Study On The Effect Of Walking Exercise Based On “Timing It Right ”on Functional Fitness In Elderly Patients With Chronic Heart Failure

Objective To understand the functional fitness level of elderly patients with chronic heart failure and to explore the effect of walking exercise based on “Timing It Right ” framework on functional fitness of elderly patients with chronic heart failure,so as to provide a reference method for formulating standardized rehabilitation exercise prescription for elderly patients with chronic heart failure.Methods In this study,we used the method of quasi-experimental research to study the elderly patients with chronic heart failure in a third-class A hospital in Hefei.The 84 patients who met the inclusion and exclusion criteria from November 2018 to January 2019 were randomly divided into the control group and the experimental group,with 42 patients in each group.The control group was given routine discharge rehabilitation guidance.The experimental group was given a 6-month walking exercise intervention based on “ Timing It Right ” framework on the basis of routine discharge rehabilitation guidance.General information questionnaire and Mini-Mental State Examination scale(MMSE)were used to investigate patients’ general information and cognitive status.Exercise self-efficacy and functional fitness were assessed by the exercise self-efficacy scale(ESES)and the Senior Fitness Test(SFT)at the beginning of treatment and 6 months after treatment,respectively.The effects of walking based on“Timing It Right ”framework on the functional fitness of elderly patients with chronic heart failure were evaluated.Results A total of 83 elderly patients with chronic heart failure completed the study(One person dropped out of the experimental group,the final experimental group of 41 people,42 people in the control group).There was no significant difference between the two groups in gender,age,heart failure course and other general information(all P >0.05).Before the intervention,there was no significant difference in the levels of motor self-efficacy and functional fitness between the two groups(all P >0.05),which was comparable.After intervention,in addition to body flexibility,there were statistically significant differences in upper body strength,lower body strength,dynamic balance and aerobic endurance between the experimental group and the control group(all P < 0.05).(1)Comparison of muscle strength:(1)Upper body muscle strength: After 6 months of intervention,the upper body strength of the experimental group was better than that of the control group and the difference was statistically significant(16.24±5.24 vs 12.02±6.06,t =-3.390,p =0.001);In the experimental group,the upper body muscle strength after intervention was higher than that before intervention(t=-46.38,p<0.001);In the control group,there was no significant difference in upper body muscle strength before and after the intervention(t =-1.57,P = 0.124).(2)Lower body muscle strength:After 6 months of intervention,the lower body strength of the experimental group was better than that of the control group,with statistically significant difference(11.44 ±3.44 vs 6.76 ±2.40,t =-7.197,p < 0.001);In the experimental group,the lower body muscle strength was improved after intervention(t =-10.441,p < 0.001);In the control group,there was no significant difference in lower body muscle strength before and after the intervention(t=-1.496,p=0.142).(2)Dynamic balance comparison: Six months after the intervention,the dynamic balance ability of the experimental group was better than that of the control group,with statistically significant difference(t=4.145,p<0.001);The dynamic balance of the experimental group after intervention was better than that before intervention and the difference was statistically significant(t=7.066,p<0.001).In the control group,there was no significant difference in the dynamic balance ability before and after the intervention(t=1.601,p=0.117).(3)Comparison of aerobic endurance:After 6 months of intervention,the aerobic endurance of the experimental group was higher than that of the control group(t=-7.194,p<0.001);The aerobic endurance of the experimental group after intervention was higher than that before intervention(t=-16.850,p<0.001);In the control group,there was no significant difference in aerobic endurance between before and after intervention(t=-0.389,p=0.700).(4)Comparison of exercise self-efficacy:After 6 months of intervention,the self-efficacy score of the experimental group was significantly higher than that of the control group(46.37 ± 7.40 VS 33.21 ± 7.25,t=-8.179,p< 0.001);The self-efficacy score of the experimental group after intervention was higher than that before intervention(46.37±7.40 VS 31.90±6.64,t=-12.375,p<0.001);In the control group,there was no significant difference in self-efficacy before and after the intervention(t=-1.967,p=0.056).Conclusions The results of this study showed that after 6 months of walking exercise intervention based on“Timing It Right ”,in addition to body flexibility,the upper body muscle strength,lower body muscle strength,dynamic balance and aerobic endurance of elderly patients with chronic heart failure were improved and the exercise self-efficacy of elderly CHF patients was also improved.This indicates that the walking exercise based on the“Timing It Right ”can improve the exercise compliance of elderly patients with chronic heart failure,improve the functional fitness of patients and provide a reference for the development of the exercise specification in line with the needs of cardiac rehabilitation of elderly patients with chronic heart failure.