scholarly journals The relationship between physical activity and appetite in patients with heart failure: A prospective observational study

2019 ◽  
Vol 18 (5) ◽  
pp. 410-417 ◽  
Author(s):  
Christina Andreae ◽  
Kristofer Årestedt ◽  
Lorraine Evangelista ◽  
Anna Strömberg
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Functional Capacity ◽  
Prospective Observational Study ◽  
Nyha Class ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
The Relationship ◽  
Minute Walk

Introduction: Physical activity and appetite are important components for maintaining health. Yet, the association between physical activity and appetite in heart failure (HF) populations is not completely understood. The aim of the present study was to investigate the relationship between physical activity, functional capacity, and appetite in patients with HF. Methods: This was a prospective observational study. In total, 186 patients diagnosed with HF, New York Heart Association (NYHA) class II–IV (mean age 70.7, 30% female), were included. Physical activity was measured using a multi-sensor actigraph for seven days and with a self-reported numeric rating scale. Physical capacity was measured by the six-minute walk test. Appetite was measured using the Council on Nutrition Appetite Questionnaire. Data were collected at inclusion and after 18 months. A series of linear regression analyses, adjusted for age, NYHA class, and B-type natriuretic peptide were conducted. Results: At baseline, higher levels of physical activity and functional capacity were significantly associated with a higher level of appetite in the unadjusted models. In the adjusted models, number of steps ( p = 0.019) and the six-minute walk test ( p = 0.007) remained significant. At the 18-month follow-up, all physical activity variables and functional capacity were significantly associated with appetite in the unadjusted regression models. In the adjusted models, number of steps ( p = 0.001) and metabolic equivalent daily averages ( p = 0.040) remained significant. Conclusion: A higher level of physical activity measured by number of steps/day was associated with better self-reported appetite, both at baseline and the 18-month follow-up. Further research is needed to establish causality and explore the intertwined relationship between activity and appetite in patients with HF.

Examination of the Six Minute Walk Test to Determine Functional Capacity in People with Chronic Heart Failure: A Systematic Review

2010 ◽  
Vol 21 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Brittany Pollentier ◽  
Sonya L. Irons ◽  
Courtney Manfredi Benedetto ◽  
Anne-Marie DiBenedetto ◽  
Dana Loton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Chronic Heart Failure ◽  
Functional Capacity ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Minute Walk

Six-Minute Walk Test for Assessing Physical Functional Capacity in Chronic Heart Failure

2017 ◽  
Vol 14 (3) ◽  
pp. 158-166 ◽  
Author(s):  
Huiyun Du ◽  
Parichat Wonggom ◽  
Jintana Tongpeth ◽  
Robyn A. Clark
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Functional Capacity ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Minute Walk

Abstract 279: Outcomes From Integrating Stroke Survivors Into Cardiac Rehabilitation

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Elizabeth W Regan ◽  
Reed Handlery ◽  
Sara Wilcox ◽  
Jill Stewart ◽  
Joseph L Pearson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Outcome Expectation ◽  
Stroke Survivors ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Increased Risk ◽  
The Impact ◽  
Minute Walk

