Heart failure affects not only the cardiovascular system with structural abnormalities of the heart, but also the musculoskeletal system, leading to exercise intolerance. Objective: To evaluate the effects of a short-term exercise protocol and phototherapy, on the functional capacity and inflammatory markers in patients with heart failure. In addition, the investigators will investigate pulmonary function, peripheral and respiratory muscle strength and quality of life. Methods: Heart failure patients (left ventricular ejection fraction \< 40%) will be selected from the outpatient clinic of the myocardium of the Department of Cardiology of Unifesp and randomized among two groups: patients who will be submitted to placebo phototherapy and cycle ergometer exercise; and patients who will be submitted to active phototherapy and cycle ergometer exercise. All groups will receive treatment twice a week for four weeks. Patients will be instructed to conduct home-based walking program at least twice a week. Patients will be evaluated before and after protocols regarding the pulmonary function, peripheral and respiratory muscle strength, functionality, quality of life and evaluation of systemic inflammatory mediators.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
40
The exercise will be performed in a cycle ergometer, intermittently, during 40 minutes, in a moderate intensity and prescribed by the perceived exertion Borg (PEB) scale.
Patients will receive the placebo application of low level laser therapy (parameters: 808nm, 100mW, 28J) in the rectus Femoris and gastrocnemius muscles of both lower limbs before the performance of the cycle ergometer exercise protocol.
Patients will receive the active application of low level laser therapy (parameters: 808nm, 100mW, 28J) in the rectus Femoris and gastrocnemius muscles of both lower limbs before the performance of the cycle ergometer exercise protocol.
Six-minute walk test to measure functional capacity change
According to the baseline distance walked, we will evaluate the improvement in functional capacity after the period of the rehabilitation programs
Time frame: Pre and post 4 weeks of rehabilitation programs
Inflammatory markers
Evaluate the change in levels of interleukin (IL): IL-1 and IL-10, and tumor necrosis factor-alpha (TNF-α)
Time frame: Pre and post 4 weeks of rehabilitation programs
Respiratory muscle strength
By manovacuometry, assessing the change in inspiratory muscle pressure and expiratory muscle pressure
Time frame: Pre and post 4 weeks of rehabilitation programs
Peripheral muscle strength
By dynamometry, assessing the change in the peak force of quadriceps femoris muscle
Time frame: Pre and post 4 weeks of rehabilitation programs
Quality of life
By Minnesota Living with Heart Failure Questionnaire assessing the change in quality of life
Time frame: Pre and post 4 weeks of rehabilitation programs
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