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| Inhoud: Inleiding Afstudeerrichting Voedingsleer Afd. Human Voeding en Epidemiologie Het UMC-Utrecht CHAIR study Hartfalen Mijn aandeel Protocol Referaat |
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| Methods: Study Design This study comprise a prospective randomized comparison of the effect of 26 week of exercise training with 26 weeks of usual medical care in CHF patients. Alle test and measurements will performed in both groups at entry and after 26 weeks study period. Study population The heart failure patients are participating in the CHAIR study �Chronic Heart failure Activity and Insulin Resistance�. A study performed bij the department of Medical Physiology and Sports Medicine at the University Utrecht and the department of Cardiology of the Eemland Hospital Amerfoort. They all have an history of CHF of at least 6 months. NYHA type II or III. They are in the age of 40-75 year. And have a peak VO2 less than 60% of the expected VO2, for age and gender.11 Training program The training program, will be performed four times a week, two times a week, supervised by a physiotherapist, and two times at home, for 26 weeks. Quality of life Two measures will be used to get insight into several qualiy of life aspects: 1. The Dutch version of the Minnesota Living with Haert Failure Questionaire, to assess the health related quality of life.12 2. A modified form of the Baecke Questionnaire, to determine the symptoms of daily activities.13 Exercise Testing: The exercise testing will consist of an incremental cycle ergometer, with increments of 29 Watt every 3 minutes. Ventilatory paramaters will be registrated usiing breath-to-breath analysis of the expired air. Exercise tolerance will be expressed as peak oxygen uptake at peak exercise, calculated as the mean of the values during the final 30 seconds of exercise. Muscle strength: The muscle strength of the forearm will be measured using a hand-dynamometer. Antropometry: Heigt, weight, Body Mass Index (BMI) and percentage body fat will be measured in both groups at entry and after 26 weeks study period. Statistical analyses: Statistical analyses will de performed with SPSS, using ANOVA repeated measures tests. Data will be presented as mean � SD. Referenties: 1. Nederlandse Hartstichting. Hartfalen, cijfers en feiten., 2001 2. Cost B. Heart failure in the elderly. (proefschrift) 3. Cowie MR, Wood DA, Coats AJS, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J 1999;20:421-428. 4. Fox KF, Cowie MR, Wood DA, et al. Coronary artery disease as the cause of incident heart failure in the population. Eur Heart J 2001; 22:228-236. 5. Bonneux L, Barendregt JJ, Meeter K, Bonsel GJ, van der Maas PJ. Estimating clinical morbidity due to ischemic heart disease and congestive heart failure; de future rise of heart failure. Am J Public Health 1994;84:20-28. 6 . Wielenga RP, Erdman RAM, et al. Effect of exercise training on quality of life in patients with chronic heart failure. J Psychosomatic 1998; 5:459-464. 7. Smith TW, Braunwald E, Kelly RA. The management of heart failure. In: Braunwald E, ed. Heart disease. Philadelphia: Saunders 1998; 485-543. 8. Willenhiemer R, Rydberg E, et al. Effect on quality of life, symptons and daily activity 6 months after termination of an exercise traing programma in heart failure patients. Int J Cardiology 2001;77:25-31. 9. Kass Wenger N. Left ventricular dysfunction. Exercise capacity and acticity recommendations. Eur Heart J 1988; 9s:63-66. 10. Wielenga RP, Coats AJS, Mosterd WL, Huisveld IA. The role of exercise traing in chronic heart failure. Heart 1997;78:431-436. 11. Jones NL: WB Saunders Company, 1998. 12. Wijbenga JAM, Duivenvoorden HJ, Balk AHMM, et al: Quality of life in chronis heart failure. Validation of the Dutch version of the Minnesota Living with Heart failure Questionnaire. Cardiologie 1998; 5: 627-631. 13. Pols MA, Peeters PHM, Bueno-de-Mesquite HB, et al:Validity and repeatability of a modified Baecke Questionnaire on physical activity. Int J Epidemiology 1995; 24: 381-388. |