Effective Strategies for Physical Activity Adherence in Heart Failure Patients: An Umbrella Review

Author: Hossein Karimi Moonaghi1,2,3, Shahnaz Ahrari4, Seyed Mousa Mahdizadeh1,2, Alireza Heidari Bakavoli5, Seyed Mohammad Riahi6
Affiliation: <sup>1</sup> Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. <sup>2</sup> Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. <sup>3</sup> Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. <sup>4</sup> Department of ParaMedicine, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. <sup>5</sup> Department of Cardiology, School of Medicine, Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran. <sup>6</sup> Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
Conference/Journal: Iran J Public Health
Date published: 2023 Sep 1
Other: Volume ID: 52 , Issue ID: 9 , Pages: 1832-1843 , Special Notes: doi: 10.18502/ijph.v52i9.13566. , Word Count: 227


Background:
Despite the importance of physical activity in heart failure treatment, physical activity adherence in heart failure patients is low. The purpose of this umbrella review was to obtain the best strategies for enhancing physical activity adherence among HF patients.

Methods:
Databases were investigated from 2010 to Jan 2022. The full text of the papers was investigated in terms of inclusion and exclusion criteria. Eventually, out of 74 relevant papers, 7-review study with 20977 patients were eligible and included in the study.

Results:
Five key effective approaches were identified in two subsets for enhancing physical activity adherence as follows: 1) exercise-based approaches including 1.1) Exergames, whereby the extent of adherence to exergames was between 84 and 98%. 1.2) Tele-rehabilitation with 70%-100% adherence the intervention groups 1.3) Tai chi and Qigong practices (TQPs), whereby the exercise adherence in TQP groups was 67-100%, 2. Theoretical-behavioral approaches 2.1) approaches based on behavioral and psychological theories, which were a combination of an exercise program alongside a behavior modification intervention, 2.2) Self-efficacy.

Conclusion:
Approaches that are based on exercise alongside behavioral and theoretical interventions could enhance physical activity adherence among HF patients. It is suggested to evaluate mix methods of exercise-based approaches and theoretical-behavioral approaches mentioned in this study in future clinical trial studies. Use of capacity of TR programs improve to physical activity adherence should receive more attention.

Keywords: Exercise; Heart failure; Patient adherence; Physical activity; Review.

PMID: 38033844 PMCID: PMC10682580 DOI: 10.18502/ijph.v52i9.13566