Enhancement of isokinetic muscle strength with a combined training programme in chronic heart failure

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Abstract
Patients with congestive heart failure (CHF) exhibit an impaired exercised tolerance that dramatically limits their functional capacity and alters their quality of life. The aim of this study was to compare the effects of two types of training programmes on isokinetic muscle strength and aerobic capacities in patients with CHF. A group of 23 stable CHF patients included consecutively followed an exercise training programme, 3 days a week for 8 weeks. The first group (P1, n=11) exercised on a cycloergometer for 45 min at 65% of peak VO2. The second group (P2, n=12) followed a 45-min combined bicycle and quadricipital strength training. Strength training consisted of 10 series of 10 repetitions at 70% of maximal voluntary force. Incremental maximal cardiopulmonary exercise tests as well as an isokinetic quadricipital dynamometry evaluation were performed before and after training. In P1, peak VO2 increased by 20% (22.3+/-4.9 versus 17.8+/-4.5 ml min(-1) kg(-1); P<0.05) without any significant change in isokinetic muscle strength. In P2, peak VO2 improved within the same range (20.5+/-2.8 versus 18.6+/-3.7 ml min(-1) kg(-1); P<0.01). This last rehabilitation programme significantly increased isokinetic muscle strength at each angular velocities (+10.5+/-13.5%, P<0.04; +5.6+/-7.0%, P<0.03; for 180 degrees s(-1) and 60 degrees s(-1) respectively). Only the combined endurance/strength training programme was associated with an improvement in both peak VO2 and peripheral muscle strength, two significant parameters of outcome and quality of life in CHF.