Exercise training program characteristics and magnitude of change in functional capacity of heart failure patients

Ismail, Hashimah; McFarlane, James R.; Dieberg, Gudrun; Smart, Neil A.

doi:10.1016/j.ijcard.2013.11.045

Cited by 53 publications

(32 citation statements)

References 17 publications

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“…This meta-analysis indicates that, in HFpEF patients, the magnitude of gain in cardio-respiratory fitness is similar to that seen in systolic heart failure patients exercising at moderate intensity [6,7]. In HFpEF, exercise training elicits in improvements in cardiac (diastolic) function, health related quality of life, general health, maximum heart rate and six minute walk distance which complement improvements seen in cardio-respiratory fitness.…”

Section: Discussionmentioning

confidence: 59%

“…We recorded the following; peak VO 2 (baseline and post exercise), V E /VCO 2 , maximum heart rate, 6 …”

Section: Outcomes Measuresmentioning

confidence: 99%

“…A 2011 review by Smart [5] estimated the hospital-based exercise therapy treatment costs to prevent mortality in one systolic heart failure patient to be approximately US$60K per annum. A range of benefits are likely in patients with systolic heart failure undertaking exercise training [6][7][8][9][10][11][12][13][14]. Meta-analyses have shown exercise training to be beneficial in HFpEF patients in terms of improved cardio-respiratory fitness [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Chan¹,

Giallauria

Vigorito

et al. 2016

Monaldi Arch Chest Dis

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Exercise training induces physical adaptations for heart failure patients with systolic dysfunction but less is known about those patients with preserved ejection fraction. This study's aims were to establish if exercise training produces changes in peak VO 2 and related measures, quality of life, general health and diastolic function in heart failure patients with preserved ejection fraction (HFpEF).We conducted a MEDLINE search (1985( to September 1, 2015, for exercise based rehabilitation trials in heart failure, using search terms 'exercise training, heart failure with preserved ejection fraction, heart failure with normal ejection fraction, peak VO 2 and diastolic heart dysfunction'. Eight intervention studies were included providing a total of 174 exercising subjects and 143 control subjects, a total of 317 participants.Peak VO 2 increased by a mean difference (MD) 2.08 mL kg -1 min -1 (95% C.I. 1.51 to 2.65, p<0.00001) in exercise training versus sedentary control, equating to a 17% improvement from baseline. V E /VCO 2 slope was not different between groups, MD -3.10 mL kg -1 min -1 (95% C.I. -7.47 to 1.27, p=0.16); maximum heart rate was significantly increased in exercise groups, MD 3.46 bpm (95% C.I. 2.41 to 4.51, p<0.00001); 6 Minute Walk Distance (6MWT) MD 32.1m (95% C.I. 17.2 to 47.1, p<0.0001); diastolic function; the ratio of early to late filling (E/A ratio) was improved after exercise training MD 0.07 (95% C.I. 0.02 to 0.12, p=0.006); as was filling pressure E/E' ratio MD -2.38 (95% C.I. -3.47 to -1.28, p<0.0001); Deceleration time (D T ) MD -13.2 msec (95% C.I. -19.8 to -6.5, p=0.0001); Minnesota Living with Heart Failure Questionnaire (MLHFQ) MD -6.77 (95% C.I. -9.70 to -3.84, p<0.00001); Short Form-36 Health Survey MD 11.38 (95% C.I. 5.28 to 17.48, p=0.0003). In 3222 patient-hours of training, not a single death was directly attributable to exercise.Exercise training appears to effect several health-related improvements in people with heart failure and preserved ejection fraction.

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Section: Discussionmentioning

confidence: 59%

“…We recorded the following; peak VO 2 (baseline and post exercise), V E /VCO 2 , maximum heart rate, 6 …”

Section: Outcomes Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Chan¹,

Giallauria

Vigorito

et al. 2016

Monaldi Arch Chest Dis

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“…This dominance of centre-based programs is also reflected in research studies, which predominately reported exercise programs as either exclusively centre-based or centre-based in combination with some home exercise sessions, with only five (15%) of the 33 studies conducted as exclusively home-based programs (Taylor et al, 2014). These centre-based programs are usually delivered in hospitals, universities and community centres, where participants attend two to seven sessions per week of supervised exercise and self-management education over a period of four to 52 weeks (Ismail et al, 2014). However, while these centre-based programs have been shown to be safe and effective (Smart & Marwick, 2004), they are of limited availability and yield low attendance rates.…”

