Effects of Exercise Training on Individuals with Chronic Heart Failure: A Systematic Review

Objective(s): To provide a contemporary systematic review of different effects of exercise training on patients with stable chronic heart failure (CHF).

Data Sources: A comprehensive search was conducted using six databases (CINAHL, Cochrane Library, EMBASE, PEDro, PUBMED, and SCOPUS) including grey literature for additional articles. Final index terms used for retrieval were “exercise training,” “heart failure,” “rehabilitation,” “physical therapy,” outcome*,” and “assessment.” Search strategy was limited to human, English language, adult (18 years old and above), and publication years (01/2010 to 12/2022).

Study Selection: Cohort studies, experimental studies, randomized clinical trials, and systematic reviews were selected in this review. Community-dwellers with stable CHF who participated in structured exercise programs were selected. Additional exclusion criteria were unstable CHF, yoga, pilates, & tai-chi. Two independent reviewers identified the selected 13 studies with a third reviewer for supervision & clarification of disagreements in the review process, including data checking. After initial screening, 178 studies were eligible for detailed review.

Data Extraction: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. All studies extracted were placed in Covidence management tool where selection and review process occurred. Cochrane risk of bias tool and Physiotherapy Evidence Database (PEDro) scale for methodology quality were used for in-depth assessment.

Data Synthesis: Total of 15,848 pooled patients were included in this review. Six exercise training effects were found in this review: improvement of exercise tolerance was supported by six studies; improvement of physical activity was supported by four studies; improvement of quality of life was supported by ten studies; reduction of depression was supported by one study; reduction of hospital admission was supported by three studies; reduction of mortality was shown by four studies.

Conclusions: Exercise is Medicine and should be prescribed to individuals who will benefit from this complementary therapy for better clinical outcomes. The effects of exercise training are beneficial to this target population. Similar review can be done for patients with acute HF.

Author(s) Disclosures: All authors have no conflict of interest to report.