Tailored BEST Exercise Protocol in Heart Failure Rehabilitation
Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses var...
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Indonesian Heart Association
2025-01-01
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| Series: | Majalah Kardiologi Indonesia |
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| Online Access: | https://ijconline.id/index.php/ijc/article/view/1738 |
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| author | Kevin Triangto Basuni Radi Bambang Budi Siswanto Tresia Fransiska Ulianna Tambunan Teuku Heriansyah Alida Rosita Harahap Aria Kekalih Ade Meidian Ambari Bambang Dwiputra Dwita Rian Desandri Hajime Katsukawa Anwar Santoso |
| author_facet | Kevin Triangto Basuni Radi Bambang Budi Siswanto Tresia Fransiska Ulianna Tambunan Teuku Heriansyah Alida Rosita Harahap Aria Kekalih Ade Meidian Ambari Bambang Dwiputra Dwita Rian Desandri Hajime Katsukawa Anwar Santoso |
| author_sort | Kevin Triangto |
| collection | DOAJ |
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Introduction
Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes.
Methods
In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders.
Results
Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively).
Conclusion
The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.
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| format | Article |
| id | doaj-art-14131af3ed5a42e7b7aab5b06a1d357e |
| institution | Kabale University |
| issn | 0126-3773 2620-4762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Indonesian Heart Association |
| record_format | Article |
| series | Majalah Kardiologi Indonesia |
| spelling | doaj-art-14131af3ed5a42e7b7aab5b06a1d357e2025-01-10T16:38:12ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-01-0146110.30701/ijc.1738Tailored BEST Exercise Protocol in Heart Failure RehabilitationKevin Triangto0Basuni Radi1Bambang Budi Siswanto2Tresia Fransiska Ulianna Tambunan3Teuku Heriansyah4Alida Rosita Harahap5Aria Kekalih6Ade Meidian Ambari7Bambang Dwiputra8Dwita Rian Desandri9Hajime Katsukawa10Anwar Santoso11University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUSK FK: Universitas Syiah Kuala Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranUniversity of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas KedokteranDepartement of Scientific Research, Japanese Society of Early MobilizationNational Cardiovascular Center Harapan Kita Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations. https://ijconline.id/index.php/ijc/article/view/1738Heart Failure with Reduced Ejection Fraction (HFrEF)Endurance ExerciseBreathing ExerciseStrengthening ExerciseHeart Failure Rehabilitation |
| spellingShingle | Kevin Triangto Basuni Radi Bambang Budi Siswanto Tresia Fransiska Ulianna Tambunan Teuku Heriansyah Alida Rosita Harahap Aria Kekalih Ade Meidian Ambari Bambang Dwiputra Dwita Rian Desandri Hajime Katsukawa Anwar Santoso Tailored BEST Exercise Protocol in Heart Failure Rehabilitation Majalah Kardiologi Indonesia Heart Failure with Reduced Ejection Fraction (HFrEF) Endurance Exercise Breathing Exercise Strengthening Exercise Heart Failure Rehabilitation |
| title | Tailored BEST Exercise Protocol in Heart Failure Rehabilitation |
| title_full | Tailored BEST Exercise Protocol in Heart Failure Rehabilitation |
| title_fullStr | Tailored BEST Exercise Protocol in Heart Failure Rehabilitation |
| title_full_unstemmed | Tailored BEST Exercise Protocol in Heart Failure Rehabilitation |
| title_short | Tailored BEST Exercise Protocol in Heart Failure Rehabilitation |
| title_sort | tailored best exercise protocol in heart failure rehabilitation |
| topic | Heart Failure with Reduced Ejection Fraction (HFrEF) Endurance Exercise Breathing Exercise Strengthening Exercise Heart Failure Rehabilitation |
| url | https://ijconline.id/index.php/ijc/article/view/1738 |
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