Effects of Concurrent,Within-Session, Aerobic and Resistance Exercise Training on Functional Capacity and Muscle Performance in ElderlyMale Patients with Chronic Heart Failure

Abstract: Background. The best format of exercise training (ET) in the setting of cardiac rehabilitationin patients with chronic heart failure (CHF) is still to be defined. Current guidelines recommendaerobic exercises, such as running and cycling, including some sessions per week of resistanceexercise. Aim. The aim of this study was to address the effectiveness of a concurrent exercise trainingprogram utilizing a circuit of sequential endurance and resistance exercises on functional capacityand muscular strength in patients with CHF. Methods. Ninety-five consecutive male patients (age63.1 6 years) with CHF (EF < 40%) in NYHA functional class II/III, were randomly assignedon 1:1 basis to a 12-week aerobic continuous training (AT) or concurrent CT), aerobic + resistance,training (CT), three times a week, with each session lasting 80 min. We used high quality, specificallydesigned ergometers, connected with each other and governed by a central console, and managedby a single physiotherapist. Before and after training all patients performed a symptoms-limitedexercise test on a treadmill and a 6-min walking test (6MWT). Patients in the CT group also performedresistance exercises of upper and lower body. Results. The 6MWT and exercise duration at ergometrictest increased significantly in both AT and CT groups, with the increase being greater in CT group(p < 0.001; ES = 0.13; p < 0.01; ES = 0.07). Muscular strength increased significantly in the CT group,particularly in the lower body muscular districts (p < 0.001). Quality of life improved in both groups,with a significantly greater improvement in the CT group (p < 0.05). No side effects leading todiscontinuation of training were observed. Conclusions. These findings indicate that concurrent,within-session training results in larger improvements in functional capacity, in addition to muscleperformance, in patients with CHF, in comparison to single-mode aerobic training.