Home-based exercise increased exercise capacity safely but did not improve quality of life in patients with chronic heart failure .
It could therefore be used to improve the management of people with chronic heart failure who do not have access to hospital-based exercise
QUESTIONS Does home-based exercise improve exercise capacity and quality of life in people with chronic heart failure ?
Is it safe ?
Predictors of a sustained response to exercise training in patients with chronic heart failure: a telemonitoring study.
BACKGROUND Exercise training ( ExT ) improves exercise capacity in chronic heart failure , but the results of home-based training have been variable . We sought the predictors of favorable outcome using a telemonitoring approach . METHODS Exercise capacity and quality of life ( QOL ) were assessed in 30 patients ( 28 men , age 64 + /- 8 years ) with symptomatic chronic heart failure and left ventricular ejection fraction < or = 35 % ( 28 % + /- 9 % ) undergoing 8 months of home ExT.  Patients were provided with heart rate monitors and exercise diaries after undergoing 4 months of hospital-based ExT. Weekly telephone contact was established and heart rate data were downloaded bimonthly . Changes in peak oxygen consumption per unit time ( V*O2 ) and QOL were compared between the 15 most and 15 least adherent patients defined by the number of hours per week at > 60 % maximum heart rate , observed during heart-rate monitoring . RESULTS Peak V*O2 increased by 26 % ( P < .001 ) after 4 months of hospital ExT , but this increase had fallen to 8 % ( P = .07 ) at 12 months ; only adherent patients ( n = 15 ) showed persistent improvement of peak V*O2 at 12 months ( P = .02 ) . Improvement in peak V*O2 at 12 months was associated with baseline peak V*O2 ( r = -0.61 , P < .001 ) and hours logged on the heart rate monitor ( r = 0.47 , P = .01 ) . Quality of life improvements were sustained at 12 months for the Minnesota Living with Heart Failure Question naire and Hare-Davis Depression Question naire . Nevertheless , QOL improvements achieved during the outpatient program were lost or attenuated at 12 months in nonadherent patients but were maintained in adherent patients . CONCLUSIONS Telemonitoring is feasible for following adherence to home ExT. Ongoing adherence is critical in obtaining sustained benefit from ExT in heart failure
Home-based exercise increased exercise capacity safely but did not improve quality of life in patients with chronic heart failure .
It could therefore be used to improve the management of people with chronic heart failure who do not have access to hospital-based exercise
QUESTIONS Does home-based exercise improve exercise capacity and quality of life in people with chronic heart failure ?
Is it safe ?