A randomized trial of the addition of home‐based exercise to specialist heart failure nurse care: the Birmingham Rehabilitation Uptake Maximisation study for patients with Congestive Heart Failure (BRUM‐CHF) study

Abstract

Aims Supervised exercise can benefit selected patients with heart failure, however the effectiveness of home‐based exercise remains uncertain. We aimed to assess the effectiveness of a home‐based exercise programme in addition to specialist heart failure nurse care. Methods and results This was a randomized controlled trial of a home‐based walking and resistance exercise programme plus specialist nurse care (n = 84) compared with specialist nurse care alone (n = 85) in a heart failure population in the West Midlands, UK. Primary outcome: Minnesota Living with Heart Failure Questionnaire (MLwHFQ) at 6 and 12 months. Secondary outcomes: composite of death, hospital admission with heart failure or myocardial infarction; psychological well‐being; generic quality of life (EQ‐5D); exercise capacity. There was no statistically significant difference between groups in the MLwHFQ at 6 month (mean, 95% CI) (−2.53, −7.87 to 2.80) and 12 month (−0.55, −5.87 to 4.76) follow‐up or secondary outcomes with the exception of a higher EQ‐5D score (0.11, 0.04 to 0.18) at 6 months and lower Hospital Anxiety and Depression Scale score (−1.07, −2.00 to −0.14) at 12 months, in favour of the exercise group. At 6 months, the control group showed deterioration in physical activity, exercise capacity, and generic quality of life. Conclusion Home‐based exercise training programmes may not be appropriate for community‐based heart failure patients.