Effect of Resistance Training on Physical Disability in Chronic Heart Failure
Open accessAbstract
PURPOSE: Patients with chronic heart failure (CHF) report difficulty performing activities of daily living. To our knowledge, however, no study has directly measured performance in activities of daily living in these patients to systematically assess their level of physical disability. Moreover, the contribution of skeletal muscle weakness to physical disability in CHF remains unclear. Thus, we measured performance in activities of daily living in CHF patients and controls, its relationship to aerobic capacity and muscle strength, and the effect of resistance exercise training to improve muscle strength and physical disability. METHODS: Patients and controls were assessed for performance in activities of daily living, self-reported physical function, peak aerobic capacity, body composition, and muscle strength before and after an 18-wk resistance training program. To remove the confounding effects of several disease-related factors (muscle disuse, hospitalization, acute illness), we recruited controls with similar activity levels as CHF patients and tested patients >6 months after any disease exacerbation/hospitalization. RESULTS: Performance in activities of daily living was 30% lower (P < 0.05) in CHF patients versus controls and was related to both reduced aerobic capacity (P < 0.001) and muscle strength (P < 0.01). Moreover, resistance training improved (P < 0.05 to P < 0.001) physical function and muscle strength in patients and controls similarly, without altering aerobic capacity. CONCLUSIONS: CHF patients are characterized by marked physical disability compared with age- and physical activity-matched controls, which is related to reduced aerobic capacity and muscle strength. CHF patients respond to resistance training with normal strength/functional adaptations. Our results support muscle weakness as a determinant of physical disability in CHF and show that interventions that increase muscle strength (resistance training) reduce physical disability.
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A consequence of the HF-mediated decline in peak VO2 is decreased physical functional performance and greater risk for poor outcomes.
“A consequence of the HF-mediated decline in peak V˙o2 is decreased physical functional performance and greater risk for poor outcomes.186,187,189–193”
The peak VO2 of a typical older patient with HF (≈14 mL·kg−1·min−1) is well below the established threshold value of 18 mL·kg−1·min−1 distinguishing between high and low physical function.
“The peak V˙o2 of a typical older patient with HF (≈14 mL·kg−1·min−1)185–188 is also well below the established threshold value (ie, 18 mL·kg−1·min−1),125 distinguishing between high and low physical function.”
In older patients with HF (mean age ≥70 years), peak VO2 during upright treadmill or cycle exercise is ≈30% lower than in age-matched healthy subjects, and the magnitude of the reduction is independent of HF phenotype.
“Studies by Kitzman et al185 and others186–188 found that in older patients with HF (mean age ≥70 years), peak V˙o2 during upright treadmill or cycle exercise is ≈30% lower than in age-matched healthy subjects, and the magnitude of the reduction is independent of HF phenotype (ejection fraction).186”
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References 44 · Cited by 109
- Authors
- SAVAGE, P. A., SHAW, A. O., MILLER, M. S., VANBUREN, P., LEWINTER, M. M., ADES, P. A., & TOTH, M. J.
- Affiliations
- University of Vermont (US)
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 2011-08
- Volume
- 43
- Issue
- 8
- Pages
- 1379-1386
- ISSN
- 0195-9131 (ISSN-L)
- PMC
- PMC3410739
- OpenAlex
- W1978261497
- Cited by
- 109
- References
- 44
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 8 · 2021: 11 · 2020: 5 · 2019: 7 · 2018: 5 · 2017: 10 · 2016: 11 · 2015: 2 · 2014: 6 · 2013: 7 · 2012: 4
- FWCI
- 17.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ScholarWorks@UMassAmherst (University of Massachusetts Amherst) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-077418, R01HL077418)
- National Center for Research Resources (RR-00109, M01RR000109)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- chronic heart failure, resistance training, physical disability, activities of daily living, muscle strength, skeletal muscle weakness, cardiorespiratory fitness, physical function, body composition, exercise intervention
- MeSH terms
- Activities of Daily Living, Aged, Body Composition, Chronic Disease, Female, Persons with Disabilities, Heart Failure, Humans, Male, Oxygen Consumption, Cohort Studies, Muscle, Skeletal, Muscle Weakness, Resistance Training
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