T Corvera-Tindel, Greater Los Angeles VAMC / UCLA School of Nursing; LV Doering, School of Nursing; K Machuca, Greater Los Angeles VAMC

Objectives: Improvement in functional status is an important element in the lives of chronic heart failure (HF) patients. In a randomized trial, we are evaluating the effects of a 12-week home-based walking program on functional status in HF patients.

Methods: Functional status was measured by maximal exercise test (peak oxygen consumption [VO2] via cardiopulmonary exercise test [CPX], submaximal exercise test (6-minute walk test), and functional status questionnaires (Heart Failure Functional Status Inventory [HFFSI], Cardiac-Quality of Life Index [C-QLI], and the Dyspnea-Fatigue Index [DFI]). Forty-five HF patients from a regional Veterans' Medical Center (aged 64 +/- 9 years, ejection fraction 28 +/- 8%, 100% male, NYHA II- 85.3%, NYHA III- 14.7%) were randomized to care as usual (n = 23) or home walking program (n = 22). The home-based walking program included progressive exercise at 60% of maximal heart rate from 10 minutes (Week 1) to 1 hour (Weeks 6 to 12). Pre-test and post-test measures were performed and analyzed by repeated measured analysis of variance.

Results: Only the 6-minute walk test, a submaximal exercise test yielded significant differences between groups on functional status (p= .007).

Conclusions: In chronic HF patients, a modest 12-week home-based walking program can make a difference in patients' every day lives by improving their ability to perform activities of daily living (functional status).

Impact: For chronic HF patients who has difficulty accessing an out-patient hospital-based cardiac rehabilitation program due to geographic location and/or transportation, a nurse initiated 12-week home-based (progressive) walking program may be an alternative to improve HF patient's functional status.