This systematic review investigates the effectiveness of exercise interventions in improving disease-related characteristics in patients with rheumatoid arthritis (RA). It also provides suggestions for exercise programmes suitable for improving the cardiovascular profile of RA patients and proposes areas for future research in the field. Six databases (Medline, Cochrane Library, CINAHL, Google Scholar, EMBASE and PEDro) were searched to identify publications from 1974 to December 2006 regarding RA and exercise interventions. The quality of the studies included was determined by using the Jadad scale. Initial searches identified 1342 articles from which 40 met the inclusion criteria. No studies were found investigating exercise interventions in relation to cardiovascular disease in RA. There is strong evidence suggesting that exercise from low to high intensity of various modes is effective in improving disease-related characteristics and functional ability in RA patients. Future studies are required to investigate the effects of exercise in improving the cardiovascular status of this patient population.

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Rheumatoid arthritis, cardiovascular disease and physical exercise: a systematic review

The aim of this study was to evaluate the effectiveness of a novel group-based aerobic interval training of high intensity on functional capacity and quality of life in patients with chronic heart failure (CHF) and examine the relation between changes in functional capacity and quality of life. Eighty patients with stable CHF (63 men, 17 women; mean age 70.1 ± 7.9 [SD] years; left ventricular ejection fraction 30 ± 8.5%) on optimal medical treatment were randomly assigned to either a 16-week group-based aerobic high-intensity interval training model twice weekly for 65 to 80 minutes/day (n = 40) or a control group (n = 40) that received standard care. Functional capacity was measured using the 6-minute walk test and cycle ergometer test. Quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. After 16 weeks, functional capacity improved significantly in the exercise group compared with the control group measured using the 6-minute walk test (+58 vs −15 meters; p

Effects of Group-Based High-Intensity Aerobic Interval Training in Patients With Chronic Heart Failure

Aims

The effects of exercise training in chronic heart failure are well established, however, they have not been evaluated in Chagas cardiomyopathy (ChC). We sought to determine the effects of exercise training on functional capacity, health-related quality of life (HQoL), and brain natriuretic peptide (BNP) levels in patients with ChC.



Methods and results

This randomized, controlled, single-blind trial included 40 patients with ChC (age 49.5 ± 7.8 years, 57.5% male) who did not practice regular exercise. All patients were assessed, at baseline and at the end of the study, by exercise test (VO2 and exercise time), six-minute walk test (6MWT), Goldman Specific Activity Scale (SAS), HQoL, and BNP levels. Patients were randomized to inactive control group (ICG = 19) or exercise training group (ETG = 21). Exercise training group patients underwent 12 weeks of exercise training: walking for up to 30 min (intensity 50–70% HR reserve + HR at rest) and warm-up and cooling-down exercising, three times a week. The data were analysed for delta values (Δ= end − baseline). After intervention, compared with the ICG, the ETG had significant increases in functional parameters including, ΔVO2 (6.5 vs. 2.8 mL/kg/min, P = 0.001), Δ exercise time (2.9 vs.1.1 min, P < 0.001), Δ6MWT distance (83.5 vs. 2.0 m, P = 0.001) improved ΔSAS (8 vs. 1 patient, P = 0.008), and HQoL: Δ domains vitality (7.5 vs. 0 points, P = 0.013), Δ emotional aspects (16.7 vs. 0 points, P = 0.012), and Δ mental health (16.1 vs. 0 points, P = 0.031). There was no difference in BNP levels.



Conclusion

In patients with ChC, exercise training was associated with a major improvement in functional capacity and HQoL without any adverse effects.

A randomized trial of the effects of exercise training in Chagas cardiomyopathy.

