Training fisico domiciliare nello scompenso cardiaco cronico: studio osservazionale sui fattori condizionanti l'aderenza al programma.

Translated title of the contribution: Home exercise therapy in chronic congestive heart failure: observational study of factors affecting adherence to the program

Soccorso Capomolla, Monica Ceresa, Agostina Civardi, Angela Lupo, Anna Ventura, Milena Scabini, Patrizia Leonelli, Giulia Salvaneschi, Alessandra Petocchi, GianDomenico Pinna, Marina Ferrari, Oreste Febo, Angelo Caporotondi, Giampaolo Guazzotti, Maria Teresa La Rovere, Marco Gnemmi, Roberto Maestri, Franco Cobelli

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Physical training has proven to be a valid and effective therapeutic tool capable of counteracting muscle changes that occur in chronic heart failure (CHF) patients. Nevertheless, few studies have analyzed the frequency of use of this therapy and the reasons for any reduced compliance and adherence to the prescription. The aim of this study was to quantify the frequency of the participation of CHF patients in a program of domiciliary physical training and to analyze the factors that can influence adherence to the program. METHODS: Three hundred and twenty-two consecutive CHF patients (ejection fraction 28 +/- 7%) in a stable condition with optimized medical therapy performed a cardiopulmonary test, including determination of peak oxygen consumption, at baseline and after 9 +/- 3 months. All the patients had participated in sessions of health education on the relationship between illness/physical activity. The prescription of physiotherapy was decided by the physician on the basis of each patient's clinical need assessed in the diagnostic-therapeutic management. The patient referred for physiotherapy entered a therapeutic strategy that included sessions of training on anaerobic threshold, self-management of the session, and formulation of a domiciliary physical training program. During the follow-up evaluation the patients were asked to complete a questionnaire, which investigated the relationship between several factors and the patient's adherence to the physical training program, which was objectively evaluated by the change in peak oxygen consumption recorded at the end of the training, taking into account the spontaneous variations found in the control group. RESULTS: Two hundred and eighty-two of the patients (88%) satisfied the criteria for inclusion in the study. Only 61 (22%) of them were judged to have adhered to the recommended physical training. Type of employment (chi 2 = 7.08, p <0.02), the state of retirement (chi 2 = 8.9, p <0.01), ischemic etiology (chi 2 = 5.91, p <0.01), compatibility with employment (chi 2 = 15.8, p <0.0004), availability of suitable domestic conditions (chi 2 = 14.5, p <0.0008), the structure of the training program (chi 2 = 22.33, p <0.0001) and a learning phase in a gym (chi 2 = 71.33, p <0.0001) were significantly correlated at univariate analysis with the performance of the physical training. Multivariate analysis identified the structure of the training program (odds ratio 9.6, 95% confidence interval 2.8-33) and a learning phase in a gym (odds ratio 49.6, 95% confidence interval 11-210.8) as independent factors (r2 = 0.48) determining adherence to the physical training program. CONCLUSIONS: Adherence to unmonitored, recommended domiciliary physical training appears to be modest even in patients who have been in-patients in a cardiac rehabilitation center. Various factors seem to influence the adherence of the patient to this therapy, but structural factors, such as the organization and learning of the program, more strongly influenced the patient's subsequent compliance.

Original languageItalian
Pages (from-to)1098-1105
Number of pages8
JournalItalian Heart Journal
Volume3
Issue number11 Suppl
Publication statusPublished - Nov 2002

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Exercise Therapy
Observational Studies
Heart Failure
Education
Patient Compliance
Learning
Oxygen Consumption
Prescriptions
Therapeutics
Odds Ratio
Confidence Intervals
Anaerobic Threshold
Rehabilitation Centers
Retirement
Self Care
Health Education
Statistical Factor Analysis
Compliance
Multivariate Analysis
Organizations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Capomolla, S., Ceresa, M., Civardi, A., Lupo, A., Ventura, A., Scabini, M., ... Cobelli, F. (2002). Training fisico domiciliare nello scompenso cardiaco cronico: studio osservazionale sui fattori condizionanti l'aderenza al programma. Italian Heart Journal, 3(11 Suppl), 1098-1105.

