Motor functions and interventions to improve frailty in patients with heart failure

Background There is limited research on the factors influencing frailty improvement and on whether exercise therapy is effective in the general population with heart failure. We aimed to examine the factors and interventions that affect the improvement of frailty in older patients with heart failure during hospitalization. Methods This multicentre prospective cohort study included patients with heart failure admitted and treated in the participating hospitals. Cox regression analysis was done to determine factors and interventions that affect improvement of frailty. After the Cox regression analysis, the receiver operating characteristic (ROC) curve was calculated for significant predictors to assess the cut-off point. Results The factors that affect improvement of frailty were the high short physical performance battery (SPPB) chair-stand test and hand grip strength values. The results of the ROC analysis revealed that the cut-off values of the SPPB chair-stand test and hand grip strength were 2 points and 13.7 kg, respectively. Interventions that affect frailty improvement were use of dobutamine, low resting heart rate, early days to start until aerobic exercise, and light intensity or higher of aerobic exercise. Moreover, the cut-off values of the resting heart rate, number of days to start until aerobic exercise, and intensity of aerobic exercise were 80 beats per minute, 7 days, and 31.6%, respectively. Conclusions Our results suggest that pharmacotherapy and exercise will be effective to improve frailty in patients with heart failure. In particular, early exercise therapy, including aerobic exercise, started within 7 days, may be effective to improve frailty in older patients with heart failure with low resting heart rate, depending on their condition on admission.