A randomised controlled trial of exercise training for older heart failure patients

Roberta Fulton, Miles D Witham, Carol A Greig, Derek Johnston, Chim C Lang, Marjon van der Pol, Dwayne Boyers, Alan Struthers, Marion E T McMurdo

Research output: Contribution to journalMeeting Abstract

Abstract

Introduction: Substantial evidence exists documenting the beneficial effects of exercise training in younger patients with heart failure. Current heart failure exercise programmes are unsuitable for the majority of very old, frail heart failure patients. We tested whether a programme tailored to the needs of such patients could improve exercise capacity and quality of life. 

Methods: Parallel-group, single-blind randomised controlled trial. Patients aged 70 years and over with symptomatic heart failure and left ventricular systolic dysfunction were randomised to either 24 weeks exercise training (8 weeks supervised in a group then home based with telephone follow-up) or to usual care. Six minute walk distance was the primary outcome; sit to stand time, shuttle walk distance, quadriceps strength, quality of life and health status (Minnesota, EuroQol, Functional Limitations Profile, Hospital Anxiety and Depression scale) and daily activity (accelerometry) were measured at baseline, 8 & 24 weeks. Carer strain and health costs were also recorded. 

Results: 107 participants were randomised, mean age 80 years. 72/107 were male. 704/850 (83%) person-sessions of exercise were attended, with 41/53 (77%) of participants in the exercise group attending at least 80% of allocated sessions. Number and intensity of exercise repetitions increased significantly for all exercises between baseline and 8 weeks. Six minute walk distance did not improve compared to control group at 8 weeks (+9.8 vs +22.4m, p=0.28) or at 24 weeks (-3.0 vs -2.8m, p=0.99). For secondary outcomes only the sit to stand test improved significantly (-8.2s vs -3.1s at 24 weeks;p=0.015); there was no between-group difference in change for the Minnesota quality of life score (0 vs -1 points at 24 weeks; p=0.85).

Conclusion: This exercise intervention did not improve exercise capacity or quality of life in older heart failure patients.
Original languageEnglish
Pages (from-to)ii9
Number of pages1
JournalAge and Ageing
Volume40
Issue numbersuppl 2
DOIs
Publication statusPublished - 2011
Externally publishedYes
EventBritish Geriatrics Society Spring Meeting 2011 - Liverpool, United Kingdom
Duration: 4 Apr 20116 Apr 2011

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Randomized Controlled Trials
Heart Failure
Exercise
Quality of Life
Accelerometry
Group Homes
Left Ventricular Dysfunction
Telephone
Health Care Costs
Caregivers
Health Status
Anxiety
Depression
Control Groups

Cite this

Fulton, R., Witham, M. D., Greig, C. A., Johnston, D., Lang, C. C., van der Pol, M., ... McMurdo, M. E. T. (2011). A randomised controlled trial of exercise training for older heart failure patients. Age and Ageing, 40(suppl 2), ii9. https://doi.org/10.1093/ageing/afr099
Fulton, Roberta ; Witham, Miles D ; Greig, Carol A ; Johnston, Derek ; Lang, Chim C ; van der Pol, Marjon ; Boyers, Dwayne ; Struthers, Alan ; McMurdo, Marion E T. / A randomised controlled trial of exercise training for older heart failure patients. In: Age and Ageing. 2011 ; Vol. 40, No. suppl 2. pp. ii9.
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abstract = "Introduction: Substantial evidence exists documenting the beneficial effects of exercise training in younger patients with heart failure. Current heart failure exercise programmes are unsuitable for the majority of very old, frail heart failure patients. We tested whether a programme tailored to the needs of such patients could improve exercise capacity and quality of life. Methods: Parallel-group, single-blind randomised controlled trial. Patients aged 70 years and over with symptomatic heart failure and left ventricular systolic dysfunction were randomised to either 24 weeks exercise training (8 weeks supervised in a group then home based with telephone follow-up) or to usual care. Six minute walk distance was the primary outcome; sit to stand time, shuttle walk distance, quadriceps strength, quality of life and health status (Minnesota, EuroQol, Functional Limitations Profile, Hospital Anxiety and Depression scale) and daily activity (accelerometry) were measured at baseline, 8 & 24 weeks. Carer strain and health costs were also recorded. Results: 107 participants were randomised, mean age 80 years. 72/107 were male. 704/850 (83{\%}) person-sessions of exercise were attended, with 41/53 (77{\%}) of participants in the exercise group attending at least 80{\%} of allocated sessions. Number and intensity of exercise repetitions increased significantly for all exercises between baseline and 8 weeks. Six minute walk distance did not improve compared to control group at 8 weeks (+9.8 vs +22.4m, p=0.28) or at 24 weeks (-3.0 vs -2.8m, p=0.99). For secondary outcomes only the sit to stand test improved significantly (-8.2s vs -3.1s at 24 weeks;p=0.015); there was no between-group difference in change for the Minnesota quality of life score (0 vs -1 points at 24 weeks; p=0.85).Conclusion: This exercise intervention did not improve exercise capacity or quality of life in older heart failure patients.",
author = "Roberta Fulton and Witham, {Miles D} and Greig, {Carol A} and Derek Johnston and Lang, {Chim C} and {van der Pol}, Marjon and Dwayne Boyers and Alan Struthers and McMurdo, {Marion E T}",
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Fulton, R, Witham, MD, Greig, CA, Johnston, D, Lang, CC, van der Pol, M, Boyers, D, Struthers, A & McMurdo, MET 2011, 'A randomised controlled trial of exercise training for older heart failure patients', Age and Ageing, vol. 40, no. suppl 2, pp. ii9. https://doi.org/10.1093/ageing/afr099

A randomised controlled trial of exercise training for older heart failure patients. / Fulton, Roberta; Witham, Miles D; Greig, Carol A; Johnston, Derek; Lang, Chim C; van der Pol, Marjon; Boyers, Dwayne; Struthers, Alan; McMurdo, Marion E T.

