Date of Award

8-2012

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Kenneth D. Phillips

Committee Members

Lora H. Beebe, Linda C. Mefford, David R. Bassett, Jr., Abbas S. Tavakoli (Courtesy Member)

Abstract

Patients experience decreased functional capacity from chronic symptoms associated with heart failure. Exercise increases activity tolerance and quality of life in heart failure patients. Physiologic responses to exercise in heart failure patients have been well-documented. In contrast, the effects of exercise on an individual’s perception of degree of disability due to chronic illness and their adaptive responses to heart failure have not been studied. The purpose of this randomized controlled trial was to examine the effects of a 12-week home-based combined aerobic and resistance training exercise intervention on an individual’s perception of degree of disability and adaptive responses to chronic illness. Seventy-one participants were randomized to receive the combined aerobic and resistance training exercise intervention or usual heart failure care. Repeated measures ANOVA and nonparametric tests were used to test the hypotheses that participants in the 12-week home-based low intensity combined aerobic and resistance training intervention would have decreased perception of illness disability, improved physiologic and psychosocial adaptation to chronic illness, and have fewer hospitalizations than the control group. Findings showed participants who received the exercise intervention had increased distance walked on the 6-Minute Walk Test (p = .03), they increased their Average Daily Pedometer Steps (p = .02), and they had fewer hospitalizations than the control group. NYHA Functional Class III participants in the intervention group showed the most improvement in NYHA Functional Class (41.2%, p =.03), and had decreased perception of illness disability with lower scores on the Illness Perception Questionnaire-Revised. Both the intervention and control groups showed improvement in psychosocial adaptation with lower scores on the Sickness Impact Profile. No exercise-related adverse events occurred. Thus, a home-based low intensity combined aerobic and resistance training exercise program is safe for NYHA Functional Class II and III heart failure patients and improves physiologic and psychosocial adaptation to chronic illness and supports the adaptation to chronic illness theory.

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