Rehabilitation Exercises for Patients with Chronic Heart Failure

  Patients with heart failure are often repeatedly hospitalized and feel chest tightness and shortness of breath when they are slightly active, at which point some people choose to be bedridden, afraid to move, and their quality of life declines, almost becoming an invalid. The following is an elaboration of these two issues.  The main symptoms of heart failure patients in the chronic stable phase are weakness and shortness of breath after activity, which is manifested by a decrease in exercise tolerance. Scientific rehabilitation exercises have been shown to improve exercise capacity, reduce plasma catecholamine concentrations, improve ventilatory function, improve vascular endothelial function, improve myocardial adaptability, improve patient survival, and improve quality of life in heart failure patients.  In 2004, a meta-analysis study of nine clinical randomized controlled trials (involving a total of 801 patients, 395 of whom were in the exercise training group and 406 in the control group) with a mean follow-up time of 705 days showed that the exercise training group had a significantly lower rate of death and readmission and a significantly longer survival time than the control group. Moreover, exercise training was evident in improving the quality of life of the patients. the HF-ACTION study used the Kansas City Cardiomyopathy Questionnaire (KCCQ) scale, and the results demonstrated that patients obtained a statistically significant improvement in self-perceived health status during exercise training, and this improvement appeared early (3 months) and persisted. How to exercise in heart failure patients?  It is recommended that patients perform aerobic exercise of low to moderate intensity, with 50% to 70% of maximum exercise tolerance as the exercise intensity for daily exercise. In the absence of exercise cardiorespiratory equipment, the maximum heart rate can be used as an indicator. Maximum heart rate for age = 220 – age and target heart rate for exercise = 170 – age. The patient’s subjective level of exertion is also an important indicator in exercise testing. The Borg Rating of Perceived Exertion (RPE) is commonly used for quantification to guide exercise intensity. A score of 12~13 is generally sufficient in daily exercise for heart failure patients.  2.Duration of each exercise The general duration of exercise to reach exercise intensity is 20~30 minutes each time, 3~5 times per week. Before each exercise there are 5~10 minutes of preparatory activities, and after the exercise, the adjustment activities should be continued to guide smooth breathing.  3, the choice of exercise Be sure to treat individually and follow the principle of interest. Only if the patient is interested is it possible to increase the motivation to participate and adhere to the scheduled rehabilitation program. Recommend the application of exercises such as walking, treadmill walking, and power cycling.  4. Monitoring and risks in exercise If the patient’s condition is stable, medication is standardized, and a suitable exercise prescription is developed after exercise cardiopulmonary function measurement, there are relatively few risks in exercise. It is recommended that the patient be followed up regularly for evaluation so that potential problems can be identified in a timely manner and the amount of exercise can be adjusted according to the patient’s condition. Rehabilitation training for patients with chronic heart failure is quite important, and patients with heart failure are hereby reminded that they must develop a scientific training program to improve their survival rate and quality of life.