Exercise-based cardiac rehabilitation for adults with heart failure

Abstract

BackgroundChronic heart failure (HF) is a growing global health challenge. People with HF experience substantial burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous (2014) Cochrane systematic review reported that exercise-based cardiac rehabilitation (CR) compared to no exercise control shows improvement in HRQoL and hospital admission among people with HF, as well as possible reduction in mortality over the longer term, and that these reductions appear to be consistent across patient and programme characteristics. Limitations noted by the authors of this previous Cochrane Review include the following: (1) most trials were undertaken in patients with HF with reduced (< 45%) ejection fraction (HFrEF), and women, older people, and those with preserved (≥ 45%) ejection fraction HF (HFpEF) were under-represented; and (2) most trials were undertaken in the hospital/centre-based setting. ObjectivesTo determine the effects of exercise-based cardiac rehabilitation on mortality, hospital admission, and health-related quality of life of people with heart failure. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and three other databases on 29 January 2018. We also checked the bibliographies of systematic reviews and two trial registers. Selection criteriaWe included randomised controlled trials that compared exercise-based CR interventions with six months' or longer follow-up versus a no exercise control that could include usual medical care. The study population comprised adults (> 18 years) with evidence of HFeither HFrEF or HFpEF. 1 Exercise-based cardiac rehabilitation for adults with heart failure (Review)

Kinesiophobia and physical activity: A systematic review and meta-analysis

“…Yet, one in four adults worldwide does not meet the recommendations for physical activity 10 . Physical activity also plays an important role in secondary and tertiary prevention by reducing the impact, slowing the progression, and preventing the recurrence of multiple health conditions, including cardiovascular disease 11,12 , osteoarthritis 13 , stroke 14,15 , and cancer 16 . Several factors may explain physical inactivity 17 , including environmental, interpersonal, and intrapersonal factors 18 .…”