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| Research Proposol The effect of exercise training on quality of life in patients with chronic heart failure Date April 2002 Supervisors: Dr. M.L. Zonderland Drs. L. Sabelis University Utrecht Department of Medical Physiology and Sports Medicine Prof. Dr. W. van Staveren Wageningen University Division of Human Nutrition and Epidemiology Personal motivation and learning objectives: Because of my interest in the health aspect of sports and phtsical activity in general, I searched for a research project where an exercise programme played an important role. The benficial effect of physical activity in healthy individuals had investigated extensively.6 Recently, several studies has shown that physical activity can improve the quality of daily life in patients with chronic heart failure (CHF) enormously.9 Therefore, I would like to known more about the effect of exercise on the quality of life in this patient group. The language chosen is English partly as exercise for my practical period in Australia next year. Background: Heart Failure is a major health problem with a gloomy prognosis. Heart failure is a syndrome of circulatory failure, secondary to ventricular disfunction. The most important symptoms are fatigue, shortness of breath, first during exercise and later also at daily activities, and buildup of excess fluid in body tissues. Edema is common in the legs, ankles and lungs of people with heart failure.1 Each year 50,000 people in the Netherlands are confronted with heart failure and its causes. Approximately 200,000 people with heart failure are living in the Netherlands at the moment.2 The single most common etiology of heart failure is coronary heart disease. Hypertension, valve disease, alcohol misuse and viral infection are less common causes. In a lot of cases the etiology cannot be determined.3,4 Due to the aging of the population, and the successful treatment of coronary heart disease more and more people will suffer from heart failure.5 The beneficial effects of physical activity and training in healthy individuals and several patient groups have been documented extensively. 6 For patients with chronic heartfailure (CHF), however, avoidance of strenuous physical activity has been advocated for a long time, often resulting in further disablement and a decrease in quality of life. 7 Recently, several studies have shown beneficial effects of exercise training with patients with CHF. Benefit has been shown in terms of exercise capacity, oxygen uptake, ability to carry out daily activities and quality of life. 8 The observed improvement of exercise capacity and oxygen uptake are sometimes small, but can have a major impact on quality of life in heart failure patients. The difference after training is reflected in the patient�s ability to cope with the physical demands of day to day activity, thus preventing the need for continuous bed rest and the loss of independence with often results in the need of chronic care.9 Most studies have examined the effect of aerobic exercise training, a form of endurance training, which does not specifically improve muscle strength. Many activities in daily live are, however, of an intermittent nature and require muscle strength as well. 10 This study is one of the first studies in which a combination of exercise training programs will be used. Objectives of the study: The aim of the study is to examine whether physical training has beneficial effects on quality of life in patients with heart failure. Study questions: Does a 26 weeks exercise program have a positive influence on the quality of life in heart failure patients? And if so, does this relate to improvement of exercise tolerance and functional capacity, through which patients are more able to cope independently with activities of daily living (ADL)? see further.. |
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