An integrative review of physical activity/exercise intervention effects on function and health-related quality of life in older adults with heart failure.
Theresa A Floegel, G Adriana Perez
PMID 27189848WHAT IT FOUND
Older adults with heart failure in 12 exercise trials had mixed physical-function and quality-of-life results.
Five improved both, one improved function only, one improved quality of life only, five showed no difference, and no trial reported adverse events.
Key findings
01Across 12 included trials of 1149 older adults with heart failure, 5 trials reported significant differences in both physical function and health-related quality of life, 1 trial reported function only, 1 trial reported health-related quality of life only, and 5 trials reported no significant difference.
02All included trials reported no participant adverse effects during the intervention.
03The trials used very different programmes: 4 were group-based, 7 were individual, 1 used both, 6 combined aerobic and resistance training, 3 used aerobic training only, 1 used Tai Chi, and 3 added education or cognitive behavioural therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 12 randomized trials were included, and they used different activities, settings, durations, and contact levels, so it is hard to know which programme to copy. The effects were inconsistent: 5 trials improved both function and quality of life, 1 improved function only, 1 improved quality of life only, and 5 showed no difference. Minority representation was poor, with 7 studies not identifying or including minority information and 2 larger studies reporting less than 15 percent minority participants. Trials mainly included stable NYHA class II or III heart failure and excluded unstable class IV patients, so the results may not apply to more frail or unstable patients. Follow-up and supervision varied, and some benefits were not maintained after supervised sessions ended, so long-term adherence and effect are uncertain. Only 1 trial used a behavioural theory, so the review cannot identify which education or behaviour-change components helped.
The easy way to misread this
Do not read this review as proof that any heart-failure exercise programme works. Five trials found no significant difference, and the positive trials used different activities, doses, settings, and follow-up, so no single programme is established.