{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T12:35:26Z","timestamp":1747658126923,"version":"3.40.5"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Heart failure (HF) imposes limitations due to severe dyspnea and fatigue, which are often linked to diminished exercise tolerance, potentially influenced by compromised microvascular density, blood flow, and muscle strength. Myofascial release techniques (MRT) have demonstrated the capacity to enhance blood flow by reducing fascial tension.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To assess the impact of incorporating MRT into Circuit Resistance Training (CRT) in comparison to an unsupervised home-based rehabilitation (RUHB) program on exercise tolerance (ET), muscle strength (MS), quality of life (QoL), and depression in patients with HF.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A randomized clinical trial involved HF patients with reduced ejection fraction (HFrEF, ejection fraction &lt;50%) and NYHA classes II\u2013IV. Participants were randomly assigned to either CRT (performing 2 circuits of 8 exercises thrice a week for three months) or CRT+MRT (receiving a combination of CRT and 6 MRT interventions once a week). Assessments included cardiopulmonary exercise tests (CPET) to measure ET, MS evaluated through One Repetition Maximum (1RM), QoL using the Minnesota Living with HF Questionnaire (MLwHFQ), and Depression through the Beck Depression Inventory (BDI) conducted before and after the intervention<jats:bold>s.<\/jats:bold><\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Thirty-eight patients (14 in CRT, 14 in CRT+MRT, and 10 in RUHB), with a mean age of 55 years and 50% male, completed the study. After 12 weeks, only the CRT group displayed a significant effect in certain ET variables VO<jats:sub>2<\/jats:sub> peak [baseline 12 (9\u201315) vs post 16 (11\u201319) ml\/kg\/min, p&lt;0.05], VO<jats:sub>2peak<\/jats:sub> (ml\/min) [baseline 848 (640\u20131056) vs post 1103 (852\u20131355) p&lt;0.05], VE\/VCO<jats:sub>2<\/jats:sub> slope [baseline 34 (27\u201341) vs post 31 (27\u201336) p&lt;0.05] and VO<jats:sub>2<\/jats:sub>\/HR<jats:sub>peak<\/jats:sub> [baseline 7 (5\u20139) vs post 11 (8\u201314) p&lt;0.05]. There were significant decreases in the \u0394MLwHFQ in the CRT group vs. RUHB (p&lt;0.001) and CRT+MRT group vs. RUHB (p&lt;0.001), demonstrating improved quality of life after 12 weeks in CRT and CRT+MRT groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings suggest that CRT alone is sufficient to enhance cardiorespiratory function and muscle capacity, improve the quality of life, and alleviate depression in individuals with HF.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299348","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T18:40:34Z","timestamp":1732214434000},"page":"e0299348","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving cardiorespiratory fitness and quality of life among heart failure patients: A comparative study of circuit resistance training and myofascial release techniques"],"prefix":"10.1371","volume":"19","author":[{"given":"Sergio R.","family":"Thomaz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e1ssia Da Luz","family":"Goulart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8550-6526","authenticated-orcid":true,"given":"Nat\u00e1lia","family":"Turri-Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe A.","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-3764","authenticated-orcid":true,"given":"Luis","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glauco Lima","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziella Fran\u00e7a B.","family":"Cipriano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerson","family":"Cipriano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence P.","family":"Cahalin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"pone.0299348.ref001","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/j.jacc.2006.06.055","article-title":"Depression in Heart Failure","volume":"48","author":"T Rutledge","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"pone.0299348.ref002","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1001\/archinte.161.15.1849","article-title":"Relationship of Depression to Increased Risk of Mortality and Rehospitalization in Patients With Congestive Heart Failure","volume":"161","author":"W Jiang","year":"2001","journal-title":"Arch Intern Med"},{"key":"pone.0299348.ref003","doi-asserted-by":"crossref","first-page":"223","DOI":"10.2459\/JCM.0b013e328343e950","article-title":"Predictors of exercise capacity in patients with chronic heart failure","volume":"12","author":"I Daullxhiu","year":"2011","journal-title":"Journal of Cardiovascular Medicine"},{"key":"pone.0299348.ref004","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1152\/japplphysiol.00195.2013","article-title":"The physiological basis of rehabilitation in chronic heart and lung disease","volume":"115","author":"I Vogiatzis","year":"2013","journal-title":"J Appl Physiol"},{"key":"pone.0299348.ref005","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/1753944708089701","article-title":"Review: Endurance exercise and resistance training in cardiovascular disease","volume":"2","author":"N Meka","year":"2008","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"pone.0299348.ref006","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ijcard.2016.12.145","article-title":"Effect of exercise training on endothelial function in heart failure patients: A systematic review meta-analysis","volume":"231","author":"MJ Pearson","year":"2017","journal-title":"Int J Cardiol"},{"key":"pone.0299348.ref007","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1161\/HYPERTENSIONAHA.110.163022","article-title":"The Impact of Exercise Training on Conduit Artery Wall Thickness and Remodeling in Chronic Heart Failure Patients","volume":"57","author":"AJ Maiorana","year":"2011","journal-title":"Hypertension"},{"key":"pone.0299348.ref008","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1001\/jama.2009.454","article-title":"Efficacy and Safety of Exercise Training in Patients With Chronic Heart Failure","volume":"301","author":"CM O\u2019Connor","year":"2009","journal-title":"JAMA"},{"key":"pone.0299348.ref009","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1249\/MSS.0b013e31820eeea1","article-title":"Effect of Resistance Training on Physical Disability in Chronic Heart Failure","volume":"43","author":"PA