Effect of Upper Extremity Aerobic Exercise Training on Exercise Capacity Patients With Chronic Heart Failure

Effects of Upper Extremity Aerobic Exercise Training on Exercise Capacity and Physical Activity Level in Patients With Chronic Heart Failure

Heart failure is a cardiac structural or functional disorder that, despite normal filling pressures, leads to inability to deliver enough oxygen to meet the metabolic needs o tissue. Heart failure is a serious chronic condition that affects a large proportion of the adult population in the world causing high mortality, leading to exercise intolerance and reduced health-related quality of life. Patients included in the cardiac rehabilitation program slow down disease progression, hospitalization decreases, quality of life improves and health expenditures decrease. Despite the frequent use of upper extremities in daily living activities, studies investigating the effect of upper extremity aerobic training on daily living activities, functional exercise capacity and other outcomes are limited. No studies have investigated the effect of upper extremity aerobic exercise training on physical activity level, functional and maximal exercise capacity and other measures in patients with heart failure.

It has been reported that exercise capacity in peak arm exercise is almost 30% lower in heart failure patients. For this reason intolerance to arm exercise is a significant problem in heart failure patients and may contribute to a decrease in performance in activities of daily living. Considering the fact that developments in these patients are caused by vasculature functional adaptation the extremity skeletal muscle and applied limbs, upper extremity exercises may be useful to reduce exercise intolerance during activities requiring continuous arm movement.

Inclusion Criteria:

• Patients with a diagnosis of chronic heart failure diagnosed at rest below 40% of the left ventricular ejection fraction and class 1-3 according to the New York Heart Association classification
• Optimal medical treatment at least 30 days and clinically stable

Exclusion Criteria:

• Patients with unstable angina pectoris
• Decompensated heart failure
• Primary pulmonary hypertension
• Complex ventricular arrhythmia
• Contraindication to cardiopulmonary exercise testing
• Patients who have had myocardial ischemia in the past 3 months
• Ischemic cerebrovascular events
• Second and third degree atrioventricular block
• Thrombus detected in the left ventricle
• Uncontrolled insulin dependent diabetes mellitus
• Uncontrolled hypertension
• Renal insufficiency
• Acute infection
• Aortic stenosis
• Acute pulmonary embolism
• Mental, musculoskeletal, neurological, or systemic illness that will prevent exercise.