Abstract
Exercise training is increasingly recognized as a viable treatment option for patients with heart failure (HF). For exercise to be a maximally effective treatment, it is important that patients adhere to the exercise prescription. In this review, the current state of adherence monitoring and intervention in randomized HF trials will be summarized, along with recommendations for advancing understanding of adherence in this population. Barriers to exercise participation and strategies to enhance adherence to exercise-training programs will be explored. Finally, directions for future research on exercise adherence in HF patients will be provided.
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Martin KA, Sinden AR (2001) Who will stay and who will go? A review of older adults’ adherence to randomized controlled trials of exercise. J Aging Phys Act 9:91–114
Marcus BH, Dubbert PM, Forsyth LH, McKenzie TL, Stone EJ, Dunn AL, Blair SN (2000) Physical activity behavior change: issues in adoption and maintenance. Health Psychol 19:32–41
Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, Blair SN (1999) Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA 281:327–334
Dishman RK, Sallis JF (1994) Determinants and interventions for physical activity and exercise. In: Bouchard C, Shephard RJ, Stephens T, Sutton JR, McPherson BD (eds) Exercise, fitness, and health: a concensus of current knowledge. Human Kinetics, Champaign, IL, pp 75–102
Cooper AF, Weinman J, Horne R (2002) Factors associated with cardiac rehabilitation attendance: a systematic review of the literature. Clin Rehabil 16:541–552
Glazer KM, Emery CF, Frid DJ, Banyasz RE (2002) Psychological predictors of adherence and outcomes among patients in cardiac rehabilitation. J Cardiopulm Rehabil 22:40–46
Turner SC, Bethell HJ, Evans JA, Goddard JR, Mullee MA (2002) Patient characteristics and outcomes of cardiac rehabilitation. J Cardiopulm Rehabil 22:253–260
Evenson KR, Fleury J (2000) Barriers to outpatient cardiac rehabilitation participation, adherence. J Cardiopul Rehabil 20:241–246
Beswick AD, Rees K, West RR, Taylor FC, Burke M, Griebsch I et al (2005) Improving uptake and adherence in cardiac rehabilitation: literature review. J Adv Nurs 49:538–555
Evangelista LS, Berg J, Dracup K (2001) Relationship between psychosocial variables and compliance in patients with heart failure. Heart Lung 30:294–301
van der Wal MHL, Jaarsma T, Moser DK, Veeger NJGM, van Gilst WH, van Veldhuisen DJ (2006) Compliance in heart failure patients: the importance of knowledge and beliefs. Eur Heart J 27:434–440
Evangelista LS, Dracup K, Erickson V, McCarthy WJ, Hamilton MA, Fonarow GC (2005) Validity of pedometers for measuring exercise adherence in heart failure patients. J Card Fail 11:366–371
Corvera-Tindel T, Doering LV, Woo MA et al (2004) Effects of a home walking exercise program on functional status and symptoms in heart failure. Am Heart J 147:339–346
Gary RA, Sueta CA, Dougherty M, Rosenberg B, Cheek D, Preisser J et al (2004) Home-based exercise improves functional performance and quality of life in women with diastolic heart failure. Heart Lung 33:210–218
McKelvie RS, Teo KK, Roberts R et al (2002) Effects of exercise training in patients with heart failure: the exercise rehabilitation trial (EXERT). Am Heart J 144:23–30
Hambrecht R, Gielen S, Linke A et al (2000) Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure. JAMA 283:3095–3101
Oka RK, De Marco T, Haskell WL et al (2000) Impact of a home-based walking and resistance training program on quality of life in patients with heart failure. Am J Cardiol 85:365–369
Belardinelli R, Georgiou D, Cianci G et al (1999) Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects of functional capacity, quality of life, and clinical outcome. Circulation 99:1173–1182
Keteyian SJ, Brawner CA, Schairer JR et al (1999) Effects of exercise training on chronotropic incompetence in patients with heart failure. Am Heart J 138:233–240
Willenheimer R, Erhardt L, Cline C et al (1998) Exercise training in heart failure improves quality of life and exercise capacity. Eur Heart J 19:774–781
Keteyian SJ, Levine AB, Brawner CA et al (1996) Exercise training in patients with heart failure: a randomized, controlled trial. Ann Intern Med 124:1051–1057
Kiilavuori K, Sovijarvi A, Naveri H et al (1996) Effect of physical training on exercise capacity and gas exchange in patients with chronic heart failure. Chest 110:985–991
Belardinelli R, Georgiou D, Scocco V et al (1995) Low intensity exercise training in patients with chronic heart failure. J Am Coll Cardiol 26:975–982
Hambrecht R, Niebauer J, Fiehn E et al (1995) Physical training in patients with stable chronic heart failure: effects on cardiorespiratory fitness and ultrastructural abnormalities of leg muscles. J Am Coll Cardiol 25:1239–1249
Coats AJS, Adamopoulos S, Radaelli A et al (1992) Controlled trial of physical training in chronic heart failure: exercise performance, hemodynamics, ventilation, and autonomic function. Circulation 85:2119–2131
