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Exercise therapy improves quality of life and physical function in chronic heart failure

Palmer K, Bowles KA, Paton M, et al. Chronic Heart Failure and Exercise Rehabilitation: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2018;99:2570-82.

Review question

In people who have chronic heart failure, does exercise improve their symptoms?


People with chronic heart failure have hearts that are too weak or damaged to move their blood efficiently. This can lead to fatigue, lung congestion, shortness of breath, poor quality of life, and reduced ability to function.

How the review was done

40 studies (27 randomized controlled trials) were published up to July 2017.

The studies included 5411 adults.

The key features of the studies were:

  • people were mostly men (73%), average age 62 years, who had chronic heart failure with no recent worsening of symptoms;
  • exercise therapy occurred in outpatient or community settings and usually involved aerobic exercise and/or strength training, although 2 studies assessed therapy pools (studies of dance, yoga, and tai chi were excluded);
  • exercise sessions were 10 to 60 minutes long and occurred 2 to 5 times per week;
  • exercise therapy was compared with no exercise or usual care; and
  • studies lasted from 8 weeks to 10 years.

What the researchers found

Exercise therapy improved quality of life and physical function compared with no exercise or usual care.


In people who have chronic heart failure, exercise improves quality of life and physical function.

Exercise therapy vs control (no exercise or usual care) in patients with chronic heart failure


Number of trials and people

Change in outcome with exercise compared with control*

Quality of life

32 studies (3753 people)

Large improvement with exercise compared with control.

Physical function

18 studies (3437 people)

Large improvement with exercise compared with control.

*Based on standard mean differences (SMD); very small = less than 0.2 SMD, small = 0.2 to 0.49 SMD, medium = 0.5 to 0.79 SMD, large = 0.8 to more SMD.

Related Topics


Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

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