Table 3:
Recommendations for Prescribing Aerobic and Resistance Training in Patients with Heart Failure
| Training parameter | Initial Prescription*** | Optimal Progression |
|---|---|---|
| Aerobic Training | ||
| Frequency | 2-3 days/week | Moderate intensity: 3-7 days/week High intensity: 1-3 days/week |
| Intensity | 40-50% VO2R or HRR; 45-55% VO2peak; RPE 11-12. Until 20 minutes duration is achieved May use short intervals if unable to maintain continuous exercise. |
Continuous: 70-80% VO2R, or HRR; 75-85% VO2peak; RPE 11-14. High intensity intervals: 80-90% VO2R, or HRR; 85-95% VO2peak; RPE 15-17. |
| Time (duration) | Session total: 15-30 minutes Work intervals: 20-30 seconds or longer (1-2 minutes) as tolerated. | Session total: 45-60 minutes High intensity intervals: 1-4 minutes interval duration (3-6 repeated bouts) |
| Type (mode) | Dynamic, rhythmic activities involving lower or upper body such as treadmill walking, cycling, arm ergometer. |
Dynamic, rhythmic activities involving lower and/or upper body such as treadmill walking/jogging, cycling, rowing, stepper, elliptical, arm ergometer). |
| Resistance Training | ||
| Frequency | 2-3 non-consecutive days/week | |
| Intensity | <30% 1-RM; RPE 11-12 | 40-70% 1-RM; RPE 12-15 |
| Time (duration) | 1-2 sets/day for each muscle group, 5-10 repetitions, 4-6 exercises | 2-3 sets/day for each muscle group, 8-15 repetitions, 8-10 exercises |
| Type (mode) | Fixed weight machines, resistance bands, handheld weights, or bodyweight exercise. Commence with isolated muscles. |
Fixed weight machines, resistance bands, handheld weights, or bodyweight exercise. |
| Inspiratory Muscle Training | ||
| Frequency | Standard protocol: 6-7 days/week (twice daily) High intensity protocol: 3-5 days/week |
|
| Intensity | Standard protocol: 50% of PImax High intensity protocol: 20-30% PImax |
Standard protocol: 50% of PImax High intensity protocol: 40-70% PImax |
| Time (duration) | Session total: 20-30 minutes Standard protocol: 30 breaths (twice daily) High intensity protocol: 2-minutes of work, 1-minute recovery, repeated 7 times |
|
| Type (mode) | Pressure threshold device | |
Adapted from Keteyian et al [22], Piepoli et al [52], Meyer [57], and American College of Sports Medicine [21].
Abbreviations: HRpeak: peak heart rate; HRR: Heart rate reserve; MET: Metabolic equivalent; VO2peak: peak oxygen uptake; PImax: Maximal inspiratory mouth pressure; RM: repetition maximum; RPE: rating of perceived exertion 6-20 Borg Scale.
***
Start at lower end of intensity ranges for deconditioned or high-risk patients.