In: Age and Ageing, Vol. 40, No. suppl 2, 2011, p. ii9.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - A randomised controlled trial of exercise training for older heart failure patients

AU - Fulton, Roberta

AU - Witham, Miles D

AU - Greig, Carol A

AU - Johnston, Derek

AU - Lang, Chim C

AU - van der Pol, Marjon

AU - Boyers, Dwayne

AU - Struthers, Alan

AU - McMurdo, Marion E T

N1 - This presentation was awarded the Ferguson Anderson Prize at the British Geriatric Society Spring Meeting

PY - 2011

Y1 - 2011

N2 - Introduction: Substantial evidence exists documenting the beneficial effects of exercise training in younger patients with heart failure. Current heart failure exercise programmes are unsuitable for the majority of very old, frail heart failure patients. We tested whether a programme tailored to the needs of such patients could improve exercise capacity and quality of life. Methods: Parallel-group, single-blind randomised controlled trial. Patients aged 70 years and over with symptomatic heart failure and left ventricular systolic dysfunction were randomised to either 24 weeks exercise training (8 weeks supervised in a group then home based with telephone follow-up) or to usual care. Six minute walk distance was the primary outcome; sit to stand time, shuttle walk distance, quadriceps strength, quality of life and health status (Minnesota, EuroQol, Functional Limitations Profile, Hospital Anxiety and Depression scale) and daily activity (accelerometry) were measured at baseline, 8 & 24 weeks. Carer strain and health costs were also recorded. Results: 107 participants were randomised, mean age 80 years. 72/107 were male. 704/850 (83%) person-sessions of exercise were attended, with 41/53 (77%) of participants in the exercise group attending at least 80% of allocated sessions. Number and intensity of exercise repetitions increased significantly for all exercises between baseline and 8 weeks. Six minute walk distance did not improve compared to control group at 8 weeks (+9.8 vs +22.4m, p=0.28) or at 24 weeks (-3.0 vs -2.8m, p=0.99). For secondary outcomes only the sit to stand test improved significantly (-8.2s vs -3.1s at 24 weeks;p=0.015); there was no between-group difference in change for the Minnesota quality of life score (0 vs -1 points at 24 weeks; p=0.85).Conclusion: This exercise intervention did not improve exercise capacity or quality of life in older heart failure patients.

AB - Introduction: Substantial evidence exists documenting the beneficial effects of exercise training in younger patients with heart failure. Current heart failure exercise programmes are unsuitable for the majority of very old, frail heart failure patients. We tested whether a programme tailored to the needs of such patients could improve exercise capacity and quality of life. Methods: Parallel-group, single-blind randomised controlled trial. Patients aged 70 years and over with symptomatic heart failure and left ventricular systolic dysfunction were randomised to either 24 weeks exercise training (8 weeks supervised in a group then home based with telephone follow-up) or to usual care. Six minute walk distance was the primary outcome; sit to stand time, shuttle walk distance, quadriceps strength, quality of life and health status (Minnesota, EuroQol, Functional Limitations Profile, Hospital Anxiety and Depression scale) and daily activity (accelerometry) were measured at baseline, 8 & 24 weeks. Carer strain and health costs were also recorded. Results: 107 participants were randomised, mean age 80 years. 72/107 were male. 704/850 (83%) person-sessions of exercise were attended, with 41/53 (77%) of participants in the exercise group attending at least 80% of allocated sessions. Number and intensity of exercise repetitions increased significantly for all exercises between baseline and 8 weeks. Six minute walk distance did not improve compared to control group at 8 weeks (+9.8 vs +22.4m, p=0.28) or at 24 weeks (-3.0 vs -2.8m, p=0.99). For secondary outcomes only the sit to stand test improved significantly (-8.2s vs -3.1s at 24 weeks;p=0.015); there was no between-group difference in change for the Minnesota quality of life score (0 vs -1 points at 24 weeks; p=0.85).Conclusion: This exercise intervention did not improve exercise capacity or quality of life in older heart failure patients.

U2 - 10.1093/ageing/afr099

DO - 10.1093/ageing/afr099

M3 - Meeting Abstract

VL - 40

SP - ii9

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - suppl 2

ER -

Fulton R, Witham MD, Greig CA, Johnston D, Lang CC, van der Pol M et al. A randomised controlled trial of exercise training for older heart failure patients. Age and Ageing. 2011;40(suppl 2):ii9. https://doi.org/10.1093/ageing/afr099