Smart N, Haluska B, Jeffriess L, Marwick TH (2005) Predictors of a sustained response to exercise training in patients with chronic heart failure: a telemonitoring study. Am Heart J 150:1240–1247
Corvera-Tindel T, Doering LV, Gomez T, Dracup K (2004) Predictors of noncompliance to exercise training in heart failure. J Cardiovasc Nurs 19:269–277
Tenenbaum A, Freimark D, Ahron E, Koren-Morag N, Schwamenthal E, Fisman EZ et al (2006) Long-term versus intermediate-term supervised exercise training in advanced heart failure: effects on exercise tolerance and mortality. Int J Cardiol 113:364–370
Smart N, Fang ZY, Marwick TH (2003) A practical guide to exercise training for heart failure patients. J Cardiac Failure 9:49–58
Whellan DJ, O’Connor CM, Pina I (2004) Training trials in heart failure: time to exercise restraint? Am Heart J 147:190–192
Pina IL, Apstein CS, Balady GJ, Belardinelli R, Chaitman BR, Duscha BD et al (2003) Exercise and heart failure: a statement from the American Heart Association committee on exercise, rehabilitation, and prevention. Circulation 107:1210–1225
Whellan DJ, O’Connor CM, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ et al (2007) Heart failure and a controlled trial investigating outcomes of exercise training (HF-ACTION): design and rationale. Am Heart J 153:201–211
Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, Newman MF (2004) Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med 66:305–315
Todaro JF, Shen B, Niaura R, Tilkemeier PL (2005) Prevalence of depressive disorders in men and women enrolled in cardiac rehabilitation. J Cardiopulm Rehabil 25:71–75
Rutledge T, Reis V, Linke SE, Greenberg BH, Mills PJ (2006) Depression in heart failure. A meta-analytic review of prevalence, intervention effects and associations with clinic outcomes. J Am Coll Cardiol 48:1527–1537
DiMatteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160:2101–2107
Marcus BH, Bock BC, Pinto BM, Forsyth LH, Roberts MB, Traficante RM (1998) Efficacy of an individualized, motivationally-tailored physical activity intervention. Ann Behav Med 20:174–180
DiClemente CC, Prochaska JO (1982) Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict Behav 7:133–142
Marcus BH, Forsyth LH (2003) Motivating people to be physically active. Human Kinetics, Champaign, IL
Bandura A (1977) Social learning theory. Prentice-Hall, Englewood Cliffs, NJ
Whiteley JA, Williams DM, Marcus BH (2006) Adherence to exercise regimens. In: O’Donohue WT, Levensky ER (Eds) Promoting treatment adherence: a practical handbook for health care providers. Sage Publications, Thousand Oaks, CA, pp 307–320
McAuley E, Jerome GJ, Elavsky S, Marquez DX, Ramsey SN (2003) Predicting long-term maintenance of physical activity in older adults. Prev Med 37:110–118
Oka R, King A (1995) Sources of social support as predictors of exercise adherence in women, men age 50 to 65 years. Womens Health 1:161–175
Fraser SN, Spink KS (2002) Examining the role of social support and group cohesion in exercise compliance. J Behav Med 25:233–249
Miller NH, Haskell WL, Berra K, DeBusk RF (1984) Home versus group exercise training for increasing functional capacity after myocardial infarction. Circulation 4:645–649
King AC, Haskell WL, Taylor B et al (1991) Group versus home-based exercise training in healthy older men and women. JAMA 266:1535–1542
Burkett PA, Rectanus EF, Bultena K (1990) Complaince to a phase III exercise program. J Cardiopulm Rehabil 10:381 (Abstr)
Stewart AL, Cerboncoeur CJ, McLellan BY, Gillis DE, Rush S, Mills KM, King AC, Ritter P, Brown BW, Bortz WM (2001) Physical activity outcomes of CHAMPS II: a physical activity promotion program for older adults. J Gerontol A Biol Sci Med Sci 56:M465–M470
Yates BC, Anderson T, Hertzog M, Ott C, Williams J (2005) Effectiveness of follow-up booster sessions in improving physical status after cardiac rehabilitation: health, behavioral, and clinical outcomes. Appl Nurs Res 18:59–62
King AC, Kiernan M, Oman RF, Kraemer HC, Hull M, Ahn D (1997) Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making. Health Psychol 16:380–389
Evangelista LS, Doering LV, Lennie T, Moser DK, Hamilton MA, Fonarow GC et al (2006) Usefulness of a home-based exercise program for overweight and obese patients with advanced heart failure. Am J Cardiol 97:886–890
Koukouvou G, Kouidi E, Iacovides A, Konstantinidou E, Kaprinis G, Deligiannis A (2004) Quality of life, psychological and physiological changes following exercise training in patients with chronic heart failure. J Rehabil Med 36:36–41
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Barbour, K.A., Miller, N.H. Adherence to exercise training in heart failure: a review . Heart Fail Rev 13, 81–89 (2008). https://doi.org/10.1007/s10741-007-9054-x
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DOI: https://doi.org/10.1007/s10741-007-9054-x