Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study

<b>Background/Objectives</b>: It is unknown how early exercise therapy combined with acupuncture (AP) affects the speed of recovery in patients suffering from heart failure with reduced ejection fraction (HFrEF) who are hospitalized due to worsening HF. <b>Methods</b>: A pros...

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Main Authors: Dejan Ilic, Zoran Jovic, Zorica Mladenovic, Vesna Pejovic, Branislava Lung, Aleksandra Kozic, Slobodan Obradovic
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/1/176
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author Dejan Ilic
Zoran Jovic
Zorica Mladenovic
Vesna Pejovic
Branislava Lung
Aleksandra Kozic
Slobodan Obradovic
author_facet Dejan Ilic
Zoran Jovic
Zorica Mladenovic
Vesna Pejovic
Branislava Lung
Aleksandra Kozic
Slobodan Obradovic
author_sort Dejan Ilic
collection DOAJ
description <b>Background/Objectives</b>: It is unknown how early exercise therapy combined with acupuncture (AP) affects the speed of recovery in patients suffering from heart failure with reduced ejection fraction (HFrEF) who are hospitalized due to worsening HF. <b>Methods</b>: A prospective, sham-procedure-controlled, double-blind, randomized clinical trial with three patient groups was conducted. The study included patients with HFrEF who were hospitalized for worsening HF. After initial stabilization, patients were randomly assigned to three groups, the controls (C) treated with optimal drug therapy (ODT); E1 received ODT with kinesitherapy, and sham AP; E2 received ODT, kinesitherapy, and needle AP aiming to enhance compensation. Improvement in physical activity was measured by the modified Barthel index (A test), 2 or 6 min walking tests, an endurance walking test, and decrease of blood brain natriuretic peptide (BNP). <b>Results</b>: A total of 120 patients completed the study. The average age was 74 years, 73.3% were male, median EF was 32%, and 83.3% were New York Heart Association (NYHA) Class III. After the fifth day of therapy, the E2 group showed the greatest improvement in the A test compared to other groups (<i>p</i> = 0.022). After 5 days, 80%, 50%, and 10% achieved an A test score of 30 or higher, demonstrating functional independence, (<i>p</i> < 0.01) in the E2, E1, and C groups, respectively. At hospital discharge, the E2 group showed significantly better walking endurance compared to the E1 and C groups (<i>p</i> < 0.001). At discharge, BNP decreased significantly more in both E groups, compared to the C group. <b>Conclusions</b>: Short-term early rehabilitation with AP and kinesitherapy significantly improves the functional status of HFrEF decompensated patients when compared to kinesitherapy alone and ODT.
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spelling doaj-art-ff7cdd0e42f24d76803399ab1d2f823a2025-01-24T13:24:17ZengMDPI AGBiomedicines2227-90592025-01-0113117610.3390/biomedicines13010176Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical StudyDejan Ilic0Zoran Jovic1Zorica Mladenovic2Vesna Pejovic3Branislava Lung4Aleksandra Kozic5Slobodan Obradovic6Clinic for Physical Medicine and Rehabilitation, Military Medical Academy, 11000 Belgrade, SerbiaClinic for Cardiology, Military Medical Academy, 11000 Belgrade, SerbiaClinic for Cardiology, Military Medical Academy, 11000 Belgrade, SerbiaClinic for Physical Medicine and Rehabilitation, Military Medical Academy, 11000 Belgrade, SerbiaClinic for Physical Medicine and Rehabilitation, Military Medical Academy, 11000 Belgrade, SerbiaMedical Faculty of the Military Medical Academy, University of Defense, 11000 Belgrade, SerbiaClinic for Cardiology, Military Medical Academy, 11000 Belgrade, Serbia<b>Background/Objectives</b>: It is unknown how early exercise therapy combined with acupuncture (AP) affects the speed of recovery in patients suffering from heart failure with reduced ejection fraction (HFrEF) who are hospitalized due to worsening HF. <b>Methods</b>: A prospective, sham-procedure-controlled, double-blind, randomized clinical trial with three patient groups was conducted. The study included patients with HFrEF who were hospitalized for worsening HF. After initial stabilization, patients were randomly assigned to three groups, the controls (C) treated with optimal drug therapy (ODT); E1 received ODT with kinesitherapy, and sham AP; E2 received ODT, kinesitherapy, and needle AP aiming to enhance compensation. Improvement in physical activity was measured by the modified Barthel index (A test), 2 or 6 min walking tests, an endurance walking test, and decrease of blood brain natriuretic peptide (BNP). <b>Results</b>: A total of 120 patients completed the study. The average age was 74 years, 73.3% were male, median EF was 32%, and 83.3% were New York Heart Association (NYHA) Class III. After the fifth day of therapy, the E2 group showed the greatest improvement in the A test compared to other groups (<i>p</i> = 0.022). After 5 days, 80%, 50%, and 10% achieved an A test score of 30 or higher, demonstrating functional independence, (<i>p</i> < 0.01) in the E2, E1, and C groups, respectively. At hospital discharge, the E2 group showed significantly better walking endurance compared to the E1 and C groups (<i>p</i> < 0.001). At discharge, BNP decreased significantly more in both E groups, compared to the C group. <b>Conclusions</b>: Short-term early rehabilitation with AP and kinesitherapy significantly improves the functional status of HFrEF decompensated patients when compared to kinesitherapy alone and ODT.https://www.mdpi.com/2227-9059/13/1/176acupuncturekinesitherapyearly rehabilitationheart failure
spellingShingle Dejan Ilic
Zoran Jovic
Zorica Mladenovic
Vesna Pejovic
Branislava Lung
Aleksandra Kozic
Slobodan Obradovic
Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
Biomedicines
acupuncture
kinesitherapy
early rehabilitation
heart failure
title Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
title_full Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
title_fullStr Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
title_full_unstemmed Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
title_short Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study
title_sort acupuncture and kinesitherapy improve physical activity more than kinesitherapy alone in patients with acute decompensated chronic heart failure with reduced ejection fraction who are already on optimal drug therapy a randomized sham controlled double blind clinical study
topic acupuncture
kinesitherapy
early rehabilitation
heart failure
url https://www.mdpi.com/2227-9059/13/1/176
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