A Home Based Telerehabilitation Exercise Program For Heart Failure Patients - Changes In Quality Of Life

Abstract

Heart failure (HF) patients are strongly recommended to participate in cardiac rehabilitation programs. Due to frailty and rural living, many HF patients refuse to do so. A home based telerehabilitation program was designed to enable heart failure patients to exercise via video-conferencing in their homes. Video-conferencing allowed for two-way communication and for patients to exercise together. PURPOSE: This project aims to study the changes in quality of life in HF patients undertaking a telerehabilitation intervention, compared to controls. METHODS: 67 patients were randomized into an exercise or control group if they had stable HF, were medically optimized, and refused to participate in standard outpatient rehabilitation. The exercise group received telerehabilitation for 3 months. Both groups participated in a 2-day “Living with HF” course. The EQ-5D (5L), and the Minnesota living with heart failure Questionnaire (MLHFQ) were administered to all participants before and after the intervention period. Patients were included in this analysis if they completed the EQ-5D and MLHFQ at baseline (BL) and at 3-month follow-up. RESULTS: Mean age was 68 (65.6-71.1) years (82 % male). There was a significant decrease in EQ-5D score for the exercise group from BL to 3md follow-up (-1.23), p=0.015. The decrease was not significant for the control group (-0.59), p=0.077. Still, there was no significant difference between groups regarding changes in EQ-5D score for the exercise (-1.23, SD 2.41) and control groups (-0.59, SD 1.67), p=0.27, or between groups regarding change in the EQ-5D VAS-score for exercise (5.18, SD 13.64) and control groups (5.48, SD 16.35), p=0.95. We found a significant decrease in MLHFQ score for the exercise group from BL to 3md follow-up (-13.8), p=0.003, and for the control group (-12.56), p=0.002. Still, there was no significant difference between groups regarding change in MLHFQ score for the exercise group (-13.8, SD 21.23) and the controls (-12.56, SD 19.08), p=0.83. CONCLUSIONS: Both groups seem to increase the quality of life by participating in this study. This might be due to the attention by attending a study, coming to regular follow-ups, or information and motivation gained during the 2-day “living with HF” course.