Effect of an Eccentric Exercise Program on Quality of Life and Function in People With Chronic Heart Failure.
Chronic Heart Failure
About this trial
This is an interventional treatment trial for Chronic Heart Failure focused on measuring eccentric, exercise, heart disease, chronic heart failure, rehabilitation
Eligibility Criteria
Inclusion Criteria:
- aged > 18 years
- a clinical diagnosis of heart failure either systolic or diastolic on transthoracic echocardiogram
- mild to moderate heart failure
- medically stable heart failure
- have received approval when assessed by the group physiotherapist to participate in the exercise program as is usual practice. Where concerns arise during assessment, clearance will be sought from the treating cardiologist.
Exclusion Criteria:
- hospitalisation for a CHF exacerbation within the previous month
- severe heart failure classified as level four on the New York heart association classification (short of breath at rest)
- unstable medical condition such as uncontrolled angina, diabetes or hypertension
- dementia or a psychological disorder that would interfere with participation in group exercise
- participation in a cardiac or heart failure rehabilitation program in the prior six months
- contraindications to exercise (ie aneurysm, valvular disease)
- the presence of any pre-existing neurological or musculoskeletal condition, for example stroke, that on assessment is deemed to interfere with exercise participation.
Sites / Locations
- The Northern Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
No Intervention
eccentric aerobic exercise group
Concentric aerobic exercise group
Waiting list control
Eccentric aerobic exercise group: Participants in this group will participate in an eccentric aerobic exercise rehabilitation program for a total of eight weeks, two sessions per week. Outcome measurements will be taken post exercise program and also after a 3 month follow-up period. Each session will be approximately 60 minutes in duration and include approximately 10 minutes of warm up (stretches), eccentric stepper aiming for 20 minutes, walking and light weights, followed by a five minute cool-down period.
Concentric aerobic exercise group (usual care): The length of the concentric aerobic exercise based rehabilitation program will be the same as the study group- twice weekly exercise sessions for 8 weeks. Outcome measurements will also be taken after a 3-month follow-up period. Participants in the concentric aerobic exercise group will participate in the same warm-up and cool down period as the eccentric group. They will also complete walking and light weights. To replace the 20 minutes of eccentric exercise, concentric participants will complete approximately 20 minutes of exercise bike, stair climbing and rowing as able with required rests.
Waiting list (no exercise): Participants assigned to this group will not receive any intervention during the study period. They will be assessed like other participants at baseline and after eight weeks, but not at three-month follow-up due to ethical concerns around withholding care known to be effective. Given that there is a waiting list for the current exercise program of 4-12 weeks, it is felt that delaying care for a set period of eight weeks is not of ethical concern. Following the completion of assessments, waiting list participants will be able to complete the traditional exercise program as usual but not as participants of the study's experimental groups.