Role of physical training in cardiac rehabilitation in patients with congestive heart failure and type 2 diabetes mellitus

Introduction. Currently, the effectiveness of cardiac rehabilitation of patients with comorbid CHF using physical training when prescribing optimal drug therapy, including SGLT2 drugs, has not been studied.

Aims. To study the effect of controlled physical training on the quality of life and prognosis of patients with CHF comorbid with type 2 diabetes mellitus against the background of rational pharmacotherapy.

Materials and methods. The study included 74 patients with CHF against the background of type 2 diabetes mellitus, receiving optimal drug therapy, with mandatory intake of SGLT2 drugs. Two groups were formed using the simple randomization method: “Physical training” (n = 35) – basic drug therapy supplemented by a program of controlled physical training and “Standard drug therapy” (n = 37) – only basic drug therapy. Patients in the standard drug therapy group were recommended regular aerobic physical activity of moderate intensity for 30–60 minutes at least 5 days a week.

Results. In the Physical Training group, after 12 months, an increase in the distance according to the results of the 6-minute walk test by 39.6% (on average 407.2 meters) was registered, in the Standard Drug Therapy group, physical tolerance increased by 12.2% (324.5 meters) (p = 0.002). According MLHFQ questionnaire in patients with CHF, the results were obtained that characterize the high social adaptation of patients during physical training in comparison with standard pathogenetic drug therapy. Thus, the MLHFQ indicator in the Physical Training group changed by an average of 25.2 points, and in the Standard Drug Therapy group – by 5.7 points, amounting to 37.3 ± 5.9 in the Physical Training group, and 58.2 ± 2.1 in the Standard Drug Therapy group (p = 0.001).

Conclusions. Physical training in patients with CHF associated with type 2 diabetes mellitus against the background of optimal drug therapy leads to an increase in the distance according to the results of the 6-minute walk test and contributes to an improvement in the quality of life.

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