exercise, functional capacity, heart failure, quality of life, walking



  1. Hong, Kevin MSN, CRNA
  2. Esquivel, Jill Howie PhD, FNP, FAAN


Background: Patients with heart failure (HF) experience decreased functional capacity (FC) and poor quality of life (QOL). Exercise and cardiac rehabilitation programs are an integral part of managing HF because they have been shown to provide a multitude of benefits including improved FC and QOL. In recent years, nonconventional exercise interventions have offered a promising approach for promoting physical activity in patients with HF, thus leading to improved FC and QOL.


Purpose: This review aimed to assess the effects of either supervised or unsupervised, nonconventional exercise interventions on FC and QOL in patients with HF.


Methods: A literature search using PubMed, Web of Science, Cochrane Library, and Science Direct for relevant studies was conducted. Experimental studies that examined nonconventional exercise interventions in adults with HF were eligible for inclusion. Two reviewers independently selected the studies, assessed the quality of the studies, and then narratively synthesized each study.


Results: The authors identified 14 studies that included 879 patients with HF. Most studies were ranked moderate to high quality where 13 studies found significantly improved FC and 10 found significantly improved QOL after nonconventional exercises.


Conclusions: This review provides preliminary evidence that patients with HF may benefit from alternative forms of exercise to improve FC and QOL. Walking was the most frequent exercise, but other nonconventional exercises such as aquatic exercise, dance, resistance training, stretching, Tai Chi, and yoga are also promising interventions that may improve FC and QOL in patients with HF.


Clinical Implications: Nonconventional exercise can be a convenient and alternative method of exercise versus traditional cardiac rehabilitation, thereby providing new opportunities that can lead to improved FC and QOL.