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Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale.
Am Heart J. 2017 Mar; 185:130-139.AH

Abstract

BACKGROUND

Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF.

HYPOTHESIS

Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization.

STUDY DESIGN

REHAB-HF is a multi-center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs.

CONCLUSIONS

REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities.

Authors+Show Affiliations

Sidney Kimmel Medical College, Philadelphia, PA. Electronic address: gordon.reeves@jefferson.edu.Sidney Kimmel Medical College, Philadelphia, PA.Wake Forest School of Medicine, Winston-Salem, NC.Inova Heart and Vascular Institute, Falls Church, VA.Duke University School of Medicine, Durham, NC.Emory Univeristy, Atlanta, GA.Thomas Jefferson University School of Health Professions, Philadelphia, PA.Wake Forest School of Medicine, Winston-Salem, NC.Duke University School of Medicine, Durham, NC.Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC.Duke University School of Medicine, Durham, NC.Duke University School of Medicine, Durham, NC.Wake Forest School of Medicine, Winston-Salem, NC.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

28267466

Citation

Reeves, Gordon R., et al. "Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) Trial: Design and Rationale." American Heart Journal, vol. 185, 2017, pp. 130-139.
Reeves GR, Whellan DJ, Duncan P, et al. Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale. Am Heart J. 2017;185:130-139.
Reeves, G. R., Whellan, D. J., Duncan, P., O'Connor, C. M., Pastva, A. M., Eggebeen, J. D., Hewston, L. A., Morgan, T. M., Reed, S. D., Rejeski, W. J., Mentz, R. J., Rosenberg, P. B., & Kitzman, D. W. (2017). Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale. American Heart Journal, 185, 130-139. https://doi.org/10.1016/j.ahj.2016.12.012
Reeves GR, et al. Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) Trial: Design and Rationale. Am Heart J. 2017;185:130-139. PubMed PMID: 28267466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial: Design and rationale. AU - Reeves,Gordon R, AU - Whellan,David J, AU - Duncan,Pamela, AU - O'Connor,Christopher M, AU - Pastva,Amy M, AU - Eggebeen,Joel D, AU - Hewston,Leigh Ann, AU - Morgan,Timothy M, AU - Reed,Shelby D, AU - Rejeski,W Jack, AU - Mentz,Robert J, AU - Rosenberg,Paul B, AU - Kitzman,Dalane W, AU - ,, Y1 - 2016/12/28/ PY - 2016/07/27/received PY - 2016/12/23/accepted PY - 2017/3/8/entrez PY - 2017/3/8/pubmed PY - 2017/6/1/medline SP - 130 EP - 139 JF - American heart journal JO - Am Heart J VL - 185 N2 - BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. HYPOTHESIS: Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization. STUDY DESIGN: REHAB-HF is a multi-center clinical trial in which 360 patients ≥60 years hospitalized with ADHF will be randomized either to a novel 12-week multi-domain physical rehabilitation intervention or to attention control. The goal of the intervention is to improve balance, mobility, strength and endurance utilizing reproducible, targeted exercises administered by a multi-disciplinary team with specific milestones for progression. The primary study aim is to assess the efficacy of the REHAB-HF intervention on physical function measured by total Short Physical Performance Battery score. The secondary outcome is 6-month all-cause rehospitalization. Additional outcome measures include quality of life and costs. CONCLUSIONS: REHAB-HF is the first randomized trial of a physical function intervention in older patients with hospitalized ADHF designed to determine if addressing deficits in balance, mobility, strength and endurance improves physical function and reduces rehospitalizations. It will address key evidence gaps concerning the role of physical rehabilitation in the care of older patients, those with ADHF, frailty, and multiple comorbidities. SN - 1097-6744 UR - https://neuro.unboundmedicine.com/medline/citation/28267466/Rehabilitation_Therapy_in_Older_Acute_Heart_Failure_Patients__REHAB_HF__trial:_Design_and_rationale_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(16)30293-9 DB - PRIME DP - Unbound Medicine ER -