Clinical InvestigationEarly rehabilitation in older patients hospitalized with acute decompensated heart failure: A retrospective cohort study
Section snippets
Study design and participants
The study was conducted under a retrospective cohort design. Study participants were recruited at two hospitals in Yokohama and Nagoya, Japan. Inclusion criteria were as follows: (1) age ≥65 years; (2) visit to the emergency department with ongoing acute decompensation defined as the onset or worsening of HF signs or symptoms, followed by hospitalization for acute HF diagnosed by emergency physicians and confirmed by cardiologists between 1 January 2012 and 31 December 2014; (3) receipt of
Results
From January, 2012 to December, 2014, a total of 1374 patients aged 65 years or older visited the emergency department and were hospitalized for AHF. Among these, we identified 361 patients who were ordered to receive rehabilitation therapy by physicians. Among these, 305 were independent patients who received physical rehabilitation therapy during their hospital stay. After excluding ineligible patients, 259 patients with an average age (SD) of 83.1 (7.7) years were included in this study
Discussion
This study found a relationship between early rehabilitation in ADHF and an improvement in return to independent functional status (mobility) at hospital discharge compared with late rehabilitation. The early rehabilitation group had a higher rate of achievement and required fewer days to be able to walk independently than the late rehabilitation group. Sensitivity analysis suggested that the effect of rehabilitation on walking without assistance was weakened when started later. These findings
Acknowledgements
The authors would like to thank DMC Corp. (www.dmed.co.jp) for providing (medical) English writing and editorial assistance. Additionally, the authors would like to thank the two hospitals for their involvement, the staff at each site for their support with this study, and the patients participating in the study.
Sources of funding
No extramural funding was used to support this work.
Declarations of interest
None.
References (36)
- et al.
Comparison of frequency of frailty and severely impaired physical function in patients ≥60 years hospitalized with acute decompensated heart failure versus chronic stable heart failure with reduced and preserved left ventricular ejection fraction
Am J Cardiol
(2016) - et al.
Hospitalizations after heart failure diagnosis a community perspective
J Am Coll Cardiol
(2009) - et al.
A Novel Rehabilitation Intervention for Older Patients With Acute Decompensated Heart Failure: The REHAB-HF Pilot Study
J Am Coll Cardiol HF
(2017) - et al.
Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale
Am Heart J
(2017) - et al.
Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial
Lancet
(2009) - et al.
Strategies for supporting intervention fidelity in the rehabilitation therapy in older acute heart failure patients (REHAB-HF) trial
Contemp Clin Trials
(2018 Jan) - et al.
Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association
Circulation
(2019) - et al.
Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population
Am Heart J
(2014) - et al.
Frailty and multiple comorbidities in the elderly patient with heart failure: Implications for management
Heart Fail Rev
(2012) - et al.
Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases
Heart
(2011)
Predictive value of the Short Physical Performance Battery following hospitalization in older patients
J Gerontol A Biol Sci Med Sci
Post-hospital syndrome–an acquired, transient condition of generalized risk
N Engl J Med
Change in disability after hospitalization or restricted activity in older persons
JAMA
Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation
Eur J Heart Fail
Evaluation of skeletal muscle function and effects of early rehabilitation during acute heart failure: rationale and study design
Biomed Res Int
EaRly-start ExerciSe training afTer acute hemodynAmic decompensation in patients with chRonic hearT failure (RE-START). A multicenter, randomized, controlled trial on short-term feasibility and impact on functional capacity, symptoms and neurohumoral activation
Monaldi Arch Chest Dis
Functional evaluation: the Barthel Index
Md State Med J
Cited by (13)
Acute-phase initiation of cardiac rehabilitation and clinical outcomes in hospitalized patients for acute heart failure
2021, International Journal of CardiologyCitation Excerpt :Furthermore, the REHAB-HF trial demonstrated that an early, transitional, tailored, progressive rehabilitation resulted in greater improvement in physical function assessed using the Short Physical Performance Battery of older patients hospitalized for acute decompensated HF [27]. The other study examined 259 patients hospitalized with acute HF and showed that early CR was associated with a higher rate of recovery of activities of daily living at 30 days after hospital admission [28]. The results of our study were in line with these previous studies.
The muscle to bone axis (and viceversa): An encrypted language affecting tissues and organs and yet to be codified?
2021, Pharmacological ResearchCitation Excerpt :Despite this, cachexia shares many clinical signs with sarcopenia. Sarcopenia, observed in heart failure is often followed by cachectic syndrome in which loss of skeletal muscle mass is accompanied by loss of body weight [211]. Myostatin, which as previously described negatively regulates muscle growth, in the terminal stages of heart failure is produced by the myocardium and in this context it seems to play a fundamental role in skeletal muscle atrophy [212,213].
Developing Multidisciplinary Management of Heart Failure in the Super-Aging Society of Japan
2024, Circulation JournalAerobic and resistance exercise in heart failure inpatients: a scoping review
2023, Heart Failure Reviews