Navigation Links
Exercise improves quality of life for heart failure patients
Date:11/12/2008

DURHAM, N.C. Heart failure patients who regularly exercise fare better and feel better about their lives than do similar patients who do not work out on a regular basis, say researchers at Duke University Medical Center.

The findings, reported today at the annual meeting of the American Heart Association's Scientific Sessions 2008, go a long way toward addressing concerns about the value of exercise for the nation's five million patients with heart failure. They also raise important policy questions for the country's Medicare program and other insurers.

"Past studies have sent mixed signals about the merit of exercise for patients with heart failure. The HF-ACTION study (A Controlled Trial Investigating Outcomes Exercise TraiNing) shows that exercise is not only safe for patients, but also helps to improve the quality of their lives, overall," says Kathryn Flynn, PhD, a health services researcher at Duke Clinical Research Institute (DCRI) and lead author of the study.

HF-ACTION is the largest clinical trial to date examining the value of exercise in the treatment of heart failure. Investigators enrolled 2331 patients with moderate to severe heart failure at 82 sites throughout the U.S., Canada and France from 2003 to 2008.

Funded by a $37 million grant from the National Heart, Blood, and Lung Institute, researchers randomized participants to receive either standard care or standard care plus an exercise program. The exercise regimen consisted of three months of supervised aerobic training on a bicycle or treadmill, followed by instruction for continued home-based training. Researchers set the exercise goal at five, 40-minute workouts, or 200 minutes of exercise per week. Participants reached about 60 percent of that goal at one year.

Participants had significant heart failure upon entering the study, measured by diminished left ventricular ejection fraction (mean, 25 percent). Ninety-five per cent of the patients were taking medications for heart failure, such as ACE-inhibitors or beta-blockers, and 40 percent were using mechanical devices to boost their hearts' ability to pump or to treat arrythmias. The average age of the patients was 59; 28 percent were women.

Upon enrollment, patients filled out the Kansas City Cardiomyopathy Questionnaire (KCCQ), a 23-item measure shown to be responsive to underlying clinical changes in patients with heart failure. The KCCQ generated an overall measure of quality of life and subscale measures reflecting the patients' physical limitations, symptoms, quality of life and social restrictions. Participants completed the questionnaire at three-month intervals for the first 12 months, and annually thereafter. The average time of follow-up was two and one-half years.

There were no significant differences between the two patient groups at baseline. The average overall KCCQ score among patients in both groups was 66.

At three months, patients in both groups showed improvement, with patients in the usual care group registering a three-point gain on the KCCQ score and those in the exercise group showing a five-point gain (p =.0005). Previous reports had defined a five-point gain as clinically significant.

Researchers also found that a higher percentage of those in the exercise group experienced more robust gains. At three months, 54 percent of those in the exercise group saw a five-point gain in overall KCCQ score, while only 28 percent of those in the usual care group met that goal. (p = .0001).

Exercise group members consistently outscored those in the usual care group on all subscale measures on the KCCQ, as well. "And the best news is that while the gains were modest, they were sustained over time," says Flynn.

During the study period, the incidence of adverse effects was similar between the two groups. There were 41 heart attacks among patients in the exercise arm and 45 heart attacks among those receiving usual care. Arrythmias occurred in about 14 percent of the patients in each group.

Researchers say the findings are important because they demonstrate that a relatively low-cost and readily available intervention can significantly improve the quality of life for heart failure patients, a finding that may be important for the country's Medicare program, which currently does not pay for exercise therapy for patients with heart failure.

"We found that a majority of those who exercised reported a five-point improvement in the KCCQ scale. That means that they experienced significant improvement in many aspects of their day-to-day activities, such as working, walking, being able to dress, bathe, and getting out to visit family and friends," says Ileana Pia, MD, a professor of medicine at Case Western Reserve University and chair of the HF-ACTION Steering Committee. Pia, who is a Quality Scholar at the Cleveland VA, says clinicians should consider using the KCCQ inventory on a regular basis. "It is a quick and easy method to find out valuable information about patients' health status. It only takes about eight minutes to fill out, which is a small burden for patients."

"This study has important implications for the 5 million Americans who have heart failure," noted Elizabeth G. Nabel, MD, NHLBI director. "As the number of people affected by heart failure is expected to rise with the aging U.S. population, it is promising to know that regular aerobic activity can not only help patients extend their lives, but exercise can also positively impact their everyday activities and outlook."


'/>"/>

Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-724-5343
Duke University Medical Center
Source:Eurekalert

Related medicine news :

1. Exercise is safe, improves outcomes for patients with heart failure
2. Exercise is Safe, Improves Outcomes for Heart Failure Patients
3. Research shows aerobic exercise combined with resistance training improves glucose control in diabetics
4. New Research Shows That Combining Aerobic Exercise With High-Force Eccentric Resistance Training Improves Glucose Control in Diabetes Patients
5. Vigorous Exercise Can Cut Breast Cancer Risk
6. Emerald Dairy Extends Terms of Offer for Early Exercise of Warrants
7. New study indicates that exercise prevents fatty liver disease
8. Exercise Improves Stroke Outcome
9. American Council on Exercise (ACE) Studies Impact of Boot Camp-Style Workouts
10. Exercise Can Help You Cope with Financial Stress and Heal Emotional Pain, Says Acclaimed Author and Psychotherapist
11. Incorporating education in exercise programs increases benefits for arthritis patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/11/2016)... ... 12, 2016 , ... The Journal of Pain Research has seen ... SJR uses data taken from the Scopus database (Elsevier B.V.) and is a measure ... by the journal over a three year period and also the importance of the ...
(Date:2/11/2016)... ... 11, 2016 , ... The president released a FY 2017 budget request on ... more of the cost burden to military beneficiaries. , MOAA’s president, retired Air ... budget as including limited quantifiable benefit fixes mixed with numerous beneficiary fee hikes. , ...
(Date:2/11/2016)... ... February 11, 2016 , ... Hall Integrative Health and ... for their simultaneous grand openings in March. All seven practices are set to ... wondering, is reversing diabetes possible? According to this 2011 CNN article it is ...
(Date:2/11/2016)... ... 2016 , ... Thermi™, a world leader in thermistor-regulated energy ... promotions of Allison Kelly to executive vice president of the company’s new North ... North American capital sales, and Wendy Oseas to vice president of global marketing. ...
(Date:2/11/2016)... ... 11, 2016 , ... Atlantic Information Services, Inc. (AIS) is ... Case Study for Plans and Purchasers.” Executives from Intel Corp. and Providence Health ... value-based health benefits program Connected Care, will discuss the challenges they faced (and ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... 11, 2016 Jeffrey Zucker , ... Trials, will present at this year,s Summit for Clinical Operations ... in Miami, FL. Zucker will discuss ... study execution, supporting SCOPE,s "Improving Site Study Activation and Performance" ... Thursday, Feb. 25 at 11:05 a.m. --> ...
(Date:2/11/2016)... , February 11, 2016 F ... answers at the ... a world-leading provider of scientific, technical and medical information products and services, ... to evidence-based, peer reviewed clinical information via a mobile device. Elsevier designed ... ClinicalKey for Nursing. The new app is available in Android ...
(Date:2/11/2016)... Feb. 11, 2016 Exactus Pharmacy Solutions, ... high-quality specialty pharmacy care for those suffering from ... has achieved full Specialty Pharmacy Accreditation from URAC, ... to promoting health care quality through accreditation, education ... --> The URAC accreditation process demonstrates a ...
Breaking Medicine Technology: