Physical Activity and Physical Performance among Patients with Heart Failure in Indonesia

ABSTRACT

Background: Heart failure (HF) is a condition in which the heart cannot function properly and does not pump blood efficiently throughout the body. This causes impaired physical performance and limitations in terms of physical activity (PA). Previous studies have shown that HF patients engage in a low level of PA, and many factors can affect their degree of engagement. However, little is known about the patients’ physical performance related to doing day to day tasks before advising them to engage in PA.
Purpose: This cross-sectional study examined the relationship between physical performance and PA among patients with HF.
Method: A convenience sample of 155 heart failure patients was recruited from a cardiology outpatient department at a public hospital in Indonesia. The short form of an International Physical Activity Questionnaire (IPAQ-SF) was used to assess PA, and the 6MWT was applied to measure physical performance. Descriptive statistics, bivariate analyses (independent t-tests, a one-way ANOVA, and a Pearson correlation), and a multiple regression analysis were utilized to analyse the data.
Results: Of the 155 participants, 57% were males, and the mean age was 55.5 years old. The mean duration since the HF diagnosis was 37.3 months, with 91 (59%) in New York Heart Association (NYHA) class II and 50 (32%) in class III. The average walking distance was 333.55 meters with a mean total PA score (METs) of 598.52 METs. More than half (64%) of participants had low PA levels. The bivariate analysis showed that gender (t = -6.13, p < .001), education (t = 4.00, p < .001), atrial fibrillation (t = 2.03, p < .05), use of diuretics (t = 3.78, p < .001), NYHA functional class (F = 73.85, p < .001), and SpO2 (r = .28, p < .01) were significantly associated with physical performance. Meanwhile, PA was significantly associated with gender (t = -2.62, p < .05), education (t = 3.50, p < .01), SpO2 (r = .21, p < .05), and NYHA functional class (F = 32.67, p < .001). Physical performance was significantly associated with PA (r = .51, p < .001). However, the multiple regression analysis showed only NYHA functional class (beta = -.42, t = -2.30, p = .003) to be significantly associated with PA.
Conclusion: Approximately 64% of the participants had low PA. The study findings did not support the study hypothesis positing that physical performance was significantly associated with PA after adjusting for demographic- and illness-related factors. When trying promote PA in patients with HF, it is necessary to consider their disease severity (NYHA class), which is the most important factor affecting PA. These findings can add to existing knowledge by highlighting several factors that need to be considered in order to design an effective program to increase physical activity among patients with HF.

Keywords: Physical activity, Physical performance, Heart failure, 6-MWT

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