Effects of home versus hospital-based exercise training in chronic heart failure

Cowie, Aynsley; Thow, Morag; Granat, Malcolm H.; Mitchell, Sarah

doi:10.1016/j.ijcard.2012.04.117

Cited by 29 publications

(42 citation statements)

References 8 publications

(3 reference statements)

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“… 29 30 32–40 Our updated searches produced a total of 12 949 titles from which an additional five studies (six publications) were included. 23–25 41 42 Outcomes of one previously included trial with a longer follow-up (18 months and 6 years postrandomisation) were also identified. 32 43 The study selection process is summarised in figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies compared comprehensive programmes (ie, exercise plus education and/or psychological management) while six reported only an exercise intervention. 23 24 29 35 37 40 Most programmes used individually tailored exercise prescriptions, making it difficult to precisely quantify the amount of exercise undertaken. Almost all home-based programmes were based on walking with intermittent support from a nurse or exercise specialist, while centre-based programmes typically provided a supervised cycle and treadmill exercise (see online supplementary table B).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies included those with New York Heart Association (NYHA) class II or III heart failure (n=315). 23–25 35…”

Section: Resultsmentioning

confidence: 99%

“…We are aware of a number of randomised head-to-head trials of centre-based versus home-based CR in heart failure that have been published since the previous review. 23–25 …”

Section: Introductionmentioning

confidence: 99%

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Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis

et al. 2016

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ObjectiveTo update the Cochrane review comparing the effects of home-based and supervised centre-based cardiac rehabilitation (CR) on mortality and morbidity, quality of life, and modifiable cardiac risk factors in patients with heart disease.MethodsSystematic review and meta-analysis. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL were searched up to October 2014, without language restriction. Randomised trials comparing home-based and centre-based CR programmes in adults with myocardial infarction, angina, heart failure or who had undergone coronary revascularisation were included.Results17 studies with 2172 patients were included. No difference was seen between home-based and centre-based CR in terms of: mortality (relative risk (RR) 0.79, 95% CI 0.43 to 1.47); cardiac events; exercise capacity (mean difference (MD) −0.10, −0.29 to 0.08); total cholesterol (MD 0.07 mmol/L, −0.24 to 0.11); low-density lipoprotein cholesterol (MD −0.06 mmol/L, −0.27 to 0.15); triglycerides (MD −0.16 mmol/L, −0.38 to 0.07); systolic blood pressure (MD 0.2 mm Hg, −3.4 to 3.8); smoking (RR 0.98, 0.79 to 1.21); health-related quality of life and healthcare costs. Lower high-density lipoprotein cholesterol (MD −0.07 mmol/L, −0.11 to −0.03, p=0.001) and lower diastolic blood pressure (MD −1.9 mm Hg, −0.8 to −3.0, p=0.009) were observed in centre-based participants. Home-based CR was associated with slightly higher adherence (RR 1.04, 95% CI 1.01 to 1.07).ConclusionsHome-based and centre-based CR provide similar benefits in terms of clinical and health-related quality of life outcomes at equivalent cost for those with heart failure and following myocardial infarction and revascularisation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Four studies included those with New York Heart Association (NYHA) class II or III heart failure (n=315). 23–25 35…”

Section: Resultsmentioning

confidence: 99%

“…We are aware of a number of randomised head-to-head trials of centre-based versus home-based CR in heart failure that have been published since the previous review. 23–25 …”

Section: Introductionmentioning

confidence: 99%

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Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis

et al. 2016

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“…mean values of 26 points out of a possible score of 105 points in the questionnaire). Cowie et al [25] also reported no significant change in quality of life in CHF patients following home-based or hospital-based intervention, even though there was a significant improvement in exercise capacity. They further suggested that in older CHF patients, maintaining quality of life rather than improving it might be a realistic aim for a physical activity or rehabilitation programme.…”

Section: Discussionmentioning

confidence: 97%

Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

et al. 2019

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Purpose: Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods: Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre-and postintervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results: Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m 2 , P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion: The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration: www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.

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Exercise-based cardiac rehabilitation for adults with heart failure

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Mordi

Bridges

et al. 2019

Cochrane Database of Systematic Reviews

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Effects of home versus hospital-based exercise training in chronic heart failure

Cited by 29 publications

References 8 publications

Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis

Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis

Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

Exercise-based cardiac rehabilitation for adults with heart failure

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