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. 2022 Oct 21;23(11):356.
doi: 10.31083/j.rcm2311356. eCollection 2022 Nov.

Early Exercise-Based Rehabilitation for Patients with Acute Decompensated Heart Failure: A Systemic Review and Meta-Analysis

Lisong Liu  1 , Jun Chen  2 , Ning Zhao  3 , Mingming Zhang  4 , Lihui Zhou  4 , Xiaoxia Ren  5 , Ting Zhang  5 , Pengcheng Zhao  5 , Dayi Hu  6 , Xingxue Pang  5 , Zhongyi Jin  5
Affiliations

Early Exercise-Based Rehabilitation for Patients with Acute Decompensated Heart Failure: A Systemic Review and Meta-Analysis

Lisong Liu et al. Rev Cardiovasc Med. .

Abstract

Background: Cardiac rehabilitation is an important part of the therapeutic regimen for chronic heart failure. Acute decompensated heart failure (ADHF) in hospitalized patients were usually excluded from cardiac rehabilitation programs. The initiation of cardiac rehabilitation with ADHF usually occurs after hospital discharge. This study included recent clinical trials in patients beginning early exercise-based rehabilitation during their hospitalization and compared the efficacy and safety of early cardiac rehabilitation to ADHF patients who didn't receive cardiac rehabilitation.

Methods: Clinical trials were searched from the EMBASE, PubMed, CENTRAL, and WAN FANG. We included randomized controlled trials (RCTs) in which early exercise-based rehabilitation started during the index hospitalization, from the establishment of the database to July 2022. RevMan 5.4 was used for the statistical analysis.

Results: Six studies, with a total of 668 patients were included; 336 patients in the early rehabilitation group and 332 patients in the control group. Exercise capacity was significantly improved in the 6-minute walk distance [mean difference (MD): 32.97, 95% CI: 31.03 to 34.90, p < 0.00001], and the Short Physical Performance Battery (MD: 1.40, 95% CI: 1.35 to 1.44, p < 0.00001). The rate of all-cause rehospitalization was significantly decreased in the early rehabilitation group (OR: 0.67, 95% CI: 0.45 to 0.99, p = 0.04).

Conclusions: Early exercise-based rehabilitation for eligible ADHF in-patients starting during, or early after, hospitalization could significantly improve exercise capacity. A transitional, individualized, progressive, exercise-based rehabilitation program during hospitalization combined with post-discharge clinic rehabilitation is an integrated rehabilitation strategy for acute decompensated heart failure.

Keywords: 6-minute walk distance; SPPB; cardiac rehabilitation; heart failure.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Selection flow chart of literature screening.
Fig. 2.
Fig. 2.
Forest plot illustrating a comparison of the efficacy between early exercise-based rehabilitation and the control. (A) 6-minute walk distance. (B) Short Physical Performance Battery (SPPB). (C) Quality of Life.
Fig. 3.
Fig. 3.
Assessment of probable bias by the included trials.
See this image and copyright information in PMC

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References

    1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal . 2021;42:3599–3726. - PubMed
    1. Sanchez E, Vidan MT, Serra JA, Fernandez-Aviles F, Bueno H. Prevalence of geriatric syndromes and impact on clinical and functional outcomes in older patients with acute cardiac diseases. Heart . 2011;97:1602–1606. - PubMed
    1. Cheng RK, Cox M, Neely ML, Heidenreich PA, Bhatt DL, Eapen ZJ, et al. Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population. American Heart Journal . 2014;168:721–730.e3. - PubMed
    1. Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, et al. Cardiac Rehabilitation for Patients with Heart Failure. Journal of the American College of Cardiology . 2021;77:1454–1469. - PubMed
    1. Kitzman DW, Whellan DJ, Duncan P, Pastva AM, Mentz RJ, Reeves GR, et al. Physical Rehabilitation for Older Patients Hospitalized for Heart Failure. New England Journal of Medicine . 2021;385:203–216. - PMC - PubMed

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