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.

Circulation reports Pub Date : 2024-09-21 eCollection Date: 2024-10-10 DOI:10.1253/circrep.CR-24-0058
Yuji Kono, Koji Sakurada, Yuki Iida, Kentato Iwata, Michitaka Kato, Kentaro Kamiya, Masakazu Saitoh, Masanobu Taya, Yoshinari Funami, Tomoyuki Morisawa, Tetsuya Takahashi
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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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针对老年心力衰竭患者的心血管物理治疗可行评估和干预的现实世界证据--日本心血管物理治疗学会 J-Proof HF 的启示。
背景:本研究旨在明确日本老年心力衰竭患者接受心血管物理治疗评估和干预的可行性:本研究旨在阐明对日本老年心力衰竭(HF)患者进行心血管物理治疗评估和干预的可行性:我们对来自全国多中心登记处(J-Proof HF)的数据进行了二次分析,登记了 2020 年 12 月至 2022 年 3 月住院期间接受心血管物理治疗的年龄≥65 岁的连续心衰患者。在9650名登记患者中(中位年龄83.0岁;49.8%为男性),合并症和评估的可用率大于95%。在日常生活活动(ADL)评估中,巴特尔指数(BI)和功能独立性测量分别为 97.6% 和 60.4%。理疗评估结果显示,完成率≥80%,80%的患者完成率较低,而进行有氧运动和阻力训练的患者分别为35.4%和2.6%:我们的研究结果表明,合并症、超声心动图和实验室检查结果等医学检查结果被认为是一种可行的评估方法,在所有医院都能得到确认。在老年心房颤动患者中,步态训练、ADL 训练和肌力训练比运动训练更为常见。
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