Integrating Aerobic, Respiratory, and Cognitive Training in Acute Heart Failure

Integrating Aerobic, Respiratory, and Cognitive Training in Acute Heart Failure

The purpose of this study is to investigate the impact of integrating aerobic, respiratory and cognitive training in acute heart failure.

Patients with acute heart failure often experience severe dyspnea, muscle weakness, and cognitive decline during hospitalization, which together impair recovery and increase the risk of rehospitalization. Respiratory muscle dysfunction contributes to exercise intolerance and worsened prognosis, highlighting the importance of targeted inspiratory training. Likewise, immobilization leads to peripheral muscle deconditioning, while cognitive impairment is associated with poor adherence to treatment and lower quality of life.

Pharmacological therapies remain the cornerstone of acute heart failure management; however, they do not directly address these functional and cognitive complications. Consequently, non-pharmacological strategies have gained increasing attention as adjunctive treatments, offering potential benefits without the risks of drug-related side effects.

It is hypothesized that patients with acute heart failure require a multidimensional rehabilitation program that simultaneously supports respiratory, muscular, and cognitive functions. The BLM approach-combining arm ergometer exercise, inspiratory muscle training, and computerized cognitive training-may represent a novel, safe, and effective strategy to accelerate recovery, improve functional outcomes, reduce hospital stay, and potentially lower readmission rates.

Few clinical trials have evaluated such an integrative program in the acute hospital setting. If proven effective, this approach could be incorporated into routine cardiac rehabilitation protocols, providing holistic care that addresses both physical and cognitive dimensions of heart failure.

Inclusion Criteria:

• Age between 50-65 years.
• All patients are male.
• Diagnosed with acute heart failure according to ESC guidelines.
• Hemodynamically stable for at least 24 hours.
• Able to follow simple verbal commands and participate in training.

Exclusion Criteria:

• Unstable angina or recent myocardial infarction (< 4 weeks).
• Severe uncontrolled arrhythmias or advanced atrioventricular block.
• Severe pulmonary disease (e.g., advanced COPD, restrictive lung disease).
• Neurological disorders causing cognitive or motor disability.
• Orthopedic or musculoskeletal conditions preventing upper-limb activity.
• Severe visual or auditory impairment limiting participation in cognitive training.