Resistance training increases 6-minute walk distance in people with chronic heart failure: a systematic review

QuestionDoes resistance training, either alone or as an adjunct to aerobic training, improve cardiac function, exercise capacity and quality of life in people with chronic heart failure?DesignSystematic review with meta-analysis of randomised trials.ParticipantsAdults with stable chronic heart failure.InterventionProgressive resistance exercise training, alone or as an adjunct to aerobic training.Outcome measuresCardiac function, exercise capacity and quality of life.Results241 participants from eight trials performed 2 to 6 months of moderate-intensity resistance training (50–75% of 1RM). Most programs consisted of 5 to 6 exercises for large limb and trunk muscles with two sets of 8 to 12 repetitions, three times a week. Resistance training significantly increased 6-minute walk distance (WMD 52 m, 95% CI 19 to 85) but not peak oxygen consumption (WMD 1.4 ml/kg/min, 95% CI –0.3 to 3.1). When used as an adjunct to aerobic training, resistance training did not significantly alter left ventricular ejection fraction (WMD –0.5%, 95% CI –4.3 to 3.3), peak oxygen consumption (WMD –0.7 ml/kg/min, 95% CI –2.3 to 1.0), or Minnesota Living with Heart Failure Questionnaire scores (WMD –0.9, 95% CI –5.4 to 3.7), compared with aerobic training alone.ConclusionResistance training increased 6-minute walk distance compared to no training, but had no other benefits on cardiac function, exercise capacity, or quality of life if used alone or as an adjunct to aerobic training in people with chronic heart failure. However, further high quality, large scale, randomised trials are needed.