Mapping of Early Exercise-Based Interventions for Patients Recovering From Acute Heart Failure: A Scoping Review.

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Exercise Science

Background:

• Exercise training is established as safe and beneficial for acute heart failure (AHF) patients.
• Significant heterogeneity exists in current exercise delivery patterns for AHF recovery.
• A comprehensive understanding of early exercise interventions is needed.

Purpose of the Study:

• To map the evidence on early exercise-based interventions for AHF patients.
• To analyze geographic distribution, exercise prescription, and initiation timing.
• To identify patterns in early mobilization and exercise training post-hospitalization.

Main Methods:

• A scoping review was conducted using the PRISMA-Extension for Scoping Reviews guidelines.
• Systematic searches were performed across 5 databases until September 2024.
• Included studies involved AHF patients from admission up to 2 weeks post-discharge, encompassing protocols.

Main Results:

• 30 studies involving 1,549,980 participants were included; 26.6% focused on older adults.
• Interventions were predominantly from higher- and upper-middle-income countries and mainly observational.
• Median exercise initiation was 3.8 days, with low-moderate intensity, 10-60 min sessions, and a median of 8 sessions.
• Standardized initiation, monitoring, and termination criteria were uncommon.

Conclusions:

• Early exercise-based interventions (mobilization and/or training) are initiated promptly (within 4 days) for AHF patients.
• These interventions are typically comprehensive, multi-modal, and of low-to-moderate intensity.
• Further research should focus on standardizing protocols and exploring interventions in diverse global settings.