Physical Rehabilitation of Elderly Patients Hospitalized for Heart Failure
In a diverse population of elderly patients hospitalized for acute uncompensated heart failure, an early, transitional, coordinated, progressive rehabilitation intervention that included multiple domains of physical functioning resulted in significant improvements in physical functioning over usual care.
Dalane W. Kitzman, MD, David J. Whellan, MD, MHS, Pamela Duncan, PT, Ph.D., Amy M. Pastova, PT, Ph.D., Robert J. Menz, MD, Gordon R. Reeves, MD, MPT, M. Benjamin Nelson, MS MS, Haiying Chen, Ph.D., Bharathi Upadhya, MD, Shelby D. Reed, Ph.D., Mark A. Espeland, Ph.D., LeighAnn Hewston, DPT, M.Ed. etal.
Commentary
A multicenter, randomized, controlled trial was conducted to evaluate a rehabilitation intervention focusing on strength, balance, mobility, and endurance in the domains of physical function in older patients hospitalized for acute uncompensated heart failure. A total of 349 patients underwent randomization, with 175 assigned to rehabilitation and 174 to a control group. These patients were assessed as having significantly impaired physical function and 97% as frail, with a reported patient retention rate of 82% in the intervention group and 67% adherence to intervention sessions.
The least squares mean (±SE) score of the Short Physical Performance Battery at 3 months was 8.3 ± 0.2 in the intervention group and 6.9 ± 0.2 in the control group, and at 6 months, the readmission rate for any cause appeared to be 1.
There were 21 deaths (15 from cardiovascular causes) reported in the intervention group and 16 deaths (8 from cardiovascular causes) in the control group, and the mortality rate from all causes was stated to be 0.13 in the intervention group and 0.10 in the control group.
