Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 +/- 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 +/- 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 +/- 3064 to 7654 +/- 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 +/- 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 +/- 18 vs. 22 +/- 19). Peak exercise stroke volume increased by 19% (127 +/- 34 vs. 151 +/- 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 +/- 1.5 vs. 7.6 +/- 2.0 L/min/m(2), P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 +/- 16 vs. 59 +/- 14 watts, P = 0.01) and 10% (11.5 +/- 2.9 vs. 12.8 +/- 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function.