Efficacy and cost of an exercise program for functionally impaired older patients with heart failure: a randomized controlled trial

Miles D. Witham (Lead / Corresponding author), Roberta L. Fulton, Carol A. Greig, Derek W. Johnston, Chim C. Lang, Marjon van der Pol, Dwayne Boyers, Allan D. Struthers, Marion E. T. McMurdo

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    27 Citations (Scopus)

    Abstract

    Background-Little is known about the optimum way to deliver exercise to older, functionally impaired patients with heart failure. We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service.

    Methods and Results-The study design was a parallel-group, single-blind, randomized controlled trial. Patients aged >= 70 years with symptomatic heart failure and left ventricular systolic dysfunction were randomized to either 24 weeks of exercise training or usual care. Six-minute walk distance was the primary outcome; markers of physical function, quality of life, health status, and daily activity were measured at baseline and 8 and 24 weeks. Carer strain and healthcare costs were also recorded. A total of 107 participants were randomized (mean age, 80 years; men, 72 [67%]). Six-minute walk distance did not improve compared to that of the control group at 8 weeks (-16.9 m; 95% CI, -41.8 to 7.9 m; P=0.18) or at 24 weeks (-5.3 m; 95% CI, -32.6 to 22.0 m; P=0.70). For secondary outcomes, only the sit-to-stand test improved significantly at 24 weeks (-6.4 s; 95% CI, -12.2 to 0.6 s; P=0.03); there was no difference in change for the Minnesota Living With Heart Failure score (0.1 points; 95% CI, -0.9 to 1.1 points; P=0.83) at 24 weeks. Carer strain did not decrease at 24 weeks (difference, -0.5 points; 95% CI, -8.3 to 7.3 points; P=0.80), and there was no difference in overall healthcare costs.

    Conclusions-This exercise intervention did not improve exercise capacity or quality of life in older patients with heart failure and was not cost saving to the National Health Service.

    Original languageEnglish
    Pages (from-to)209-216
    Number of pages8
    JournalCirculation: Heart Failure
    Volume5
    Issue number2
    DOIs
    Publication statusPublished - 2012

    Cite this

    @article{fed3c11269a947bfa7504f22cbe91c76,
    title = "Efficacy and cost of an exercise program for functionally impaired older patients with heart failure: a randomized controlled trial",
    abstract = "Background-Little is known about the optimum way to deliver exercise to older, functionally impaired patients with heart failure. We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service.Methods and Results-The study design was a parallel-group, single-blind, randomized controlled trial. Patients aged >= 70 years with symptomatic heart failure and left ventricular systolic dysfunction were randomized to either 24 weeks of exercise training or usual care. Six-minute walk distance was the primary outcome; markers of physical function, quality of life, health status, and daily activity were measured at baseline and 8 and 24 weeks. Carer strain and healthcare costs were also recorded. A total of 107 participants were randomized (mean age, 80 years; men, 72 [67{\%}]). Six-minute walk distance did not improve compared to that of the control group at 8 weeks (-16.9 m; 95{\%} CI, -41.8 to 7.9 m; P=0.18) or at 24 weeks (-5.3 m; 95{\%} CI, -32.6 to 22.0 m; P=0.70). For secondary outcomes, only the sit-to-stand test improved significantly at 24 weeks (-6.4 s; 95{\%} CI, -12.2 to 0.6 s; P=0.03); there was no difference in change for the Minnesota Living With Heart Failure score (0.1 points; 95{\%} CI, -0.9 to 1.1 points; P=0.83) at 24 weeks. Carer strain did not decrease at 24 weeks (difference, -0.5 points; 95{\%} CI, -8.3 to 7.3 points; P=0.80), and there was no difference in overall healthcare costs.Conclusions-This exercise intervention did not improve exercise capacity or quality of life in older patients with heart failure and was not cost saving to the National Health Service.",
    author = "Witham, {Miles D.} and Fulton, {Roberta L.} and Greig, {Carol A.} and Johnston, {Derek W.} and Lang, {Chim C.} and {van der Pol}, Marjon and Dwayne Boyers and Struthers, {Allan D.} and McMurdo, {Marion E. T.}",
    year = "2012",
    doi = "10.1161/CIRCHEARTFAILURE.111.963132",
    language = "English",
    volume = "5",
    pages = "209--216",
    journal = "Circulation: Heart Failure",
    issn = "1941-3289",
    publisher = "American Heart Association",
    number = "2",

    }

    TY - JOUR

    T1 - Efficacy and cost of an exercise program for functionally impaired older patients with heart failure

    T2 - a randomized controlled trial

    AU - Witham, Miles D.

