Page 55 - Today's Dietitian (February 2020)

that the type of exercise is less impor- combined aerobic/strength interval much-needed guidance and encourage-
tant than the patient’s engagement and training all improved quality of life ment to jump-start an exercise program
commitment. A 2018 systematic review and functioning. 6 on their own. Regular exercise is severely
and meta-analysis of 40 studies (total- • Aquatic exercise (eg, swimming, underutilized in managing patients with
ing 5,411 patients) found significant water aerobics, water walking) was heart failure. 3-5
improvements in quality of life and comparable to land-based exercise Research suggests that helping cli-
physical functioning associated with in improving exercise capacity, mus- ents with heart failure recognize their
regular exercise. The researchers evalu- cular strength, and quality of life for barriers to regular exercise and find
ated different factors that might affect patients with stable heart failure. 7 exercise activities that they enjoy might
outcomes and found that type of exer- • Resistance/strength training alone or be more helpful than prescribing a tra-
cise, intensity, level of supervision, and combined resistance/aerobic exercise ditional and generalized exercise regi-
exercise setting didn’t affect the signifi- improved quality of life, walking abil- men. Because those with heart failure
cant improvements in quality of life and ity, and peak oxygen uptake. 8 often have other comorbidities, exercise
physical functioning associated with • Yoga significantly improved quality activities should be appropriate for age
regular exercise. Exercise programs in of life, exercise capacity, and clini- and physical abilities. NYHA III and IV
all studies in this review were struc- cal heart failure outcomes as much clients may require supervised exercise
tured to ensure patient engagement as aquatic exercise. In addition, yoga sessions. The safest exercise options for
and adherence, leading researchers to significantly reduced anxiety and most clients with heart failure include
conclude that engagement and adher- depression. 9 aquatic exercise, walking, gentle or chair
ence contributed to improvements for • Tai chi significantly improved walk- yoga, tai chi, and strength training with
patients. The study included patients ing distance, quality of life, and cer- light handheld weights.
with all NYHA functional statuses; most tain cardiac performance measures
2
patients were NYHA II or III. in patients with heart failure. 10 Jennifer Van Pelt, MA, is a certified group
Other recently published system- fitness instructor and health care researcher
atic reviews and meta-analyses have Despite guideline recommendations in the Lancaster, Pennsylvania, area.
reported the following regarding exer- and proven health benefits, only about
cise and heart failure: 10% of heart failure patients are referred
to cardiac rehabilitation after diag- For references, view this article on our
• Interval training, continuous aero- nosis or hospitalization for heart fail- website at www.TodaysDietitian.com.
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bic exercise, strength training, and ure. Patients therefore aren’t receiving
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