Physical activity is associated with improved survival and better quality of life for people with chronic heart failure. Previous research by the group based in the Centre for Academic Primary Care showed that many people with heart failure want to be more physically active but are uncertain about how much and what type of activity they should do. Health professionals are unsure how to support this mostly older population of patients, many of whom have no or limited access to cardiovascular rehabilitation programmes.
This new study explored how people with heart failure think about and approach being physically active, and what helps or hinders them.
The researchers reviewed data from 25 previous studies, involving 483 people with heart failure, 64 carers, and 12 healthcare professionals, offering a comprehensive view of the challenges and motivations surrounding physical activity participation in this group. Using insights from this review, they had conversations with people with heart failure, health professionals and charities to produce a blueprint to design future supportive services.
Factors that affected whether people with heart failure felt confident or able to be physically active were:
- fluctuating physical symptoms
- emotional factors, including low mood and fear
- external factors, such as living conditions, the weather and costs
- lack of knowledge or access to advice about their condition, physical activity or the benefits of regular physical activity
- levels of personal motivation to engage in physical activity
- influence of others, for example friends, family, healthcare professionals
- positive experiences of physical activity.
The study recommends a personalised approach to physical activity facilitated by health professionals focusing on both physical and mental health. This needs to be practical and slotted into people’s everyday routine, allowing the person to adapt it if needed. Some people found it useful to track and monitor their activity, rewarding themselves for progress.
People with heart failure need the reassurance and support of health professionals who know them. This includes providing access to clear information and advice on how physical activity can benefit them, addressing any concerns, and signposting them to local support groups. Many people found support from other people with heart failure important, and may be inspired by success stories from people they can relate to.
Dr Alyson Huntley, Senior Research Fellow in Evidence-based Primary Health Care at the Centre for Academic Care, said: “People with heart failure tell us that physical limitations of the diagnosis are a significant barrier to being physically active, and feelings of fear, anxiety, and low self-esteem are common. However, despite challenges, many people with heart failure report experiencing significant physical and emotional benefits from engaging in physical activity.”
Dr Rachel Johnson, GP and Associate Professor in Primary Care at the Centre for Academic Primary Care, said: “This study is an important step toward designing supportive services tailored to the needs of people with heart failure, empowering them to engage in physical activity safely and confidently. While the findings provide valuable insight to participation in physical activity by people with heart failure, the study also highlights the need for further research. We are currently exploring the perspectives of community healthcare professionals in order to understand how they can respond to their patients’ needs.”
The research was part of the National Institute for Health and Care Research (NIHR) funded HAPPY (Heart failure And Participation in Physical activitY) Study.
Paper: What are the experiences of people with heart failure regarding participation in physical activity? A systematic review, meta-aggregation and development of a logic model. Lorna Duncan et al. Published in BMJ Open. 5 April 2025.