Abstract
Objective
The aim of this systematic review was to identify the effect of specific exercise
parameters on physical function and quality of life (QOL) in people with chronic heart
failure living in the community.
Data Sources
A total of 5 electronic databases were searched for relevant studies published after 1994.
Study Selection
The screening process was completed by 2 independent researchers, with a third independent
reviewer for conflict resolution. Studies were selected if they included only chronic
hHart failure participants, and the sole intervention was a structured exercise training
program in an outpatient or community setting.
Data Extraction
Two independent researchers completed the data extraction and qualiy assessment. Quality
was assessed using the Physiotherapy Evidence Database and Grading of Recommendations
Assessment, Development and Evaluation scales.
Data Synthesis
In total, 40 articles (n=5411) were included in the review for meta-analysis and meta-regression,
including 27 randomized control trials and 13 cohort studies. Exercise was shown to
have a positive effect on QOL outcomes (standardized mean difference 1.16; 95% confidence
interval [CI], 0.76-1.56) with the most commonly used measure, the Minnesota Living
with Heart Failure Questionnaire, showing a clinically significant change of 8.5 points.
Physical function was improved postexercise intervention in the 23 included studies
(standardized mean difference 0.89; 95% CI, 0.40-1.38), with a clinically significant
change of 49.8 m seen in studies using the 6-minute walk test (95% CI, 26.52-73.13).
These improvements were independent of study design, study quality, participant demographics,
disease severity, and exercise prescription variables.
Conclusion
Exercise significantly improves QOL and physical function. Current evidence suggests
that engagement with exercise is a more important factor in achieving improvement
than how the exercise is performed. Future research should aim to identify and address
barriers to engagement in exercise rehabilitation in this population.
Keywords
List of abreviations:
CHF (chronic heart failure), CI (confidence interval), PEDro (Physiotherapy Evidence Database), QOL (quality of life), RCT (randomized control trial), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 23, 2018
Footnotes
Disclosures: None.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
