Effect of resistance training on physical disability in chronic heart failure. Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: the rationale, design and methodology of the HF‐Wii study; a multicentre randomized controlled trial Effects of an exercise adherence intervention on outcomes in patients with heart failure. A group-based exercise program did not improve physical activity in patients with chronic heart failure and comorbidity: a randomized controlled trial. A Novel Rehabilitation Intervention for Older Patients With Acute Decompensated Heart Failure: The REHAB-HF Pilot Study. Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping Maintaining physical fitness of patients with chronic heart failure: a randomized controlled trial Motivational interviewing to promote physical activity for people with chronic heart failure. Quality of life in patients with chronic heart failure: a randomized controlled trial of changes induced by a regular exercise program. Effect of behavioral management on quality of life in mild heart failure: a randomized controlled trial. Heart failure and a controlled trial investigating outcomes of exercise training (HF-ACTION): design and rationale. Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB‐HF) trial: Design and rationale Combined aerobic and resistance exercise program improves task performance in patients with heart failure. Exercise capacity, physical activity patterns and outcomes six years after cardiac rehabilitation in patients with heart failure Exercise Training for Heart Failure Patients with and without Systolic Dysfunction: An Evidence-Based Analysis of How Patients Benefit Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: results of an exercise counseling program. A Combined Aerobic and Resistance Exercise Program Improves Physical Functional Performance in Patients With Heart Failure: A Pilot Study
PURPOSE Patients with chronic heart failure ( CHF ) report difficulty performing activities of daily living . To our knowledge , however , no study has directly measured performance in activities of daily living in these patients to systematic ally assess their level of physical disability . Moreover , the contribution of skeletal muscle weakness to physical disability in CHF remains unclear . Thus , we measured performance in activities of daily living in CHF patients and controls , its relationship to aerobic capacity and muscle strength , and the effect of resistance exercise training to improve muscle strength and physical disability . METHODS Patients and controls were assessed for performance in activities of daily living , self-reported physical function , peak aerobic capacity , body composition , and muscle strength before and after an 18-wk resistance training program . To remove the confounding effects of several disease-related factors ( muscle disuse , hospitalization , acute illness ) , we recruited controls with similar activity levels as CHF patients and tested patients > 6 months after any disease exacerbation/hospitalization . RESULTS Performance in activities of daily living was 30 % lower ( P < 0.05 ) in CHF patients versus controls and was related to both reduced aerobic capacity ( P < 0.001 ) and muscle strength ( P < 0.01 ) . Moreover , resistance training improved ( P < 0.05 to P < 0.001 ) physical function and muscle strength in patients and controls similarly , without altering aerobic capacity . CONCLUSIONS CHF patients are characterized by marked physical disability compared with age- and physical activity-matched controls , which is related to reduced aerobic capacity and muscle strength . CHF patients respond to resistance training with normal strength/functional adaptations . Our results support muscle weakness as a determinant of physical disability in CHF and show that interventions that increase muscle strength  ( resistance training ) reduce physical disability Aims Exercise is known to be beneficial for patients with heart failure ( HF ) , and these patients should therefore be routinely advised to exercise and to be or to become physically active . Despite the beneficial effects of exercise such as improved functional capacity and favourable clinical outcomes , the level of daily physical activity in most patients with HF is low . Exergaming may be a promising new approach to increase the physical activity of patients with HF at home . The aim of this study is to determine the effectiveness of the structured introduction and access to a Wii game computer in patients with HF to improve exercise capacity and level of daily physical activity , to decrease healthcare re source use , and to improve self‐care and health‐related quality of life . Methods and results A multicentre r and omized controlled study with two treatment groups will include 600 patients with HF . In each centre , patients will be r and omized to either motivational support only ( control ) or structured access to a Wii game computer ( Wii ) . Patients in the  control  group will receive advice on physical activity and will be contacted by four telephone calls . Patients in the Wii group also will receive advice on physical activity along with a Wii game computer , with instructions and training . The primary endpoint will be exercise capacity at 3 months as measured by the 6 min walk test . Secondary endpoints include exercise capacity at 6 and 12 months , level of daily physical activity , muscle function , health‐related quality of life , and hospitalization or death during the 12 months follow‐up . Conclusion The HF‐Wii study is a r and omized study that will evaluate the effect of exergaming in patients with HF . The findings can be useful to healthcare professionals and improve our underst and ing of the potential role of exergaming in the treatment and management of patients with HF . Trial registration The purpose of this study was to determine how an exercise adherence intervention affects the physiological , functional , and quality of life outcomes of patients with heart failure ( HF ) . Sixteen HF patients were r and omly assigned to an  exercise-only group  ( n = 8) or to an  exercise-with-adherence group ( n = 8) . Two of the 16 people  died from nonexercise related causes during the study and were not included in the analysis . The intervention was tested over a 24-week period in which patients participated in a 12-week supervised exercise program ( Phase 1 ) followed by 12 weeks of unsupervised home exercise ( Phase 2 ) . The intervention format was one of individualized graphic feedback on exercise goals and participation and problem-solving support by nurses . Results indicate that patients who received the intervention exercised more frequently and experienced improved outcomes during both phases . The adherence intervention may encourage HF patients to continue to exercise and thereby maintain the health benefits gained in both phases of an exercise program OBJECTIVE To investigate how group-based exercise affects the levels of physical activity , physical fitness and health- related quality of life ( HRQoL ) in patients with chronic heart failure and comorbidities . DESIGN R and omized controlled trial . PATIENTS A total of 48 patients ( 10 women , 38 men ) , mean age 71 years ( st and ard deviation 8 years ) , ejection fraction 27 % ( st and ard deviation 10 % ) , and New York Heart Association functional class II-III . METHODS A bicycle test , 6-min walk test ( 6MWT ) and muscle endurance tests were performed . Physical activity was assessed with a pedometer and the International Physical Activity Question naire ( IPAQ ) , HRQoL was evaluated with the Short Form-36 ( SF-36 ) . Patients were r and omized to control or intervention groups . Intervention consisted of an individually design ed group-based exercise programme twice a week , for a period of 3 months . Subjects in the control group were asked to continue with their usual lives . RESULTS A total of 42 patients completed the study , and 6 dropped-out .  Steps/day did not increase significantly after intervention ( p = 0.351 ) , but IPAQ score did ( p = 0.008 ) . Exercise tolerance ( p = 0.001 ) , 6MWT ( p = 0.014 ) , shoulder abduction ( p = 0.028 ) , heel lift ( p < 0.0001 ) and HRQoL ( p = 0.018 ) improved significantly in the intervention group compared with the control group . CONCLUSION Group-based exercise did not improve the level of physical activity in patients with chronic heart failure and comorbidity ; however , physical fitness and HRQoL were significantly improved OBJECTIVES This study sought to assess a novel physical rehabilitation intervention in older patients hospitalized for acute decompensated heart failure ( ADHF ) . BACKGROUND After ADHF , older patients , who are frequently frail with multiple comorbidities , have prolonged and incomplete recovery of physical function and remain at high risk for poor outcomes . METHODS The REHAB-HF ( Rehabilitation Therapy in Older Acute Heart Failure Patients ) pilot study was a 3-site , r and omized , attention-controlled pilot study of a tailored , progressive , multidomain physical rehabilitation intervention beginning in the hospital and continuing for 12 weeks post-discharge in patients ≥60 years hospitalized with ADHF . The primary purpose was to assess the feasibility and reasonableness of the hypothesis that the novel rehabilitation intervention would improve physical function ( Short Physical Performance Battery [ SPPB ] ) over 3 months and reduce all-cause rehospitalizations over 6 months . RESULTS The study enrolled 27 patients with ADHF ( ages 60 to 98 years ; 59 % women ; 56 % African American ; 41 % with preserved ejection fraction [ ≥45 % ] ) . At baseline , participants had marked impairments in physical function , multiple comorbidities , and frailty . Study retention ( 89 % ) and intervention adherence ( 93 % ) were excellent . At 3 months , an intervention effect size was measured for the SPPB score of + 1.1 U ( 7.4 ± 0.5 U vs. 6.3 ± 0.5 U ) , and at 6 months an effect size was observed for an all-cause rehospitalization rate of -0.48 ( 1.16 ± 0.35 vs. 1.64 ± 0.39 ) . The change in SPPB score was strongly related to all-cause rehospitalizations , explaining 91 % of change . CONCLUSIONS These findings support the feasibility and rationale for a recently launched , National Institutes of Health-funded trial to test the safety and efficacy of this novel multidomain physical rehabilitation intervention to improve physical function and reduce rehospitalizations in older , frail patients with ADHF with multiple comorbidities . ( Rehabilitation and Exercise Training After Hospitalization [ REHAB-HF ] ; NCT01508650 ; A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients [ REHAB-HF ] ; NCT02196038 ) Background We aim ed to establish the support needs of people with heart failure