Effects of Cardiac Rehabilitation Exercise Protocols on Physical Function in Patients with Chronic Heart Failure: An Experience from a Resource Constraint Nation

Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p < 0.05. Results: EG and CG were comparable in age and physical characteristics. Physical function and cardiovascular parameters were comparable at baseline (p > 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO2 max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO2 max (10.3 ± 0.5 mL/kg/min) (p < 0.05) than CG: ADL (42.0% ± 5.0%), 6MWD (321.0 ± 25.7 m) and VO2 max (8.9 ± 0.4 mL/kg/min) at eighth (p > 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.