PMID- 34516959
OWN - NLM
STAT- MEDLINE
DCOM- 20220211
LR  - 20230102
IS  - 1555-7162 (Electronic)
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 135
IP  - 1
DP  - 2022 Jan
TI  - Physical Rehabilitation in Older Patients Hospitalized with Acute Heart Failure 
      and Diabetes: Insights from REHAB-HF.
PG  - 82-90
LID - S0002-9343(21)00555-6 [pii]
LID - 10.1016/j.amjmed.2021.08.001 [doi]
AB  - BACKGROUND: Prior studies showed an attenuated response to exercise training 
      among patients with heart failure and type 2 diabetes mellitus. We explored the 
      interaction between diabetes status and a novel, transitional, tailored, 
      progressive rehabilitation intervention that improved physical function compared 
      with usual care in the Rehabilitation Therapy in Older Acute Heart Failure 
      Patients (REHAB-HF) trial. METHODS: The effect of the intervention on 3-month 
      Short Physical Performance Battery (SPPB) (primary endpoint), 6-minute walk 
      distance (6MWD), modified Fried frailty criteria, and quality-of-life scores 
      (Kansas City Cardiomyopathy Questionnaire [KCCQ] and EuroQoL Visual Analogue 
      Scale [VAS]) was compared between participants with and without diabetes. 
      Differences in 6-month clinical outcomes were also explored. RESULTS: Of the 349 
      participants enrolled in REHAB-HF, 186 (53%) had diabetes. The prevalence of 
      diabetes was higher in the intervention group (59% vs 48%). Participants with 
      diabetes had worse baseline physical function by the SPPB and 6MWD, but similar 
      frailty and quality-of-life scores. There was a consistent improvement with the 
      intervention for 3-month SPPB, 6MWD, and VAS regardless of diabetes status (all 
      interaction P value > .6), but participants with diabetes had significantly less 
      improvement for frailty (P = .021) and a trend toward lower improvement in KCCQ 
      (P = .11). There was no significant interaction by diabetes status for 6-month 
      clinical event outcomes (all interaction P value > .3). CONCLUSIONS: Participants 
      with diabetes had worse baseline physical function but showed similar clinically 
      meaningful improvements from the intervention. There was less benefit for frailty 
      with the intervention in participants with diabetes.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Murray, Evan M
AU  - Murray EM
AD  - Duke University School of Medicine, Durham, NC.
FAU - Whellan, David J
AU  - Whellan DJ
AD  - Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson 
      University, Philadelphia, PA.
FAU - Chen, Haiying
AU  - Chen H
AD  - Department of Biostatistics and Data Science.
FAU - Bertoni, Alain G
AU  - Bertoni AG
AD  - Department of Epidemiology and Prevention.
FAU - Duncan, Pamela
AU  - Duncan P
AD  - Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC.
FAU - Pastva, Amy M
AU  - Pastva AM
AD  - Department of Orthopaedic Surgery, Doctor of Physical Therapy Division, Duke 
      University School of Medicine, Durham, NC.
FAU - Kitzman, Dalane W
AU  - Kitzman DW
AD  - Department of Internal Medicine, Section on Cardiovascular Medicine; Department 
      of Internal Medicine, Sections on Geriatrics, Wake Forest School of Medicine, 
      Winston-Salem, NC.
FAU - Mentz, Robert J
AU  - Mentz RJ
AD  - Department of Medicine, Division of Cardiology, Duke University School of 
      Medicine, Durham, NC. Electronic address: Robert.mentz@duke.edu.
LA  - eng
GR  - R01 AG018915/AG/NIA NIH HHS/United States
GR  - U24 AG059624/AG/NIA NIH HHS/United States
GR  - R01 AG045551/AG/NIA NIH HHS/United States
GR  - P30 AG028716/AG/NIA NIH HHS/United States
GR  - P30 AG021332/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20210910
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Diabetes Complications/*rehabilitation
MH  - Female
MH  - Frailty
MH  - Heart Failure/*rehabilitation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Physical Functional Performance
MH  - Quality of Life
PMC - PMC8688185
MID - NIHMS1739644
OTO - NOTNLM
OT  - Acute decompensated heart failure
OT  - Diabetes mellitus
OT  - Heart failure
OT  - Physical rehabilitation
EDAT- 2021/09/14 06:00
MHDA- 2022/02/12 06:00
PMCR- 2023/01/01
CRDT- 2021/09/13 20:25
PHST- 2021/08/23 00:00 [received]
PHST- 2021/08/31 00:00 [revised]
PHST- 2021/08/31 00:00 [accepted]
PHST- 2021/09/14 06:00 [pubmed]
PHST- 2022/02/12 06:00 [medline]
PHST- 2021/09/13 20:25 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - S0002-9343(21)00555-6 [pii]
AID - 10.1016/j.amjmed.2021.08.001 [doi]
PST - ppublish
SO  - Am J Med. 2022 Jan;135(1):82-90. doi: 10.1016/j.amjmed.2021.08.001. Epub 2021 Sep 
      10.