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Exercise capacity, physical activity patterns and outcomes six years after cardiac rehabilitation in patients with heart failure

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Jonathan Myers

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland, drj993{at}aol.com

Wilhard Kottman

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Ulrike Oswald

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Claudia Boesch

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Nayana Arbrol

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Paul Dubach

Rehabilitation Center, Seewis, Cardiology Divisions, Kantonsspital Chur, Switzerland

Objective: To determine the short- and long-term effects of an intensive, concentrated rehabilitation programme in patients with chronic heart failure.

Design: Randomized controlled trial, with one-month and six-year evaluations. Setting: Residential rehabilitation centre in Switzerland.

Subjects: Fifty patients with chronic heart failure, randomized to exercise or control groups.

Interventions: A rehabilitation programme lasting one month, including educational sessions, a low-fat diet, and 2 hours of individually prescribed exercise daily.

Main measures: Exercise test responses, health outcomes and physical activity patterns.

Results: Peak Vo₂ increased 21.4% in the exercise group during the rehabilitation programme (P<0.05), whereas peak Vo₂ did not change among controls. After the six-year follow-up period, peak Vo₂ was only slightly higher than that at baseline in the trained group (7%, NS), while peak Vo₂ among controls was unchanged. During long-term follow-up, 9 and 12 patients died in the exercise and control groups, respectively (P = 0.63). At six years, physical activity patterns tended to be higher in the exercise group; the mean energy expenditure values over the last year were 2704 ± 1970 and 2085 ± 1522 kcal/week during recreational activities for the exercise and control groups, respectively. However, both groups were more active compared to energy expenditure prior to their cardiac event (P<0.001).

Conclusions: Six years after participation in a residential rehabilitation programme, patients with chronic heart failure had slightly better outcomes than control subjects, maintained exercise capacity and engaged in activities that exceed the minimal amount recommended by guidelines for cardiovascular health.

Clinical Rehabilitation, Vol. 21, No. 10, 923-931 (2007)
DOI: 10.1177/0269215507079097


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