Evidence-Based Application of Aerobic and Resistance Training in Patients With Congestive Heart Failure

In Brief 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 (v̇O2 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 v̇O2 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 v̇O2 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. A literature search was conducted utilizing strict inclusion criteria to evaluate the evidence of therapeutic aerobic and resistance exercise in patients with congestive heart failure (CHF). Both types of exercise were shown to have clinical importance. Results indicate that aerobic and resistance training in patients with CHF is clinically efficacious.