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Eccentric training in chronic heart failure: feasibility and functional effects. Results of a comparative study
Besson D, Joussain C, Gremeaux V, Morisset C, Laurent Y, Casillas J-M, Laroche D
Annals of Physical and Rehabilitation Medicine 2013 Feb;56(1):30-40
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To evaluate, in chronic heart failure (CHF) patients, feasibility, safety, compliance and functional improvements of an eccentric (ECC) cycle training protocol personalized by the rate of perceived exertion (RPE; 9 to 11 Borg Scale), compared to concentric (CON) training at workload corresponding to the first ventilatory threshold. METHODS: Thirty patients were randomly allocated to ECC or CON training (20 sessions). Compliance was evaluated with RPE, visual analog scale for muscle soreness and monitoring of heart rate (HR). Functional parameters were measured by the distance walked and the VO2 uptake during the 6-minute walk test (6MWT) before and after training. RESULTS: Two patients were excluded due to adverse effects in each group. RPE was 9 to 11 in ECC training while it reached 12 to 14 in CON training. HR remained stable in ECC group during exercise whereas it increased during CON exercise. 6MWT distance improved in both group (ECC +53m; CON +33m). 6MWT VO2 uptake remained stable in ECC group whereas it increased in CON group. CONCLUSION: ECC training tailored by RPE appears to be an efficient and safe alternative for CHF patients. Indeed, it induces functional improvement similar to conventional CON training with lower demand on the cardiovascular system during exercise.

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