Do exercise programs help if you have heart failure?

Photo of people training at a gym

Many people with heart failure avoid strenuous physical activities. But that is not actually a good idea. Special exercise programs can help to improve your physical fitness and quality of life.

People with heart failure usually get exhausted and out of breath more quickly, even during physical activities that didn’t use to cause any problems. Their hearts no longer manage to pump enough oxygen-rich blood to organs, muscles and other tissue. This can be frightening, and many people with heart failure stop being so physically active. But if you hardly get any exercise, you become less fit, which affects your quality of life and independence too.

In order to break this vicious cycle, special exercise programs have been developed for people with heart failure. The exercises in these programs aim to strengthen their cardiovascular system without being too much for their bodies to handle.

What is exercise-based cardiac rehabilitation?

Exercise-based cardiac rehabilitation mostly involves doing endurance exercises, such as brisk walking or cycling, whether on an exercise bike or outdoors. Other options include rowing machines or step climbers that simulate climbing stairs. It is best to be cautious when starting with endurance exercise. You might just walk short distances at a moderate pace, for example. It is then important to stick to it, and gradually increase the intensity with guidance from your doctor.

Exercise-based cardiac rehabilitation is often done in groups. These groups are supervised by medical professionals and led by qualified trainers.

How effective is exercise-based cardiac rehabilitation?

People with mild or moderate heart failure might find it helpful to train for 30 to 60 minutes several times a week. Studies show that people who took part in exercise-based cardiac rehabilitation programs became physically fitter and could move about, walk and work better than people who didn't take part. They also rated their quality of life higher, and needed fewer hospital visits:

  • Without exercise-based cardiac rehabilitation, about 20 in 100 people needed to go to the hospital within one year.
  • With exercise-based cardiac rehabilitation, about 14 in 100 participants needed to go to the hospital within one year.

The studies didn’t find any that the exercise programs might be associated with any risks. People who took part in these programs even had a slightly better life expectancy in the long term.

Do home-based exercise programs help too?

It is thought that home-based training is similarly effective as taking part in an exercise-based cardiac rehabilitation program. Before starting, it’s important to talk to your doctor about what types of exercise you can do, and at which level of intensity. You can use things like pulse monitors and step counters when training to keep an eye on your physical activity and fitness. A lot of people who have heart failure get a feel for how far they can push themselves after a while – and start feeling increasingly confident about doing exercises on their own.

But people who are afraid to exercise on their own might find it helpful to do it together with other people at first.

It is important to seek medical advice if you develop worrying symptoms while exercising or your fitness decreases over the course of several days. You should temporarily stop doing the exercises during acute illnesses, or if you have a fever.

Where can I find exercise-based cardiac rehabilitation?

There are exercise-based cardiac rehabilitation groups in lots of towns and cities in Germany, sometimes organized by sports clubs. Your doctor can give you information about them and a prescription to join one. Participation in exercise-based cardiac rehabilitation is usually covered by statutory health insurance in Germany, but it’s best to check with your insurer.

Anderson L, Sharp GA, Norton RJ et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2017; (6): CD007130.

Charuel E, Bernard M, Vaillant Roussel H et al. "I Can't Go Far": Perceptions and Experiences of Heart Failure Patients Regarding Physical Activity: A Qualitative Study Using Semistructured Face-to-Face Interviews. Health Educ Behav 2022; 49(1): 78-86.

Long L, Mordi IR, Bridges C et al. Exercise-based cardiac rehabilitation for adults with heart failure. Cochrane Database Syst Rev 2019; (1): CD003331.

Zwisler AD, Norton RJ, Dean SG et al. Home-based cardiac rehabilitation for people with heart failure: A systematic review and meta-analysis. Int J Cardiol 2016; 221: 963-969.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on November 28, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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