Home-based training program in patients with chronic heart failure and reduced ejection fraction: a randomized pilot study

Autor(es)

Geisa Nascimento de Andrade ^[1] ; Iracema Ioco Kikuchi Umeda ^[2] ; Angela Rubia Cavalcanti Neves Fuchs ^[3] ; Luiz Eduardo Mastrocola ^[4] ; João Manoel Rossi-Neto ^[5] ; Dalmo Antonio Ribeiro Moreira ^[6] ; Patricia Alves de Oliveira ^[7] ; Carmen Diva Saldiva de André ^[8] ; Lawrence Patrick Cahalin ^[9] ; Naomi Kondo Nakagawa ^[10]

Afiliação do(s) autor(es)

^[1] Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Departamento Fisioterapia - Brasil

^[2] Instituto Dante Pazzanese de Cardiologia - Brasil

^[3] Instituto Dante Pazzanese de Cardiologia - Brasil

^[4] Instituto Dante Pazzanese de Cardiologia - Brasil

^[5] Instituto Dante Pazzanese de Cardiologia - Brasil

^[6] Instituto Dante Pazzanese de Cardiologia - Brasil

^[7] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Instituto do Coracao (InCor). Divisao de Cardiologia - Brasil

^[8] Universidade de Sao Paulo. Instituto de Matematica e Estatistica. Departamento de Estatistica - Brasil

^[9] University of Miami, Miller School of Medicine. Department of Physical Therapy - Estados Unidos

^[10] Universidade de Sao Paulo. Faculdade de Medicina FMUSP. Departamento Fisioterapia - Brasil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 76, 2021-06-11.

Resumo

OBJECTIVES: We aimed to compare the effects of home-and center-based exercise training programs on functional capacity, inspiratory muscle strength, daily physical activity level, and quality of life (QoL) in patients with chronic heart failure (CHF) over a 12-week period. METHODS: This study included 23 patients with CHF (left ventricular ejection fraction 31±6%) randomized to a home-based (n=11) or center-based (n=12) program. Patients underwent 12 weeks of aerobic training (60%-70% heart rate reserve): walking for the home-based and supervised cycling for the center-based group, both combined with resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed cardiopulmonary test variables, 6-min walk test distance (6 MWD), steps/day with accelerometry, and QoL (Minnesota Living with Heart Failure questionnaire). Maximal inspiratory pressure and handgrip strength were measured at baseline and after 4, 8, and 12 weeks of training. ClinicalTrials.gov: NCT03615157. RESULTS: There were no adverse events during training in either group. The home- and center-based training groups obtained similar improvements in peak oxygen uptake, maximal ventilation, and 6 MWD. However, there were significant between-group differences: center-based training was more effective in improving maximal inspiratory pressure (p=0.042), number of steps/day (p=0.001), and QoL (p=0.039). CONCLUSIONS: Home-based training is safe and can be an alternative to improve the exercise capacity of patients with stable CHF. However, center-based training was superior in improving inspiratory muscle strength, QoL, and daily physical activity. (AU)

• Processo FAPESP: 17/21264-7 - Fatores preditores de fraqueza muscular inspiratória em pacientes com insuficiência cardíaca: parâmetros clínicos, funcionais e biomarcadores inflamatórios e de doenças cardiovasculares
• Beneficiário: Naomi Kondo Nakagawa
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/13598-1 - Fisioterapia: funcionalidade e estudo celular e biomolecular no tratamento de pacientes com disfunções cardiorrespiratórias
• Beneficiário: Naomi Kondo Nakagawa
• Modalidade de apoio: Auxílio à Pesquisa - Regular