Impact of exercise training program attendance and physical activity participation on six minute walk distance in patients with heart failure

Adsett, Julie; Morris, Norman; Mudge, Alison

doi:10.1080/09593985.2019.1669232

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…Attendance at center‐based ET was relatively low, reflecting the pragmatic trial design and consistent with other large pragmatic ET trials, 15 and so the findings of no additional benefit with center‐based ET need to be interpreted with caution. We recognize that ET attendance is a limited measure of intervention dose and fidelity, although this simple measure was strongly associated with improvements in 6MWD 36 . Fidelity to home exercise was measured only by self‐report of PA, and PA and 6MWD data were only available for participants who attended follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…We recognize that ET attendance is a limited measure of intervention dose and fidelity, although this simple measure was strongly associated with improvements in 6MWD. 36 Fidelity to home exercise was measured only by self-report of PA, and PA and 6MWD data were only available for participants who attended follow-up. The FI was constructed using available data items, although we used a well-accepted method, and there were missing data at 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Frailty implications for exercise participation and outcomes in patients with heart failure

Mudge

Pelecanos

Adsett

2021

J American Geriatrics Society

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Background/Objectives Frailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim of this study was to describe the characteristics, exercise participation, and outcomes of frail and not‐frail participants enrolled in a randomized trial of exercise training (ET) within a cardiac rehabilitation (CR) program. Design Secondary analysis of EJECTION‐HF randomized trial (ACTRN12608000263392). Setting Five HF‐specific CR programs in Queensland, Australia. Participants Adults recently hospitalized with HF. Intervention All participated in CR including home exercise prescription and monitoring; half were randomized to center‐based ET. Measurements A frailty index (FI) was constructed at randomization and 6‐month follow‐up. Outcomes included ET attendance, change in 6‐min walk distance (6MWD), improved FI (>0.09 units) at 6 months, achieving physical activity (PA) guidelines at 6 months, and 12 month all‐cause death or readmission. Results The FI was measured in 256 participants at randomization: 110 (43%) were not‐frail (FI 0.2 or less), 119 (46%) were frail (FI >0.2 to 0.39), and 27 (11%) were very frail (FI ≥0.4). Frailty was more common with older age, female gender, decompensated HF, worse HF symptoms, and preserved ejection fraction. ET attendance did not differ by frailty group. Participants who were more frail had lower 6WMD at enrollment, but similar improvement over 6 months. Mean FI improved by 0.03 units at 6 months (95% CI 0.02–0.04, p < 0.001). Participants who were more frail had significantly greater improvements in FI compared with not‐frail participants and were often able to achieve PA guidelines, both in intervention and control groups. Neither baseline frailty nor intervention was significantly associated with 12‐month death or readmission. Conclusion Frail people with HF participating in CR that includes home and/or center‐based ET often achieve PA guidelines, and some may have meaningful reductions in frailty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Frailty implications for exercise participation and outcomes in patients with heart failure

Mudge

Pelecanos

Adsett

2021

J American Geriatrics Society

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“…Being physically active and frequent program attendance were associated with significant improvements in 6MWD. 30) Another secondary analysis of the EJECTION-HF trial, analyzed the effects on ET on frail subjects, using a frailty index (FI) that was constructed using cumulative deficits index at randomization and 6-month follow-up. Participants who were frailer had significantly greater improvements in FI and improvement in physical activity, compared with not-frail participants.…”

Section: Exercisementioning

confidence: 99%

Lifestyle Modification in Heart Failure Management: Are We Using Evidence-Based Recommendations in Real World Practice?

2023

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The heart failure (HF) guideline’s purpose is to assist medical professionals while treating patients with HF in accordance with the best current research. Many cases of HF are both, avoidable and treatable thanks to scientific trials. Management is, therefore, based on lifestyle changes, also called non-pharmacological treatment. These, based on lifestyle changes, should be recommended in every patient at risk for HF or with diagnosed of HF, but evidence in itself is scarce. DASH Diet could be clearly beneficial while Mediterranean diet doesn't have enough evidence at the present moment. Smoking should be stopped, and excessive amounts of alcohol drinking avoided, but there is no clinical trial nor registry performed on these aspects. A moderate salt restriction is better than a strict reduction. Exercise and cardiac rehabilitation are beneficial but there are no clear recommendations about type, duration, etc. Most of the evidence that we have in HF patients with obesity is contradictory. Finally, due to the high number of aged frail patients in HF lifestyle changes should be individualized, but again available data is scant. Therefore, due to the lack of current evidence, these gaps need to be considered and need new efforts on investigation in the next future.

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“…Physical activity is one of the important therapeutic aspects in HF patients. Nevertheless, the adherence of HF patients to physical activity is low whether in daily life or in rehabilitation programs ( 6 , 7 ). In this regard, 40–91% of HF patients do not participate in regular exercise ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Effective Strategies for Physical Activity Adherence in Heart Failure Patients: An Umbrella Review

Moonaghi,

Ahrari,

Mahdizadeh

et al. 2023

ijph

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Background: Despite the importance of physical activity in heart failure treatment, physical activity adherence in heart failure patients is low. The purpose of this umbrella review was to obtain the best strategies for enhancing physical activity adherence among HF patients. Methods: Databases were investigated from 2010 to Jan 2022. The full text of the papers was investigated in terms of inclusion and exclusion criteria. Eventually, out of 74 relevant papers, 7-review study with 20977 patients were eligible and included in the study. Results: Five key effective approaches were identified in two subsets for enhancing physical activity adherence as follows: 1) exercise-based approaches including 1.1) Exergames, whereby the extent of adherence to exergames was between 84 and 98%. 1.2) Tele-rehabilitation with 70%-100% adherence the intervention groups 1.3) Tai chi and Qigong practices (TQPs), whereby the exercise adherence in TQP groups was 67-100%, 2. Theoretical-behavioral approaches 2.1) approaches based on behavioral and psychological theories, which were a combination of an exercise program alongside a behavior modification intervention, 2.2) Self-efficacy. Conclusion: Approaches that are based on exercise alongside behavioral and theoretical interventions could enhance physical activity adherence among HF patients. It is suggested to evaluate mix methods of exercise-based approaches and theoretical-behavioral approaches mentioned in this study in future clinical trial studies. Use of capacity of TR programs improve to physical activity adherence should receive more attention.

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Impact of exercise training program attendance and physical activity participation on six minute walk distance in patients with heart failure

Cited by 3 publications

References 31 publications

Frailty implications for exercise participation and outcomes in patients with heart failure

Frailty implications for exercise participation and outcomes in patients with heart failure

Lifestyle Modification in Heart Failure Management: Are We Using Evidence-Based Recommendations in Real World Practice?

Effective Strategies for Physical Activity Adherence in Heart Failure Patients: An Umbrella Review

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