Beyond the clinic: a six-month home-based exercise and respiratory rehabilitation program improves functional capacity, respiratory muscle strength, and fatigue in chronic heart failure

Abstract

Optimal models of rehabilitation dedicated for patients with heart failure (HF) remain under investigation. The aim of this study was to assess the safety and effectiveness of a 6-month home-based rehabilitation program in patients with HF. 63 patients with stable HF were randomized, 28 patients from intervention group completed the study and were included in the analysis. Assessments including the 6-minute walk test, respiratory muscle strength, and quality of life measures (SF-36 and Fatigue Severity Scale – FSS) were conducted at baseline and after 6 months. Additionally, adverse events and adherence to the training protocol were monitored. Due to objective challenges caused by the COVID-19 pandemic outbreak, the course and final outcomes of the study differed from the original protocol; the control group was not assessed after 6 months. In the intervention group, 6 months of rehabilitation resulted in statistically significant improvements: the 6-minute walk distance increased by 37.86 meters ( p  = 0.001), maximal inspiratory pressure (PImax) improved by 20.21 cmH₂O, and maximal expiratory pressure (PEmax) by 20.75 cmH₂O (both p  < 0.01). A significant reduction in fatigue was observed, as measured by FSS, with a mean decrease of 0.68 points ( p  = 0.029). Adherence to the exercise protocol averaged 91.5 ± 15.3%. No serious adverse events were reported. The home-based rehabilitation program, including respiratory muscle training, is safe and effective for patients with chronic HF. It improves functional capacity and reduces fatigue levels. https://clinicaltrials.gov/ct2/show/NCT03780803 , ClinicalTrials.gov, NCT03780803. Registered 19/12/2018.