Chronic heart failure (CHF) is a complex disease process connected with cardiovascular system as well as other organs and skeletal muscles. In connection with the above, cardiac rehabilitation, consisting of exercise training and diet supplementation, aims at recovery of physical, social and psychic function and removing risk factors influencing the occurrence of circulatory system diseases. Evidence has shown that exercise training in CHF patients, both aerobic and resistance, can increase peak oxygen consumption and exercise capacity, improve NYHA (New York Heart Association) functional class, reduce mortality and improve the quality of life. Evidence suggests that most improvement is due to the effects of training on the peripheral circulation and skeletal muscle, rather than on the heart itself. Exercise training can improve skeletal muscle metabolism, increase blood flow within the active skeletal muscles, increase capillary density, promote the synthesis and release of nitric oxide, improve angiogenesis, and decrease oxidative stress. Physical effort reduces sympathetic arousal and increases parasympathetic arousal, thus reducing cardiac dysrythmia and ischemia. Mitochondria start working harder, as the demand for energy is higher and electron flow provides energy in the form of ATP. Studies have consistently demonstrated that exercise training is safe and has no deleterious effect on central haemodynamics, left ventricular remodeling, systolic or diastolic function, or myocardial metabolism. Taking several supplements that have documented roles in medical therapy, including vitamins B, C and E, coenzyme Q10, alpha-lipoic acid, chromium, omega-3 polyunsaturated fatty acids, L-carnitine, and quercetin, has beneficiary effect on many diseases, including CHF. In our experience, 19 patients with CHF who undertook resistance (weight) training and food supplementation, returned to their normal activities after 4 months, without any complaints.

/pdf/comprehensive-rehabilitation-in-chronic-heart-failure-4ggnewujbv.pdf

Comprehensive rehabilitation in chronic heart failure.

Purpose: This study compared the heart rate (HR), rate of perceived exertion (RPE), and blood lactate (BL) responses to aerobic exercise between posttreated breast cancer patients and apparently healthy, age-matched controls. Methods: Seven patients and 7 control subjects underwent a submaximal treadmill test for the estimation of Vo2max. Exercise intensities of 40%, 60%, and 70% of Vo2max were calculated from the treadmill test and randomly examined between groups during three 9-minute exercise bouts on 3 different days. Independent samples t tests were used to examine the HR, RPE, and BL responses at each intensity between groups. Results: No significant differences were observed between the control and patient groups for HR, RPE, and BL at 40% (101 ± 9 vs 101 ± 11 bpm, P = .979; 8 ± 1 vs 9 ± 3, P = .237; and 1.11 ± 0.73 vs 1.26 ± 0.64 mmol/L, P = .188, respectively) and 60% (127 ± 17 vs 117 ± 13 bpm, P = .523; 12 ± 2 vs 11 ± 3, P = .267, and 3.83 ± 2.48 vs 2.23 ± 1.65 mmol/L, P = .237, respectively) of...

https://journals.sagepub.com/doi/pdf/10.1177/1534735409335506

Aerobic exercise intensity in breast cancer patients: a preliminary investigation.

Heart failure (HF) is characterized by dyspnea and fatigue leading to exercise intolerance. HF patients have been advised to avoid exercise because of concerns about detrimental cardiac effects. However, in many studies on the effects of exercise training HF patients have demonstrated beneficial outcomes. Furthermore, exercise training has been found to be safe. Recent studies have demonstrated that exercise training might reduce morbidity and mortality. Although these data are promising, confirmation is required from a large clinical trial powered to examine the effects of exercise training on mortality and morbidity. The "Heart Failure - A Controlled Trial Investigating Outcomes of Exercise TraiNing" (HF-ACTION) trial, a large randomized controlled clinical trial, will answer that question. Standardized guidelines for exercise training HF patients have not been established. Exercise training should be individualized according to the results of the exercise test. Ideally, the exercise program should be initiated in the setting of a supervised program followed by a home-based program. Each patient should have a tailored activity program based on a prescription for the frequency of each session, the intensity, duration of each session, and modalities to be used. Exercise training should involve aerobic exercise. Resistance exercise and interval training might be an acceptable method for HF patients; however, more studies are required for these types of exercise programs.

J K Ko

Papers

The role of exercise training for patients with heart failure.