Heart Failure, Physical Activity
Conditions
Brief summary
Heart failure affects not only the cardiovascular system with structural abnormalities of the heart, but also the musculoskeletal system, leading to exercise intolerance. Objective: To evaluate the effects of a short-term exercise protocol and phototherapy, on the functional capacity and inflammatory markers in patients with heart failure. In addition, the investigators will investigate pulmonary function, peripheral and respiratory muscle strength and quality of life. Methods: Heart failure patients (left ventricular ejection fraction \< 40%) will be selected from the outpatient clinic of the myocardium of the Department of Cardiology of Unifesp and randomized among two groups: patients who will be submitted to placebo phototherapy and cycle ergometer exercise; and patients who will be submitted to active phototherapy and cycle ergometer exercise. All groups will receive treatment twice a week for four weeks. Patients will be instructed to conduct home-based walking program at least twice a week. Patients will be evaluated before and after protocols regarding the pulmonary function, peripheral and respiratory muscle strength, functionality, quality of life and evaluation of systemic inflammatory mediators.
Interventions
OTHERExercise
The exercise will be performed in a cycle ergometer, intermittently, during 40 minutes, in a moderate intensity and prescribed by the perceived exertion Borg (PEB) scale.
OTHERPlacebo Phototherapy
Patients will receive the placebo application of low level laser therapy (parameters: 808nm, 100mW, 28J) in the rectus Femoris and gastrocnemius muscles of both lower limbs before the performance of the cycle ergometer exercise protocol.
OTHERActive Phototherapy
Patients will receive the active application of low level laser therapy (parameters: 808nm, 100mW, 28J) in the rectus Femoris and gastrocnemius muscles of both lower limbs before the performance of the cycle ergometer exercise protocol.
Sponsors
Federal University of São Paulo
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
30 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Heart Failure diagnosis determined by clinical presentation and confirmed on echocardiography by clinicians, with a left ventricular ejection fraction (LVEF) \< 40% * New York Heart Association (NYHA) classes II and III.
Exclusion criteria
* chronic lung disease confirmed by pulmonary function testing * unstable angina pectoris and acute coronary syndromes * dialysis * neuromuscular and psychiatric conditions that interfere in exercise
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Six-minute walk test to measure functional capacity change | Pre and post 4 weeks of rehabilitation programs | According to the baseline distance walked, we will evaluate the improvement in functional capacity after the period of the rehabilitation programs |
| Inflammatory markers | Pre and post 4 weeks of rehabilitation programs | Evaluate the change in levels of interleukin (IL): IL-1 and IL-10, and tumor necrosis factor-alpha (TNF-α) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory muscle strength | Pre and post 4 weeks of rehabilitation programs | By manovacuometry, assessing the change in inspiratory muscle pressure and expiratory muscle pressure |
| Peripheral muscle strength | Pre and post 4 weeks of rehabilitation programs | By dynamometry, assessing the change in the peak force of quadriceps femoris muscle |
| Quality of life | Pre and post 4 weeks of rehabilitation programs | By Minnesota Living with Heart Failure Questionnaire assessing the change in quality of life |
Other
| Measure | Time frame | Description |
|---|---|---|
| Peripheral muscle strength | Follow up after 3 months of the end of the rehabilitation programs | By dynamometry, assessing the change in the peak force of quadriceps |
| Respiratory muscle strength | Follow up after 3 months of the end of the rehabilitation programs | By manovacuometry, assessing the change in inspiratory muscle pressure and expiratory muscle pressure |
| Quality of life | Follow up after 3 months of the end of the rehabilitation programs | By Minnesota Living with Heart Failure Questionnaire assessing the change in quality of life |
| Six-minute walk test to measure functional capacity change | Follow up after 3 months of the end of the rehabilitation programs | Evaluate the improvement in functional capacity |
Outcome results
None listed