Phase-1 Cardiac Rehabilitation in Acute Heart Failure: Development of an Early Mobilization Algorithm Through Delphi...

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Clinical Practice Guidelines

Background:

• Early mobilization and exercise training show promise for patients recovering from acute heart failure (AHF).
• Current practices lack uniformity regarding the timing, prescription, safety, and termination of mobilization and exercise.
• Standardization is needed to optimize recovery and patient outcomes in AHF.

Purpose of the Study:

• To develop a consensus-based mobilization algorithm for patients recovering from AHF.
• To establish uniform criteria for early mobilization and exercise training in AHF patients.

Main Methods:

• A modified, web-based Delphi process involving 15 international panelists was employed.
• Three rounds of consensus-building using Likert scales and web-based discussions were conducted.
• Statistical analyses, including descriptive statistics and Kappa statistics, were used to assess agreement.

Main Results:

• 54 new variables were identified in Round 1, with 69% of statements reaching consensus.
• A fair level of agreement (Kappa W ≥ 0.3) was reported among panelists for most criteria.
• The final mobilization algorithm achieved 100% consensus among the panelists.

Conclusions:

• A comprehensive mobilization algorithm was formulated for AHF patients.
• Key components include physician-referral criteria, physiotherapy assessment, exercise prescription, and safety/termination criteria.
• This algorithm provides a standardized framework to guide early mobilization and exercise in AHF recovery.