HF Action Study Shows Exercise Benefits Heart Failure Patients

Kathleen Blanchard's picture
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Results of a large study show that in just three months, walking on a treadmill or using a stationary bicycle improved the lives of patients with heart failure. The HF-ACTION study included 2331 patients with moderate to severe heart failure, and is the largest study to show that exercise can definitely benefit heart failure patients.

The heart failure patients in the HF-ACTION study received three months of supervised exercise for forty minutes, five times a week. After three months, they were instructed to continue aerobic exercise at home. The average age of the heart failure patients was 59 years. Sixty percent had mechanical devices implanted to treat heart rhythm problems and increase the pumping action of the heart from weakened heart muscle. The researchers saw significant clinical benefits from exercise among the heart failure patients enrolled.

According to Ileana Piña, MD, a professor of medicine at Case Western Reserve University and chair of the HF-ACTION Steering Committee, the heart failure patients included in the study, "experienced significant improvement in many aspects of their day-to-day activities, such as working, walking, being able to dress, bathe, and getting out to visit family and friends." The study authors say that patient improvements seen in the HF-ACTION study should provide impetus to Medicare to include payment for supervised exercise programs that can benefit heart failure patients.

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The researchers used a tool called the Kansas City Cardiomyopathy Questionnaire (KCCQ) to evaluate the heart failure patient’s response to exercise before enrolling in the program, at three months intervals for a year, and annually thereafter. The HF-ACTION study took place at 82 facilities throughout the U.S., Canada and France from 2003 to 2008.

Patients with heart failure reached sixty percent of their exercise goals within one year of enrollment in the study. A tool called the KCCQ questionnaire was used that reflects the patients' physical limitations, symptoms related to heart failure, quality of life and social restrictions. At three months, the patients in the exercise group, compared to those who received usual care, experienced measureable benefits from the exercise program shown by a three-point improvement on the KCCQ scale used for the HF-ACTION study.

Kathryn Flynn, Ph.D., a health services researcher at the Duke Clinical Research Institute (DCRI) and lead author of the study says the best news is that the HF-ACTION study also showed the exercise benefits to heart failure patients were sustained throughout the study.

The HF-ACTION study shows that an inexpensive intervention that includes regular aerobic exercise can benefit heart failure patients. The results should prompt policy changes from Medicare to cover payment for exercise programs that can modestly improve the lives of five million patients affected with heart failure.

Journal of the American Medical Association

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