Training fisico domiciliare nello scompenso cardiaco cronico : studio osservazionale sui fattori condizionanti l'aderenza al programma. / Capomolla, Soccorso; Ceresa, Monica; Civardi, Agostina; Lupo, Angela; Ventura, Anna; Scabini, Milena; Leonelli, Patrizia; Salvaneschi, Giulia; Petocchi, Alessandra; Pinna, GianDomenico; Ferrari, Marina; Febo, Oreste; Caporotondi, Angelo; Guazzotti, Giampaolo; La Rovere, Maria Teresa; Gnemmi, Marco; Maestri, Roberto; Cobelli, Franco.

In: Italian Heart Journal, Vol. 3, No. 11 Suppl, 11.2002, p. 1098-1105.

Research output: Contribution to journalArticle

Capomolla, S, Ceresa, M, Civardi, A, Lupo, A, Ventura, A, Scabini, M, Leonelli, P, Salvaneschi, G, Petocchi, A, Pinna, G, Ferrari, M, Febo, O, Caporotondi, A, Guazzotti, G, La Rovere, MT, Gnemmi, M, Maestri, R & Cobelli, F 2002, 'Training fisico domiciliare nello scompenso cardiaco cronico: studio osservazionale sui fattori condizionanti l'aderenza al programma.', Italian Heart Journal, vol. 3, no. 11 Suppl, pp. 1098-1105.
Capomolla, Soccorso ; Ceresa, Monica ; Civardi, Agostina ; Lupo, Angela ; Ventura, Anna ; Scabini, Milena ; Leonelli, Patrizia ; Salvaneschi, Giulia ; Petocchi, Alessandra ; Pinna, GianDomenico ; Ferrari, Marina ; Febo, Oreste ; Caporotondi, Angelo ; Guazzotti, Giampaolo ; La Rovere, Maria Teresa ; Gnemmi, Marco ; Maestri, Roberto ; Cobelli, Franco. / Training fisico domiciliare nello scompenso cardiaco cronico : studio osservazionale sui fattori condizionanti l'aderenza al programma. In: Italian Heart Journal. 2002 ; Vol. 3, No. 11 Suppl. pp. 1098-1105.
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title = "Training fisico domiciliare nello scompenso cardiaco cronico: studio osservazionale sui fattori condizionanti l'aderenza al programma.",
abstract = "BACKGROUND: Physical training has proven to be a valid and effective therapeutic tool capable of counteracting muscle changes that occur in chronic heart failure (CHF) patients. Nevertheless, few studies have analyzed the frequency of use of this therapy and the reasons for any reduced compliance and adherence to the prescription. The aim of this study was to quantify the frequency of the participation of CHF patients in a program of domiciliary physical training and to analyze the factors that can influence adherence to the program. METHODS: Three hundred and twenty-two consecutive CHF patients (ejection fraction 28 +/- 7{\%}) in a stable condition with optimized medical therapy performed a cardiopulmonary test, including determination of peak oxygen consumption, at baseline and after 9 +/- 3 months. All the patients had participated in sessions of health education on the relationship between illness/physical activity. The prescription of physiotherapy was decided by the physician on the basis of each patient's clinical need assessed in the diagnostic-therapeutic management. The patient referred for physiotherapy entered a therapeutic strategy that included sessions of training on anaerobic threshold, self-management of the session, and formulation of a domiciliary physical training program. During the follow-up evaluation the patients were asked to complete a questionnaire, which investigated the relationship between several factors and the patient's adherence to the physical training program, which was objectively evaluated by the change in peak oxygen consumption recorded at the end of the training, taking into account the spontaneous variations found in the control group. RESULTS: Two hundred and eighty-two of the patients (88{\%}) satisfied the criteria for inclusion in the study. Only 61 (22{\%}) of them were judged to have adhered to the recommended physical training. Type of employment (chi 2 = 7.08, p <0.02), the state of retirement (chi 2 = 8.9, p <0.01), ischemic etiology (chi 2 = 5.91, p <0.01), compatibility with employment (chi 2 = 15.8, p <0.0004), availability of suitable domestic conditions (chi 2 = 14.5, p <0.0008), the structure of the training program (chi 2 = 22.33, p <0.0001) and a learning phase in a gym (chi 2 = 71.33, p <0.0001) were significantly correlated at univariate analysis with the performance of the physical training. Multivariate analysis identified the structure of the training program (odds ratio 9.6, 95{\%} confidence interval 2.8-33) and a learning phase in a gym (odds ratio 49.6, 95{\%} confidence interval 11-210.8) as independent factors (r2 = 0.48) determining adherence to the physical training program. CONCLUSIONS: Adherence to unmonitored, recommended domiciliary physical training appears to be modest even in patients who have been in-patients in a cardiac rehabilitation center. Various factors seem to influence the adherence of the patient to this therapy, but structural factors, such as the organization and learning of the program, more strongly influenced the patient's subsequent compliance.",
author = "Soccorso Capomolla and Monica Ceresa and Agostina Civardi and Angela Lupo and Anna Ventura and Milena Scabini and Patrizia Leonelli and Giulia Salvaneschi and Alessandra Petocchi and GianDomenico Pinna and Marina Ferrari and Oreste Febo and Angelo Caporotondi and Giampaolo Guazzotti and {La Rovere}, {Maria Teresa} and Marco Gnemmi and Roberto Maestri and Franco Cobelli",
year = "2002",
month = "11",
language = "Italian",
volume = "3",
pages = "1098--1105",
journal = "Italian Heart Journal",
issn = "1129-471X",
publisher = "Societa Italiana di Cardiologia",
number = "11 Suppl",

