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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">The Clinician</journal-id><journal-title-group><journal-title xml:lang="en">The Clinician</journal-title><trans-title-group xml:lang="ru"><trans-title>Клиницист</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1818-8338</issn><issn publication-format="electronic">2412-8775</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">657</article-id><article-id pub-id-type="doi">10.17650/1818-8338-2025-19-2-K732</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>REVIEW</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОБЗОР</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">The role of physical exercise in management of patients with chronic heart failure</article-title><trans-title-group xml:lang="ru"><trans-title>Роль физических упражнений в ведении пациентов с хронической сердечной недостаточностью</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3456-4782</contrib-id><name-alternatives><name xml:lang="en"><surname>Payudis</surname><given-names>А. N.</given-names></name><name xml:lang="ru"><surname>Паюдис</surname><given-names>А. Н.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Аleksey Nikolaevich Payudis</p><p>85 Pobedy St., Belgorod 308015, Russia; 20/22 Bogdana Khmel’nitskogo Prospekt, Belgorod 308009, Russia</p></bio><bio xml:lang="ru"><p>Алексей Николаевич Паюдис</p><p>Россия, 308015 Белгород, ул. Победы, 85; Россия, 308009 Белгород, пр-т Богдана Хмельницкого, 20/22</p></bio><email>alekseipau@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-2917-5595</contrib-id><name-alternatives><name xml:lang="en"><surname>Bayduk</surname><given-names>D. V.</given-names></name><name xml:lang="ru"><surname>Байдук</surname><given-names>Д. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>85 Pobedy St., Belgorod 308015, Russia; 20/22 Bogdana Khmel’nitskogo Prospekt, Belgorod 308009, Russia</p></bio><bio xml:lang="ru"><p>Россия, 308015 Белгород, ул. Победы, 85; Россия, 308009 Белгород, пр-т Богдана Хмельницкого, 20/22</p></bio><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6129-0625</contrib-id><name-alternatives><name xml:lang="en"><surname>Kamyshnikova</surname><given-names>L. А.</given-names></name><name xml:lang="ru"><surname>Камышникова</surname><given-names>Л. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>85 Pobedy St., Belgorod 308015, Russia; 133G Bogdana Khmel’nitskogo Prospekt, Belgorod 308002, Russia</p></bio><bio xml:lang="ru"><p>Россия, 308015 Белгород, ул. Победы, 85; Россия, 308002 Белгород, пр-т Богдана Хмельницкого, 133Г</p></bio><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6395-1626</contrib-id><name-alternatives><name xml:lang="en"><surname>Еfremovа</surname><given-names>О. А.</given-names></name><name xml:lang="ru"><surname>Ефремова</surname><given-names>О. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>85 Pobedy St., Belgorod 308015, Russia; 12А Esenina St., Belgorod 308036, Russia</p></bio><bio xml:lang="ru"><p>Россия, 308015 Белгород, ул. Победы, 85; Россия, 308036 Белгород, ул. Есенина, 12А</p></bio><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9958-2917</contrib-id><name-alternatives><name xml:lang="en"><surname>Pavlovа</surname><given-names>Yu. S.</given-names></name><name xml:lang="ru"><surname>Павлова</surname><given-names>Ю. С.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>85 Pobedy St., Belgorod 308015, Russia; 36А Khar’kovskiy Pereulok, Belgorod 308012, Russia</p></bio><bio xml:lang="ru"><p>Россия, 308015 Белгород, ул. Победы, 85; Россия, 308012 Белгород, Харьковский пер., 36А</p></bio><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff5"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Belgorod State National Research University</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Белгородский государственный национальный исследовательский университет»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">MedGorod</institution></aff><aff><institution xml:lang="ru">ООО «МедГород»</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Meditsina</institution></aff><aff><institution xml:lang="ru">ООО «Медицина»</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Medical Center Alpha</institution></aff><aff><institution xml:lang="ru">ООО «Медицинский Центр Альфа»</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Endocrinology Center – Diaexpert</institution></aff><aff><institution xml:lang="ru">ООО «Эндокринологический Центр – Диаэксперт»</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-04-15" publication-format="electronic"><day>15</day><month>04</month><year>2025</year></pub-date><volume>19</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>12</fpage><lpage>23</lpage><history><date date-type="received" iso-8601-date="2025-09-03"><day>03</day><month>09</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-09-03"><day>03</day><month>09</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Payudis А.N., Bayduk D.V., Kamyshnikova L.А., Еfremovа О.А., Pavlovа Y.S.