Effect of Exercise Rehabilitation in Patients With Acute Heart Failure A Systematic Review and Meta-analysis

Background: Exercise rehabilitation is conducive to increasing functional ability and improving health outcomes, but its effectiveness in patients with acute heart failure (AHF) is still controversial. Purpose: In this study, our aim was to systematically examine the efficacy of exercise rehabilitation in people with AHF. Methods: A search was conducted for randomized controlled trial studies on exercise rehabilitation in patients with AHF up to November 2021. Two investigators conducted literature selection, quality assessments, and data extractions independently. The primary outcome was 6-minute walk distance, and the secondary outcomes were left ventricular ejection fraction, quality of life, Short Physical Performance Battery, readmission, and mortality. RevMan (version 5.3) software was used for the meta-analysis. Results: Twelve studies with 1215 participants were included. Exercise rehabilitation significantly improved the 6-minute walk distance (mean difference [MD], 33.04; 95% confidence interval [CI], 31.37-34.70; P < .001; I-2 = 0%), quality of life (MD, -11.57; 95% CI, -19.25 to -3.89; P = .003; I-2 = 98%), Short Physical Performance Battery (MD, 1.40; 95% CI, 1.36-1.44; P < .001; I-2 = 0%), and rate of readmission for any cause (risk ratio, 0.48; 95% CI, 0.26-0.88; P = .02; I-2 = 7%), compared with routine care. However, no statistically significant effects on left ventricular ejection fraction (MD, 0.94; 95% CI, -1.62 to 3.51; P = .47; I-2 = 0%) and mortality (risk ratio, 1.07; 95% CI, 0.64-1.80; P = .79; I-2 = 0%) were observed. Conclusions: Compared with routine care, exercise rehabilitation improved functional ability and quality of life, reducing readmission in patients with AHF.