Article

OBJECTIVE: To evaluate the effects of home-based exercise for patients with
chronic heart failure and sleep apnoea and to compare two different training
programmes. DESIGN: A randomized, prospective controlled trial. SETTING:
Department of Cardiology, University Hospital, Brazil. SUBJECTS: Fifty chronic
heart failure patients with sleep apnoea were randomized in three groups: Group 1
(aerobic training, n = 18), Group 2 (aerobic with strength training, n = 18), and
Group 3 (untrained, n = 14). INTERVENTIONS: The training programme for Groups 1
and 2 began with three supervised exercise sessions, after they underwent three
months of home-based exercise. Patients were followed by weekly telephone call
and were reviewed monthly. Group 3 had the status of physical activity evaluated
weekly by interview to make sure they remained untrained. MAIN OUTCOME MEASURES:
At baseline and after three months: cardiopulmonary exercise testing, isokinetic
strength and endurance, Minnesota living with heart failure questionnaire and
polysomnography. Adherence was evaluated weekly. RESULTS: Of the 50 patients
enrolled in the study, 45 completed the programme. Clinical events: Group 1 (one
death), Group 2 (one myocardial infarction), Group 3 (one death and two strokes).
None were training related. Training groups showed improvement in all outcomes
evaluated and the adherence was an important factor (Group 1 = 98.5% and Group 2
= 100.2%, P = 0.743). Untrained Group 3 demonstrated significant decrease or no
change on measurements after three months without training. CONCLUSION:
Home-based exercise training is an important therapeutic strategy in chronic
heart failure patients with sleep apnoea, and strength training resulted in a
higher increase in muscle strength and endurance.

Langue : ANGLAIS