Effectiveness of combined eccentric and concentric exercise over traditional cardiac exercise rehabilitation programme in patients with chronic heart failure: protocol for a randomised controlled study

IntroductionExercise-based rehabilitation is a standard feature of chronic heart failure management. The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixe...

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Published in:BMJ open 2019-09, Vol.9 (9), p.e028749-e028749
Main Authors: Plaquevent-Hostache, Guillaume, Touron, Julianne, Costes, Frédéric, Perrault, Hélène, Clerfond, Guillaume, Cuenin, Christine, Moisa, Andreea, Pereira, Bruno, Boiteux, Marie-Claire, Eschalier, Romain, Richard, Ruddy
Format: Article
Language:English
Subjects:
Anaerobic threshold
Beta blockers
Biopsy
cardiac failure
Cardiovascular disease
chronic disease
Chronic obstructive pulmonary disease
Ejection fraction
Exercise
exercise training
Fitness training programs
functional capacities
Heart failure
Human health and pathology
Life Sciences
Metabolism
Musculoskeletal system
Patients
Rehabilitation
Rehabilitation Medicine
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creator Plaquevent-Hostache, Guillaume
Touron, Julianne
Costes, Frédéric
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Clerfond, Guillaume
Cuenin, Christine
Moisa, Andreea
Pereira, Bruno
Boiteux, Marie-Claire
Eschalier, Romain
Richard, Ruddy
description IntroductionExercise-based rehabilitation is a standard feature of chronic heart failure management. The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixed eccentric and concentric cycling training programme, to that of conventional concentric cycling rehabilitation in patients with chronic heart failure (peak oxygen consumption (VO2Peak) < 15 mL⋅kg- 1⋅min- 1, ejection fraction
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The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixed eccentric and concentric cycling training programme, to that of conventional concentric cycling rehabilitation in patients with chronic heart failure (peak oxygen consumption (VO2Peak) &lt; 15 mL⋅kg- 1⋅min- 1, ejection fraction &lt;40%).Methods and analysisIt is a prospective, open, controlled and randomised study (2×25 subjects) carried out in a single centre. Subjects will perform five exercise sessions per week per the randomisation outcome, with the intervention group performing eccentric in three of the five weekly sessions while the control group will perform the five sessions of concentric exercise. Cycling intensity will be the same in both groups and fixed to the power associated with the first ventilatory threshold. Self-management education programme, callisthenics sessions and muscle strength trainings will also be carried out as for any heart failure patient normally included in the rehabilitation programme. The primary outcome will be the change in distance covered during the 6 min walk test. Secondary outcomes will include other physical mobility parameters, functional exercise capacities, quality of life and body composition as well as skeletal muscle properties including mitochondrial function parameters.Ethics and disseminationThe study has been approved by the institutional ethics review board (17.079) and the French regulatory authority for research (2017-A00969-44). Adverse events that could occur during the protocol will be reported to the principal investigator. The results will be published in an international peer-reviewed journal.Trial registration number NCT03716778.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2018-028749</identifier><identifier>PMID: 31558450</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Anaerobic threshold ; Beta blockers ; Biopsy ; cardiac failure ; Cardiovascular disease ; chronic disease ; Chronic obstructive pulmonary disease ; Ejection fraction ; Exercise ; exercise training ; Fitness training programs ; functional capacities ; Heart failure ; Human health and pathology ; Life Sciences ; Metabolism ; Musculoskeletal system ; Patients ; Rehabilitation ; Rehabilitation Medicine</subject><ispartof>BMJ open, 2019-09, Vol.9 (9), p.e028749-e028749</ispartof><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. 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The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixed eccentric and concentric cycling training programme, to that of conventional concentric cycling rehabilitation in patients with chronic heart failure (peak oxygen consumption (VO2Peak) &lt; 15 mL⋅kg- 1⋅min- 1, ejection fraction &lt;40%).Methods and analysisIt is a prospective, open, controlled and randomised study (2×25 subjects) carried out in a single centre. Subjects will perform five exercise sessions per week per the randomisation outcome, with the intervention group performing eccentric in three of the five weekly sessions while the control group will perform the five sessions of concentric exercise. Cycling intensity will be the same in both groups and fixed to the power associated with the first ventilatory threshold. 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The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixed eccentric and concentric cycling training programme, to that of conventional concentric cycling rehabilitation in patients with chronic heart failure (peak oxygen consumption (VO2Peak) &lt; 15 mL⋅kg- 1⋅min- 1, ejection fraction &lt;40%).Methods and analysisIt is a prospective, open, controlled and randomised study (2×25 subjects) carried out in a single centre. Subjects will perform five exercise sessions per week per the randomisation outcome, with the intervention group performing eccentric in three of the five weekly sessions while the control group will perform the five sessions of concentric exercise. Cycling intensity will be the same in both groups and fixed to the power associated with the first ventilatory threshold. Self-management education programme, callisthenics sessions and muscle strength trainings will also be carried out as for any heart failure patient normally included in the rehabilitation programme. The primary outcome will be the change in distance covered during the 6 min walk test. Secondary outcomes will include other physical mobility parameters, functional exercise capacities, quality of life and body composition as well as skeletal muscle properties including mitochondrial function parameters.Ethics and disseminationThe study has been approved by the institutional ethics review board (17.079) and the French regulatory authority for research (2017-A00969-44). Adverse events that could occur during the protocol will be reported to the principal investigator. 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subjects Anaerobic threshold
Beta blockers
Biopsy
cardiac failure
Cardiovascular disease
chronic disease
Chronic obstructive pulmonary disease
Ejection fraction
Exercise
exercise training
Fitness training programs
functional capacities
Heart failure
Human health and pathology
Life Sciences
Metabolism
Musculoskeletal system
Patients
Rehabilitation
Rehabilitation Medicine
title Effectiveness of combined eccentric and concentric exercise over traditional cardiac exercise rehabilitation programme in patients with chronic heart failure: protocol for a randomised controlled study
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