Adding steps can help heart failure patients walk their way back to good health

ANN ARBOR, Mich. — Patients with heart failure can improve their health simply by increasing the number of steps they take on their daily walk, a new study reveals. Researchers suggest that using a step counter could be clinically meaningful and could help inform future trials and medical care.

Patients were evaluated on a scale of zero to 100 based on their physical limitations, frequency of symptoms, quality of life, and social limitations. A higher score on this scale indicated better health. Each person wore a Fitbit-like health tracker for a duration of 12 weeks. The research team found that exercise became easier for the participants who walked more, and these individuals also reported fewer symptoms.

By the end of the 12 weeks, the entire study group had increased their walking habits, leading to an improvement in their physical limitation scores by four points. Their average score at week two was 55.7 out of 100. Moreover, their average score for symptom frequency improved by 2.5 points over the same period.

Those who experienced more frequent symptoms of heart failure averaged 2,473 steps a day, with a total symptom score between zero and 24. Among the 425 participants, those who scored between 75 and 100 averaged 5,351 daily steps.

Woman in sneakers walking — Photo by Sincerely Media on Unsplash

“Given the increasing availability of wearable technology to monitor physical activity, there is a pressing need to understand the clinical significance of changes in activity,” says Jessica Golbus, MD, MS, first author of the study and clinical instructor in the Division of Cardiovascular Diseases and the Department of Internal Medicine at the University of Michigan, in a media release.

“[Our research showed] increased step counts were significantly associated with improvements in health status, suggesting that increases in step count over time as assessed by a wearable device may be clinically meaningful.”

“What does this mean at the end of the day? If providers see improvements in step counts, then that is a good thing and reflects that patients’ health status is likely improving,” Golbus continues. “However, seeing a decrease in step counts does not necessarily mean the converse and would not necessarily require an intervention. It might mean following up with a patient though.”

The study showed that regardless of how their disease manifested, participants climbed an average of 2.7 floors a day. The most significant improvement was observed among participants who increased their daily step count between 1,000 and 5,000 steps. Beyond the 5,000-step mark, further increases in daily steps did not make a notable difference. Participants who walked 2,000 steps a day had total symptom scores 3.11 points higher than those who only managed 1,000. Meanwhile, those achieving 3,000 daily steps scored 2.89 points higher in the same area.

However, Dr. Mitchell Psotka, from Inova Schar Heart and Vascular Institute in Falls Church, Virginia, says actigraphy — quantifying physical movement using steps — is a promising but not completely established tool for clinical and research purposes.

“These data are part of a large body of necessary and incremental work that will be required for actigraphy to attempt to achieve its potential as a patient-centered and efficient measure of functional status,” Psotka says.

“The authors have thankfully moved our understanding of actigraphy forward, though it is still the new kid on the block and will require substantial further testing and validation prior to widespread reliable clinical and research use.”

The researchers acknowledged the study was limited as commercially available devices, such as Fitbit, may not be optimal for monitoring the functional performance of patients with chronic disease.

The findings are published in JACC: Heart Failure.