Mansueto Gomes-Neto1, André Rodrigues Durães2, Lino Sergio Rocha Conceição3, Leonardo Roever4, Cassio Magalhães Silva5, Iura Gonzalez Nogueira Alves6, Øyvind Ellingsen7, Vitor Oliveira Carvalho8. 1. Physical Therapy Department, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil; Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil; Physiotherapy Research Group, UFBA, Brazil; The GREAT Group (GRupo de Estudos em ATividade física), Brazil. Electronic address: mansueto.neto@ufba.br. 2. Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil. 3. The GREAT Group (GRupo de Estudos em ATividade física), Brazil; Federal University of Uberlândia, Department of Clinical Research, Brazil. 4. Federal University of Uberlândia, Department of Clinical Research, Brazil. 5. Physical Therapy Department, Federal University of Bahia - UFBA, Salvador, Bahia, Brazil; Physiotherapy Research Group, UFBA, Brazil. 6. Physiotherapy Research Group, UFBA, Brazil. 7. K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 8. Physiotherapy Research Group, UFBA, Brazil; The GREAT Group (GRupo de Estudos em ATividade física), Brazil; Physical Therapy Department, Federal University of Sergipe - UFS, Aracaju, SE, Brazil.
Abstract
OBJECTIVE: The aim of this study was to investigate the effects of combined aerobic and resistance training on peak oxygen consumption (peak VO2), minute ventilation/carbon dioxide production (VE/VCO2 slope), muscle strength and health-related quality of life (HRQoL) in heart failure patients with reduced left ventricular ejection fraction (HFrEF). METHODS: We searched Cochrane, Pubmed, and PEDro (from the earliest date available to September 2018) for RCTs that evaluated the effects of combined aerobic and resistance training in HFrEF patients. Weighted mean differences (WMD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated. RESULTS: 39 studies met the study criteria, including 2008 patients, 14 compared combined aerobic and resistance training versus aerobic training, and 25 compared combined aerobic and resistance training versus control. Compared to aerobic training, combined aerobic and resistance training resulted in improvement in muscle strength SMD 0.7 (95% CI: 0.3 to 1.0 N = 167) and, HRQoL WMD -2.6 (95% CI: -5.0 to -0.1 N = 138). A nonsignificant difference in peak VO2 and VE/VCO2 slope was found for participants in the combined aerobic and resistance training group compared with aerobic training group. Compared to control, combined aerobic and resistance training resulted in improvement in peak VO2 WMD 2.9 (95% CI: 1.6 to 4.4 N = 638), muscle strength SMD 0.64 (95% CI: 0.4 to 0.9 N = 315) and, HRQoL WMD -9.8 (95% CI: -15.2 to -4.5 N = 524). CONCLUSIONS: Combined aerobic and resistance training improves peak VO2, muscle strength and HRQoL and should be considered as a component of care of HFrEF patients.
OBJECTIVE: The aim of this study was to investigate the effects of combined aerobic and resistance training on peak oxygen consumption (peak VO2), minute ventilation/carbon dioxide production (VE/VCO2 slope), muscle strength and health-related quality of life (HRQoL) in heart failurepatients with reduced left ventricular ejection fraction (HFrEF). METHODS: We searched Cochrane, Pubmed, and PEDro (from the earliest date available to September 2018) for RCTs that evaluated the effects of combined aerobic and resistance training in HFrEF patients. Weighted mean differences (WMD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated. RESULTS: 39 studies met the study criteria, including 2008 patients, 14 compared combined aerobic and resistance training versus aerobic training, and 25 compared combined aerobic and resistance training versus control. Compared to aerobic training, combined aerobic and resistance training resulted in improvement in muscle strength SMD 0.7 (95% CI: 0.3 to 1.0 N = 167) and, HRQoL WMD -2.6 (95% CI: -5.0 to -0.1 N = 138). A nonsignificant difference in peak VO2 and VE/VCO2 slope was found for participants in the combined aerobic and resistance training group compared with aerobic training group. Compared to control, combined aerobic and resistance training resulted in improvement in peak VO2 WMD 2.9 (95% CI: 1.6 to 4.4 N = 638), muscle strength SMD 0.64 (95% CI: 0.4 to 0.9 N = 315) and, HRQoL WMD -9.8 (95% CI: -15.2 to -4.5 N = 524). CONCLUSIONS: Combined aerobic and resistance training improves peak VO2, muscle strength and HRQoL and should be considered as a component of care of HFrEF patients.