Optimising clinical and functional outcomes in older adults with Heart Failure (HF) using the Peripheral Remodeling through Intermittent Muscular Exercise (PRIME) approach: A pilot study

This pilot study will employ a randomised controlled, single-blinded parallel group design to test the hypothesis that 4 weeks of PRIME training, prior to 4 weeks of traditional HF rehabilitation (combination aerobic plus resistance exercise) is a feasible ‘primer’ to produce relevant additive gains in primary efficacy outcomes of aerobic capacity and muscle strength in comparison to 8 weeks of traditional HF rehabilitation, in elderly patients with HF. Participants were randomised in a 1:1 ratio to PRIME or COMBO training for the first 4 weeks, after which all participants will complete a further 4 weeks of COMBO training. All exercise-training sessions lasted 60 minutes, including warm-up, training, and cooldown and were conducted twice per week for a total of 8 weeks. Participants were supervised by an accredited exercise physiologist’s and an attendance record kept and documented daily. Exercise sessions were conducted at the Victoria University Clinical Exercise Rehabilitation Clinic and/or the Western Centre for Health, Research and Education. In the case of missed exercise sessions, catch up sessions were offered. The PRIME protocol included eight exercises completed within 60 min including warm-up, rest periods, stretching between exercises, and cooldown activities (see Table 1 in attached research protocol). Each exercise started at approximately 50% of 1RM at a cadence of 1 concentric phase every 4 seconds for a period of 5 minutes. During each exercise subjects were allowed to take breaks as needed with each for a minimum of 30 seconds. Progression was made first by decreasing the number of required rest periods during each exercise. When the subject could complete the whole duration of the exercise (6 minutes) without rest the load was increased by ~10%.