Effects of a home-based exercise program on clinical outcomes in heart failure

Dracup, Kathleen; Evangelista, Lorraine S.; Hamilton, Michele A.; Erickson, Virginia; Hage, Antoine; Moriguchi, Jamie; Canary, Cheryl; MacLellan, W. Robb; Fonarow, Gregg C.

doi:10.1016/j.ahj.2007.07.019

« Previous Next »American Heart Journal
Volume 154, Issue 5 , Pages 877-883, November 2007

Effects of a home-based exercise program on clinical outcomes in heart failure☆

Kathleen Dracup, RN, DNSc
- School of Nursing, University of California, San Francisco, CA
- Reprint requests: Kathleen Dracup, RN, DNSc, UCSF School of Nursing N319C, 2 Kirkham Street, Box 0604, San Francisco, CA 94143-0604.
Lorraine S. Evangelista, RN, PhD
- School of Nursing, University of California, Los Angeles, CA
Michele A. Hamilton, MD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA
Virginia Erickson, RN, PhD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA
Antoine Hage, MD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA
Jamie Moriguchi, MD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA
Cheryl Canary, RN, PhD
- California State University Fullerton, Los Angeles, CA
W. Robb MacLellan, MD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA
Gregg C. Fonarow, MD
- Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, CA

Received 7 May 2007; accepted 24 July 2007. published online 13 September 2007.

Background

The aim of this study was to determine the effects of a home-based exercise program on clinical outcomes. Exercise training improves exercise capacity in patients with heart failure (HF) but the long-term effects on clinical outcomes remain unknown.

Methods

We randomized 173 patients with systolic HF to control (n = 87) or home-based exercise (n = 86). The primary end point was a composite of all-cause hospitalizations, emergency department admissions, urgent transplantation, and death at 12 months. Functional performance (as assessed by cardiopulmonary exercise testing and the 6-minute walk test), quality of life, and psychological states were measured at baseline, 3 months, and 6 months.

Results

There was no significant difference between experimental and control groups in the combined clinical end point at 12 months and in functional status, quality of life, or psychological states over 6 months. Patients in the exercise group had a lower incidence of multiple (2 or more) hospitalizations compared with the control group: 12.8% versus 26.6%, respectively (P = .018).

Conclusions

A home-based walking program that incorporated aerobic and resistance exercise did not result in improved clinical outcomes at 1-year follow-up in this cohort of patients with systolic HF. However, the exercise program resulted in reduced rehospitalization rates.