Exercise, Counseling Benefits Depressed Heart Failure Patients
THURSDAY May 1, 2008 -- Exercise and counseling are the prescription for improving the quality of life of heart failure patients who suffer depression, a new report says.
Aerobic exercise -- such as walking outdoors -- paired with cognitive behavioral therapy aimed at improving the patient's attitude boosted physical abilities and reduced symptoms of depression, according to researchers who were expected to present their findings Thursday at the American Heart Association's Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke in Baltimore.
In the study, researchers divided 74 heart failure patients with clinical depression into four groups: One group received a 12-week, home-based program of exercise and psychological counseling; one received counseling alone; another did only exercise; and the last received only standard care.
"By combining exercise with psychological counseling, these depressed patients do better in all parameters compared to the other groups," study author Rebecca Gary, an assistant professor in the School of Nursing at Emory University in Atlanta, said in a prepared statement. "This may be the best method for improving their depression, symptom severity and quality of life."
Patients who exercised followed a progressive program of low-to-moderate intensity in which they were encouraged to walk outdoors three times a week for at least 30 minutes. They received heart rate monitors and training in how to track their exertion level and when to stop exercising. All patients achieved these goals, even though some were quite debilitated at the start of the sessions.
Those receiving counseling had weekly one-on-one cognitive therapy sessions in their homes with psychiatric nurse specialists and doctoral students trained in counseling techniques for 12 weeks.
"The cognitive behavioral therapy was geared toward changing the attitude of the patients about their illness," Gary said. "We wanted them to change their negative thoughts and beliefs, and restructure and reformat how they think about their illness and limitations. For example, we developed a volunteer and activities sign-up sheet in each community that provided transportation for those who wanted to get out of the home or contribute in some way."
Patients combining exercise and behavioral therapy improved significantly in a six-minute walk test than the other groups. They also had fewer symptoms of depression than those having only standard care.
Oddly, even though those in the counseling-only group had fewer depressive symptoms after therapy, they believed their quality of life was worse than those of the combined group or exercise-only group.
The American Academy of Family Physicians has more about depression and heart failure.
Posted: May 2008
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