Feasibility of chair based exercise in a group based setting for patients with systolic heart failure.

Abstract
Background – Clinical guidance recommends that patients with heart failure (HF) should be offered exercise based cardia rehabilitation (CR) in a group setting. The NHS long term plan reiterates these recommendations and has set an ambitious target for much greater uptake through a broader range of modes of CR delivery. In the UK 80% of patients attending cardiac rehabilitation do so through supervised exercise in groups yet fewer than 15% of patients with heart failure (HF) take up any form of CR. This shortfall in uptake is partly due to existing CR being dominated by exercise that requires patients to stand and walk for long periods which is something many HF patients are unable to do.
Purpose - This study aimed to evaluate the feasibility of Chair based exercise (CBE) delivered in a group setting, as part of routine clinical practice.
Design and methods – A prospective feasibility study was approved by the NHS and undertaken by recruiting a cohort of HF patients from routine clinical practice. A pre assessment including an incremental shuttle walk test was carried out before the start of the exercise programme which was delivered two times per week over an eight week period. Prior to study commencement ethical approval was obtained from an NHS ethics committee.
Results- The study recruited 10 patients with an average age of 73 years with equal 50/50 % being male and female. The chair based exercise intervention was safe with participants exercising at 65-70% of their maximum without any adverse events. With a caveat around a small sample size descriptive analysis of outcomes indicates slight positive trends in physical, psychological and quality of life measures. Patient feedback on carrying out chair based exercise using a DVD in a group setting was mixed with an overall positive sense of group exercise alongside some perceived challenges in tailoring the exercise levels to the different levels of fitness in the group.
Conclusion- The research study was successful in achieving approval from NHS ethics and achieved its aim in that patients with HF were recruited to a chair based exercise programme as part of routine practice. The exercise intervention was delivered safely and at an appropriate intensity in a group setting without any adverse events.