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Exercise in elderly patients with chronic heart failure in primary care: Effects on physical capacity and health-related quality of life
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
Physiotherapy Department, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Medicine and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden.
Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
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2011 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 3, 150-158 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: 

Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). 

AIM: 

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 12 months.

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. 

CONCLUSION: 

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. ©Sage Publications

Place, publisher, year, edition, pages
London: Sage Publications, 2011. Vol. 10, no 3, 150-158 p.
Keyword [en]
Chronic heart failure, Elderly, Exercise, Health-related quality of life, Physical fitness, Primary care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-16233DOI: 10.1016/j.ejcnurse.2011.03.002ISI: 000294037100004PubMedID: 21470913Scopus ID: 2-s2.0-79960316103OAI: oai:DiVA.org:hh-16233DiVA: diva2:441060
Projects
Ingår i avhandling: The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure
Available from: 2011-09-14 Created: 2011-09-14 Last updated: 2017-07-06Bibliographically approved
In thesis
1. The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure
Open this publication in new window or tab >>The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore and describe couples’ experiences of patients’ physical limitation in activities of daily life and evaluate the effects of an exercise programme in primary care when having chronic heart failure (CHF). In Study I, a comparison between patients with CHF and their spouses was made regarding health-related quality of life and depression. Inthe thesis a comparison was also made between patients, spouses and specific age and gender matched norms. There were statistically significant differences in health-related quality of life between patients and spouses as well as between patients and their norms as in SF-36 scores. The deteriorated health-related quality of life in patients was most present in the physical component but also in social function in the mental component. There were no differences between patients and spouses in depression symptoms. In Study II, patients with CHF described their conceptions of physical limitation in daily life activities. A phenomenographic approach made it possible to identify variations of the conceptions and the referential aspects that emerged were: need of finding practical solutions in daily life, having realistic expectations about the future, not believing in one’s own ability and losing one’s social role in daily life. In Study III, spouses’ conceptions about the physical limitation in daily life activities in a loved one with CHF andthe impact these limitations had on their daily life were examined. The phenomenographic approach resulted in different referential aspects. These were: losing self-containment, missing communality, accommodating to the situation and finding satisfaction in life. Study IV aimed at determining effects of an exercise programme in primary care in elderly patients with CHF. The intervention period was 12 months with continuous exercise in the primary care centre and in the patients’ homes. Tests of physical capacity showed significant consistent improvement in the exercise group in arms and shoulders during the intervention and in the 6 minute walk test at 3 months compared to the control group. The physical dimension of Minnesota living with heart failure was significantly improved at 3 months and Euroqol5DVAS was significantly improved at 3 and 12 months in the exercise group compared to the control group. The thesis shows that patients and spouses conceive a variety of issues of physical limitation in daily life and the physical component of health-related quality of life is the most affected. The physical capacity in patients is possible to affect with an exercise programme in primary care and patient homes. The exercise programme is beneficial interms of physical capacity in the upper body and walked distance in 6 minutes.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2010. 122 p.
Series
Dissertation Series. School of Health Sciences, ISSN 1654-3602 ; 12
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-16235 (URN)978-91-85835-11-9 (ISBN)
Public defence
2010-10-22, R4312, Halmstad Högskola, Halmstad, 11:51 (Swedish)
Opponent
Supervisors
Available from: 2011-09-14 Created: 2011-09-14 Last updated: 2012-12-14Bibliographically approved

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