Physical Rehabilitation for Older Patients Hospitalized for Heart Failure

This multicenter randomized controlled trial (REHAB-HF) assessed the impact of a transitional, tailored, progressive physical rehabilitation program in older patients hospitalized for acute decompensated heart failure. The intervention targeted four domains strength, balance, mobility, and endurance, with 36 outpatient sessions initiated during or shortly after hospitalization. Among 349 randomized patients (mean age 72.7; 97% frail or prefrail), the 3-month Short Physical Performance Battery score improved significantly with intervention (8.3 ± 0.2 vs. 6.9 ± 0.2 in controls; difference: 1.5 points; 95% CI: 0.9 to 2.0; P<0.001). Secondary outcomes showed no significant reduction in 6-month all-cause rehospitalization (rate ratio: 0.93; 95% CI: 0.66 to 1.19) or mortality (rate ratio: 1.17; 95% CI: 0.61 to 2.27). However, intervention patients showed marked improvement in endurance (mean walking time doubled), frailty status, mood (Geriatric Depression Scale −0.7 points), and quality-of-life metrics (KCCQ +7.1 points). Benefits were consistent across subgroups. 

This multicenter randomized controlled trial (REHAB-HF) assessed the impact of a transitional, tailored, progressive physical rehabilitation program in older patients hospitalized for acute decompensated heart failure. The intervention targeted four domains strength, balance, mobility, and endurance, with 36 outpatient sessions initiated during or shortly after hospitalization. Among 349 randomized patients (mean age 72.7; 97% frail or prefrail), the 3-month Short Physical Performance Battery score improved significantly with intervention (8.3 ± 0.2 vs. 6.9 ± 0.2 in controls; difference: 1.5 points; 95% CI: 0.9 to 2.0; P<0.001). Secondary outcomes showed no significant reduction in 6-month all-cause rehospitalization (rate ratio: 0.93; 95% CI: 0.66 to 1.19) or mortality (rate ratio: 1.17; 95% CI: 0.61 to 2.27). However, intervention patients showed marked improvement in endurance (mean walking time doubled), frailty status, mood (Geriatric Depression Scale −0.7 points), and quality-of-life metrics (KCCQ +7.1 points). Benefits were consistent across subgroups.