Priority 2 from the Advanced Heart Failure PSP
| UNCERTAINTY: What amount and type of exercise is safe and effective for people with advanced heart failure? (JLA PSP Priority 2) | |
|---|---|
| Overall ranking | 2 |
| JLA question ID | 0098/02 |
| Explanatory note |
There is a large body of evidence for rehabilitation/supervised exercise as well as 'informal exercise' such as tai chi functional measures e.g. heart capabilities and to a lesser extent quality of life measures but no guidance on which/how much/how often - this lack of evidence is reflected in clinical guidelines. Equally there is no guidance for everyday actitivies for people with advanced heart failure e.g. going to shops, walking up hills |
| Evidence |
Three recent reviews: 1. Clin Rehabil. 2018 Nov;32(11):1482-1492. doi: 10.1177/0269215518784345. Epub 2018 Jul 9.The impact of high-intensity inspiratory muscle training on exercise capacity and inspiratory muscle strength in heart failure with reduced ejection fraction: a systematic review and meta-analysis. Gomes Neto M, Ferrari F4,5, Helal L, Lopes A. 2. Int J Cardiol. 2018 Mar 1;254:224-229. doi: 10.1016/j.ijcard.2017.10.114. Epub 2018 Jan 28.Determinants of exercise intolerance in heart failure with preserved ejection fraction: A systematic review and meta-analysis.Montero D1, Diaz-Cañestro C2. 3. Arch Cardiol Mex. 2017 Oct - Dec;87(4):326-335. doi: 10.1016/j.acmx.2016.12.002. Epub 2017 Jan 5. [The exercise training restores the heart rate variability in heart failure patients. A systematic review]. [Article in Spanish] Segovia V1 . |
| Health Research Classification System category | Cardiovascular |
| Extra information provided by this PSP | |
|---|---|
| Could graded exercise be useful for heart failure patients? ~ In advanced heart failure some patients seem to have a period of stability when more care is provided, adaptations to the home and equipment is provided. Does rest in advanced heart failure improve cardiac function? ~ [What can help me with my tiredness and] will exercise help my heart failure? ~ What sort of exercise is safe to do? ~ How much exercise? How long for? | |
| Submitted by | 28 x patients, 22 x health professionals, 3 x carers , 1 x other |
| PSP information | |
|---|---|
| PSP unique ID | 0098 |
| PSP name | Advanced Heart Failure |
| Total number of uncertainties identified by this PSP. | 65 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website) |
| Date of priority setting workshop | 13 February 2019 |