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 attack
|Contact: Michelle Gailiun|
Duke University Medical Center