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NIH Record - National Institutes of Health

Tailored, Earlier Cardiac Rehab Shows Benefits

A doctor holds a stethoscope up to an older adult's heart

Research shows tailored, earlier cardiac rehab can benefit heart failure patients.


New research shows that an innovative cardiac rehabilitation intervention started earlier and more custom-tailored to the individual improved physical function, frailty, quality-of-life and depression in hospitalized heart failure patients, compared to traditional rehab programs. These findings, supported by NIA, were published in the New England Journal of Medicine.

“These results mark encouraging progress on a path to better overall quality-of-life and physical function for the millions of older Americans who develop heart failure each year,” said NIA director Dr. Richard Hodes.

For this new study, a research team followed 349 people with heart failure enrolled in “A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients” (REHAB-HF). Participants had an average of five comorbidities—diabetes, obesity, high blood pressure, lung disease or kidney disease—that also contributed to loss of physical function.

In an earlier pilot study, researchers found striking deficits in strength, mobility and balance in older patients with acute heart failure, along with the expected loss of endurance, worsened by the prescribed lengthy bedrest. The REHAB-HF team designed earlier and more customized exercise programs that emphasized improving these areas of physical function. 

The team also began REHAB-HF during a patient’s hospital stay when feasible instead of waiting until the traditional 6 weeks after discharge. After release from the hospital, study participants shifted to outpatient sessions 3 times per week for 3 months.

Compared to a control group that received usual cardiac rehab care, REHAB-HF participants showed marked gains in measures of physical functioning and overall quality-of-life, including significant progress in a series of tests to evaluate lower extremity function and mobility. They also had notable improvements in self-perception of their health status. And, more than 80 percent of REHAB-HF participants reported they were still doing their exercises 6 months after completing the study. The research team plans to expand REHAB-HF into larger and longer-term trials with broader participant subgroups.

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