and their caregivers and develop an intervention to improve their health-related quality of life . Methods We used intervention mapping to guide the development of our intervention . We identified “ targets for change ” by synthesis ing research evidence and international guidelines and consulting with patients , caregivers and health service providers . We then used behaviour change theory , expert opinion and a taxonomy of behaviour change techniques , to identify barriers to and facilitators of change and to match intervention strategies to each target . A patient and public involvement group helped to identify patient and caregiver needs , refine the intervention objectives and strategies and deliver training to the intervention facilitators . A feasibility study ( IS RCT N25032672 ) involving 23 patients , 12 caregivers and seven trained facilitators at four sites assessed the feasibility and acceptability of the intervention and quality of delivery and generated ideas to help refine the intervention . Results The Rehabilitation Enablement in Chronic Heart Failure ( REACH-HF ) intervention is a comprehensive self-care support programme comprising the “ Heart Failure Manual ” , a choice of two exercise programmes for patients , a “ Family and Friends Re source ” for caregivers , a “ Progress Tracker ” tool and a facilitator training course . The main targets for change are engaging in exercise training , monitoring for symptom deterioration , managing stress and anxiety , managing medications and underst and ing heart failure . Secondary targets include managing low mood and smoking cessation . The intervention is facilitated by trained healthcare professionals with specialist cardiac experience over 12 weeks , via home and telephone contacts . The feasibility study found high levels of satisfaction and engagement with the intervention from facilitators , patients and caregivers . Intervention fidelity analysis and stakeholder feedback suggested that there was room for improvement in several areas , especially in terms of addressing caregivers ’ needs . The REACH-HF material s were revised accordingly . Conclusions We have developed a comprehensive , evidence -informed , theoretically driven self-care and rehabilitation intervention that is grounded in the needs of patients and caregivers . A r and omised controlled trial is underway to assess the effectiveness and cost-effectiveness of the REACH-HF intervention in people with heart failure and their caregivers Background We aim ed to compare the effects of three different training advices , after 1 year , following a 6 months supervised cardiac rehabilitation period in patients with chronic heart failure ( CHF ) . Methods Sixty-nine CHF patients were r and omized , at the end of their rehabilitation period , either to usual care ( UC ) or to UC and controlled home training ( HT ) , prolonged supervised training ( ST ) or preferred training ( PT ) . Treadmill cardiopulmonary exercise testing was performed before rehabilitation , postrehabilitation and thereafter at 3-month intervals during the 1-year follow-up . submaximal exercise capacity [ Oxygen consumption and workload at the respiratory compensation point ( VO2RCP , WattRCP ) and submaximal workload ( SMW ) efficiency ( SMW/HR ) at 70 % of the initial maximal workload ] was chosen as a primary endpoint , because health status in CHF patients depends largely on their ability to perform activities at a submaximal level . Results After 6 months of rehabilitation , the four groups ( UC , HT , ST and PT ) were comparable with regard to cardiac rehabilitation-derived benefit , both at the submaximal and maximal level . Although exercise capacity during follow-up declined in both UC and HT patients , ST and especially PT patients maintained and even improved VO2peak and VO2RCP . However , only PT patients managed to maintain or even increase submaximal ( WattRCP and SMW/HR ratio ) workload ( P= 0.045 and < 0.0001 for interaction , respectively ) . Ventilatory-derived prognostic markers during treadmill cardio pulmonary exercise testing evolved similarly in the four subgroups . Conclusion This study suggests that engagement in physical training of their own choice ( PT ) , might be the optimal training modality for maintaining physical capacity in CHF patients AIM This paper reports a study comparing , over a 5-month period , two different methods of increasing physical activity : a traditional exercise programme and one based on motivational interviewing . BACKGROUND Chronic heart failure is associated with poor quality of life that can be improved by increased physical activity . Patients who are directed to engage in physical activity have a record of low compliance . METHOD Sixty older aged heart failure patients were r and omly assigned to st and ard care , motivational interviewing or both treatments . The primary outcome was physical activity ( kcal/kg/day ) , with the 6-minute walk test as a secondary outcome . FINDINGS At entry , no significant differences were observed between the three groups . Following treatment , the ' motivational interviewing ' and ' both treatments ' groups reported an increase in their level and type of activities , whereas the ' st and ard care ' group did not . All groups significantly increased their 6-minute walk distance . CONCLUSIONS Motivational interviewing , which incorporates established behaviour change principles and a flexible approach to promotion of activity , increases reported physical activity in older patients with heart failure over a short period . In terms of level and type of activity , this approach gives a better outcome than st and ard care , and nurses should explore alternative strategies to promote health in this population The aim of this study was to evaluate the impact of a three-month exercise program on the perception of quality of life in patients with severe chronic heart failure . In a r and omized controlled setting , 27 patients with a left ventricular ejection fraction of 18.1 + /- 8.0 % were entered into the study . The training group performed aerobic exercises for three hours/week while the control group continued their usual activities of daily living .  