Andrade GN1, Umeda IIK2, Cahalin LP3, Nakagawa NK1
1Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, 2Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil, 3University of Miami, Miami, United States
Background: Exercise training induce some favorable outcomes in chronic heart failure (CHF). Supervised exercise training performed in centre-based rehabilitation has been associated with low adherence rates. As an alternative training, home-based exercise has been proposed. It is based on education, phone calls support, orientation of walking and resistance exercise.
Purpose: We aimed to compare the effects of home-based and centre-based training programs on functional capacity, lifestyle and quality of life in CHF patients along 12 weeks.
Methods: This study included 23 consecutive CHF patients (NYHA II and III, left ventricular ejection fraction 31 ± 6%) randomized to home-based training group (HBG, n=11, aged 59 ± 5 years, 5 male) or centre-based training group (CBG, n=12, aged 61 ± 7 years, 9 male). Patients underwent 12-week period of aerobic training (60-70% reserve heart rate) and resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed peak oxygen consumption, six-minute walk test distance (6MW), maximal inspiratory pressure (MIP), peripheral muscle strength (dynamometer), number of steps per day (accelerometer) and quality of life assessed by Minnesota Living with Heart Failure questionnaire (MLHF).
Results: HBG and CBG presented significant mean improvements in peak oxygen consumption (0.8±3.0 and 3.7±4.5 ml/kg/min, respectively, p=0.013), 6MW (40±49 and 26±28 meters, respectively, p=0.001), MIP (7±18 and 16±25 cmH2O, respectively, p=0.019), hand grip strength (2±3 and 2±2 kgf, respectively, p=0.004) and right quadriceps strength (52±53 and 27±58 N, respectively, p=0.003). However CBG showed better performance in the number of steps/day (CBG: 5640±2259 to 6541±2225 vs HBG: 7335±3015 to 6873±2819 steps/day, p=0.018) as well as in quality of life (CBG: 35±24 to 22±13 vs HB: 29±33 to 28±33, p=0.039). Both programs did not change lifestyle, induced complications or were associated with hospitalizations.
Conclusion(s): Home-based training showed good performance in functional capacity as centre-based training. However, centre-based training program improved daily number of steps and quality of life.
Implications: Home-based training is a simple, safe and effective non-pharmacological therapeutic to improve functional capacity in CHF patients.
Keywords: Cardiac rehabilitation, functional capacity, heart failure
Funding acknowledgements: This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (13/13598-1).
Purpose: We aimed to compare the effects of home-based and centre-based training programs on functional capacity, lifestyle and quality of life in CHF patients along 12 weeks.
Methods: This study included 23 consecutive CHF patients (NYHA II and III, left ventricular ejection fraction 31 ± 6%) randomized to home-based training group (HBG, n=11, aged 59 ± 5 years, 5 male) or centre-based training group (CBG, n=12, aged 61 ± 7 years, 9 male). Patients underwent 12-week period of aerobic training (60-70% reserve heart rate) and resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed peak oxygen consumption, six-minute walk test distance (6MW), maximal inspiratory pressure (MIP), peripheral muscle strength (dynamometer), number of steps per day (accelerometer) and quality of life assessed by Minnesota Living with Heart Failure questionnaire (MLHF).
Results: HBG and CBG presented significant mean improvements in peak oxygen consumption (0.8±3.0 and 3.7±4.5 ml/kg/min, respectively, p=0.013), 6MW (40±49 and 26±28 meters, respectively, p=0.001), MIP (7±18 and 16±25 cmH2O, respectively, p=0.019), hand grip strength (2±3 and 2±2 kgf, respectively, p=0.004) and right quadriceps strength (52±53 and 27±58 N, respectively, p=0.003). However CBG showed better performance in the number of steps/day (CBG: 5640±2259 to 6541±2225 vs HBG: 7335±3015 to 6873±2819 steps/day, p=0.018) as well as in quality of life (CBG: 35±24 to 22±13 vs HB: 29±33 to 28±33, p=0.039). Both programs did not change lifestyle, induced complications or were associated with hospitalizations.
Conclusion(s): Home-based training showed good performance in functional capacity as centre-based training. However, centre-based training program improved daily number of steps and quality of life.
Implications: Home-based training is a simple, safe and effective non-pharmacological therapeutic to improve functional capacity in CHF patients.
Keywords: Cardiac rehabilitation, functional capacity, heart failure
Funding acknowledgements: This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (13/13598-1).
Topic: Cardiorespiratory
Ethics approval required: Yes
Institution: Hospital das Clínicas da Faculdade de Medicina da USP
Ethics committee: Comitê de ética em Pesquisa
Ethics number: 411/14
All authors, affiliations and abstracts have been published as submitted.
