Are older heart patients with poorer initial physical performance more likely to improve during cardiac rehabilitation?

Details

Cardiac rehabilitation (CR) improves clinical and functional recovery in older patients after acute cardiac syndromes. Their outcomes are influenced not only by cardiac disease severity but also by comorbidity and frailty. This study aimed to identify predictors of improvement in physical frailty during CR.

This observational study collected data on all patients older than 75 years consecutively admitted to the researchers’ CR program from 1 January through December 2017. The program lasted four weeks, with 30-minute sessions five days per week, alternating biking and calisthenics on different days. Physical frailty was measured at entry and at the end of CR using the Short Physical Performance Battery (SPPB). The study defined improvement as an increase of at least 1 point in the SPPB score from baseline to the end of the program.

The study included 100 patients, with a mean age of 81 years. Poorer baseline SPPB performance was a strong predictor of improvement: for each 1-point lower baseline score, the odds ratio for improved physical performance at the end of CR was 2.50 (95% CI = 1.64–3.85; p = 0.001). Patients who performed worse on the SPPB balance and chair-standing tasks also had a greater likelihood of improvement in their physical frailty profile by the end of CR.

The authors concluded that their data strongly suggest significant improvement in physical frailty during CR after acute cardiac syndrome among patients with a worse initial frailty profile, particularly those with impaired chair standing or balance at entry.