SAVAGE","year":"2011","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0299348.ref010","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S1071-9164(03)00583-9","article-title":"Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow*1","volume":"10","author":"S SELIG","year":"2004","journal-title":"J Card Fail"},{"key":"pone.0299348.ref011","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.cardfail.2006.10.017","article-title":"Circuit Resistance Training in Chronic Heart Failure Improves Skeletal Muscle Mitochondrial ATP Production Rate\u2014A Randomized Controlled Trial","volume":"13","author":"AD Williams","year":"2007","journal-title":"J Card Fail"},{"key":"pone.0299348.ref012","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1475-097X.2007.00741.x","article-title":"Enhancement of isokinetic muscle strength with a combined training programme in chronic heart failure","volume":"27","author":"F Degache","year":"2007","journal-title":"Clin Physiol Funct Imaging"},{"key":"pone.0299348.ref013","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.ijcard.2016.06.207","article-title":"Home-based cardiac rehabilitation for people with heart failure: A systematic review and meta-analysis","volume":"221","author":"A-D Zwisler","year":"2016","journal-title":"Int J Cardiol"},{"key":"pone.0299348.ref014","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijosm.2012.07.001","article-title":"The effect of osteopathic manual therapy on the vascular supply to the lower extremity in individuals with knee osteoarthritis: A randomized trial","volume":"15","author":"WM Jardine","year":"2012","journal-title":"International Journal of Osteopathic Medicine"},{"key":"pone.0299348.ref015","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jbmt.2008.06.012","article-title":"Fasciatherapy combined with pulsology touch induces changes in blood turbulence potentially beneficial for vascular endothelium","volume":"13","author":"N Quer\u00e9","year":"2009","journal-title":"J Bodyw Mov Ther"},{"key":"pone.0299348.ref016","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.math.2008.08.002","article-title":"The use of osteopathic manipulative treatment as adjuvant therapy in patients with peripheral arterial disease","volume":"14","author":"R Lombardini","year":"2009","journal-title":"Man Ther"},{"key":"pone.0299348.ref017","doi-asserted-by":"crossref","first-page":"252","DOI":"10.7326\/0003-4819-155-4-201108160-00009","article-title":"Management of Chronic Heart Failure in Adults: Synopsis of the National Institute for Health and Clinical Excellence Guideline","volume":"155","author":"J. Mant","year":"2011","journal-title":"Ann Intern Med"},{"key":"pone.0299348.ref018","first-page":"231","article-title":"Seguran\u00e7a, reprodutibilidade, fatores intervenientes e aplicabilidade de testes de 1-RM","volume":"19","author":"RMR Dias","year":"2013","journal-title":"Motriz: Revista de Educa\u00e7\u00e3o F\u00edsica"},{"key":"pone.0299348.ref019","first-page":"221","article-title":"Reliability of the one-repetition maximum test based on muscle group and gender","volume":"11","author":"D-I Seo","year":"2012","journal-title":"J Sports Sci Med"},{"key":"pone.0299348.ref020","article-title":"The Brazilian Society of Cardiology and Brazilian Society of Exercise and Sports Medicine Updated Guidelines for Sports and Exercise Cardiology\u20142019","author":"N Ghorayeb","year":"2019","journal-title":"Arq Bras Cardiol"},{"key":"pone.0299348.ref021","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1590\/S0066-782X2009000700008","article-title":"Valida\u00e7\u00e3o da vers\u00e3o em portugu\u00eas do Minnesota Living with Heart Failure Questionnaire","volume":"93","author":"VO Carvalho","year":"2009","journal-title":"Arq Bras Cardiol"},{"key":"pone.0299348.ref022","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.rbp.2012.03.005","article-title":"Validation of the Brazilian Portuguese Version of the Beck Depression Inventory-II in a community sample","volume":"34","author":"MH Gomes-Oliveira","year":"2012","journal-title":"Revista Brasileira de Psiquiatria"},{"key":"pone.0299348.ref023","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1161\/01.CIR.101.7.828","article-title":"Resistance Exercise in Individuals With and Without Cardiovascular Disease","volume":"101","author":"ML Pollock","year":"2000","journal-title":"Circulation"},{"key":"pone.0299348.ref024","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.961414","article-title":"Effects of high-intensity and moderate-intensity exercise training on cardiopulmonary function in patients with coronary artery disease: A meta-analysis","volume":"9","author":"L Zheng","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"pone.0299348.ref025","doi-asserted-by":"crossref","first-page":"256","DOI":"10.14336\/AD.2013.0400256","article-title":"Impact of Resistance Circuit Training on Neuromuscular, Cardiorespiratory and Body Composition Adaptations in the Elderly","volume":"04","author":"S. Romero-Arenas","year":"2013","journal-title":"Aging Dis"},{"key":"pone.0299348.ref026","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0735-1097(86)80256-X","article-title":"Circuit weight training in cardiac patients","volume":"7","author":"MH Kelemen","year":"1986","journal-title":"J Am Coll Cardiol"},{"key":"pone.0299348.ref027","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1161\/01.CIR.99.9.1173","article-title":"Randomized, Controlled Trial of Long-Term Moderate Exercise Training in Chronic Heart Failure","volume":"99","author":"R Belardinelli","year":"1999","journal-title":"Circulation"},{"key":"pone.0299348.ref028","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1097\/00005768-200212000-00002","article-title":"Strength\/endurance training versus endurance training in congestive heart failure","volume":"34","author":"C DELAGARDELLE","year":"2002","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0299348.ref029","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.ijcard.2004.05.061","article-title":"Resistance training for chronic heart failure patients on beta blocker medications","volume":"102","author":"I Levinger","year":"2005","journal-title":"Int J Cardiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T18:40:45Z","timestamp":1732214445000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299348"}},"subtitle":[],"editor":[{"given":"Yoshihiro","family":"Fukumoto","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0299348","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}