Stage of readiness for planned activity reveals heart failure patients at higher risk

Abstract

Few individuals with chronic heart failure (CHF) engage in regular physical activity. PURPOSE: 1) To examine stage of readiness for planned physical activity; 2) To compare estimated self-reported daily physical activity and exercise tolerance/capacity by stage of readiness; and 3) To determine the association between stages of readiness for planned physical activity, self-reported daily physical activity and exercise tolerance, in CHF patients. METHODS: One-hundred eleven CHF patients (Age: 53 ± 14 yrs; New YorkHeart Association class II/III) participated. Each participant’s stage of readiness for planned physical activity was assessed. Patients completed a self-reported daily physical activity questionnaire, and performed a six-minute walk test. RESULTS: Average left ventricular ejection fraction (LVEF) was 30.12% ± 10.72%. Twelve patients were in Precontemplation (PC),29 inContemplation (C),30 inPreparation (PR),20 inAction (A), and20 inMaintenance (M). There were no differences in age and LVEF between stages. Those classified in A/M performed more minutes in activities > 3 METs. Average 6MWD was 349 ± 118 meters, with significant differences between stages (PC, C CONCLUSION: The majority of CHF patients are in pre-action stages of readiness for adoption of planned physical activity. Patients in pre-action are engaged in less daily activity and have lower exercise tolerance/capacity than those in A/M. Lower exercise tolerance/capacity suggests these patients are more fragile and at greater risk for complications and early mortality. Greater emphasis should be placed on strategies to move patients toward A/M.