Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes

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Servantes, Denise Maria [UNIFESP]
Pelcerman, Amalia [UNIFESP]
Salvetti, Xiomara Miranda [UNIFESP]
Salles, Ana Fátima [UNIFESP]
Albuquerque, Pedro Ferreira de [UNIFESP]
Alves de Salles, Fernando Cezar [UNIFESP]
Lopes, Cleide [UNIFESP]
Mello, Marco Tulio de [UNIFESP]
Almeida, Dirceu Rodrigues de [UNIFESP]
Oliveira Filho, Japy Angelini [UNIFESP]
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Objective: To evaluate the effects of home-based exercise for patients with chronic heart failure and sleep apnoea and to compare two different training programmes.Design: A randomized, prospective controlled trial.Setting: Department of Cardiology, University Hospital, Brazil.Subjects: Fifty chronic heart failure patients with sleep apnoea were randomized in three groups: Group 1 (aerobic training, n = 18), Group 2 (aerobic with strength training, n = 18), and Group 3 (untrained, n = 14).Interventions: the training programme for Groups 1 and 2 began with three supervised exercise sessions, after they underwent three months of home-based exercise. Patients were followed by weekly telephone call and were reviewed monthly. Group 3 had the status of physical activity evaluated weekly by interview to make sure they remained untrained.Main outcome measures: At baseline and after three months: cardiopulmonary exercise testing, isokinetic strength and endurance, Minnesota living with heart failure questionnaire and polysomnography. Adherence was evaluated weekly.Results: of the 50 patients enrolled in the study, 45 completed the programme. Clinical events: Group 1 (one death), Group 2 (one myocardial infarction), Group 3 (one death and two strokes). None were training related. Training groups showed improvement in all outcomes evaluated and the adherence was an important factor (Group 1 = 98.5% and Group 2 = 100.2%, P = 0.743). Untrained Group 3 demonstrated significant decrease or no change on measurements after three months without training.Conclusion: Home-based exercise training is an important therapeutic strategy in chronic heart failure patients with sleep apnoea, and strength training resulted in a higher increase in muscle strength and endurance.
Clinical Rehabilitation. London: Sage Publications Ltd, v. 26, n. 1, p. 45-57, 2012.