Effects on quality of life, symptoms and daily activity 6 months after termination of an exercise training programme in heart failure patients

Background: Exercise training in heart failure patients improves exercise c apacity, physical function, and quality-of-life. Prior studies indicate a r apid loss of these effects following termination of the training. We wanted to assess any sustained post-training effects on patients global assessmen t of change in quality-of-life (PGACQoL) and physical function. Methods: Fi fty-four stable heart failure patients were randomised to exercise or contr ol. The 4-month exercise programme consisted of bicycle training at 80% of maximal intensity three times/week, and 49 patients completed the active st udy period. At 10 months (6 months post training) 37 patients were assessed regarding PGACQoL, habitual physical activity, and dyspnea-fatigue-index. Results: Both post-training patients (n=17) and controls (n=20) deteriorate d PGACQoL during the 6-month extended follow-up, although insignificantly. However, post-training patients improved PGACQoL slightly but significantly from baseline to 10 months (P=0.006), differing significantly (P=0.023) fr om controls who were unchanged. Regarding dyspnea-fatigue-index, post-train ing patients were largely unchanged and controls deteriorated insignificant ly, during the extended follow-up as well as from baseline to 10 months. Bo th groups decreased physical activity insignificantly during the extended f ollow-up, and from baseline to 10 months post-training patients tended to d ecrease whereas controls significantly (P=0.007) decreased physical activit y. Conclusion: There was no important sustained benefit 6 months after term ination of an exercise training programme in heart failure patients. A smal l, probably clinically insignificant sustained improvement in PGACQoL was s een in post-training patients. Controls significantly decreased the habitua l physical activity over 10 months and post-training patients showed a simi lar trend. Exercise braining obviously has to be continuing to result in su stained benefit. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved .