Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters
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To compare the effects of home-based and hospital-based exercise programs on exercise capacity, quality of life, psychological symptoms, and hemodynamic parameters in heart failure (HF) patients.
Seventy-four patients were randomized into either a hospital-based exercise (Group 1) or a home-based exercise (Group 2) group. Prior to and after the 8-week rehabilitation program, the two groups were compared with respect to their functional capacity [maximal oxygen uptake (pVO2) and 6-min walk test (6MWT)], quality of life (Medical Outcomes Study and the 36-item Short Form Survey, SF-36), psychological symptoms [Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory], and hemodynamic parameters [(left ventricular diastolic diameter in diastole, left ventricular diameter in systole, Mitral Early diastolic peak flow velocity (E)/late diastolic peak flow velocity (A), Mitral E/Mitral early peak velocity (E m), Tei index, right ventricular systolic peak velocity (S m), tricuspid annular plane systolic excursion, systolic pulmonary arterial pressure (SPAP), and left and right ventricular ejection fraction (LVEF and RVEF)].
After the exercise programs, significant improvement was observed in pVO2, 6MWT and subscales of physical function, general health, and vitality of SF 36, as well as BDI and LVEF in both groups (P < 0.05). A comparison of the two exercise groups revealed no significant differences between them regarding the analyzed variables (P > 0.05).
Both the hospital-based and home-based exercise groups improved significantly in functional capacity, quality of life, depression symptoms, and LVEF. Based on these results, we believe that physicians can recommend home-based exercise under strict supervision for stable HF patients. However, additional research should be conducted in this area.
KeywordsExercise training Heart failure
We have no support for this study.
- 1.Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, Ganiats TG, Goldstein S, Gregoratos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr (2001) ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to revise the 1995 guidelines for the evaluation and management of heart failure): developed in collaboration with the International Society for Heart and Lung Transplantation; endorsed by the Heart Failure Society of America. Circulation 104:2996–3007PubMedCrossRefGoogle Scholar
- 2.Whellan DJ, O’Connor CM, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzman DW, Blumenthal JA, Rendall DS, Houston-Miller N, Fleg JL, Schulman KA, Piña IL (2007) Heart failure and a controlled trial investigating outcomes of exercise training (HF-ACTION): design and rationale. Am Heart J 153:201–211PubMedCrossRefGoogle Scholar
- 10.American College of Sports Medicine (1990) The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 22:265–274Google Scholar
- 13.Trust MedicalOutcomes (1994) How to score SF-36 health survey, 2nd edn. Medical Outcomes Trust, BostonGoogle Scholar
- 14.Beck AT, Stear RA, Garben MG (1985) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. The Beck depression inventory, 2nd edn. Houghton Mifflin, BostonGoogle Scholar
- 15.Spielberger CD, Gorsuch RL, Lushene RE (1970) Manual for the State-Trait Anxiety Inventory. Consulting Psychology Press, Palo AltoGoogle Scholar
- 17.Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I (1989) Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 2:358–367PubMedGoogle Scholar
- 21.Friedmann E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS, Sudden Cardiac Death in Heart Failure Trial Investigators (2006) Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J 152:940.e1–940.e8Google Scholar
- 26.Yu CM, Li LS, Lam MF, Siu DC, Miu RK, Lau CP (2004) Effect of a cardiac rehabilitation program on left ventricular diastolic function and its relationship to exercise capacity in patients with coronary heart disease: experience from a randomized, controlled study. Am Heart J 147:e24PubMedCrossRefGoogle Scholar
- 27.Sullivan MJ, Higginbotham MB, Cobb FR (1998) Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation 78:506–515Google Scholar
- 29.Erbs S, Linke A, Gielen S, Fiehn E, Walther C, Yu J, Adams V, Schuler G, Hambrecht R (2003) Exercise training in patients with severe chronic heart failure: impact on left ventricular performance and cardiac size. A retrospective analysis of the Leipzig Heart Failure Training Trial. Eur J Cardiovasc Prev Rehabil 10:336–344PubMedCrossRefGoogle Scholar
- 30.Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L (2003) Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the exercise in left ventricular dysfunction and chronic heart failure (ELVD-CHF) trial. Circulation 108:554–559PubMedCrossRefGoogle Scholar