Impact of a Physical Exercise Program on the Self-care Capacity of People Hospitalized for Heart Failure

The 6MWT is one of the most widely used instruments to assess an individual's tolerance to exertion. It reflects functional capacity, participant gait autonomy, and effectiveness of the physical exercise training This test should be performed in a 30 to 50 meter corridor that is familiar to the individual. The person is asked to walk as fast as possible over a period of six minutes.

Hand grip strength is essential for performing various daily activities, being a predictive factor of functional capacity, all-cause mortality, cardiac mortality, and predictive of hospital readmission due to decompensated heart failure. It is a force assessment test that measures force production in kilograms. It is easy to apply, and the participant must perform 3 measurements with a dynamometer and the average value calculated is accepted.

This instrument allows the assessment of self-care in the maintenance, management and self-confidence stages of people with heart failure, allowing the identification of the stage(s) in which self-care is compromised. The scale consists of twenty-two items, distributed in three subscales called sections A, B and C. Section A consists of 10 items and is related to the maintenance of self-care. Section B consists of six items related to self-care management. Section C is composed of six items related to confidence in self-care.

This scale evaluates the impact of dyspnea on the various activities of daily living (ADL), in order to measure its limitation. This questionnaire consists of 15 items that are divided into four domains related to personal care, domestic activities, physical activities and leisure, allowing the assessment of the person's degree of dyspnea and the response to a therapeutic intervention. Each of the items is assigned a score from 0 to 5, in which higher values indicate greater limitation in ADL due to dyspnea. A partial score can be obtained for each domain or a global assessment of the scale with a maximum score of 75 points can be used. Given that the program is applied in the context of hospitalization, the partial score is chosen, and the components related to domestic care are not evaluated, and thus the maximum score to be obtained will be 45.

This instrument consists of 3 components - orthostatic balance test in 3 different positions, test of the gait speed that the participant can achieve in a 4-meter course and test evaluation of the time it takes the participant to perform 5 repetitions of getting up and sitting down from a chair. The total score varies between 0 and 12 points, in which the highest value corresponds to better mobility and muscle strength of the lower limbs. It is an instrument that is easy to apply and can be used in an inpatient context. A final score lower than 10 is predictive of mortality and hospital readmission. This instrument is valid for inferring about the function and muscle strength of people's lower limbs, which is very useful in the heart failure population, in which loss of muscle mass and strength are generally present and affect tolerance to exertion and competence in the execution of ADLs.

This self-completion tool consists of 21 questions that address the impact of heart failure on physical, emotional and social levels, and the person can choose an answer option ranging from 0 (not applicable), 1 (very little) to 5 (too much). Thus, the total score can vary between 0 and 105, and the greater the sum of the results of all the questions, the greater the impact of the heart failure on the person's life. This scale is also used to assess whether a particular treatment or clinical program for heart failure improves the quality of life of individuals by reducing the adverse effects that the disease causes.