Purpose: Lack of physical activity after stroke results in increased risk of stroke recurrence and other health problems. While some survivors receive physical therapy (PT), it is often discontinued within a year. Cardiac Rehabilitation (CR) is a community exercise program for people with cardiac dysfunction; however, stroke is not a covered diagnosis despite high cardiovascular risk. CR for stroke survivors is an opportunity to bridge the gap between PT and community physical activity. The study evaluated the impact of CR participation on stroke survivors. Materials and Methods: A pilot study was completed at a phase 3 CR facility. Participants were screened for eligibility and entered the CR program (3 x per week for 12 weeks) with an aerobic fitness focus. Individual outcomes were taken pre- and post-program, and 6-months follow up. Program impact was measured by paired t-tests (24 participants) and repeated measures ANOVA (18 participants) for 6-month follow up. Results: Twenty-four participants completed the study. Participants were 79% (19/24) male with an average age of 62.2 years old (range 33.5 -81.5) with a time since stroke of 29.7 months (range 3-123). Most participants (20/24) were community ambulators at the start of the study (six-minute walk test (6MWT) > 288 m). Pre-Post Program: The six-minute walk test (6MWT) (endurance) improved by 62 ± 66 m (p<0.005). The five times sit to stand test (5xSS) (strength) improved by 3.8 ± 5.8 sec (P=0.004). The Stroke Impact Scale Mobility Subscale improved by 7.3% ± 11.8%, (p=0.006), the Activities of Daily Living Subscale improved by 6.2% ± 9.9%, (p=0.006) and the Memory Subscale by 6.4% ± 14.7%, (p=0.043). Fast Walking Speed, Self-Efficacy and Exercise Outcome Expectation Scales improved with statistical significance but lacked clinical significance. No other outcomes had statistically significant changes. Six-month Follow up: At 6-month follow up, 89.5% (16/18) of participants were still exercising at least once a week. The CR program elicited statistically significant participant improvements over time in the 6MWT (p=0.001) and 5xSS (p<0.001). Post-hoc analysis revealed a statistically significant improvement from pre-program to 6-month follow up in 6MWT distance (66.52 ± 53.73m, p=0.013), 5xSS (-3.44 ± 2.20s, p=0.003) but not post-program to 6 months follow up 6MWT (-5.2 ± 26.4m, p=1.00) and 5xSS (-0.24 ± 1.69s, p=1.00) demonstrating maintenance of gains, but no additional gains. Conclusions: CR elicited meaningful improvements for stroke survivors (exceeding minimal clinically important differences) in walking endurance, strength, perceived memory and perceived mobility with gains maintained for endurance and strength at 6-month follow up. CR enhances exercise habits and physical activity through structured exercise after discharge from PT and may improve community participation.

Abstract P333: Heart Rate Control in Patients With Chronic Atrial Fibrillation and Heart Failure

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Helme Silvet ◽  
Lee Ann Hawkins
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Rate Control ◽  
Nyha Class ◽  
Chronic Atrial Fibrillation ◽  
Walk Test ◽  
Heart Rate Control ◽  
6 Minute Walk Test ◽  
Minute Walk

Background. Heart rate (HR) control is one of the main goals in management of patients with chronic atrial fibrillation (AF). However, rate control can be challenging in patients with heart failure (HF). The goal of our study was to determine if aggressive heart rate control in patients with both chronic AF and HF results in better exercise tolerance and/or quality of life (QOL) as compared to the “usual” care. Methods. This was a single center interventional study at VA Loma Linda Healthcare System using patients as their own controls. Patients with chronic AF and LVEF ≤ 40% were recruited. Intervention consisted of increasing doses of Metoprolol XL to achieve target resting heart rate less than 70 bpm. Clinical data was collected at baseline (“usual care”) and at follow-up (3 months) and included HR data, 6-minute walk test, QOL questionnaire (Minnesota Living with Heart Failure), and brain natriuretic peptide (BNP) levels. Paired t-test was performed to evaluate statistically significant change in these clinical measures. The study had 80% power to detect clinically significant improvement in 6-minute walk test (50 meters). Results. 20 patients were recruited with an average follow-up of 98 days. Mean age was 66 years and all the patients were male with an average LVEF of 30 ± 8% and NYHA class of II-III. Average resting HR was 94 ± 14 bpm at baseline and 85 ± 12 bpm after the intervention. Average Metoprolol XL dose at the end of the study was 121mg with the average increase of the dose during the study of 59 mg. Further increases of Metoprolol doses to achieve target HR were not tolerated by the patients. Conclusion. In this small group of patients with chronic AF and HF aggressive HR control was difficult due to patient intolerance of increasing doses of beta-blockade and was not associated with better exercise tolerance, better QOL or improved HF based on BNP measurement. Further studies are needed to establish guidelines for target HR in patients with chronic AF who also have significant HF. Clinical parameter Baseline Follow-up p-value 6-min walk test (meters) 326 ± 83 330 ± 86 0.47 QOL score 42.5 ± 19 38 ± 21 >0.5 BNP 242 ± 306 279 ± 395 >0.5 NYHA class 2.4 ± 0.7 2.2 ± 0.7 0.009

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