Efficacy and safety of exercise rehabilitation in the vulnerable phase in patients with acute decompensated heart failure: A systematic review and meta-analysis.
Lihua Zhao, Jing Ye, Zhuo Zhao and 2 others
PMID 40786857WHAT IT FOUND
Exercise rehabilitation in the first three months after discharge for acute heart failure improves walking distance, physical performance, and quality of life.
It reduces all-cause readmissions by six months. However, it does not significantly improve heart pumping function, reduce heart failure-specific readmissions, or lower mortality rates.
Key findings
01Exercise rehabilitation significantly improved the 6-minute walk test distance and Short Physical Performance Battery scores, indicating better functional capacity.
02The intervention reduced the risk of all-cause readmission within 6 months but did not significantly affect heart failure-related readmission or all-cause mortality.
03Safety data showed no adverse events in six studies, though one patient experienced a suspected intervention-related myocardial infarction.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The number of studies included was small (seven RCTs), and sample sizes were modest. There was high heterogeneity in some outcomes, such as quality of life, due to the use of different assessment tools. Most studies did not distinguish between types of heart failure based on ejection fraction, which may mask specific effects. Blinding of participants and personnel was not possible due to the nature of exercise interventions, introducing potential performance bias. The generalizability may be limited by geographical heterogeneity and varying healthcare settings.
Declared interests
The study was funded by the Young Clinical Research Special Fund Project of Peking University First Hospital. The authors declare no competing financial interests or personal relationships.
The easy way to misread this
Do not assume exercise rehabilitation improves heart pumping function (LVEF) or prevents heart failure-specific readmissions. The meta-analysis found no significant difference in these outcomes compared to standard care, despite improvements in walking distance and overall readmission rates.