Do special exercise programs help people to stay fit?
Many people with heart failure avoid strenuous physical activities. For most people, though, the opposite would be a good idea: Special exercise programs can help to improve your physical fitness and quality of life.
In people with heart failure, the heart can no longer pump enough oxygen-rich blood to the organs, muscles and other tissues in their body. As a result, they may get out of breath and have trouble breathing when they do physically strenuous activities. This can be frightening, and many people with heart failure start avoiding strenuous activities because of it. But if you hardly get any exercise, you become even 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.
Studies have shown that exercise can improve both fitness and quality of life
Researchers from the Cochrane Collaboration – an international research network – wanted to find out whether exercise programs help and are safe for people who have heart failure. They looked at the results of 34 studies involving more than 4,700 participants. Most of the participants were between 50 and 80 years old, and had mild or moderate heart failure.
The results confirm that people with heart failure can benefit from special exercise programs: Participants’ physical fitness improved, and they could move, run and work better than people who had not taken part in a program. They also rated their quality of life higher, and needed fewer hospital visits for heart problems:
- Without special exercise programs, about 12 in 100 people needed to go to the hospital within one year.
- With special exercise programs, about 7 in 100 participants needed to go to the hospital within one year.
In other words, the exercise programs prevented 5 out of 100 people from having to go to the hospital because of their heart failure.
The studies didn’t find any evidence that the exercise programs were associated with any risks. People who took part in these programs even had a slightly better life expectancy in the long term.
What did the special exercise programs involve?
In most of the studies, the participants tried to improve their stamina through brisk walking or by cycling indoors or outdoors. They could also use a rowing machine or a stepper machine that simulates climbing stairs.
The amount and frequency of exercise varied from study to study, ranging between two to seven times per week, for a total of 15 to 120 minutes. The majority of participants had three sessions per week, lasting between 30 and 60 minutes each. In some cases, the intensity of exercise was increased over the course of the program.
Do home-based exercise programs help too?
In a more recent analysis, researchers summarized the results of several studies in which people were shown how to do exercises by a doctor, and then did them on their own at home. The researchers concluded that home-based exercise programs are probably just as effective as supervised center-based exercise programs. In the home-based programs, people used devices like wristbands and pedometers to monitor their physical activity and the strain on their body. A lot of people who have heart failure get a feel for how far they can push themselves after a while – and start feeling more confident about doing exercises on their own.
People who are afraid to exercise on their own may find it helpful to do it together with friends or family at first. Before starting, it’s important to talk to your doctor about what types of exercise you can do, and at which level of intensity.
If worrying symptoms arise while doing exercise, or your fitness decreases over the course of several days, it's important to seek medical advice. You should temporarily stop doing the exercises during acute illnesses, or if you have a fever.
Taylor RS, Dalal H, Jolly K, Zawada A, Dean SG, Cowie A et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2015; (8): CD007130.
Taylor RS, Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal H et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev 2014; (4): CD003331.
Zwisler AD, Norton RJ, Dean SG, Dalal H, Tang LH, Wingham J et al. Home-based cardiac rehabilitation for people with heart failure: A systematic review and meta-analysis. Int J Cardiol 2016; 221: 963-969.
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