title: Usefulness of a home-based exercise program for overweight and obese patients with advanced heart failure.
abstract: Exercise is an important behavior for long-term weight control in overweight and obese patients. However, little evidence exists confirming such findings in patients with advanced heart failure (HF). Using a prospective, experimental design, the effects of 24 weeks of a low-level, home-based walking program on weight loss were studied in overweight and obese (body mass index > or =27 kg/m(2)) patients with advanced HF who were randomized to exercise (n = 48) and control (n = 51) groups. Weight changes between the 2 groups at baseline and 6 months were compared using repeated-measures analysis of variance. Patients were on average aged 53.3 +/- 10.1 years and predominantly male (75%), Caucasian (57%), and married (55%). Most patients were in New York Heart Association class III or IV (67%), with a mean ejection fraction of 25%. Patients in the exercise group showed significant weight reduction from baseline to 6 months compared with those in the control group (-6.37 +/- 11.7 vs -0.33 +/- 9.3 kg, p = 0.002). No significant differences were noted between the 2 groups in 6-minute walk distance or depression, although the changes were in the anticipated direction. Modest weight losses of >5% were associated with cardiopulmonary exercise test-documented workload levels at 6 months (r = 0.331, p = 0.006), as well as decreased depression (r = -0.315, p = 0.01) and hostility (r = -0.355, p = 0.005). The number of hospital admissions was significantly smaller for patients in the exercise group compared with those in the control group (0.63 +/- 0.94 vs 1.07 +/- 0.95, p <0.05). In conclusion, the findings demonstrate the beneficial effects of a low-level, home-based walking program on weight loss in overweight and obese patients with advanced HF.
authors.affiliation: School of Nursing, University of California, Los Angeles, USA. levangel@ucla.edu
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Lynn V
authors.initials: LV
authors.lastname: Doering
authors.forename: Terry
authors.initials: T
authors.lastname: Lennie
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Michele A
authors.initials: MA
authors.lastname: Hamilton
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D015444:Exercise; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000628:therapy*; D010101:Oxygen Consumption; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology / Q000523:psychology