BACKGROUND: Now a correspondingly stable project was performed in the rehabilitative treatment for patients with chronic heart failure in China, but it was difficult to be carried out on the wide range because of difficulties in adjusting movement capacity, lower compliance and so on, especially for the elder patients or those with severe chronic heart failure. The movement project will be required with the advantages of good compliance, moderate movement capacity and reproducibility in clinic. OBJECTIVE: To investigate the change of exercise tolerance and cardiac function after the intervention in movement training in patients with chronic heart failure. DESIGN: Randomized and controlled observation. PARTICIPANTS: Seventy inpatients with stable chronic heart failure were chosen from the Department of Gerontology in Wuhan Union Hospital of Hubei Province from August 2002 to October 2003. All patients agreed to this test. Functional class of New York Heart Association (NYHA) was 2.69 +/- 0.13. Chronic heart failure duration of all patients was over six months. Seventy patients were randomly divided into movement group (n = 34) and control group (n = 36). In the movement group with 19 males and 15 females, functional class was 2.68 +/- 0.12. In the control group, there were 19 males and 17 females. METHODS: The patients in the movement group underwent three weeks of movement training (bicycle ergometer, treadmill walking and walking on foot). The patients in the control group underwent three weeks of activity restriction. All patients received the 6-minute walking test under the condition of the same rating of perceived exertion before and after the test. Totally 5 mL of venous blood was drawn without eating anything in the morning before and after the test. The levels of interleukin-6 and norepinephrine were evaluated and left ventricle ejection fraction was observed and determined. MAIN OUTCOME MEASURES: Comparison of walking distance, interleukin-6, norepinephrine, left ventricle ejection fraction and cardiac functional class before and after the intervention in all patients. RESULTS: Seventy patients with chronic heart failure were involved in the statistical analysis at last. After the intervention, walking distance covered during 6 minutes and left ventricle ejection fraction in the movement group were obviously longer and higher than those before the intervention and in the control group (385 +/- 30 m, 43 +/- 5%; 324 +/- 35 m, 39 +/- 6%; 292 +/- 30 m, 35 +/- 4%, p < 0.05). After the intervention, the levels of plasma interleukin-6 and norepinephrine and cardiac functional class in the movement group were lower than those in the control group and before the intervention (0.86 +/- 0.25 pmol/L, 2.05 +/- 0.48 nmol/L, 1.89 +/- 0.11; 1.00 +/- 0.25 pmol/L, 2.21 +/- 0.47 nmol/L, 2.45 +/- 0.12; 1.12 +/- 0.23 pmol/L, 2.46 +/- 0.53 nmol/L, 2.68 +/- 0.12, p < 0.05 to 0.01). CONCLUSION: The project of movement training designed in our study can improve exercise tolerance and ameliorate cardiac function in patients with chronic heart failure. This project has the advantage of better compliance designed according to oneself.

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