Section: Exercise and Chronic Heart Failurementioning

confidence: 99%

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Hwang

Bruning

Mandrusiak

et al. 2016

Heart, Lung and Circulation

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Exercise is effective for patients with chronic heart failure (CHF). Despite this, many patients are unable to access traditional exercise-based rehabilitation programs for various reasons, such as transport difficulties and program availability. Telerehabilitation, in which telecommunication technologies are used to provide rehabilitation at a distance, is an alternative approach which may overcome some of these barriers.The current literature suggests that telerehabilitation is effective in patients with cardiopulmonary diseases. However the majority of studies focus on phone-based interventions, so there is a need for more studies on the use of video-based telerehabilitation programs. Video-based telerehabilitation is a new approach which enables patients to exercise in the comfort of their homes, whilst maintaining synchronous audiovisual communication. This approach enables the clinician to watch patients performing the exercises and to provide real-time feedback and modification as required, as well as facilitate the development of rapport between the clinician and patients, and peer support amongst patients. Video-based telerehabilitation also presents a potential way to conduct remote assessment of functional exercise capacity.This thesis aimed to explore a new service delivery model for providing heart failure exercise-based rehabilitation programs. The thesis commences with a systematic review of telerehabilitation in patients with cardiopulmonary diseases (Study 1, Paper 1). The next study aimed to determine the suitability of the timed up and go test (TUGT) as an outcome measurement in heart failure rehabilitation programs (Study 2, Paper 2). In addition, the validity and reliability of telerehabilitation assessments of functional tests including the TUGT were examined in patients with CHF (Study 3, Paper 3). A randomised controlled trial determined the feasibility and effectiveness of a home-based heart failure telerehabilitation program compared with a traditional centre-based program (Study 4, Paper 4). A mixed methods study was also conducted to determine patient experiences and perspectives related to a heart failure telerehabilitation program (Study 5, Paper 5).Based on the systematic review of 11 studies, telerehabilitation appears to be a promising alternative to traditional centre-based programs in patients with cardiopulmonary diseases. In particular, telerehabilitation has been shown to improve exercise capacity and quality of life in these patient groups and has higher adherence rates compared with traditional centre-based programs.iii However, suitable outcome measures that can be administered via telerehabilitation are required. A possible outcome measure is the TUGT, which is a quick and easy-to-administer functional test.However prior to using the TUGT as an outcome measure in telerehabilitation studies, it was first important to validate its use in both face-to-face and telerehabilitation environments. The TUGT demonstrated excellent test-retest reliability in patients with C...

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“…This program should be constituted by tests consistent with the objectives, capacities and necessities of the elderly that are submitted to the physical exercise program. The results of this evaluation provide the conditions for establishing a more secure and adequate physical activity program (Ismail et al, 2014).…”

Section: Introductionmentioning

confidence: 97%

Estimation of specific VO2max for elderly in cycle ergometer

Nunes

Castro

Silva

et al. 2017

jhse

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The aim of the present study was to develop and validate a specific estimation model of maximal oxygen consumption (VO2max) based on submaximal ventilatory indicators on a cycle ergometer test protocol in elderly men. We tested, using an incremental protocol, 181 healthy and non-athletes male volunteers, aged between 60 and 79 years old, randomly divided into two groups: group A, of estimation (n = 137), and group B, of validation (n = 44). The independent variables were: body mass in kg, second workload threshold (WT2) and heart rate at the second ventilatory threshold (VT2). The cross-validation method was used in group B, with group A serving as the basis for the model and the validation dataset. The results presented a multiple linear regression model for estimation of VO2max = 31.62 + 0.182 (WT2) -0.302 (body mass) in mlO2/kg/min-1; adjusted R2 = 0.98 and SEE = 0.682 (mlO2/Kg/min-1). The construction of this specific model for healthy and non-athletes elderly men can demonstrate that it is possible to estimate VO2max with a minimum error (SEE < 1.00) from indicators of ventilatory thresholds obtained in an incremental submaximal test.

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Exercise training program characteristics and magnitude of change in functional capacity of heart failure patients

Cited by 53 publications

References 17 publications

Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Estimation of specific VO2max for elderly in cycle ergometer

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