IMR Press / RCM / Volume 23 / Issue 11 / DOI: 10.31083/j.rcm2311356
Open Access Systematic Review
Early Exercise-Based Rehabilitation for Patients with Acute Decompensated Heart Failure: A Systemic Review and Meta-Analysis
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1 Cardiac Rehabilitation Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China
2 Doctoral Department, Capital Medical University, 100069 Beijing, China
3 Department of Geriatrics, Chui Yang Liu Hospital Affiliated to Tsinghua University, 100021 Beijing, China
4 Department of Cardiology, Chui Yang Liu Hospital Affiliated to Tsinghua University, 100021 Beijing, China
5 Department of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China
6 Department of Cardiology, Peking University People's Hospital, 100044 Beijing, China
*Correspondence: (Zhongyi Jin); (Xingxue Pang)
These authors contributed equally.
Academic Editors: Julio Núñez Villota and Peter Kokkinos
Rev. Cardiovasc. Med. 2022, 23(11), 356;
Submitted: 26 July 2022 | Revised: 21 August 2022 | Accepted: 22 August 2022 | Published: 21 October 2022
(This article belongs to the Section Cardiovascular Intervention and Therapeutics)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Cardiac rehabilitation is an important part of the therapeutic regimen for chronic heart failure. Acute decompensated heart failure (ADHF) in hospitalized patients were usually excluded from cardiac rehabilitation programs. The initiation of cardiac rehabilitation with ADHF usually occurs after hospital discharge. This study included recent clinical trials in patients beginning early exercise-based rehabilitation during their hospitalization and compared the efficacy and safety of early cardiac rehabilitation to ADHF patients who didn’t receive cardiac rehabilitation. Methods: Clinical trials were searched from the EMBASE, PubMed, CENTRAL, and WAN FANG. We included randomized controlled trials (RCTs) in which early exercise-based rehabilitation started during the index hospitalization, from the establishment of the database to July 2022. RevMan 5.4 was used for the statistical analysis. Results: Six studies, with a total of 668 patients were included; 336 patients in the early rehabilitation group and 332 patients in the control group. Exercise capacity was significantly improved in the 6-minute walk distance [mean difference (MD): 32.97, 95% CI: 31.03 to 34.90, p < 0.00001], and the Short Physical Performance Battery (MD: 1.40, 95% CI: 1.35 to 1.44, p < 0.00001). The rate of all-cause rehospitalization was significantly decreased in the early rehabilitation group (OR: 0.67, 95% CI: 0.45 to 0.99, p = 0.04). Conclusions: Early exercise-based rehabilitation for eligible ADHF in-patients starting during, or early after, hospitalization could significantly improve exercise capacity. A transitional, individualized, progressive, exercise-based rehabilitation program during hospitalization combined with post-discharge clinic rehabilitation is an integrated rehabilitation strategy for acute decompensated heart failure.

cardiac rehabilitation
heart failure
6-minute walk distance
2022-3-7088/Capital’s Funds for Health Improvement and Research (CFH)
Fig. 1.
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