ABSTRACT
Exercise training is the cornerstone of rehabilitation for patients with chronic stable heart failure (HF) regardless of ejection fraction. Moderate-intensity exercise programs including aerobic activities and potentially low-to-moderate intensity resistance exercises are the most evidence-based exercise training recommendations for patients with HF. More recently, high-intensity interval exercise training (HIIT) has become the focus of intensive research, and accumulating evidence suggests a beneficial effect of HIIT on outcomes. However, the potential risks of higher-intensity exercise training, especially in highly symptomatic patients or those with severe disease, have not been fully evaluated. Recently, nonpharmacological options have gained importance as adjuvant modalities to physical training. These modalities include ventilatory muscle training, non-invasive ventilation, and neuromuscular electrical stimulation. Although to a lesser extent, studies have demonstrated that initiating mobilization as early as possible in patients hospitalized for HF exacerbation is beneficial. Early physical rehabilitation during an acute HF episode may contribute to decreased loss of muscle mass and increased functional capacity in these patients.
