting enzyme inhibitors ( aged 75.5±11.1 years ; left ventricular [ LV ] ejection fraction 29 % ; & OV0312;o2peak 13 mL · kg−1 · min−1 ) were r and omized to either moderate continuous training ( 70 % of highest measured heart rate , ie , peak heart rate ) or aerobic interval training ( 95 % of peak heart rate ) 3 times per week for 12 weeks or to a control group that received st and ard advice regarding physical activity . & OV0312;o2peak increased more with aerobic interval training than moderate continuous training ( 46 % versus 14 % , P<0.001 ) and was associated with reverse LV remodeling . LV end-diastolic and end-systolic volumes declined with aerobic interval training only , by 18 % and 25 % , respectively ; LV ejection fraction increased 35 % , and pro-brain natriuretic peptide decreased 40 % . Improvement in brachial artery flow-mediated dilation ( endothelial function ) was greater with aerobic interval training , and mitochondrial function in lateral vastus muscle increased with aerobic interval training only . The MacNew global score for quality of life in cardiovascular disease increased in both exercise groups . No changes occurred in the control group . Conclusions — Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity , endothelial function , and quality of life in patients with postinfa rct ion heart failure . These findings may have important implication s for exercise training in rehabilitation programs and future studies BACKGROUND Resistance exercise ( RE ) is an important part of cardiac rehabilitation . However , it is not known about the low intensity of RE training that could modify the heart rate variability ( HRV ) , muscular strength and endurance in patients with coronary artery disease ( CAD ) . AIM To investigate the effects of high repetition/low load resistance training ( HR/LL-RT ) program on HRV and muscular strength and endurance in CAD patients . DESIGN R and omized and controlled trial . SETTING Patients seen at the Cardiopulmonary Physical Therapy Laboratory between May 2011 and November 2013 . POPULATION Twenty male patients with CAD were r and omized to a training group ( 61.3±5.2 years ) or control group ( 61±4.4 years ) . METHODS 1 repetition maximum ( 1-RM ) maneuver , discontinuous exercise test on the leg press ( DET-L ) , and resting HRV were performed before and after 8 weeks of HR/LL-RT on a 45 ° leg press . RMSSD , SD1 , mean HR and ApEn indices were calculated . The HR/LL-RT program consisted of a lower limb exercise using a 45 ° leg press ; 3 sets of 20 repetitions , two times a week . The initial load was set at 30 % of the 1-RM load and the duration of the HR/LL-RT program was performed for 8 weeks . RESULTS After 8 weeks of HR/LL-RT there were significant increases of RMSSD and SD1 indices in the training group only ( P<0.05 ) . There was a significant decrease in mean HR after HR/LL-RT in the training group ( P<0.05 ) . There was a significantly higher ApEn after in the training group ( P<0.05 ) . There were significantly higher values in the training group in contrast to the control group ( P<0.05 ) . CONCLUSION These results show positive improvements on HRV , as well as muscle strength and endurance in CAD patients . CLINICAL REHABILITATION IMPACT Eight weeks of HR/LL-RT is an effective sufficient to beneficially modify important outcomes as HRV , muscle strength and endurance in CAD patients Exercise training is an important adjunct to medical therapy in chronic heart failure , but the extent to which exercise impacts on conduit artery remodeling is unknown . The aim of this study was to evaluate the impact of aerobic and resistance exercise training modalities on arterial remodeling in patients with chronic heart failure . We r and omized 36 untrained subjects with chronic heart failure to resistance training ( 58.8±3.5 years ) , aerobic training ( 61.3±2.8 years ) , or an untrained control group ( 64.4±2.4 years ) .  Peak oxygen consumption during cycle ergometry  increased after 12 weeks in both the resistance and aerobic training ( P<0.001 ) groups , but not in controls , whereas leg strength only increased after resistance training ( P<0.05 ) . Brachial artery wall thickness decreased in the resistance training group ( 475±10 versus 443±13 & mgr;m ; P<0.01 ) , whereas no changes were apparent in the aerobic or control groups . Brachial diameter increased by ≈6 % and ≈5 % in the aerobic training and resistance training groups ( P<0.01 ) , with no change evident in the control group . The wall : lumen ratio consequently declined in the resistance training group at 12 weeks ( 0.121±0.004 versus 0.107±0.004 ; P<0.01 ) and increased in the control group ( 0.111±0.006 versus 0.121±0.009 ; P<0.05 ) . No wall : lumen change was evident in the aerobic training group . Our findings suggest that exercise has a systemic impact on remodeling of conduit arteries in humans and that resistance exercise training may be advantageous in subjects with chronic heart failure in this regard 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 r and omized 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 R AND 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
Resistance training increased 6-minute walk distance compared to no training , but had no other benefits on cardiac function , exercise capacity , or quality of life if used alone or as an adjunct to aerobic training in people with chronic heart failure .
QUESTION Does resistance training , either alone or as an adjunct to aerobic training , improve cardiac function , exercise capacity and quality of life in people with chronic heart failure ?