Cardiopulmonary exercise capacity and quality of life of patients with heart failure undergoing a functional training program: study protocol for a randomized clinical trial.

do Nascimento DM, Machado KC, Bock PM, Saffi MAL, Goldraich LA, Silveira AD, Clausell N, Schaan BD

BMC Cardiovasc Disord. 2020 Apr 25;20(1):200. doi: 10.1186/s12872-020-01481-6.

BACKGROUND: Exercise intolerance is a common finding in heart failure that
generates a vicious cycle in which the individual starts to limit his activities
even more due to progressive fatigue. Regular physical exercise can increase the
cardiopulmonary exercise capacity of these individuals. A new approach to
physical exercise, known as functional training, could improve the oxygen
consumption and quality of life of patients with heart failure; however, there is
no information about the effect of this modality of exercise in this patient
population. This randomized trial will compare the effects of 36 sessions of
functional training versus strength training in heart failure patients.
METHODS: This randomized parallel-design examiner-blinded clinical trial includes
individuals of both sexes aged ≥40 years receiving regular follow-up at a single
academic hospital. Subjects will be randomly allocated to an intervention group
(for 12-week functional training) or an active comparator group (for 12-week
strength training). The primary outcomes will be the difference from baseline to
the 3-month time point in peak oxygen consumption on cardiopulmonary exercise
testing and quality of life assessed by the Minnesota Living with Heart Failure
Questionnaire. Secondary outcome measures will include functionality assessed by
the Duke Activity Status Index and gait speed test; peripheral and inspiratory
muscular strength, assessed by hand grip and manovacuometry testing,
respectively; endothelial function by brachial artery flow-mediated dilation;
lean body mass by arm muscle circumference; and participant adherence to the
exercise programs classified as a percentage of the prescribed exercise dose.
DISCUSSION: The functional training program aims to improve the functional
capacity of the individual using exercises that relate to his specific physical
activity transferring gains effectively to one’s daily life. In this context, we
believe that that functional training can increase the cardiopulmonary exercise
capacity and quality of life of patients with heart failure. The trial has been
recruiting patients since October 2017.