Leg Exercises May Help Improve Failing Hearts

(HealthDay News) – While it’s not exactly a take-off on the old song that has lyrics like “the leg bone is connected to the thigh bone,” medical research indicates that people with weak hearts can benefit from doing some exercises involving their legs.

In fact, the scientists overseeing a carefully controlled series of exercises involving people at various stages of heart failure found that light-to-moderate workouts helped in a variety of ways, including improved breathing.

Three months of exercise sessions on treadmills or stationary bikes reduced the labored breathing known as dyspnea, often afflicting people with moderate heart failure, according to the researchers who originally reported their findings in the Journal of the American College of Cardiology.

One purpose of the study was to show that people with heart failure can be helped by light exercise, even if their condition makes them feel shortness of breath during mild exertion, says Dr. Donna Mancini, professor of medicine at Columbia University in New York City.

Twenty-five patients were enlisted in the trial, and 17 of them agreed to do light exercise over the three-month period. The other eight attended classes on relaxation and guided imagery techniques, with no exercise training, to serve as a control group.

"We were able to show that in the training group there was less shortness of breath during exercise than before the training program, while in the control group there were no changes," Mancini says.

The exercise program concentrated on improving function of the muscles of the legs for a reason, she says. It has been thought that better breathing would come only from better heart muscle function, but the study shows that improving muscle function "can improve the symptoms of heart failure. Otherwise you could say that the reason they are less short of breath is that their respiratory muscles are also being trained," she explains.

While Mancini says the study indicates that "even a low level of exercise is beneficial in improving symptoms," she also warns that anyone with heart failure should approach exercise with caution and should start training only after talking with a physician.

"You should probably have an exercise prescription, x number of repetitions of y kinds of exercise," she says. "The duration and setting of a workout on a treadmill or stationary bicycle should be specified."

The benefits of exercise probably come from improvements in muscle metabolism that changes the activity of receptors that set off signals triggering shortness of breath, Mancini says. However, it's also possible the training just makes people feel better overall, so that the symptoms of breathlessness become less bothersome to them. Either way, she says, "exercise helps these people feel better."

It's certainly possible that there was also a psychological element in the improvement, says Dr. Stanley Rubin of the Greater Los Angeles Health Care System, who was asked to comment on the American College of Cardiology study. "The active group clearly had more health-care giver interaction than the placebo group," Rubin says. "Because the outcomes are modestly beneficial, it is difficult to know for certain that the observed effect is solely due to the physical conditioning."

Nevertheless, he says, "therapy directed to the physical conditioning of the heart failure patient may be beneficial in improvement of symptoms."

On the Web

A primer on heart failure is offered by the American Heart Association.

SOURCES: Donna Mancini, M.D., professor of medicine, Columbia University, New York City; Stanley Rubin, M.D., cardiologist, Greater Los Angeles Health Care System; Nov. 6, 2002, Journal of the American College of Cardiology
Publication date: April 9, 2007
Author: Ed Edelson, HealthDay Reporter
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