Physical Activity Interventions for Heart Failure Management

Physical activity is a cornerstone of contemporary heart failure management, complementing pharmacological and device therapies to improve symptoms, functional capacity and quality of life. Exercise training programmes typically combine aerobic and resistance components, tailored to individual functional status, often assessed by the six-minute walk test and peak work capacity. Despite strong guideline recommendations, adherence to prescribed activity remains suboptimal, particularly among older or more symptomatic patients. Barriers include fear of symptom exacerbation, low self-efficacy and logistical constraints. Interventions have evolved from centre-based rehabilitation to home-based and technology-enhanced models, incorporating telemonitoring, digital coaching and gamified platforms to sustain engagement. Emerging evidence supports adaptive goal setting and real-time feedback to overcome psychosocial obstacles, while novel formats such as exergaming and tele-yoga show potential to diversify exercise modalities. Globally, scalable and accessible approaches are essential to reach diverse populations, reduce hospitalisation and prolong independent living in heart failure cohorts.

Research from Nature Portfolio

Recent studies have evaluated a telemonitoring-based exercise intervention in a large multicentre trial involving patients with chronic heart failure. Over 12 months, participants receiving digital exercise instruction and activity tracking demonstrated increased self-reported physical activity and reduced sedentary time, whereas daily step counts remained stable. Multivariate analysis identified baseline exercise capacity, heart failure severity, atrial fibrillation status and age as key predictors of physical activity progression. Body mass index and initial engagement with video instructions also influenced adherence trajectories. These findings emphasise the importance of individualised goal setting and ongoing remote support to sustain long-term exercise adherence in chronic heart failure.

Physical Activity Interventions for Heart Failure Management publication trend

The graph below shows the total number of articles in physical activity interventions for heart failure management across all publications each year (not limited to Nature Index journals).

Technical terms

Metabolic equivalent of task (MET): A unit that expresses the energy cost of activities as multiples of resting metabolic rate.

Telemonitoring: Remote collection and transmission of patient data (such as activity levels or physiological measures) to support healthcare delivery and behaviour change.

Exergaming: Use of interactive video games that require physical movement to promote exercise engagement and enjoyment.

Self-efficacy: An individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments.

References

1. Adherence to long-term telemonitoring-supported physical activity in patients with chronic heart failure. Scientific Reports (2024).
2. Feasibility of a Sensor-Controlled Digital Game for Heart Failure Self-management: Randomized Controlled Trial. JMIR Serious Games (2021).
3. Perceived barriers and enablers influencing physical activity in heart failure: A qualitative one-to-one interview study. PLOS ONE (2022).
4. Associations of fear of physical activity, coping style and self-reported exercise behavior in patients with chronic heart failure. PLOS ONE (2024).
5. Exergaming to increase the exercise capacity and daily physical activity in heart failure patients: a pilot study. BMC Geriatrics (2014).
6. Tele-Yoga in Long Term Illness–Protocol for a Randomised Controlled Trial Including a Process Evaluation and Results from a Pilot Study. International Journal of Environmental Research and Public Health (2021).