Quality of life was measured using the German version of the MOS SF-36 . Two patients required a change in their drug regimen and were therefore withdrawn from the study . Twenty-five patients completed the study . In the exercise group the perception of quality of life improved significantly in the domains of vitality ( p = 0.0001 ) , physical role fulfillment ( p = 0.001 ) , physical ( p = 0.02 ) and social ( p = 0.0002 ) functioning . Exercise was effective in increasing peak oxygen uptake and exercise time ( p < 0.01 ) . Only weak correlations were registered between parameters of physical performance and quality of life domains . The results of the study indicate that aerobic exercise can improve the perception of quality of life in patients with severe chronic heart failure There has been a lack of research regarding nonpharmacologic interventions in heart failure . The objective was to determine the effect of behavioral management on health related quality of life ( HRQL ) in patients with heart failure . Participants ( N = 116 ) were r and omly assigned to one of two groups : usual care for heart failure ( n = 58 ) and the 15-week behavioral management program ( n = 58 ) . Outcomes included exercise performance ( 6-min walk ) , physical and mental functioning ( SF-36 ) , general health perceptions ( SF-36 ) , and disease specific HRQL ( Minnesota Living with Heart Failure Question naire-MLHF ) . Outcomes were assessed at baseline , 4 , 10 and 16 months . Participants were mostly male ( 95 % ) and Caucasian ( 75 % ) , with a mean age of 67 years ( S.D. = 10 ) . Intervention patients showed significantly improved self-reported disease specific HRQL ( MLHF physical dimension scores ) over time compared to control patients . There were no group differences in exercise performance , physical functioning , mental functioning or general health perceptions BACKGROUND Although there are limited clinical data to support the use of exercise training as a means to reduce mortality and morbidity in patients with heart failure , current guidelines state that exercise is beneficial . TRIAL DESIGN The objective of this trial is to determine whether exercise training reduces all-cause mortality or all-cause hospitalization for patients with left ventricular systolic dysfunction and heart failure symptoms . After undergoing baseline assessment s to determine whether they can safely exercise , patients are r and omized to either usual care or exercise training . Patients in the exercise training arm attend 36 supervised facility-based exercise training sessions . Exercise modalities are cycling or walking . After completing 18 sessions , patients initiate home-based exercise and then transition to solely home-based exercise after completing all 36 sessions . Patients return for facility-based training every 3 months to reinforce their exercise training program . Patients are followed for up to 4 years . Physiologic , quality -of-life , and economic end points that characterize the effect of exercise training in this patient population will be measured at baseline and at intervals throughout the trial . Blood sample s will be collected to examine biomarkers such as brain natriuretic peptide , tumor necrosis factor , and C-reactive protein . CONCLUSIONS Because of its relatively low cost , high availability , and ease of use , exercise training is an intervention that could be accessible to most patients with heart failure . The HF-ACTION trial is design ed to definitively assess the effect of exercise training on the clinical ly relevant end points of mortality , hospitalization , and quality of life in patients with heart failure Background Acute decompensated heart failure ( ADHF ) is a leading cause of hospitalization in older persons in the United States . Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF . However , these are not addressed by current heart failure ( HF ) management strategies and there has been little study of exercise training in older , frail HF patients with recent ADHF . Hypothesis Targeting physical frailty with a multi‐domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization . Study design REHAB‐HF is a multi‐center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be r and omized either to a novel 12‐week multi‐domain physical rehabilitation intervention or to attention control . The goal of the intervention is to improve balance , mobility , strength and endurance utilizing reproducible , targeted exercises administered by a multi‐disciplinary team with specific milestones for progression . The primary study aim is to assess the efficacy