Walking performance and economy in chronic heart failure patients pre and post exercise training

The effect of a 3-week exercise programme on performance and economy of walking was analysed in 16 male patients with chronic heart failure [mean age 51.8 (SD 6.9) years, height 174.9 (SD 6.3) cm, body mass 75.3 (SD 11.5) kg, ejection fraction 20.8 (SD 5.0)%]. They were submitted to a cardiopulmonary exercise test on a cycle ergometer and a 6-min walking test on a treadmill before and after the period of exercise training. The training programme consisted of interval cycle (five times a week for 15 min), and treadmill ergometer training (three times a week for 10 min) at approximately 70% cycling peak oxygen uptake (VO2peak) and supplementary exercises (three times a week for 20 min). Compared to the pre values cycling VO2peak [11.9 (SD 2.9) vs 14.0 (SD 2.3) ml. kg-1.min-1], maximal self paced walking speed [0.68 (SD 0.33) vs 1.16 (SD 0.30) m.s-1], and net walking power [2.16 (SD 0.89) vs 2.73 (SD 0.91) W.kg-1] had increased (P < 0.01) while net energy cost [3.31 (SD 0.66) vs 2.33 (SD 0.38) J.kg-1. m-1] had decreased (P < 0.001) after the training period. Approximately 42% of the increase of walking speed resulted from a higher walking power output, whereas approximately 58% corresponded to a positive effect on walking economy. The improvement in walking economy was a function of an increase in walking velocity itself and a result of a more efficient walking technique. These results would indicate that in patients with marked exercise intolerance, adequate exercise training programmes could contribute to favourable metabolic changes with positive effects on the economy of motion.