Home-based cardiac rehabilitation improves quality of life, aerobic capacity, and readmission rates in patients with chronic heart failure

Abstract

Background:Exercise tolerance and cardiac output have a major impact on the quality of life (QOL) of patients experiencing heart failure (HF). Home-based cardiac rehabilitation can significantly improve not only exercise tolerance but also peak oxygen uptake ( peak), and the QOL in patients with HF. The aim of this prospective study was to evaluate the beneficial effects of home-based cardiac rehabilitation on the quality of medical care in patients with chronic HF.Methods:This study was a randomized prospective trial. HF patients with a left ventricular ejection fraction (LVEF) of less than 50% were included in this study. We randomly assigned patients to the control group (n = 18) and the interventional group (n = 19). Within the interventional group, we arranged individualized rehabilitation programs, including home-based cardiac rehabilitation, diet education, and management of daily activity over a 3-month period. Information such as general data, laboratory data, Cardiopulmonary Exercise Test (CPET) results, Six-minute Walk Test (6MWT) results, and the scores for the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after the intervention, was collected from all patients in this study.Results:Patients enrolled in the home-based cardiac rehabilitation programs displayed statistically significant improvement in peak (18.2 ± 4.1 vs 20.9 ± 6.6 mL/kg/min, P = .02), maximal 6-Minute Walking Distance (6MWD) (421 ± 90 vs 462 ± 74 m, P = .03), anaerobic threshold (12.4 ± 2.5 vs 13.4 ± 2.6 mL/kg/min, P = .005), and QOL. In summary, patients receiving home-based cardiac rehabilitation experienced a 14.2% increase in peak, a 37% increase in QOL score, and an improvement of 41 m on the 6MWD test. The 90-day readmission rate for patients reduced to 5% from 14% after receiving cardiac rehabilitation.Conclusion:Home-based cardiac rehabilitation offered the most improved results in functional capacity, QOL, and a reduced the rate of readmission within 90 days.

Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms: A Randomized Clinical Trial

“…The 129.6-and 141.6-m increases in the 6MWT distance (both p < 0.05; Table 2) suggest improvements in fitness and walking and balance abilities far exceeding the ∼5 m increase in the ParkFit study [25]. Especially in low-fitness individuals, such as our patients, the walking distance at baseline [26] and the increases in the distance walked correlate with the maximal oxygen uptake up to r = 0.77 [27][28][29][30] (a measure of cardiorespiratory fitness), suggesting that EXE and CYC could improve PD patients' walking and balance abilities due to increased physical conditioning and fitness.…”

“…While the 100% adherence and 0% dropout rates make a high exercise intensity feasible [8], therapists delivered exercise sessions in a designated hospital facility, conditions often unavailable to PD patients. However, patients could perform agility exercises or cycle on an ergometer at home with remote supervision, reducing costs and staff burdens [26,35]. In this randomized comparative effectiveness trial the assessors were blinded to the patients' group assignment; there could still be a bias in the assessments because there was no assessment of masking maintenance.…”

A szívbetegek rehabilitációjának sportos arca

“…Otthoni rehabilitációval és diétás oktatással az 50%-osnál kisebb ejekciós frakciójú szívbetegek a napi aktivitások szorgalmazásával 3 hónap alatt 2,7 ml/kg.perc növekedést értek el az aerob kapacitásban, 421-ről 462 méterre nőtt a hatperces gyaloglástáv, 12,4-ről 13,4 ml/kg.percre nőtt oxigénfelvétel mellett jelentkezett a spiroergometriás anaerob küszöb, javult az életminőség, 14-ről 5%-ra csökkent a 90 napos kórházi újrafelvétel [14].…”

“…A koreai szívelégtelen, 40% alatti ejekciós frakciójú betegek egy centrumban, nem random módon a kórházban 60%-os intenzitású edzésen vettek részt, míg mások otthonukban, fizioterapeuta vezetésével edzettek három hónapig. A kórházi csoport VO 2 -maximuma 19,4-ről 21,4-re nőtt, az otthon edzőké nem változott (18,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)4). Egyéves követés során nem volt közöttük különbség a szíveseményekben [21].…”

Efeitos de um programa de treinamento domiciliar sobre a capacidade funcional e a qualidade de vida de pacientes com insuficiência cardíaca crônica

“…Other home-based programs have combined aerobic and resistance exercise [16,17], some have added telemonitoring to walking [18] and to resistance exercise [19]. Compared with non-training, home-based programs has showed benefits on exercise capacity [13,15,20] and quality of life [13,17,20]. Compared with traditional centre-based trainings, home-based programs with telemonitoring has shown similar results on exercise capacity, quality of life and exercise safety [18,19].…”