of the REHAB‐HF intervention on physical function measured by total Short Physical Performance Battery score . The secondary outcome is 6‐month all‐cause rehospitalization . Additional outcome measures include quality of life and costs . Conclusions REHAB‐HF is the first r and omized trial of a physical function intervention in older patients with hospitalized ADHF design ed to determine if addressing deficits in balance , mobility , strength and endurance improves physical function and reduces rehospitalizations . It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients , those with ADHF , frailty , and multiple comorbidities OBJECTIVES To assess the effects of a home-based aerobic and resistance training program on the physical function of adults with New York Heart Association ( NYHA ) class II and III patients and systolic heart failure ( HF ) . DESIGN R and omized controlled trial . SETTING Home based . PARTICIPANTS Stable patients ( N=24 ; mean age , 60 ± 10 y ; left ventricular ejection fraction , 25 % ± 9 % ; 50 % white ; 50 % women ) with New York Heart Association ( NYHA ) classes II and III ( NYHA class III , 58 % ) systolic heart failure ( HF ) . INTERVENTION A 12-week progressive home-based program of moderate-intensity aerobic and resistance exercise . Attention control wait list participants performed light stretching and flexibility exercises . MAIN OUTCOME MEASURES A 10-item performance-based physical function measure , the Continuous Scale Physical Functional Performance test ( CS-PFP10 ) , was the major outcome variable and included specific physical activities measured in time to complete a task , weight carried during a task , and distance walked . Other measures included muscle strength , HRQOL ( Minnesota Living With Heart Failure Question naire , Epworth Sleepiness Scale ) , functional capacity ( Duke Activity Status Index ) , and disease severity ( brain natriuretic peptide ) levels . RESULTS After the exercise intervention , 9 of 10 specific task activities were performed more rapidly , with increased weight carried by exercise participants compared with the attention control wait list group . Exercise participants also showed significant improvements in CS-PFP10 total score ( P<.025 ) , upper and lower muscle strength , and HRQOL ( P<.001 ) compared with the attention control wait list group . Adherence rates were 83 % and 99 % for the aerobic and resistance training , respectively . CONCLUSIONS Patients with stable HF who participate in a moderate-intensity combined aerobic and resistance exercise program may improve performance of routine physical activities of daily living by using a home-based exercise approach . Performance-based measures such as the CS-PFP10 may provide additional insights into physical function in patients with HF that more commonly used exercise tests may not identify . Early detection of subtle changes that may signal declining physical function that are amenable to intervention potentially may slow further loss of function in this patient population Objective : To determine the short- and long-term effects of an intensive , concentrated rehabilitation programme in patients with chronic heart failure . Design : R and omized controlled trial , with one-month and six-year evaluations . Setting : Residential rehabilitation centre in Switzerl and . Subjects : Fifty patients with chronic heart failure , r and omized to exercise or control groups . Interventions : A rehabilitation programme lasting one month , including educational sessions , a low-fat diet , and 2 hours of individually prescribed exercise daily . Main measures : Exercise test responses , health outcomes and physical activity patterns . Results : Peak Vo2 increased 21.4 % in the exercise group during the rehabilitation programme ( P<0.05 ) , whereas peak Vo2 did not change among controls . After the six-year follow-up period , peak Vo2 was only slightly higher than that at baseline in the trained group ( 7 % , NS ) , while peak Vo2 among controls was unchanged . During long-term follow-up , 9 and 12 patients died in the exercise and control groups , respectively ( P = 0.63 ) . At six years , physical activity patterns tended to be higher in the exercise group ; the mean energy expenditure values over the last year were 2704 ± 1970 and 2085 ± 1522 kcal/week during recreational activities for the exercise and control groups , respectively . However , both groups were more active compared to energy expenditure prior to their cardiac event ( P<0.001 ) . Conclusions : Six years after participation in a residential rehabilitation programme , patients with chronic heart failure had slightly better outcomes than control subjects , maintained exercise capacity and engaged in activities that exceed the minimal amount recommended by guidelines for cardiovascular health Significant benefits can be derived by heart failure patients from exercise training . This paper provides an evidence -based assessment of expected clinical benefits of exercise training for heart failure patients . Meta-analyses and r and omized , controlled trials of exercise training in heart failure patients were review ed from a search of PubMed , Cochrane Controlled Trial Registry ( CCTR ) , CINAHL , and EMBASE . Exercise training improves functional capacity , quality of life , hospitalization , and systolic and diastolic function in heart failure patients . Heart failure