Waltzing beats exercise for patients with CHF

The clinical difference is small, but the evidence is in ? waltzing does more than other aerobic exercise (ET) for the health of a patient with chronic heart failure (CHF).

Waltzing improves heart rate and peak oxygen uptake, but perhaps more important many patients find this form of aerobic activity intrinsically enjoyable and they are more likely to do it.

A study from Italy reported in a Sunday news conference noted that waltzing improves functional capacity and has been shown to improve peak VO2, anaerobic threshold, VE/VCO2 slope and VO2/W slope. Furthermore, heart rate during ET was 110?15 beats/minute versus 113?19 beats per minute (P NS) for waltzing.

The core problem is compliance, said lead author Romualdo Belardinelli, M.D., of the Lancisi Heart Institute in Ancona, Italy.

?Exercise compliance among patients with chronic heart failure is very low ? less than 50 percent at some centers,? Dr. Belardinelli said. ?After one month, half of the patients don?t continue the exercise program, and this is not acceptable.We have to find something that captures their interest.?

Why not waltzing?

According to Dr. Belardinelli, any waltz, the most popular being Johann Strauss? Blue Danube, improved peak oxygen uptake.

?Improvement of peak oxygen uptake is the most important parameter suggesting event-free survival,? Dr. Belardinelli said. ?To improve patient health and maintain improvement for years means a lower rate of hospitalization and lower health system expenditures. That is very important.?

The 110 patients in the study (89 males, mean age 59?11 years) had stable CHF in NYHA classes II and III and an LV ejection fraction less than 40 percent. Patients were randomized to two groups ? the exercise group (n=44) and the dance group (n=44). A third control group (C) (n=22) neither danced nor exercised.

The exercise group (E) underwent supervised ET (cycling, treadmill) at 70 percent of peak VO2 three times a week for 8 weeks, while the dance group (D) waltzed for 21 minutes, alternating between slow (five-minute) and fast (three-minute) dances.

Patients underwent cardiopulmonary exercise testing on entry and at eight weeks until volitional fatigue, 2D-echo with Doppler and endothelium-dependent dilation (EDD) of the brachial artery. Quality of life was assessed by the Minnesota Heart Failure Living Questionnaire.

It is one year since the study?s close, and Dr. Belardinelli described informal follow-up data.

?Generally both groups maintained their peak oxygen uptake at the level they reached at the end of the two-month, in-hospital protocol,? he said. ?The dancers continue to dance at least once a week and combine standard exercise at home with dancing.

Generally the amount of peak oxygen uptake is similar in the two groups at one year. Waltzing may improve adherence to exercise training protocol in patients with heart failure.?


Spirit India