Effects of Home-Based Exercise on Depression, Anxiety, Functional Capacity, and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND

Structured exercise programs have been shown to improve functional capacity and mitigate depressive symptoms in various populations. However, no review has examined the effects of home-based exercise on depression in patients with heart failure with reduced ejection fraction (HFrEF).

PURPOSE: The objective of this study is to evaluate the effects of home-based exercise in patients with HFrEF.

METHODS

Seven databases were searched from inception until August 2024. The Cochrane Risk of Bias Tool was used to assess study quality. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was quantified using Hedges g and 95% confidence interval (CI) using a random-effects model. Heterogeneity was examined using Q values and I 2 statistics. Moderator analysis was performed to identify sources of heterogeneity. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system.

RESULTS

Thirteen randomized controlled trials were included. Home-based exercise had a significant effect on depression ( g = -0.298; 95% CI, -0.470 to -0.125; P = .001; I 2 = 0%), anxiety ( g = -0.217; 95% CI, -0.414 to -0.020; P = .031; I 2 = 0%), peak oxygen consumption ( g = 0.551; 95% CI, 0.160-0.941; P = .006; I 2 = 74.29%), 6-minute walking distance ( g = 0.692; 95% CI, 0.272-1.112; P = .001; I 2 = 81.12%), and quality of life ( g = -0.778; 95% CI, -1.206 to -0.350; P < .001; I 2 = 84.62%).

CONCLUSION

Home-based exercise may be effective in mitigating depression and anxiety in patients with HFrEF.