Authors (including presenting author) :
Chan MWT(1), Shek CCF(1), Chau CKW(1), Lee SKW(1), Chan CMC(2), Lee MKY(2), Chan ACM(1)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital
(2)Department of Medicine, Queen Elizabeth Hospital
Introduction :
Heart Failure (HF) is a prevalent condition characterized by significant morbidity and mortality, impacting the functional capacity, and quality of life of affected individuals. In Hong Kong, there were over 20000 HF hospitalizations annually with a mortality rate exceeding 50% within five years of diagnosis. The Comprehensive HF Rehabilitation Program (CHFP) plays an essential role in enhancing the functional capacity, heart function and exercise tolerance of HF patients, enabling them to participate more fully and independently in daily activities.
Objectives :
This study aimed to evaluate the effectiveness of CHFP on enhancing functional capacity among patients with HF.
Methodology :
It was a retrospective longitudinal study. Physiotherapy records of patients who participated in CHFP in the Queen Elizabeth Hospital between October 2022 and November 2024 were retrieved for analysis. The program comprised of 12 sessions with two 90-minute sessions per week. Each session included warm-up, aerobic, resistance exercise and cool-down under close monitoring of heart rate with telemetry, peripheral oxygen saturation and reported rate of perceived exertion. Demographics were collected for subgroup analysis. Six-minute walk test (6MWT) for exercise capacity, and timed-up-and-go test (TUGT) for functional and balance capacity were administered pre- and post-program. Results were evaluated by paired t-test and if normality and homogeneity of variance were not fulfilled, Wilcoxon Signed-Rank Test was used. Peak exercise oxygen uptake (VO2 max) and metabolic equivalents (MET) were predicted using the Cahalin formula: VO2 max=0.006 x 6-minute walk distance (6MWD)+3.38 and MET=VO2 max/3.5.
Result & Outcome :
112 patients with mean age of 63.81±11.08 years completed the program. 93.7% were Class II while 6.3% were Class I under New York Heart Association (NYHA) classification. Upon program completion, patients demonstrated a statistically significant improvement from 370.64±87.28 to 425.02±85.83 meters in 6MWD (p<0.001) and from 8.36±2.97 to 7.39±2.49 seconds in TUGT (p<0.001). Over 86% of patients reported an improvement on Numeric Global Rating of Change Scale of 5 or above. Percentage of patients in NYHA class I doubled to 14.3% post-program. The progression from 3.05 to 3.36 METs post-rehabilitation by Cahalin formula, and transition of NYHA Classification percentage indicated a positive engagement in moderate-intensity physical activities (3.0 – 6.0 METs) with a substantial decrease in functional limitations for HF patients. To conclude, the CHFP was effective in enhancing functional capacity in HF patients.