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Паюдис А.Н., Байдук Д.В., Камышникова Л.А., Ефремова О.А., Павлова Ю.С.</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Payudis А.N., Bayduk D.V., Kamyshnikova L.А., Еfremovа О.А., Pavlovа Y.S.</copyright-holder><copyright-holder xml:lang="ru">Паюдис А.Н., Байдук Д.В., Камышникова Л.А., Ефремова О.А., Павлова Ю.С.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://klinitsist.abvpress.ru/Klin/article/view/657">https://klinitsist.abvpress.ru/Klin/article/view/657</self-uri><abstract xml:lang="en"><p>Chronic heart failure is common among the population. In addition to the necessary drug treatment of this disease, non-drug approaches to management and rehabilitation of patients are also of great importance. One of the main approaches is physical training which can be divided into several types: high-intensity interval training, moderateintensity aerobic training, and resistance training. A search for literature reviews, systematic reviews and meta-analyses from 2023–2024 was performed in the eLibrary, Google Scholar and PubMed databases using relevant keywords. An analysis of the identified sources was performed, the results of which were also compared with the studies published in 2010–2014. All types of physical training had positive effect on the health of the patients. The advantage of high-intensity interval training and resistance training over moderate-intensity aerobic training in the short and intermediate term was shown, which was later smoothed out, probably due to a decrease in patient adherence to non-pharmacological treatment and kinesiophobia. At the same time, the greatest efficacy of the rehabilitation process and positive impact were achieved by combining different types of training, taking into account cognitive, mental and physiological characteristics of the patient, as well as their social, household, and economic capabilities. Telemedicine technologies and personalized selection of treatment tactics taking into account the stages of treatment and rehabilitation the patient was at, as well as a number of measures such as raising awareness and training the patient, improving their communication and interactions with medical personnel, psychological support and treatment of anxiety and depressive disorders helped to improve compliance.</p></abstract><trans-abstract xml:lang="ru"><p>Хроническая сердечная недостаточность широко распространена среди населения. Помимо очевидно необходимого медикаментозного лечения этого заболевания, огромную роль играют и немедикаментозные подходы к поддержанию состояния и реабилитации больных. Среди них важное значение имеют физические нагрузки, в ряду которых можно выделить несколько видов тренировок, а именно: интервальные с высокой интенсивностью нагрузки, аэробные с длительной нагрузкой умеренной интенсивности и силовые. Был выполнен поиск обзоров литературы, систематических обзоров и метаанализов за 2023–2024 гг. в базах данных eLibrary, Google Scholar и PubMed по ключевым словам и проведен анализ найденных источников, результаты которого также сравнивались с материалами исследований, публиковавшихся в 2010–2014 гг. Все виды физических тренировок оказывали положительное влияние на здоровье больных. Показано преимущество интервальных тренировок высокой интенсивности и силовых упражнений над аэробными тренировками с умеренной интенсивностью нагрузки на краткои среднесрочной перспективе, которые позже сглаживались, вероятно, из-за снижения приверженности пациентов нефармакологическому лечению и кинезиофобии. При этом наибольшая эффективность реабилитационного процесса и положительное влияние на здоровье достигались при комбинировании различных типов тренировок с учетом когнитивных, психических и физиологических особенностей пациента, а также его социальных, бытовых и экономических возможностей. Улучшить приверженность помогали телемедицинские технологии и персонализированный подбор тактики лечения с учетом того, на каком этапе лечебно-реабилитационного процесса находился пациент, а также такие меры, как повышение информированности и обучение пациента, улучшение его коммуникации и взаимодействия с медицинским персоналом, психологическая поддержка и лечение тревожных и депрессивных расстройств.</p></trans-abstract><kwd-group xml:lang="en"><kwd>сhronic heart failure</kwd><kwd>physical training</kwd><kwd>resistance training</kwd><kwd>aerobic exercise</kwd><kwd>interval training</kwd><kwd>rehabilitation</kwd><kwd>personalized medicine</kwd><kwd>treatment compliance</kwd><kwd>telemedicine</kwd><kwd>kinesiophobia</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>хроническая сердечная недостаточность</kwd><kwd>физическая тренировка</kwd><kwd>силовое упражнение</kwd><kwd>аэробное упражнение</kwd><kwd>интервальная тренировка</kwd><kwd>реабилитация</kwd><kwd>персонализированная медицина</kwd><kwd>приверженность лечению</kwd><kwd>телемедицина</kwd><kwd>кинезиофобия</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">1. 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