title: Effects of a home-based exercise program on clinical outcomes in heart failure.
abstract: 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.
authors.affiliation: School of Nursing, University of California, San Francisco, CA 94143-0604, USA. kathy.dracup@nursing.ucsf.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Michele A
authors.initials: MA
authors.lastname: Hamilton
authors.forename: Virginia
authors.initials: V
authors.lastname: Erickson
authors.forename: Antoine
authors.initials: A
authors.lastname: Hage
authors.forename: Jamie
authors.initials: J
authors.lastname: Moriguchi
authors.forename: Cheryl
authors.initials: C
authors.lastname: Canary
authors.forename: W Robb
authors.initials: WR
authors.lastname: MacLellan
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011659:Pulmonary Gas Exchange / Q000502:physiology; D011788:Quality of Life; D016896:Treatment Outcome