Heart Failure Reviews

, Volume 17, Issue 1, pp 107–115 | Cite as

What strategies are effective for exercise adherence in heart failure? A systematic review of controlled studies

  • Stephanie TierneyEmail author
  • Mamas Mamas
  • Stephen Woods
  • Martin K. Rutter
  • Martin Gibson
  • Ludwig Neyses
  • Christi Deaton


Physical activity is recommended for people with stable heart failure (HF), because it is known to improve quality of life and health outcomes. However, adherence to this recommendation has been poor in many studies. A systematic review was conducted to examine the effectiveness of strategies used to promote exercise adherence in those with HF. The following databases were searched for relevant literature published between January 1980 and December 2010: British Nursing Index; CINAHL; Cochrane Library; Embase; Medline and PsycINFO. Papers with a control group focused on adults with HF that measured exercise or physical activity adherence were included. Nine randomised controlled trials were identified, involving a total of 3,231 patients (range 16–2,331). Six of these studies were informed by specific psychological theories. Positive outcomes occurred in the short-term from interventions using approaches such as exercise prescriptions, goal setting, feedback and problem-solving. However, longer-term maintenance of exercise was less successful. There was some support for interventions underpinned by theoretical frameworks, but more research is required to make clearer recommendations. Addressing self-efficacy in relation to exercise may be a particularly useful area to consider in this respect.


Controlled trials Exercise adherence Heart failure Physical activity Self-management Systematic review 



This project was funded by the Greater Manchester Collaborative Leadership in Applied Health Research and Care (CLAHRC) flexibility and sustainability funding. The work was supported by the Manchester Academic Health Sciences Centre and the NIHR Manchester Biomedical Research Centre.

Conflict of interest

None of the authors have any conflict of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Stephanie Tierney
    • 1
    Email author
  • Mamas Mamas
    • 2
    • 3
  • Stephen Woods
    • 4
  • Martin K. Rutter
    • 2
    • 3
  • Martin Gibson
    • 2
    • 5
  • Ludwig Neyses
    • 2
    • 3
  • Christi Deaton
    • 1
    • 3
  1. 1.School of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
  2. 2.School of MedicineUniversity of ManchesterManchesterUK
  3. 3.Central Manchester University Hospitals NHS Foundation TrustManchesterUK
  4. 4.University Hospital of South Manchester NHS Foundation TrustManchesterUK
  5. 5.Salford Royal NHS Foundation TrustSalfordUK

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