Getting to the Heart of the Matter: What is the Landscape of Exercise Rehabilitation for People With Heart Failure in Australia?

• Published in: Heart, lung & circulation Vol. 27; no. 11; pp. 1350 - 1356
• Main Authors: Miller, Simon, Mandrusiak, Allison, Adsett, Julie
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.11.2018
• Subjects: Australia - epidemiology; Cardiac rehabilitation; Cardiac Rehabilitation - methods; Cross-Sectional Studies; Exercise Test; Exercise therapy; Exercise Therapy - methods; Exercise Tolerance - physiology; Female; Heart failure; Heart Failure - epidemiology; Heart Failure - physiopathology; Heart Failure - rehabilitation; Humans; Male; Morbidity - trends; Prognosis; Quality of Life; Surveys and Questionnaires; Survival Rate - trends; Heart failure; Surveys and questionnaires; Exercise therapy; Cardiac rehabilitation
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2017.08.016

The benefits of exercise rehabilitation for people with heart failure (HF) are well established. In Australia, little is known about how the guidelines around exercise rehabilitation for people with HF are being implemented in clinical practice. Furthermore, it is unknown what organisational barriers are faced in providing exercise rehabilitation programs for this population. The aim of this study is to provide an updated review of exercise rehabilitation services for people with HF in Australia and to identify perceived organisational barriers to providing these services. A cross-sectional survey of cardiac rehabilitation centres in Australia, investigating the number and characteristics of services providing exercise rehabilitation for people with HF. A total of 334 of 457 identified services responded to the survey. Of these, 251 reported providing a supervised group-based exercise rehabilitation program for people with HF. These services were mapped, showing their distribution across Australia. Services which were unable to provide group-based exercise training for HF patients reported organisational barriers including insufficient funding (60%), staffing (56%) and clinical resources (53%). Of the 78 services that reported patients in their local area were unable to access appropriate exercise guidance, 81% were located in regional or remote areas. We found that reported exercise practices align with current best-practice guidelines with 99% of group based exercise programs reportedly including endurance training and 89% including resistance training. In Australia, exercise practices for people with HF align with current best-practice guidelines for this condition. Limited resources, funding and geographic isolation are reported as the major organisational barriers to providing these programs. Future endeavours should include the development of alternative and flexible delivery models such as telerehabilitation and other home-based therapies to improve access for these individuals to such services.