}

TY - JOUR

T1 - Training fisico domiciliare nello scompenso cardiaco cronico

T2 - studio osservazionale sui fattori condizionanti l'aderenza al programma.

AU - Capomolla, Soccorso

AU - Ceresa, Monica

AU - Civardi, Agostina

AU - Lupo, Angela

AU - Ventura, Anna

AU - Scabini, Milena

AU - Leonelli, Patrizia

AU - Salvaneschi, Giulia

AU - Petocchi, Alessandra

AU - Pinna, GianDomenico

AU - Ferrari, Marina

AU - Febo, Oreste

AU - Caporotondi, Angelo

AU - Guazzotti, Giampaolo

AU - La Rovere, Maria Teresa

AU - Gnemmi, Marco

AU - Maestri, Roberto

AU - Cobelli, Franco

PY - 2002/11

Y1 - 2002/11

N2 - BACKGROUND: Physical training has proven to be a valid and effective therapeutic tool capable of counteracting muscle changes that occur in chronic heart failure (CHF) patients. Nevertheless, few studies have analyzed the frequency of use of this therapy and the reasons for any reduced compliance and adherence to the prescription. The aim of this study was to quantify the frequency of the participation of CHF patients in a program of domiciliary physical training and to analyze the factors that can influence adherence to the program. METHODS: Three hundred and twenty-two consecutive CHF patients (ejection fraction 28 +/- 7%) in a stable condition with optimized medical therapy performed a cardiopulmonary test, including determination of peak oxygen consumption, at baseline and after 9 +/- 3 months. All the patients had participated in sessions of health education on the relationship between illness/physical activity. The prescription of physiotherapy was decided by the physician on the basis of each patient's clinical need assessed in the diagnostic-therapeutic management. The patient referred for physiotherapy entered a therapeutic strategy that included sessions of training on anaerobic threshold, self-management of the session, and formulation of a domiciliary physical training program. During the follow-up evaluation the patients were asked to complete a questionnaire, which investigated the relationship between several factors and the patient's adherence to the physical training program, which was objectively evaluated by the change in peak oxygen consumption recorded at the end of the training, taking into account the spontaneous variations found in the control group. RESULTS: Two hundred and eighty-two of the patients (88%) satisfied the criteria for inclusion in the study. Only 61 (22%) of them were judged to have adhered to the recommended physical training. Type of employment (chi 2 = 7.08, p <0.02), the state of retirement (chi 2 = 8.9, p <0.01), ischemic etiology (chi 2 = 5.91, p <0.01), compatibility with employment (chi 2 = 15.8, p <0.0004), availability of suitable domestic conditions (chi 2 = 14.5, p <0.0008), the structure of the training program (chi 2 = 22.33, p <0.0001) and a learning phase in a gym (chi 2 = 71.33, p <0.0001) were significantly correlated at univariate analysis with the performance of the physical training. Multivariate analysis identified the structure of the training program (odds ratio 9.6, 95% confidence interval 2.8-33) and a learning phase in a gym (odds ratio 49.6, 95% confidence interval 11-210.8) as independent factors (r2 = 0.48) determining adherence to the physical training program. CONCLUSIONS: Adherence to unmonitored, recommended domiciliary physical training appears to be modest even in patients who have been in-patients in a cardiac rehabilitation center. Various factors seem to influence the adherence of the patient to this therapy, but structural factors, such as the organization and learning of the program, more strongly influenced the patient's subsequent compliance.

