Impact of Cardiac Rehabilitation Adapted for Patients With Heart Failure

RAP-IC Study: Impact of Cardiac Rehabilitation Adapted for Patients With Heart Failure

The aim of the study is to evaluate whether a tailored cardiac rehabilitation program, initiated during hospitalization and continued after discharge, can improve functional capacity, mobility, and quality of life in patients over 65 years old with heart failure.

If you meet the inclusion criteria and wish to participate, an initial assessment of your clinical and functional status will be conducted during your hospital stay. A computer system will then randomly assign you to one of the following groups:

Cardiac Rehabilitation Group (treatment group): You will participate in a mild exercise program during hospitalization (Phase I), including mobility and respiratory exercises adapted to your clinical condition. After discharge, you will enter a structured in-person cardiac rehabilitation program (Phase II) lasting 3 months, consisting of two 1-hour exercise sessions per week (aerobic, strength, inspiratory, and proprioceptive exercises) plus one weekly educational session.

Usual Care Group (control group): You will receive standard recommendations for physical activity and general care.

At the end of the study, a final consultation will be conducted to assess differences between the two groups in functional capacity and quality of life.

Inclusion Criteria:

• Patients hospitalized for acute heart failure in a stable phase (on a stable dose or tapering intravenous diuretics for at least 48 hours, without intravenous inotropes or vasodilators for >72 hours).
• Baseline functional class II-III
• Age ≥ 65 years
• Able to walk >4 meters
• Any range of left ventricular ejection fraction

Exclusion Criteria:

• Moderate to severe dementia
• Cardiac or other disease with a life expectancy <12 months
• Institutionalized patients or unable to travel to the rehabilitation center
• Functional class I or IV
• Uncontrolled arrhythmias
• Inability to perform a basic exercise protocol