title: Exercise in elderly patients with chronic heart failure in primary care: effects on physical capacity and health-related quality of life.
abstract: BACKGROUND
  Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL).
  
  
  OBJECTIVE
  The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.
  
  
  METHODS
  An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12months.
  
  
  RESULTS
  Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group.
  
  
  CONCLUSIONS
  This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population.
authors.affiliation: Department of Nursing, School of Health Sciences, Jönköping University, Sweden. emma.pihl@regionhalland.se
authors.forename: Emma
authors.initials: E
authors.lastname: Pihl
authors.forename: Asa
authors.initials: A
authors.lastname: Cider
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.forename: Jan
authors.initials: J
authors.lastname: Mårtensson
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015444:Exercise; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010807:Physical Endurance; D010809:Physical Fitness; D011320:Primary Health Care; D011446:Prospective Studies; D011788:Quality of Life; D013548:Sweden