Article

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). 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: DeltaVO2peak (Delta2.0 +/- 2.4 vs Delta-0.2
+/- 2.1, p = 0.0004); Deltat (Delta108 +/- 108 vs Delta0.94 +/- 109, p = 0.0031);
Delta6-MWT (Delta53.8 +/- 63.9 vs Delta22.0 +/- 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.
CI - (c) The European Society of Cardiology 2014.

Langue : ANGLAIS