Does the Addition of Strength Training to a High-Intensity Interval Training Program Benefit More the Patients with Chronic Heart Failure
Question
Does adding strength training to a supervised HIIT cardiac rehabilitation program provide extra benefits for functional capacity and quality of life in patients with chronic heart failure?
Summary
This randomized cardiac rehabilitation trial tested whether patients with stable chronic heart failure got more benefit from HIIT alone or HIIT plus strength training. Both groups completed a 3-month, 36-session supervised program using the same 31-minute cycling HIIT structure. Functional capacity, ejection fraction, strength/endurance, and quality of life improved within groups. Adding strength training did not improve most outcomes more than HIIT alone, but it did add benefits for chest muscle strength/endurance and workload at the anaerobic threshold.
Methodology
- Stable chronic heart failure patients with NYHA class II/III and EF <=49%.
- 44 participants.
- Stationary cycling.
- Work intervals: 4 minutes at 80% peak VO2, progressed over sessions.
- Recovery: 3 minutes active recovery at 50% peak VO2.
- Intensity: CPET-derived watts corresponding to peak VO2 percentages; Borg monitored.
- 31 minutes for aerobic HIIT.
- 3 sessions per week.
- 3 months / 36 sessions.
- Single-blinded randomized controlled clinical study with two exercise groups.
- Peak VO2, Work rate at anaerobic threshold, Ejection fraction, and Strength and muscular endurance were tracked.
Outcomes
Functional capacity and quality of life
Both HIIT and COM improved multiple CPET indices and MLWHFQ physical/total scores within groups.
Reported p < 0.05 for many within-group changes; most between-group comparisons were not significant.
Chest strength/endurance
COM improved chest 1RM and chest muscular endurance more than HIIT.
Between-group p = 0.039 for chest 1RM, p = 0.021 for relative chest 1RM, p = 0.002 for chest endurance.
Workload at anaerobic threshold
COM showed greater improvement in workload at AT than HIIT.
Between-group difference reported significant in Table 2.
Insights
- A supervised 4x4-minute cycling HIIT protocol can be used in stable CHF cardiac rehab with medical oversight.
- Adding strength training to HIIT mainly adds strength/endurance benefits rather than broad additional VO2 or quality-of-life benefits.
- Clinical HIIT protocols should use measured prescription, progressive overload, and monitoring.
Limitations
- Small clinical sample.
- Only compliant completers included in analysis.
- No usual-care or moderate continuous exercise control in this comparison.
- Not directly translatable to unsupervised consumer workouts.
Safety
- Patients were medically screened before participation.
- BP, oxygen saturation, HR, dyspnea, and fatigue were monitored during sessions.
- Adverse event counts were not clearly reported in extracted sections.