A supervised exercise programme following hospitalisation for heart failure: does it add to disease management?

Conditions

None listed

Brief summary

Heart failure is a common, disabling condition. Research has shown that a disease management programme for patients recently in hospital with heart failure, including education, attention to diet, exercise and medications, and regular review by trained staff can reduce death and hospital admissions. There is some evidence to suggest benefits of a supervised programme of exercise in improving fitness and well-being in this patient group. This study will show whether adding regular supervised gym-based exercise to a disease management programme can further improve important outcomes including death, hospital use and depression in a cost-effective manner.

Alison Mudge, Anita Pelecanos, Julie Adsett

Journal of the American Geriatrics Society2021-04-0733 citations

10.1111/jgs.17145

Impact of exercise training program attendance and physical activity participation on six minute walk distance in patients with heart failure

Julie Adsett, Norman Morris, Alison Mudge

Physiotherapy Theory and Practice2019-09-233 citations

10.1080/09593985.2019.1669232

Addition of Supervised Exercise Training to a Post-Hospital Disease Management Program for Patients Recently Hospitalized With Acute Heart Failure: The EJECTION-HF Randomized Phase 4 Trial.

Mudge AM, Denaro CP, Scott AC, Meyers D, Adsett JA, Mullins RW, Suna JM, Atherton JJ, Marwick TH, Scuffham P, O'Rourke P.

2018-02-0136 citations

10.1016/j.jchf.2017.11.016

Exercise training in recently hospitalized heart failure patients enrolled in a disease management programme: design of the EJECTION-HF randomized controlled trial.

Mudge AM, Denaro CP, Scott AC, Atherton JJ, Meyers DE, Marwick TH, Adsett JA, Mullins RW, Suna JM, Scuffham PA, O'Rourke PK.

2011-11-0618 citations

10.1093/eurjhf/hfr139

Interventions

A supervised exercise programme consisting of 36 one hour sessions of gym-based aerobic and resistance exercise over 6 months with active encouragement of home based exercise, administered in addition to an established disease management programme including education, early review, telephone and outreach support and optimal drug titration

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Blinded (masking used) (Outcomes Assessor)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

Less than or equal to 6 weeks post acute admission to hospital with symptomatic congestive heart failure as dominant clinical diagnosis. Evidence during admission of clinically significant criteria: including documented symptoms (dyspnoea, fatigue, and/or peripheral oedema) and signs (raised jugular venous pressure, displaced apex beat, 3rd heart sound, and/or crepitations on chest examination). Chest xray changes (pulmonary venous congestion, pulmonary oedema and cardiomegaly) or current/past echocardiography evidence of left ventricular dysfunction. Echocardiography within 6 months. On medical therapy for heart failure. Able to regularly attend the duration of the programme and all follow-ups. Satisfy safety criteria; Signed written informed consent; Aged 18 years or older.

Exclusion criteria

Terminally ill. Serious cognitive impairment. Serious other physical impairment which prevents attendance and participation. Implantable cardioverter defibrillator insertion < 4 weeks preceding programme. Cardiac re-synchonisation therapy < 6 months preceding programme. Awaiting cardiovascular procedure or hospitalisation for surgery. Exercise testing results or clinical judgement by the exercise specialist that would preclude safe exercise training participation. Completed a full 12 week regime of formal exercise rehabilitation in the past 12 month period.

Outcome results