Changes in dyspnea and fatigue associated with heart failure after an upper or lower limbs strength training: A randomized clinical trial

Introduction: Cardiovascular diseases are the first cause of mortality. Nowadays, exercise is shown as an effective treatment to decrease the effects of heart failure. Objective: To determine the changes in dyspnea and fatigue associated with heart failure after an upper or lower limbs strength training program. Method: Three-years randomized clinical trial (Registration: Clinicaltrials. gov NCT03913780), with a sample of 920 patients with heart failure distributed in three groups (aerobic exercise alone [control group], aerobic exercise plus strength for upper limbs [experimental group 1], aerobic exercise plus strength for lower limbs [experimental group 2]). Exercise stress and 6-minute walk tests were performed and the following variables were assessed: anthropometry, depression, anxiety and hemodynamic parameters. Assessments were performed at the beginning of the study and after 24 training sessions of 60-minutes, three times a week. Results: When comparing the results among groups, a significant superiority was found in the experimental group 2 (p<0.05%). It is highlighted that, both in the control (CG) and the experimental groups (EG), fatigue levels decreased (CG: 8.0 +/- 1.7 vs. 4.0 +/- 2.3; EG1: 8.0 +/- 1.7 vs. 5.0 +/- 2.3 and EG2: 9.0 +/- 1.1 vs. 3.0 +/- 2.6) and of dyspnea (CG: 9.0 +/- 2.4 vs. 7 +/- 1.0; EG1: 9.0 +/- 2.4 vs. 7.0 +/- 1.6: EG2: 8.0 +/- 3.8 vs. 4.3 +/- 2.3) after the training program. Conclusions: Strength training proved inescapably that it is an effective and safe treatment to reduce the levels of dyspnea and fatigue associated with heart failure. In addition, it significantly improved ejection fraction, anthropometric variables, depression, anxiety, oxygen consumption, heart rate and several cardiovascular risk factors compared to the control group.