Dose-Response Relationship Between Exercise Intensity, Mood States, and Quality of Life in Patients With Heart Failure.
Lorraine S Evangelista, Marysol Cacciata, Anna Stromberg and 1 others
PMID 28353541WHAT IT FOUND
Among heart failure patients in the exercise group whose exercise capacity improved had better mood and some quality-of-life outcomes than those whose capacity fell.
The parent randomized trial did not show a difference between exercise and control groups, so this is association, not proof.
Key findings
01Over time, all participants showed lower depression and hostility and higher physical and overall quality of life.
02Greater improvement in exercise capacity was strongly associated with lower depression, but not with changes in physical or overall quality of life.
03Participants who showed any improvement in exercise capacity differed significantly from those who showed any reduction in anxiety, depression, physical quality of life and overall quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This is a secondary analysis of data from a parent randomized trial, and it analysed only participants assigned to the exercise group. The four groups were not randomized; they were formed after the study by change in exercise capacity, so cause and effect cannot be established. The analysis included 71 of 87 exercise-group participants, and the four groups contained 19, 16, 9 and 27 participants. The parent trial did not find a difference in mood or quality of life between exercise and control groups. Exercise adherence was measured by self-report diaries and pedometer readings, which have limited accuracy. Monthly nurse visits may have added attention that could affect quality of life independently of exercise. The sample was younger than the general heart failure population. The statistical analyses did not take into account potential overlap between predictor variables. The groups differed in hospitalizations during the study year, and it cannot be determined whether fewer hospitalizations were related to adherence, exercise capacity, or other clinical deterioration.
The easy way to misread this
Do not conclude that the home exercise program caused better mood or quality of life. The parent randomized trial did not show a difference between the exercise and control groups, and this analysis compared participants after they had already changed exercise capacity, so the groups were not randomized.