patients with preserved systolic function ( HFnEF ) participating in exercise training studies are more likely to be women and are 5–7 years older than their systolic heart failure ( CHF ) counterparts . All patients exhibit low functional capacities , although in HFnEF patients this may be age related , therefore subtle differences in exercise prescriptions are required . Published works report that exercise training is beneficial for heart failure patients with and without systolic dysfunction OBJECTIVE To investigate whether a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity in outclinic Chronic Obstructive Pulmonary Disease ( COPD ) patients who do not participate in a rehabilitation program in a controlled way . METHODS 35 outclinic COPD patients ( 21 males , mean age 62 years , GOLD I-III , mean FEV(1)% predicted 64.7 ) were r and omized for a 12-week individual pedometer-based exercise counseling program promoting daily physical activities or usual care .  Daily physical activity ( DigiWalker SW-200 ) , physical fitness , health-related quality of life , self-efficacy , fatigue , depression and motivation to be physically active were assessed before and after the intervention . RESULTS After the intervention , COPD patients in the exercise counseling group showed a significant increase in their mean number of steps/day ( from 7087 to 7872 ) , whereas the usual care group showed a decrease ( from 7539 to 6172 ) . Significant differences favoring the exercise counseling group were demonstrated in arm strength , leg strength , health-related quality of life and intrinsic motivation to be physically active . CONCLUSION Our study shows that a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity , physical fitness , health-related quality of life and intrinsic motivation in outclinic COPD patients who do not participate in a rehabilitation program . PRACTICE IMPLICATION S The feasibility of our exercise counseling strategy is good and patients were motivated to participate Background : Recent guidelines for exercise in patients with heart failure ( HF ) recommended aerobic and resistance exercise as being safe and effective ; however , the clinical and functional significance of these combined training modalities has not been established . In this pilot study , combined aerobic and resistance training was hypothesized to improve physical function , muscle strength , and health-related quality of life ( HRQOL ) compared with an attention control wait list ( ACWL ) . Methods : The 10-item Continuous Scale Physical Functional Performance Test ( CS-PFP10 ) , which simulates common household chores ; muscle strength ( h and grip and knee extension ) ; and HRQOL ( Kansas City Cardiomyopathy Question naire ) were evaluated at baseline ( T1 ) and at 12 weeks ( T2 ) . The home-based moderate-intensity walking and resistance training program was performed 5 days a week . Results : Twenty-four New York Heart Association class II to III HF patients ( mean [ SD ] age , 60 [ 10 ] years ; mean [ SD ] left ventricular ejection fraction , 25 % [ 9 % ] ) were r and omized to a combined aerobic and resistance exercise program or to an ACWL group . Of the total group , 58 % were New York Heart Association class III HF patients , 50 % were white , and 50 % were female . The CS-PFP10 total scores were significantly increased in the exercise group , from 45 ( 18 ) to 56 ( 16 ) . The Kansas City Cardiomyopathy Question naire overall summary score was significantly improved ( P < .001 ) at T2 in the exercise intervention group compared with the ACWL group . Conclusions : Participants provided the home-based , combined aerobic and resistance exercise program had significantly improved physical function , muscle strength , symptom severity , and HRQOL compared with the ACWL group . The findings of this study must be interpreted cautiously owing to the limitations of a small sample , data collection from a single center , and differences between control and interventions groups at baseline . A combined aerobic and resistance exercise approach may improve physical function in stable HF patients , but further study in a larger , more diverse population is recommended . However , in this study , the CS-PFP10 instrument demonstrated its ability to identify functional health status in HF patients and thus warrants further testing in a larger sample for possible use in clinical practice
How individuals responded to their diagnosis and their altered physical status related to their activity levels , as did the degree of encouragement to exercise coming from family , friends , and professionals .
These findings can be connected to the theory of behavioral change developed by B and ura , known as social cognitive theory ( SCT ) .
SCT may be a useful framework for developing interventions to support patients with HF in undertaking and maintaining regular exercise patterns .
These were issues referred to in papers for the systematic review that appear to be particularly related to exercise adherence
OBJECTIVES Keeping physically active has been shown to bring positive outcomes for patients diagnosed with heart failure ( HF ) .
However , a number of individuals with this health problem do not undertake regular exercise .
A review of extant qualitative research was conducted to explore what it can tell us about barriers and enablers to physical activity among people with HF .