Heart failure and promotion of physical activity before and after cardiac rehabilitation (HF-aPProACH): a study protocol

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
66 Downloads (Pure)


Aims: Lifestyle changes, such as increasing physical activity (PA), are a cornerstone of treatment of patients with chronic heart failure (HF). However, improving PA in HF patients is challenging, and low participation rates for cardiac rehabilitation (CR) as well as relapse to low PA levels after CR are major issues. We designed a randomized controlled trial to investigate if PA monitoring with motivational feedback before and after centre-based CR in HF patients with reduced ejection fraction (HFrEF) will lead to a clinically meaningful increase in physical fitness. Methods and results: A randomized controlled trial will be conducted in a sample of 180 HFrEF patients (New York Heart Association Class II/III) who are referred to 12-week standard CR. Patients will be randomized (2:1) to (1) standard of care (SoC) plus wearing a PA monitoring device (Fitbit Charge 3) with personalized step goals, feedback and motivation or (2) SoC only. The intervention lasts ±7 months: 4–5 weeks before CR, 12 weeks during CR and 12 weeks after CR. Measurements will take place at three time points. The primary endpoint is the change in the distance in 6-min walking test (6MWT) over the entire study period. Other endpoints include step count, grip strength, quality of life and all-cause mortality or hospitalization. Conclusions: HF-aPProACH will provide novel information on the effectiveness of remote PA stimulation and feedback before, during and after standard CR using a commercially available device to improve physical fitness in HFrEF patients.

Original languageEnglish
Pages (from-to)3621-3627
Number of pages7
JournalESC heart failure
Issue number5
Early online date16 Jul 2021
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
This work was supported by the European Union's Horizon 2020 research and innovation programme (780495). Any dissemination of results here presented reflects only the author's view. The Commission is not responsible for any use that may be made of the information it contains.

Publisher Copyright:
© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.


Dive into the research topics of 'Heart failure and promotion of physical activity before and after cardiac rehabilitation (HF-aPProACH): a study protocol'. Together they form a unique fingerprint.

Cite this