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Home-based cardiac rehabilitation improves quality of life, aerobic capacity, and readmission rates in patients with chronic heart failure
Chen Y-W, Wang C-Y, Lai Y-H, Liao Y-C, Wen Y-K, Chang S-T, Huang J-L, Wu T-J
Medicine 2018 Jan;97(4):e9629
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Exercise tolerance and cardiac output have a major impact on the quality of life (QOL) of patients experiencing heart failure (HF). Home-based cardiac rehabilitation can significantly improve not only exercise tolerance but also peak oxygen uptake (VO2peak), and the QOL in patients with HF. The aim of this prospective study was to evaluate the beneficial effects of home-based cardiac rehabilitation on the quality of medical care in patients with chronic HF. METHODS: This study was a randomized prospective trial. HF patients with a left ventricular ejection fraction (LVEF) of less than 50% were included in this study. We randomly assigned patients to the control group (n = 18) and the interventional group (n = 19). Within the interventional group, we arranged individualized rehabilitation programs, including home-based cardiac rehabilitation, diet education, and management of daily activity over a 3-month period. Information such as general data, laboratory data, cardiopulmonary exercise test (CPET) results, Six-minute Walk Test (6MWT) results, and the scores for the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after the intervention, was collected from all patients in this study. RESULTS: Patients enrolled in the home-based cardiac rehabilitation programs displayed statistically significant improvement in VO2peak (18.2 +/- 4.1 versus 20.9 +/- 6.6 mL/kg/min, p = 0.02), maximal 6-Minute Walking Distance (6MWD) (421 +/- 90 versus 462 +/- 74 m, p = 0.03), anaerobic threshold (12.4 +/- 2.5 versus 13.4 +/- 2.6 mL/kg/min, p = 0.005), and QOL. In summary, patients receiving home-based cardiac rehabilitation experienced a 14.2% increase in VO2peak, a 37% increase in QOL score, and an improvement of 41 m on the 6MWD test. The 90-day readmission rate for patients reduced to 5% from 14% after receiving cardiac rehabilitation. CONCLUSION: Home-based cardiac rehabilitation offered the most improved results in functional capacity, QOL, and a reduced the rate of readmission within 90 days.

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