Changes in gait speed during hospitalization according to baseline gait speed in patients with heart failure

Abstract Purpose: Gait speed is an established prognostic marker in patients with heart failure (HF). However, whether improvement during hospitalization differs according to baseline gait speed remains unclear. This study investigated whether improvement differed across baseline gait speed levels. Methods: This prospective cohort study included 538 patients with HF undergoing inpatient cardiac rehabilitation. Usual 10-m gait speed was assessed at baseline and discharge. Patients were classified into low (<0.67 m/s), middle (0.67 to <0.94 m/s), or high (≥0.94 m/s) group according to baseline gait speed. Improvement was defined as a ≥10% increase from baseline. Improvement proportions were compared using the chi-square test; magnitude of improvement and achievement of ≥0.98 m/s at discharge were also evaluated. Results: Overall, 55.4% of patients showed gait speed improvement, with improvement occurring in 73%, 57%, and 36% of the low, middle, and high groups, respectively (p <.001). The magnitude was greatest in the low group (+26.2%) and lowest in the high group (+6.4%). Conversely, achievement of a discharge gait speed ≥0.98 m/s was lowest in the low group (8.8%) and highest in the high group (91.1%). Patients with lower baseline gait speed were characterized by older age, greater comorbidity burden, poorer nutritional status, and lower physical function. Conclusion: Patterns of gait speed improvement during hospitalization differed according to baseline gait speed. Patients with lower baseline gait speed were more likely to improve and showed greater improvement, but few achieved the prognostic threshold at discharge. Rehabilitation goals may need to be individualized according to baseline gait speed.