Functional capacity-based rehabilitation of patients with chronic stable left ventricular heart failure

Context Heart failure (HF) is a common and costly condition. Reduced endurance is the main limiting factor of exercise capacity in HF patients. Cardiopulmonary exercise testing (CPX) is considered the most objective method to assess exercise capacity in HF patients. Aim To study the degree of improvement among patients with chronic stable left ventricular HF with low and average functional capacity after functional capacity-based rehabilitation program. Settings and design Rehabilitation was done at department of cardiology, department of physical medicine and rehabilitation, Ain Shams university. CPX was done at the National institute of research. Patients and methods A total of 40 patients with chronic heart failure were randomized to either a control (received their medical treatment with no specific rehabilitation program) or a rehabilitation group. Symptom-limited CPX was performed at baseline and at discharge from the program. Rehabilitation group was further divided according to their functional capacity measures obtained from CPX into group 1 and group 2. Minnesota Living with Heart Failure Questionnaire was obtained from all participants. Group 1 received electric muscle stimulation (EMS) of both lower limbs 5 days/week for 5 weeks. Group 2 received a conventional aerobic rehabilitation program 2 or 3 times/week for ∼40 sessions. VO2 peak, VO2-VT, VE/VCO2, peak load, heart rate recovery, and Minnesota Living with Heart Failure Questionnaire values were compared before and after the treatment period. Statistical analysis used Statistical presentation and analysis of the present study was conducted using the mean, SD, Student’s t-test, paired t-test, χ2, linear correlation coefficient, and analysis of variance tests by SPSS, version 17. Results EMS produced significant improvement of functional capacity measures in addition to quality of life. It was comparable to the aerobic rehabilitation in group 2. Both rehabilitation protocols caused significant improvement when compared with the control group. Conclusion Functional capacity and quality of life were improved after either EMS or aerobic rehabilitation protocol when applied to selected patients with chronic heart failure when compared with control patients who did not receive any rehabilitation program.