![]() Diuretics are the mainstay of therapy to relieve congestive or fluid overload symptoms, but often not effective in patients with diuretic resistance or renal insufficiency. The surveillance and management of worsening fluid overload symptoms is the cornerstone of HF care. The occurrence or exacerbation of fluid overload symptoms is the major reason for patients with HF to be admitted or readmitted to hospital, imposing considerable burdens on the individual, family, and health care system. Fluid overload symptoms in patients with HF can be defined as symptoms that impede multiple body system functions due to fluid retention or redistribution and can be categorized into symptoms of pulmonary congestion (e.g., dyspnea, orthopnea, coughing, or wheezing) and systemic venous congestion (e.g., edema, fatigue, bodily pain, and gastrointestinal disturbance). The accumulation of body fluids progressively manifests itself in multiple congestion symptoms, causing patient distress. Fluid overload is the hallmark of HF that leads to hemodynamic and clinical congestion. Heart failure (HF) is a growing public health problem affecting 26 million people worldwide. Future studies with high methodological quality and comprehensive assessment of symptoms and objective measure of fluid overload are warranted. More research should investigate the mechanism of fatigue related to heart failure. Exercise-based interventions seem to have very limited effect on fatigue. In conclusion, exercise-based interventions can be considered as an effective nonpharmacological therapy for patients with heart failure to promote lymph flow and manage fluid overload symptoms. ![]() Findings regarding the effects of exercises on bodily pain, gastro-intestinal symptoms, and peripheral circulatory symptoms were inconclusive due to limited available studies. In contrast, the exercise-based interventions did not improve fatigue compared with usual care (SMD = −0.27 95%CI p = 0.11). Initial evidence from existing limited research showed that exercise-based intervention had positive effect to alleviate edema, yet more studies are needed to verify the effect. We found robust evidence indicating the positive effect of exercises in dyspnea relief (SMD = −0.48 95%CI p = 0.001) the intervention length also influenced the treatment effect (β = 0.033 95%CI p = 0.04). Seventeen studies covering 1086 participants were included. A random-effects meta-analysis was used to estimate the effectiveness, and a subgroup analysis and univariate meta-regression analysis were used to explore heterogeneity. We included randomized controlled trials that compared exercise-based interventions of different modalities and usual medical care for adult patients with heart failure and reported the effects of interventions on any symptoms related to fluid overload. ![]() ![]() MEDLINE, Embase, Cochrane Library, and CINAHL databases were systematically searched for relevant studies published from inception to August 2021. The objective of this systematic review was to examine the effects of exercise-based interventions on fluid overload symptoms among patients with heart failure. Exercise can help the lymphatic system function more effectively to prevent fluid build-up in tissues and interstitium, thus potentially mitigating the symptoms due to fluid overload. Patients with heart failure are subjected to a substantial burden related to fluid overload symptoms. ![]()
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