Home-based exercise improves the quality of life and physical function but not the psychological status of people with chronic heart failure: a randomised trial

Questions: Are anxiety and depression correlated with physical function, disability, and quality of life in people with chronic heart failure? Does 8 weeks of home-based exercise improve anxiety, depression, physical function, disability, and quality of life in these patients? Do the changes in these outcomes correlate? Design: Randomised trial. Participants: 51 people with clinically stable chronic heart failure were randomised into an experimental group (n = 24) or a control group (n = 27). Intervention: The experimental group undertook an individualised home-based exercise program, 30 minutes per session, 3 sessions per week for 8 weeks, with regular telephone follow-up and consultations. The control group maintained their usual activity during this period. Outcome measures: The Hospital Anxiety and Depression Scale, six-minute walk test, Groningen Activity Restriction Scale, and Minnesota Living with Heart Failure Questionnaire were administered at baseline and 8 weeks. Results: At baseline, anxiety and depression were inversely moderately correlated with walking distance, activity, and quality of life. Compared with controls, the experimental group improved significantly more in their walking distance (by 21 m, 95% CI 7 to 36) and their quality of life (by 7 points on the 105-point Minnesota score, 95% CI 1 to 12). In the experimental group, the changes in quality of life correlated moderately strongly with changes in anxiety (r = 0.539, p = 0.01). Conclusions: Anxiety and depression were associated with physical function, disability, and quality of life in people with chronic heart failure. Home-based exercise improved quality of life and physical function significantly but not psychological status in these patients. Trial registration: ClinicalTrials.gov: NCT01197313. [Chien C-L, Lee C-M, Wu Y-W, Wu Y-T (2011) Home-based exercise improves the quality of life and physical function but not the psychological status of people with chronic heart failure: a randomised trial. Journal of Physiotherapy 57: 157-163]