A systematic review and metaanalysis of the effect

A systematic review and meta-analysis of the effect of exercise parameters on quality of life and physical function in community dwelling people with Chronic Heart Failure Katie Palmer 1, 2, Dr Kelly-Ann Bowles 1, Michelle Paton 1, 2, Megan Jepson 1, Dr Rebecca Lane 3 1 Monash University, Australia, 2 Monash Health, Australia, 3 Australian Catholic University, Australia

The Economic Impact Global Cost $108 billion per annum Over 511, 000 Sufferers Total Cost $3. 1 billion 2 Chen et al. 2017, Cook et al. 2014

The Personal Impact 3 Sagar et al. 2015

The Role of Exercise ↑ Quality of Life ↑ Exercise Capacity Exercise in CHF ↑ Physical Function ↓ Admission Rates 4 Lewinter et al. 2015, Palmer et al. 2018

Aim and Methods Aims: To identify the effect of specific exercise parameters on physical function and quality of life in people with CHF, living in the community. Search Run: July 2017 Databases: Scopus, Medline (OVID), Cochrane, Pro. Quest, AMED Intervention Heart Failure Exercis* Rehab* Prescription OR Cardiac Failure OR Myocardial Failure OR Physical Activit* OR OR Community OR Aerobic Exercise 5 Home based AND Intervention AND Patient/ Population OR Plan OR Program*

Search Results Electronic Database Search (n=2200) Title and abstract screened (n=1295) Removal of duplicates (n=905) Included Studies: • 27 RCTs • 13 cohort studies Articles excluded (n=1044) Eligible for full review (n=251) Articles excluded (n=215) Articles included for data extraction (n=40) Articles included from hand searching (n=4) 6 Overall Study Quality: • PEDRO: 4. 9 • GRADE: moderate

Study Characteristics Participant characteristics (n=5411) – – Age: 62 years Gender: 73% Male Left Ventricular Ejection Fraction: 29% New York Heart Association Classes: I – IV Intervention characteristics (n=40) – Length: 8 weeks – 10 years – Exercise Types: Aerobic (Interval, Continuous), Strength, Combined Aerobic and Strength, Hydrotherapy – Supervision level: Home-based, Gym based (supervised), Mixed – Intensity: Low, Moderate, Vigorous, High – Duration: 10 – 60 minutes – Frequency: 2 – 5 times per week 7

Effect of Exercise on Quality of Life 8

Effect of Exercise on the Minnesota Living with Heart Failure Questionnaire 9

Effect of Exercise on Physical Function 10

Effect of Exercise on the Six Minute Walk Test 11

Prescription vs Engagement? Engagement in exercise is more important than the details 12 Piepoli et al. 2011

Take Home Messages Chronic Heart Failure and Exercise Rehabilitation: A systematic review 13 and meta-analysis