Home-based telemonitored Nordic walking training is well accepted, safe, effective and has high adherence among heart failure patients, including those with cardiovascular implantable electronic devices: a randomised controlled study.
Study Goal
The researchers aimed to assess the safety, effectiveness, adherence, and acceptance of home-based telemonitored Nordic walking in heart failure patients, including those with cardiovascular implantable electronic devices.
Results Summary
Nordic walking significantly improved functional capacity (VO2peak), workload duration, six-minute walking test distance, and quality of life in heart failure patients, with no adverse events or hospitalizations reported. The control group showed no favorable results.
Population
Heart failure patients (NYHA II-III) with left ventricular ejection fraction ≤40%, including those with cardiovascular implantable electronic devices.
Effective Dosage
Five times weekly
Duration
Eight weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
home-based telemonitored Nordic walking (NW) | increase | VO2peak | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | 16.1 ± 4.0 vs 18.4 ± 4.1 (ml/kg/min) | resulted in significant improvement in | #1 |
home-based telemonitored Nordic walking (NW) | increase | workload duration (t) in cardiopulmonary exercise test (CPET) | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | 471 ± 141 vs 577 ± 158 (s) | resulted in significant improvement in | #2 |
home-based telemonitored Nordic walking (NW) | increase | six-minute walking test (6-MWT) distance | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | 428 ± 93 vs 480 ± 87 (m) | resulted in significant improvement in | #3 |
home-based telemonitored Nordic walking (NW) | increase | quality of life (QoL), Medical Outcome Survey Short Form 36 (SF-36) | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | 79.0 ± 31.3 vs 70.8 ± 30.3 (score) | resulted in significant improvement in | #4 |
home-based telemonitored Nordic walking (NW) | increase | ΔVO2peak | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | Δ2.0 ± 2.4 vs Δ-0.2 ± 2.1 | The differences between the TG and CG were significant in | #5 |
home-based telemonitored Nordic walking (NW) | increase | Δt | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | Δ108 ± 108 vs Δ0.94 ± 109 | The differences between the TG and CG were significant in | #6 |
home-based telemonitored Nordic walking (NW) | increase | Δ6-MWT | HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40% | Δ53.8 ± 63.9 vs Δ22.0 ± 68.7 | The differences between the TG and CG were significant in | #7 |
home-based telemonitored Nordic walking (NW) | no change | CIEDs during NW | HF patients with cardiovascular implantable electronic devices (CIEDs) | - | We did not observe any intervention from | #8 |
home-based telemonitored Nordic walking (NW) | neutral | - | HF patients, including those with CIEDs | - | is safe and effective | #9 |
BACKGROUND: The benefits of rehabilitation in heart failure (HF) patients are well established. Little is known about Nordic walking (NW) training in HF patients especially in those with cardiovascular implantable electronic devices (CIEDs). PURPOSE: The purpose of this study was to assess safety, effectiveness, adherence to and acceptance of home-based telemonitored NW in HF patients, including those with CIEDs (i.e. cardiac resynchronisation therapy, implantable cardioverter-defibrillator). METHODS: The study design was a single-centre, prospective, parallel-group, randomised (2:1), controlled trial among 111 HF patients, New York Heart Association (NYHA) II-III; left ventricular ejection fraction (EF) ≤ 40%. The intervention was a home-based telemonitored eight-week NW (training group (TG) n = 77) five times weekly vs usual care alone (control group (CG) n = 34). Outcome measures included a primary end point of functional capacity assessed by peak oxygen consumption (VO2peak). Secondary end points included: workload duration (t) in cardiopulmonary exercise test (CPET), six-minute walking test (6-MWT) distance and quality of life (QoL), Medical Outcome Survey Short Form 36 (SF-36); safety; adherence to and acceptance of NW. Measurements were made before and after intervention. RESULTS: NW resulted in significant improvement in: VO2peak (16.1 ± 4.0 vs 18.4 ± 4.1(ml/kg/min), p = 0.0001), t (471 ± 141 vs 577 ± 158 (s), p = 0.0001), 6-MWT(428 ± 93 vs 480 ± 87 (m), p = 0.0001) and QoL (79.0 ± 31.3 vs 70.8 ± 30.3 (score), p = 0.0001). We did not observe favourable results in the CG. The differences between the TG and CG were significant in: ΔVO2peak (Δ2.0 ± 2.4 vs Δ-0.2 ± 2.1, p = 0.0004); Δt (Δ108 ± 108 vs Δ0.94 ± 109, p = 0.0031); Δ6-MWT (Δ53.8 ± 63.9 vs Δ22.0 ± 68.7, p = 0.0483). In neither group were there deaths nor necessity for hospitalisation. We did not observe any intervention from CIEDs during NW. All patients in the TG completed rehabilitation and accepted it well. CONCLUSION: In HF patients, including those with CIEDs, home-based telemonitored NW is safe and effective. NW was well accepted by patients and adherence was high and promising.