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A randomized trial of the addition of home‐based exercise to specialist heart failure nurse care: the Birmingham Rehabilitation Uptake Maximisation study for patients with Congestive Heart Failure (BRUM‐CHF) study
Author(s) -
Jolly Kate,
Taylor Rod S.,
Lip Gregory Y.H.,
Davies Mick,
Davis Russell,
Mant Jonathan,
Singh Sally,
Greenfield Sheila,
Ingram Jackie,
Stubley Jane,
Bryan Stirling,
Stevens Andrew
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfn029
Subject(s) - medicine , heart failure , randomized controlled trial , physical therapy , quality of life (healthcare) , rehabilitation , population , myocardial infarction , hospital anxiety and depression scale , anxiety , depression (economics) , nursing , environmental health , psychiatry , economics , macroeconomics
Aims Supervised exercise can benefit selected patients with heart failure, however the effectiveness of home‐based exercise remains uncertain. We aimed to assess the effectiveness of a home‐based exercise programme in addition to specialist heart failure nurse care. Methods and results This was a randomized controlled trial of a home‐based walking and resistance exercise programme plus specialist nurse care ( n = 84) compared with specialist nurse care alone ( n = 85) in a heart failure population in the West Midlands, UK. Primary outcome: Minnesota Living with Heart Failure Questionnaire (MLwHFQ) at 6 and 12 months. Secondary outcomes: composite of death, hospital admission with heart failure or myocardial infarction; psychological well‐being; generic quality of life (EQ‐5D); exercise capacity. There was no statistically significant difference between groups in the MLwHFQ at 6 month (mean, 95% CI) (−2.53, −7.87 to 2.80) and 12 month (−0.55, −5.87 to 4.76) follow‐up or secondary outcomes with the exception of a higher EQ‐5D score (0.11, 0.04 to 0.18) at 6 months and lower Hospital Anxiety and Depression Scale score (−1.07, −2.00 to −0.14) at 12 months, in favour of the exercise group. At 6 months, the control group showed deterioration in physical activity, exercise capacity, and generic quality of life. Conclusion Home‐based exercise training programmes may not be appropriate for community‐based heart failure patients.