Exercise Training Improves Activities of Daily Living in Elderly Patients with Congestive Heart Failure.

Abstract Introduction A high proportion of elderly patients with Chronic Heart Failure (CHF) experience dyspnea and fatigue during the activities of daily living (ADLs). Purpose We aimed to determine 1) the VO2 peak of some basic ADLs comparing it to VO2 peak at CardioPulmonary Exercise Test (CPET) and 2) the effects of 3-week inpatient cardiac rehabilitation program on ADLs' performance. Methods At entry and at the end of a 20-day cardiac rehabilitation program patients performed an ADL-test consisting of five task-related ADL activities and two time-related ADL activities while wearing a metabolimeter mobile device (K5, Cosmed). Task-related activities were: 1) to put on and take off socks, shoes and jacket (ADL 1); 2) to fold eight towels (ADL 2); 3) to put 6 bottles on a shelve (ADL 3); 4) to make a bed (ADL 4); 5) to go up and down 1-floor stairs (ADL 5). Time-related ADL activities were: 1) to sweep the floor for 4 minutes (ADL 6) and 2) to walk for six minute (6MWT). Metabolic load, oxygen uptake, ventilation, heart rate and symptom of dyspnea were computed for each ADL. During the program, patients performed a CPET. Results Fifty-six CHF patients [89% men; age 72±6 years; Ejection Fraction (EF) 38±12%; 66% with EF<40%] were enrolled. At entry, the least demanding ADL [expressed as proportion of peak oxygen uptake (VO2 peak) reached at CPET] was ADL 3 with 53,14±18.53%, while the most challenging was the 6MWT with 116.81±34.48%. Forty-two (75%) patients reached the VO2peak of CPET during 6MWT. After rehabilitation, there was a significant decrease in the time required to perform the task-related activities (ADL 1–5) [from 382.25±114.90 to 354.48±116.92 seconds, p=0.0175] and a significant increase in the distance covered during 6MWT [from 421.35±81.64 to 448.84±89.69 meters, p=0.000]. Moreover, following rehabilitation a significant decrease of heart rate in ADL1, ADL 3 and ADL 5 and a significant decrease of dyspnea in ADL 5, ADL 6 and 6MWT was recorded. Conclusion A comprehensive cardiac rehabilitation program can improve ADL performance due to the change of some physiological variables during effort. Further studies about the role of dedicated rehabilitation program (i.e. occupational rehab) are necessary.

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Relationship between Activities of Daily Living and Readmission within 90 Days in Hospitalized Elderly Patients with Heart Failure

BioMed Research International ◽

10.1155/2017/7420738 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Masahiro Kitamura ◽

Kazuhiro P. Izawa ◽

Hiroki Taniue ◽

Yumi Mimura ◽

Keita Imamura ◽

...

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Elderly Patients ◽

Activities Of Daily Living ◽

Roc Curve ◽

Daily Living ◽

Cutoff Value ◽

Hospitalized Elderly ◽

Patients With Heart Failure ◽

Hospitalized Elderly Patients

Aims. To examine the relationship between activities of daily living (ADL) and readmission within 90 days and assess the cutoff value of ADL to predict readmission in hospitalized elderly patients with heart failure (HF). Methods. This cohort study comprised 589 consecutive patients with HF aged ≥65 years, who underwent cardiac rehabilitation from May 2012 to May 2016 and were discharged home. We investigated patients’ characteristics, basic attributes, and ADL (motor and cognitive Functional Independence Measure [FIM]). We analyzed the data using the unpaired t-test, χ2 test, Cox proportional hazard model, receiver operating characteristic (ROC) curve, and Kaplan-Meier method. Results. Of 589 patients, 113 met the criteria, and they were divided into the nonreadmission (n=90) and readmission groups (n=23). Age, body mass index, New York Heart Association class, hemoglobin level, and motor FIM score were significantly different between the two groups (p<0.05). The body mass index (hazard ratio [HR]: 0.87; p<0.05) and motor FIM score (HR: 0.94; p<0.01) remained statistically significant. The cutoff value for the motor FIM score determined by ROC curve analysis was 74.5 points (area under the curve = 0.78; p<0.001). Conclusion. The motor FIM score in elderly patients with HF was an independent predictor of rehospitalization within 90 days.

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565 The tissue effects of long-term treatment with ACE inhibitor and metoprolol in elderly patients with congestive heart failure (CHF) and preserved systolic function

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80362-0 ◽

2006 ◽

Vol 5 (1) ◽

pp. 127-127

Author(s):

O SOYA ◽

O KURYATA

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Elderly Patients ◽

Ace Inhibitor ◽

Systolic Function ◽

Term Treatment ◽

Tissue Effects ◽

Long Term Treatment

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Impairment in activities of daily living and readmission in older patients with heart failure: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-044416 ◽

2021 ◽

Vol 11 (2) ◽

pp. e044416

Author(s):

Tan Van Nguyen ◽

Huyen Thanh Dang ◽

Mason Jenner Burns ◽

Hiep HH Dao ◽

Tu Ngoc Nguyen

Keyword(s):

Heart Failure ◽

Cohort Study ◽

Activities Of Daily Living ◽

Daily Living ◽

Older Patients ◽

Tertiary Hospital ◽

Logistic Regression Models ◽

Hospitalised Patients ◽

Patients With Heart Failure ◽

The Impact

ObjectivesThis study aims to investigate the prevalence of impairment of activities of daily living (ADLs) in older patients with heart failure (HF), and to examine the impact of ADL impairment on readmission after discharge.Design and settingsA prospective cohort study was conducted in patients aged ≥65 years with HF admitted to a tertiary hospital in Vietnam from August 2016 to June 2017. Difficulties with six ADLs were assessed by a questionnaire. Participants were classified into two categories (with and without ADL impairment). The associations of ADL impairment with 3-month readmission were examined using logistic regression models.ResultsThere were 180 participants (mean age 80.6±8.2, 50% female) and 26.1% were classified as having ADL impairment. The most common impaired activity was bathing (21.1%), followed by transferring (20.0%), toileting (12.2%), dressing (8.9%), eating (3.3%), and continence (2.8%). During 3-month follow-up, 32.8% of the participants were readmitted to hospitals (55.3% in participants with ADL impairment, 24.8% in those without ADL impairment, p<0.001). ADL impairment significantly increased the risk of 3-month readmission (adjusted OR 2.75, 95% CI 1.25 to 6.05, p=0.01).ConclusionsIn summary, ADL impairment was common in older hospitalised patients with HF and was associated with increased readmission. These findings suggest further studies on ADL assessment and intervention during transition care for older patients with HF after discharge to prevent readmission.

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