Real-World Evidence of Feasible Assessment and Intervention in Cardiovascular Physical Therapy for Older Patients With Heart Failure - Insight From the J-Proof HF of the Japanese Society of Cardiovascular Physical Therapy

来自日本心血管物理治疗学会J-Proof HF项目的启示:针对老年心力衰竭患者的心血管物理治疗可行性评估和干预的真实世界证据

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Abstract

BACKGROUND: This study aimed to clarify the feasibility of cardiovascular physical therapy assessment and intervention in older patients with heart failure (HF) in Japan. METHODS AND RESULTS: We performed a secondary analysis of data from a nationwide multicenter registry (the J-Proof HF), and enrolled consecutive HF patients aged ≥65 years who were prescribed cardiovascular physical therapy during hospitalization from December 2020 to March 2022. Of the 9,650 enrolled patients (median age 83.0 years; 49.8% male), the availability rate of comorbidities and assessments was >95%. In the activities of daily living (ADL) assessment, the Barthel Index (BI) and Functional Independence Measure were 97.6% and 60.4%, respectively. The results of the physical therapy assessment indicated completion rates of ≥80%, with lower rates of <60% for gait speed and short-performance physical battery in the group with a BI of <85 points. In physiotherapy intervention, gait training and muscle strength training were performed by >80% of patients, whereas aerobic exercise and resistance training were performed by 35.4% and 2.6% patients, respectively. CONCLUSIONS: Our results in this study indicated that medical findings, such as comorbidities, echocardiography, and laboratory findings, were considered a feasible assessment that could be confirmed at all hospitals. Gait training, ADL training, and muscle strength training are much more common than exercise training in older patients with HF.

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