Evidence-based application of aerobic and resistance training in patients with congestive heart failure.

PURPOSE: The objective of this study was to use a modified Philadelphia Panel rating method to evaluate the evidence supporting the use of therapeutic exercise interventions in patients with congestive heart failure (CHF).

METHODS: A computerized literature search was conducted. Inclusion criteria included studies using randomized clinical trial (RCT) or controlled clinical trial (CCT) study designs, participants from populations with CHF, and studies that evaluate the effects of aerobic exercise and/or strength training exercise. The outcomes examined were blood pressure (BP), maximum oxygen consumption (VO2 max), resting heart rate (HR), left ventricular function, peak lactate levels, dyspnea, work capacity, muscle strength, and muscle endurance. The therapeutic interventions assessed were treadmill aerobic exercise, bicycle ergometer aerobic exercise, and resistance exercise.

RESULTS: Aerobic exercise was shown to have significant (P < .01) clinical importance in the outcomes of VO2 max levels, dyspnea, work capacity, and left ventricular function. Resistance exercise was shown to have clinical importance in improving left ventricular function (P = .0085), peak lactate levels (P = .064), muscle strength (P = .05), and muscle endurance (P = .001).

CONCLUSIONS: There is evidence to establish the efficacy of aerobic and resistance training for patients with CHF. Aerobic exercise was shown to improve VO2 max, dyspnea, work capacity, and left ventricular function. Resistance exercise was shown to improve left ventricular function, peak lactate levels, muscle strength, and muscle endurance. These results support the inclusion of aerobic exercise programs and resistance training for patients with CHF.