Home-based exercise increases exercise capacity but not quality of life in people with chronic heart failure: a systematic review.
OBJECTIVE
Does home-based exercise improve exercise capacity and quality of life in people with chronic heart failure? Is it safe?


METHODS
Systematic review with meta-analysis.


METHODS
Adults with heart failure > 3 months duration.


METHODS
Home-based aerobic exercise with or without resistance exercise.


METHODS
Exercise capacity (measured at the impairment level by peak VO2 and at the activity level by 6-min Walk Test), quality of life (measured by disease-specific scales), and adverse events (measured as death, hospitalisation).


RESULTS
10 randomised controlled trials with 648 participants of New York Heart Association Class II or III were included. Most participants were male > or = 50 years old with an ejection fraction < or = 40%. The exercise programs ranged from 6 weeks to 9 months at low to moderate intensity (40-70% of maximum heart rate or heart rate at 70% peak VO2. Home-based exercise increased 6-min walking distance by 41 m (WMD, 95% CI 19 to 63) and peak VO2 by 2.71 ml/kg/min (WMD, 95% CI 0.67 to 4.74) more than usual activity. It did not improve scores on the Minnesota Heart Failure Questionnaire (WMD 0.5 points out of 105, 95% CI -4.4 to 5.4) or increase the odds of hospitalisation (OR 0.75, 95% CI 0.19 to 2.92) more than usual activity.


CONCLUSIONS
Home-based exercise increased exercise capacity safely but did not improve quality of life in patients with chronic heart failure. It could therefore be used to improve the management of people with chronic heart failure who do not have access to hospital-based exercise.
Chien
Chen-Lin
CL
National Taiwan University, Taipei City, Taiwan.
Lee
Chii-Ming
CM
Wu
Yen-Wen
YW
Chen
Tzu-An
TA
Wu
Ying-Tai
YT
D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011788:Quality of Life; D013318:Stroke Volume; D011795:Surveys and Questionnaires