Greater physical improvement seen with early, transitional, tailored, progressive rehab intervention including physical function domains
TUESDAY, May 25, 2021 (HealthDay News) — For older patients with decompensated heart failure, a tailored rehabilitation intervention results in greater improvement in physical function than usual care, according to a study published online May 16 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Cardiology, held virtually from May 15 to 17.
Dalane W. Kitzman, M.D., from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues conducted a multicenter, randomized trial to examine a transitional, tailored, progressive rehabilitation intervention that included four physical function domains. Three hundred forty-nine patients were randomly assigned as follows: 175 to the rehabilitation intervention (initiated during or soon after hospitalization) and 174 to usual care.
The researchers found that the least-squares mean score on the Short Physical Performance Battery at three months was 8.3 Â± 0.2 and 6.9 Â± 0.2 in the intervention and control groups, respectively, after adjustment for baseline Short Physical Performance Battery score and other characteristics (mean between-group difference, 1.5; 95 percent confidence interval, 0.9 to 2.0; P < 0.001). The rates of prehospitalization for any cause were 1.18 and 1.28 in the intervention and control groups, respectively, at six months (rate ratio, 0.93; 95 percent confidence interval, 0.66 to 1.19). The corresponding rates of death from any cause were 0.13 and 0.10 (rate ratio, 1.17; 95 percent confidence interval, 0.61 to 2.27).
“The study was not large enough to really look at clinical events,” Kitzman said in a statement. “But by improving quality of life and physical functioning, the patient feels better, which is a positive outcome.”
Several authors disclosed financial ties to the biopharmaceutical industry.
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