Effects of Home-Based Exercise on Depression, Anxiety, Functional Capacity, and Quality of Life in Patients With Heart Failure With Reduced Ejection Fraction

BACKGROUND: Structured exercise programs have been shown to improve functional capacity and mitigate depressive symptoms in various populations. However, no review has examined the effects of home-based exercise on depression in patients with heart failure with reduced ejection fraction (HFrEF). PURPOSE: The objective of this study is to evaluate the effects of home-based exercise in patients with HFrEF. METHODS: Seven databases were searched from inception until August 2024. The Cochrane Risk of Bias Tool was used to assess study quality. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was quantified using Hedges g and 95% confidence interval (CI) using a random-effects model. Heterogeneity was examined using Q values and I 2 statistics. Moderator analysis was performed to identify sources of heterogeneity. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations system. RESULTS: Thirteen randomized controlled trials were included. Home-based exercise had a significant effect on depression ( g = -0.298; 95% CI, -0.470 to -0.125; P = .001; I 2 = 0%), anxiety ( g = -0.217; 95% CI, -0.414 to -0.020; P = .031; I 2 = 0%), peak oxygen consumption ( g = 0.551; 95% CI, 0.160-0.941; P = .006; I 2 = 74.29%), 6-minute walking distance ( g = 0.692; 95% CI, 0.272-1.112; P = .001; I 2 = 81.12%), and quality of life ( g = -0.778; 95% CI, -1.206 to -0.350; P < .001; I 2 = 84.62%). CONCLUSION: Home-based exercise may be effective in mitigating depression and anxiety in patients with HFrEF.