lthough supervised aerobic physical
activity is a proven therapy for heart
failure patients, lack of social support
and practical barriers such as lack of
transportation, keep many patients from
benefitting from cardiac rehab programs,
“Patients, family members and healthcare providers should
work together to find solutions to the barriers preventing a
patient from participating in a structured exercise program,
because exercise programs can help patients manage their
condition,” said Lauren B. Cooper, M.D., lead author of the
study and a fellow in cardiovascular diseases at the Duke
University School of Medicine in Durham, North Carolina.
Researchers studied data from 2,279 heart failure
patients in a trial called Heart Failure: A Controlled Trial
Investigating Outcomes of Exercise Training (HF-ACTION).
Patients were randomly assigned to receive usual care, which
included detailed self-management educational materials
without a formal exercise prescription, or usual care plus
a 36-session supervised exercise program for the first
three months, transitioning to home exercise for two years.
Patients in the study were given a survey that measured their
perception of social support and evaluated the extent to which
10 potential barriers (for example: finances, child care, weather)
may interfere with their participation in an exercise program.
Among those in the exercise group, researchers found:
• Heart failure patients with the highest perceived social
support exercised more (average 118 minutes per
week) at 12 months, compared to those with the lowest
perceived social support (average 92 minutes per week).
• Similarly, at 12 months patients with the fewest
barriers exercised more (average 169 minutes per
week) than those with the most barriers (average 86
minutes per week).
These findings add to results from a prior HF-ACTION
analysis, which included exercise intensity along with exercise
time, and showed that moderate exercise was associated
with decreased risk of heart failure hospitalization or of dying
from heart disease, researchers said.
At one time, lack of Medicare coverage for cardiac
rehabilitation was a barrier to participation in these
programs. However, since 2014, Medicare
has covered cardiac rehabilitation for patients
with chronic heart failure, but the treatment
is still underutilized. Previous studies
documented how physical limitations can
reduce participation in exercise programs,
but the current study adds information about
“Competing responsibilities and lack
of support may prevent patients with
heart failure from participating in exercise
programs. Assessing a patient’s social
support system and barriers that may
interfere with their exercise program may
help medical professionals to customize
exercise programs that better fit individual
patient needs,” Cooper said.
Source: American Heart Association News
HF Patients & Exercise
SOCIAL AND PRACTICAL BARRIERS KEEP HEART FAILURE
PATIENTS FROM BENEFITS OF EXERCISE THERAPY