Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters.
OBJECTIVE
To compare the effects of home-based and hospital-based exercise programs on exercise capacity, quality of life, psychological symptoms, and hemodynamic parameters in heart failure (HF) patients.


METHODS
Seventy-four patients were randomized into either a hospital-based exercise (Group 1) or a home-based exercise (Group 2) group. Prior to and after the 8-week rehabilitation program, the two groups were compared with respect to their functional capacity [maximal oxygen uptake (pVO(2)) and 6-min walk test (6MWT)], quality of life (Medical Outcomes Study and the 36-item Short Form Survey, SF-36), psychological symptoms [Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory], and hemodynamic parameters [(left ventricular diastolic diameter in diastole, left ventricular diameter in systole, mitral early diastolic peak flow velocity (E)/late diastolic peak flow velocity (A), mitral E/mitral early peak velocity (E (m)), tei index, right ventricular systolic peak velocity (S (m)), tricuspid annular plane systolic excursion, systolic pulmonary arterial pressure (SPAP), and left and right ventricular ejection fraction (LVEF and RVEF)].


RESULTS
After the exercise programs, significant improvement was observed in pVO(2), 6MWT and subscales of physical function, general health, and vitality of SF 36, as well as BDI and LVEF in both groups (P < 0.05). A comparison of the two exercise groups revealed no significant differences between them regarding the analyzed variables (P > 0.05).


CONCLUSIONS
Both the hospital-based and home-based exercise groups improved significantly in functional capacity, quality of life, depression symptoms, and LVEF. Based on these results, we believe that physicians can recommend home-based exercise under strict supervision for stable HF patients. However, additional research should be conducted in this area.
Karapolat
Hale
H
Physical Medicine and Rehabilitation Department, Ege University Medical Faculty, Bornova, Izmir, Turkey. haleuzum76@hotmail.com
Demir
Emre
E
Bozkaya
Yasemin Turan
YT
Eyigor
Sibel
S
Nalbantgil
Sanem
S
Durmaz
Berrin
B
Zoghi
Mehdi
M
D000328:Adult; D000553:Ambulatory Care; D003863:Depression / Q000209:etiology / Q000628:therapy; D004185:Disability Evaluation; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006439:Hemodynamics; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function; D016138:Walking