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KMID : 0368120170470050742
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Korean Circulation Journal
2017 Volume.47 No. 5 p.742 ~ p.751
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Comparison of Supervised Hospital-based versus Educated Home-based Exercise Training in Korean Heart Failure Patients
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Kim Min-Su
Kim Min-Seok
Lim Seo-Jin
Ahn Jung-Min
Kim Jae-Joong
Park Seung-Jung
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Abstract
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Background and Objectives: Although many clinical trials have shown that exercise training (ET) improves functional capacity and clinical outcomes in heart failure (HF) patients, data comparing supervised hospital-based and educated home-based ET in HF patients is lacking.
Subjects and Methods: This was a single-center, non-randomized, prospective study of 82 HF patients with reduced ejection fraction (≤40%) who completed ET. The hospital-based group (n=30) underwent supervised ET at 60% of peak oxygen consumption (VO2), while a physiotherapist-educated group (n=52) exercised at home without monitoring. The 2 groups were compared before and after the 3-month ET program with respect to functional capacity, quality of life (QOL), and cardiac events (all-cause mortality or hospitalization with worsening HF).
Results: After ET, peak VO2 increased in the hospital-based group (19.4±4.4 to 21.4±4.3 mL/min/kg, p=0.006) and remained unchanged in the home-based group (18.9±4.6 to 18.4±4.6 mL/min/kg, p=0.660). The change in peak VO2 after ET was greater in the hospital-based group compared to the home-based group by 2.5 mL/min/kg (p=0.014). QOL improved in the hospital-based group (43.1±18.0 to 28.1±21.6, p=0.003). During one year of follow-up, a comparison of the 2 groups did not reveal a statistical difference in cardiac events (hazard ratio, 0.66; 95% confidence interval, 0.2?2.8; p=0.570).
Conclusion: Hospital-based ET was beneficial for HF patients, improving functional capacity and QOL. However, no significant advantages were observed in terms of a composite endpoint compared to home-based ET. Further investigations are required to address the effects and roles of the 2 ET programs for HF patients.
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KEYWORD
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Heart failure, Exercise, Rehabilitation
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