Key result
RHIIT significantly improved peripheral and inspiratory muscle strength compared to standard training (p<0.01), with similar improvements in VO2peak (p=0.91) in chronic heart failure patients.
Why the study?
There is still debate regarding the optimal cardiac rehabilitation training protocol in chronic heart failure.
Does high intensity interval training supplemented with peripheral and inspiratory resistance training improve exercise capacity and muscle strength in patients with chronic heart failure?
RCT (n=20)
1:1
Does high intensity interval training supplemented with peripheral and inspiratory resistance training improve exercise capacity and muscle strength in patients with chronic heart failure?
Absolute Event Rate: 19.3% vs -6.89%
p-value: p=<0.01
In patients with chronic heart failure, a cardiac rehabilitation program combining HIIT with peripheral and inspiratory resistance training significantly improves muscle strength compared to standard moderate-intensity training, while achieving similar improvements in peak exercise capacity.
Supports adding resistance training to HIIT in HF rehab for strength gains; extends prior trials with similar VO2peak in this pilot RCT.
Background: Cardiac rehabilitation (CR) is an evidence-based therapy in chronic heart failure (CHF). There is still debate about the optimal training protocol in CHF. The use of high intensity interval training (HIIT) supplemented with peripheral (PRT) and inspiratory resistance training (IRT) might be more beneficial because of the higher impact on the peripheral and inspiratory muscles, with less symptoms of dyspnoea and lower amount of dropouts as a result. We compared our standard exercise-based CR programme, mainly consisting of moderate intensity interval training to a programme combining HIIT, PRT and IRT (resistance training supplemented HIIT (RHIIT) programme).Design: Randomised controlled pilot study.Methods: Twenty patients with CHF were randomised on a 1:1 basis to the standard or RHIIT programme. At baseline and after 3 months, peak exercise capacity (VO2peak), peripheral (QF) and inspiratory respiratory muscle strength (MIP), quality of life (QOL) and physical activity were measured.Results: The RHIIT programme resulted in a significantly larger improvement in QF (ΔQF RHIIT programme: 19.3 ± 11.8 vs standard programme: –6.89 ± 19.0 Nm (p < .01)) and MIP (ΔMIP RHIIT programme: –44.9 ± 29.9 vs standard programme: 0.56 ± 19.4 cmH2O (p < .01)). Both programmes equally improved in VO2peak (p = .91), whereas ventilatory efficiency and physical activity remained stable.Conclusion: HIIT supplemented with PRT and IRT might be applicable as standard protocol in CHF. Larger studies are warranted to confirm our findings. The RHIIT programme resulted in similar training effects in VO2peak in a shorter training period. This might be beneficial in a chronic patient population such as CHF, where adherence is difficult.
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Hornikx et al. (2019) conducted an RCT in chronic heart failure (CHF) (n=20). High intensity interval training supplemented with peripheral and inspiratory resistance training (RHIIT) vs. Standard exercise-based cardiac rehabilitation (moderate intensity interval training) was evaluated on Change in peripheral muscle strength (QF) in Nm (p=<0.01). RHIIT significantly improved peripheral and inspiratory muscle strength compared to standard training (p<0.01), with similar improvements in VO2peak (p=0.91) in chronic heart failure patients.
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