    AU - Fulton, Roberta L.

    AU - Greig, Carol A.

    AU - Johnston, Derek W.

    AU - Lang, Chim C.

    AU - van der Pol, Marjon

    AU - Boyers, Dwayne

    AU - Struthers, Allan D.

    AU - McMurdo, Marion E. T.

    PY - 2012

    Y1 - 2012

    N2 - Background-Little is known about the optimum way to deliver exercise to older, functionally impaired patients with heart failure. We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service.Methods and Results-The study design was a parallel-group, single-blind, randomized controlled trial. Patients aged >= 70 years with symptomatic heart failure and left ventricular systolic dysfunction were randomized to either 24 weeks of exercise training or usual care. Six-minute walk distance was the primary outcome; markers of physical function, quality of life, health status, and daily activity were measured at baseline and 8 and 24 weeks. Carer strain and healthcare costs were also recorded. A total of 107 participants were randomized (mean age, 80 years; men, 72 [67%]). Six-minute walk distance did not improve compared to that of the control group at 8 weeks (-16.9 m; 95% CI, -41.8 to 7.9 m; P=0.18) or at 24 weeks (-5.3 m; 95% CI, -32.6 to 22.0 m; P=0.70). For secondary outcomes, only the sit-to-stand test improved significantly at 24 weeks (-6.4 s; 95% CI, -12.2 to 0.6 s; P=0.03); there was no difference in change for the Minnesota Living With Heart Failure score (0.1 points; 95% CI, -0.9 to 1.1 points; P=0.83) at 24 weeks. Carer strain did not decrease at 24 weeks (difference, -0.5 points; 95% CI, -8.3 to 7.3 points; P=0.80), and there was no difference in overall healthcare costs.Conclusions-This exercise intervention did not improve exercise capacity or quality of life in older patients with heart failure and was not cost saving to the National Health Service.

    AB - Background-Little is known about the optimum way to deliver exercise to older, functionally impaired patients with heart failure. We tested whether an exercise program tailored to the needs of these patients could improve exercise capacity and quality of life or reduce costs to the National Health Service.Methods and Results-The study design was a parallel-group, single-blind, randomized controlled trial. Patients aged >= 70 years with symptomatic heart failure and left ventricular systolic dysfunction were randomized to either 24 weeks of exercise training or usual care. Six-minute walk distance was the primary outcome; markers of physical function, quality of life, health status, and daily activity were measured at baseline and 8 and 24 weeks. Carer strain and healthcare costs were also recorded. A total of 107 participants were randomized (mean age, 80 years; men, 72 [67%]). Six-minute walk distance did not improve compared to that of the control group at 8 weeks (-16.9 m; 95% CI, -41.8 to 7.9 m; P=0.18) or at 24 weeks (-5.3 m; 95% CI, -32.6 to 22.0 m; P=0.70). For secondary outcomes, only the sit-to-stand test improved significantly at 24 weeks (-6.4 s; 95% CI, -12.2 to 0.6 s; P=0.03); there was no difference in change for the Minnesota Living With Heart Failure score (0.1 points; 95% CI, -0.9 to 1.1 points; P=0.83) at 24 weeks. Carer strain did not decrease at 24 weeks (difference, -0.5 points; 95% CI, -8.3 to 7.3 points; P=0.80), and there was no difference in overall healthcare costs.Conclusions-This exercise intervention did not improve exercise capacity or quality of life in older patients with heart failure and was not cost saving to the National Health Service.

    UR - http://www.scopus.com/inward/record.url?scp=84860791454&partnerID=8YFLogxK

    U2 - 10.1161/CIRCHEARTFAILURE.111.963132

    DO - 10.1161/CIRCHEARTFAILURE.111.963132

    M3 - Article

    C2 - 22271753

    VL - 5

    SP - 209

    EP - 216

    JO - Circulation: Heart Failure

    JF - Circulation: Heart Failure

    SN - 1941-3289

    IS - 2

    ER -