Effectiveness and reproducibility of an exercise training program: the ERIC-HF - multicenter randomized controlled trial
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Decompensated Heart Failure patients are characterized by functional dependence and low exercise tolerance. Aerobic exercise can improve symptoms, promoting functional capacity and increasing exercise tolerance. Little is known about the effectiveness and feasibility of it. The ERIC-HF program is an aerobic exercise training program developed for HF inpatients and includes cycloergometer training, walking and climbing stairs in order to promote patient’s functional capacity during the in-hospital stay period. Objective: To analyze the effect of an aerobic exercise training program (ERIC-HF)on exercise capacity of patients with decompensated heart failure. Secondary objectives were to assess the effects of an aerobic exercise training on functional independence and experience of dyspnea during activities of daily living. Design and setting: A randomised controlled clinical trial with follow-up at discharge. Eight different hospitals were included where patients with decompensated heart failure, admitted to the hospital, were randomly assigned to training (aerobic exercise program) or control (usual rehabilitation care guideline recommended). Patients were randomized (at a ratio of 1:1) to training group or control group using the software available online. After randomization, patients were clarified about the study and asked to provide informed consent. Patients were not informed about the group they were part of and no one declined participation. Only the investigators knew in which group patients were. The main outcome was exercise capacity, measured by 6-minute walking test at discharge. Other outcomes were the independence for the activitiers of daily living and the dyspnea associated to the activities of daily living.
Results: 257 patients were included. The mean age of the patients was 67±11 years, 84% (n = 205) presented reduced ejection fraction and the in hospital stay average was 16±10 days. At discharge, patients in the ERIC-HF group walked further compared to the control group (278±117m vs 219±115m) and this difference stayed significant after correcting for confounders (p-value<0.001). A statistically significant difference was found favoring the ERIC-HF exercise group in functional independence (96±7 vs 93±12) and dyspnea associated to ADL (13±5 vs 17±7)
and these differences stayed in correcting for baseline values and confounders (functional independence p-value=0.002; dyspnea associated to ADL p = 0.018).
Conclusion: The ERIC-HF program is safe, feasible and an effective exercise
program to increase exercise capacity and functional independence and to decrease dyspnea during ADL in in-hospital patients admitted due to decompensated HF.
