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Exercising with video games improves quality of life in patients with heart failure

Heart Failure

Vienna, Austria – 27 May 2018:  

Playing video games that involve physical exertion (known as exergaming) improves quality of life in patients with heart failure, according to late breaking results from the HF-Wii study presented today at Heart Failure 2018 and the World Congress on Acute Heart Failure, a European Society of Cardiology congress (1).

Professor Tiny Jaarsma, principal investigator of the study, of Linköping University, Sweden, said: “Exergaming is an alternative way for patients with heart failure to be physically active. It increases their fitness and can improve their wellbeing because they can do more in their day-to-day life.”

The HF-Wii study assessed whether exergaming, for example standing in front of a TV set and playing virtual tennis, improves exercise capacity and other outcomes in patients with heart failure. The study design has been previously published(2). Briefly, 605 patients with heart failure were randomised to the exergame or standard exercise advice. Patients in the exergame group had the game installed in their home, a tutorial on how to play, and were advised to play for 30 minutes a day. Patients in the standard exercise group were advised to be physically active for 30 minutes a day.

Exercise capacity was measured using the six-minute walk test. At the start of the study, there was no difference between groups in the distance walked. Results of the primary analysis, presented at ESC Congress 2017, showed that after three months patients in the exergame group could walk significantly farther – 33 metres more on average – than those in the standard exercise group.

Today researchers are presenting results on the impact of exergaming on quality of life, anxiety, and depression, which were assessed by validated questionnaires at the start of the study and at three months. They found that the exergame group had greater improvement than the standard exercise group in all three variables, but only quality of life reached statistical significance.

Professor Jaarsma said: “Patients in the exergame group had significantly higher quality of life after three months than those who received standard exercise advice. While there was no statistical difference in anxiety and depression, it was encouraging that playing the exergame did not increase anxiety.”

“We think quality of life improved with exergaming because patients could walk further and do more activities around the house with those meters gained,” she continued. “Patients also told us they felt more included socially. They often played the game with friends, their spouse, or grandchildren – ‘they visit to beat grandmother’, said one patient.”

Professor Jaarsma noted: “Patients with heart failure often feel that everything in their lives is negative – they cannot do this, they have to do that. This new way of exercising is something they can do. Exergaming enables them to be active at home.  For example, patients like being able to play tennis for half an hour with their spouse without having to go out.”

The researchers also assessed whether the amount of time spent exergaming was related to the number of meters gained. Surprisingly, patients who played more during the three month period did not walk significantly further during the six minute walk test. This could be explained by the fact that patients who played the most were the healthiest – they walked the furthest at the start of the study and had less room for improvement. But all patients, even the sickest, could walk further after exergaming than at the start of the study.

Professor Jaarsma said: “While we cannot specify the number of minutes that should be played to achieve the best results, we can say that exergaming can be beneficial for patients with heart failure.”

On behalf of her co-authors, Professor Anna Strömberg and Dr Leonie Klompstra, she concluded: “Exercise is recommended for all patients with heart failure (3) but many don’t do it because they feel too tired to go out, the weather is too bad, or they’re not motivated. Exergaming is an ideal option for some patients.”



Notes to editor

Authors: ESC Press Office
Tel: +33 (0)4 8987 2499
Mobile: +336 (0) 2314 5784

SOURCES OF FUNDING: The study was sponsored by the Swedish National Science Council, Swedish Heart and Lung Association, Swedish Heart-Lung Foundation, Vårdal Foundation, Regional Funding FORSS (474681), VR-FORTE Linköping University.




References and notes

1The abstract ‘The HF-Wii study: Improving exercise capacity of patients with heart failure through exergaming: Secondary outcomes and per protocol analysis of an international multicenter RCT’ will be presented during the session Late breaking trial II – Chronic heart failure which takes place on 27 May from 08:30 to 10:00 CEST in room Vienna.

2Jaarsma TKlompstra LBen Gal T, et al. Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: the rationale, design and methodology of the HF-Wii study; a multicentre randomized controlled trial. Eur J Heart Fail. 2015;17:743–748.

3Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37(27):2129–2200.


About Heart Failure 2018 and the World Congress on Acute Heart Failure

Heart Failure and the World Congress on Acute Heart Failure are annual congresses of the Heart Failure Association (HFA) of the ESC.


About the Heart Failure Association

The Heart Failure Association (HFA) is a branch of the ESC. Its aim is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.


Information for journalists attending Heart Failure 2018

Heart Failure 2018 and the World Congress on Acute Heart Failure will be held 26 to 29 May at the Messe Wien in Vienna, Austria. Read the full scientific programme.

  • To register on-site please bring avalid press card or appropriate letter of assignment with proof of three recent published articles (cardiology or health-related, or referring to a previous ESC Event).
  • Press registration is not available to industry or its public relations representatives, event management, marketing or communications representatives.