Effects of home versus hospital-based exercise training in chronic heart failure

Abstract

Many researchers have demonstrated that supervised hospital-based training yields improvements in exercise capacity and quality of life (QoL) for heart failure (HF) sufferers [ 1 Davies E.J. Moxham T. Rees K. et al. Exercise Based Rehabilitation for Heart Failure (Review). in: Cochrane Database of Systematic Reviews. John Wiley, Chichester2010 Google Scholar ]. Though comparatively under-researched, home-training does not involve a potentially tiring return journey to hospital, and can be undertaken whenever the individual feels best able to exercise, therefore may offer a more pragmatic exercise option for this frail group [ 2 Chien C. Lee C. Wu Y. Chen T. Wu Y. Home-based exercise increases exercise capacity but not quality of life in people with chronic heart failure: a systematic review. Aust J Physiother. 2008; 54: 87-93 Google Scholar , 3 Hwang R. Marwick T. Efficacy of home-based exercise programmes for people with chronic heart failure: a meta-analysis. Eur J Cardiovasc Prev Rehabil. 2009; 16: 527-535 Google Scholar ]. Three previous non-controlled trials have compared effects of home and hospital-based exercise training in HF [ 4 Daskapan A. Arikan H. Caglar N. Tunali N. Ataman S. Comparison of supervised exercise training and home-based exercise training in chronic heart failure. Saudi Med J. 2005; 26: 842-847 Google Scholar , 5 Karapolat H. Demir E. Bozkaya Y.T. et al. Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters. Clin Res Cardiol. 2009; 98: 635-642 Google Scholar , 6 Piotrowicz E. Baranowski R. Bilinska M. et al. A new model of home-based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life and adherence. Eur J Heart Fail. 2010; 12: 164-171 Google Scholar ]. Two [ 5 Karapolat H. Demir E. Bozkaya Y.T. et al. Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters. Clin Res Cardiol. 2009; 98: 635-642 Google Scholar , 6 Piotrowicz E. Baranowski R. Bilinska M. et al. A new model of home-based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life and adherence. Eur J Heart Fail. 2010; 12: 164-171 Google Scholar ] found significant improvements in exercise capacity and QoL of up to 10% with both types of training, whilst the other [ 4 Daskapan A. Arikan H. Caglar N. Tunali N. Ataman S. Comparison of supervised exercise training and home-based exercise training in chronic heart failure. Saudi Med J. 2005; 26: 842-847 Google Scholar ] found that only hospital-training significantly improved exercise capacity (by 19%). To date, this is the only trial to compare effects of home versus hospital-based aerobic exercise training versus control upon exercise capacity and QoL in HF.