Authors: (including presenting author): :
SO KYK(1), LIN ACY(1), HO ATC(1), LEE SKW(1), CHAN CMC(2), FONG EYH(2), WONG CY(2), CHAN ACM(1)
Affiliation: :
(1) Physiotherapy Department, Queen Elizabeth Hospital (2) Department of Medicine, Queen Elizabeth Hospital
Keyword 1: :
Heart Failure
Keyword 2: :
Domiciliary Physiotherapy
Keyword 3: :
Functional Capacity
Keyword 4: :
Ambulation Status
Introduction: :
Heart failure (HF) is a progressive disorder characterized by the impaired cardiac function, leading to dyspnea, exercise intolerance, and reduced quality of life (QoL). American Heart Association/ European Society of Cardiology recommended that all patients with heart failure should be introduced to exercise training along their disease trajectory in order to improve their functional status, exercise capacity and QoL. However, symptoms progression of diminished physical status created barriers to HF patients to conventional center‑based rehabilitation and also resulted in social isolation. Home-based program could be a solution to enhance the accessibility of frail HF patients to cardiac rehabilitation (CR). Other than centre-based training, Comprehensive Heart Failure Program (CHFP) at Queen Elizabeth Hospital (QEH) introduced domiciliary physiotherapy (DPT), a tailored home‑based CR service integrating individualized exercise, home environment assessment, caregiver education, disease management, and well supported by timely and close collaboration with the clinical team.
Objectives: :
This study aimed to evaluate the effectiveness of CHFP-DPT service on functional capacity and ambulation status in patients with HF.
Methodology: :
This retrospective study reviewed patients receiving CHFP-DPT service between June 2023 and December 2025. Functional capacity and ambulation were assessed during initial and discharge home visits by the Timed Up and Go Test (TUGT), Modified Functional Ambulation Classification (MFAC) and New York Heart Association (NYHA) classification. Normality and variance between pre- and post-intervention measures were analyzed using the Kolmogorov-Smirnov test and Wilcoxon Signed‑Rank test respectively.
Result & Outcome: :
Among 35 patients included for analysis, 24 (69%) were female. The mean age was 80.5±5.4, ranged from 64 to 93. The average number of DPT sessions was 6.3±4.6. Statistically significant improvements were demonstrated in TUGT, MFAC and NYHA classification (p< 0.05). The mean time of TUGT improved from 17.3±5.3 to 14.5±5.7 seconds, with a mean reduction of 2.8 seconds. Twenty-three patients (66%) demonstrated advancement of at least one category in MFAC, and 17 patients (49%) attained category 7 (outdoor walker). Fifteen patients (43%) showed improvement in NYHA classification, including 11 patients progressing from Class III to Class II/I and 4 patients from Class II to Class I. CHFP home-based training service demonstrated significant improvement in the functional capacity and ambulatory status of patients with HF, enhancing their functional independence with decreasing exercise intolerance, which would facilitate social/ community engagement.
