Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure

Rebecca A. Gary, Sandra B. Dunbar, Melinda K. Higgins, Dominique L. Musselman, Andrew L. Smith

Research output: Contribution to journalArticle

112 Scopus citations

Abstract

Objective: The purpose of this study is to compare the effectiveness of a combined 12-week home-based exercise (EX)/cognitive behavioral therapy (CBT) program (n=18) with CBT alone (n=19), EX alone (n=20), and with usual care (UC, n=17) in stable New York Heart Association Class II to III heart failure (HF) patients diagnosed with depression. Methods: Depressive symptom severity [Hamilton Rating Scale for Depression (HAM-D)], physical function [6-min walk test (6MWT)], and health-related quality of life (HRQOL) (Minnesota Living with Heart Failure Questionnaire) were evaluated at baseline (T1), after the 12-week intervention/control (T2), and following a 3-month telephone follow-up (T3). A repeated measures analysis of variance was used to determine group differences. Depression severity was dichotomized as minor (HAM-D, 11-14) and moderate-to-major depression (HAM-D, ≥15), and group intervention and control responses were also evaluated on that basis. Results: The greatest reduction in HAM-D scores over time occurred in the EX/CBT group (-10.4) followed by CBT (-9.6), EX (-7.3), and UC (-6.2), but none were statistically significant. The combined group showed a significant increase in 6-min walk distance at 24 weeks (F=13.5, P<001). Among all groups with moderate-to-major depression, only those in CBT/EX had sustained lower HAM-D scores at 12 and 24 weeks, 6MWT distances were significantly greater at 12 (P=018) and 24 (P=013) weeks, and the greatest improvement in HRQOL also occurred. Conclusions: Interventions designed to improve both physical and psychological symptoms may provide the best method for optimizing functioning and enhancing HRQOL in patients with HF.

Original languageEnglish (US)
Pages (from-to)119-131
Number of pages13
JournalJournal of Psychosomatic Research
Volume69
Issue number2
DOIs
StatePublished - Aug 2010

Keywords

  • Cognitive behavioral therapy
  • Depression
  • Heart failure
  • Home-based exercise

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Fingerprint Dive into the research topics of 'Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure'. Together they form a unique fingerprint.

  • Cite this