AB - BACKGROUND: Physical training has proven to be a valid and effective therapeutic tool capable of counteracting muscle changes that occur in chronic heart failure (CHF) patients. Nevertheless, few studies have analyzed the frequency of use of this therapy and the reasons for any reduced compliance and adherence to the prescription. The aim of this study was to quantify the frequency of the participation of CHF patients in a program of domiciliary physical training and to analyze the factors that can influence adherence to the program. METHODS: Three hundred and twenty-two consecutive CHF patients (ejection fraction 28 +/- 7%) in a stable condition with optimized medical therapy performed a cardiopulmonary test, including determination of peak oxygen consumption, at baseline and after 9 +/- 3 months. All the patients had participated in sessions of health education on the relationship between illness/physical activity. The prescription of physiotherapy was decided by the physician on the basis of each patient's clinical need assessed in the diagnostic-therapeutic management. The patient referred for physiotherapy entered a therapeutic strategy that included sessions of training on anaerobic threshold, self-management of the session, and formulation of a domiciliary physical training program. During the follow-up evaluation the patients were asked to complete a questionnaire, which investigated the relationship between several factors and the patient's adherence to the physical training program, which was objectively evaluated by the change in peak oxygen consumption recorded at the end of the training, taking into account the spontaneous variations found in the control group. RESULTS: Two hundred and eighty-two of the patients (88%) satisfied the criteria for inclusion in the study. Only 61 (22%) of them were judged to have adhered to the recommended physical training. Type of employment (chi 2 = 7.08, p <0.02), the state of retirement (chi 2 = 8.9, p <0.01), ischemic etiology (chi 2 = 5.91, p <0.01), compatibility with employment (chi 2 = 15.8, p <0.0004), availability of suitable domestic conditions (chi 2 = 14.5, p <0.0008), the structure of the training program (chi 2 = 22.33, p <0.0001) and a learning phase in a gym (chi 2 = 71.33, p <0.0001) were significantly correlated at univariate analysis with the performance of the physical training. Multivariate analysis identified the structure of the training program (odds ratio 9.6, 95% confidence interval 2.8-33) and a learning phase in a gym (odds ratio 49.6, 95% confidence interval 11-210.8) as independent factors (r2 = 0.48) determining adherence to the physical training program. CONCLUSIONS: Adherence to unmonitored, recommended domiciliary physical training appears to be modest even in patients who have been in-patients in a cardiac rehabilitation center. Various factors seem to influence the adherence of the patient to this therapy, but structural factors, such as the organization and learning of the program, more strongly influenced the patient's subsequent compliance.

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