Do exercise programs help if you have heart failure?

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.

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 evidence 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.

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.

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.