Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

Q: What are the key findings of this study?

Outpatient cardiac rehabilitation reduced the 1-year incidence of falls from 31.0% to 9.6% in older cardiovascular disease patients, with adjusted IRR 0.42 and RR 0.39.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Older patients (aged ≥65 years) with cardiovascular disease who participated in early phase II cardiac rehabilitation (n=110). Intervention: Outpatient cardiac rehabilitation (OCR) program vs. Non-participation in outpatient cardiac rehabilitation. Primary outcome: Incidence and frequency of falls within 1 year after hospital discharge (Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39, 95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89, p=IRR P<0.01; RR P=0.02).

Q: What does this research mean for the field?

Outpatient cardiac rehabilitation significantly reduces the 1-year incidence of falls in older patients with cardiovascular disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Kenzo Shiota; Masakazu Saitoh; Kotaro Iwatsu; Tomoyuki Morisawa; Tetsuya Takahashi; Junya Nishimura; Masamichi Mochizuki; Eriko Kitahara; Toshiyuki Fujiwara; Miho Yokoyama; T Minamino

doi:10.1253/circrep.cr-25-0267

February 19, 2026Circulation ReportsOpen Access

Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

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Key result

Outpatient cardiac rehabilitation linked to ~61% lower 1-year fall risk in older cardiovascular patients.

Figures

Why the study?

Evidence regarding falls in aging patients with cardiovascular disease is limited, and the impact of cardiac rehabilitation remains unclear.

Does outpatient cardiac rehabilitation reduce the incidence of falls in older patients with cardiovascular disease?

Key Points

To determine the incidence of falls over a 1-year period and evaluate the association between outpatient cardiac rehabilitation participation and fall outcomes in older patients with cardiovascular disease.
Single-center prospective cohort study evaluating 110 patients aged ≥65 years (mean age 77.2±6.3 years; 36.4% women) categorized into an outpatient cardiac rehabilitation group (n=52) and a non-rehabilitation group (n=58).
Fall occurrences and injury treatments were recorded over a 1-year follow-up via questionnaires and medical records.
Associations between outpatient rehabilitation and fall rates were analyzed using negative binomial regression adjusted through stabilized inverse probability weighting based on propensity scores.
Over 1 year, falls occurred in 20.9% (23/110) of participants overall, with a significantly lower incidence in the rehabilitation group (9.6%, 5/52) compared to the non-rehabilitation group (31.0%, 18/58; P<0.01).
Fall-related injury treatments were needed by 2.0% (1/52) of rehabilitation participants versus 20.7% (12/58) of non-participants (P<0.01).
Outpatient rehabilitation participation was significantly associated with a lower fall rate in both univariate analysis (IRR 0.24, 95% CI 0.12–0.49, P<0.01) and propensity score-weighted analysis (IRR 0.42, 95% CI 0.23–0.76, P<0.01).

Study Design

Type

Cohort (n=110)

Multicenter

No

Structured PICO

Does outpatient cardiac rehabilitation reduce the incidence of falls in older patients with cardiovascular disease?

P

Population

110 patients with cardiovascular disease aged ≥65 years who were hospitalized and participated in early phase II cardiac rehabilitation, mean age 77.2, 36.4% female, based in Japan.

I

Intervention

Outpatient cardiac rehabilitation (OCR) program comprising aerobic and resistance exercises, and multidisciplinary guidance (medication, nutrition, fall prevention), attending at least once within 3 months of discharge (median 18 sessions).

C

Comparator

Non-OCR group (did not participate in outpatient cardiac rehabilitation).

O

Outcome

Incidence and frequency of falls within 1 year after hospital discharge, assessed via mailed self-reported questionnaire and medical records.patient reported

Main Result

Effect estimate: Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39 (95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89)

Absolute Event Rate: 9.6% vs 31%

p-value: p=IRR P<0.01; RR P=0.02

Participation in outpatient cardiac rehabilitation is associated with a significantly lower incidence and risk of falls in older patients with cardiovascular disease.

Limitations

Limited number of outcome events restricting adjustment for multiple confounders
Falls data collected via self-reported questionnaire once at 1 year possibly introducing recall bias
Some OCR participants attended only one session possibly attenuating effects
Exclusion of patients not participating in early phase II CR may introduce selection bias
Timing of falls not recorded preventing temporal pattern analysis
No systematic follow-up assessments of physical function or frailty after OCR
Observational single-center study design limits generalizability and residual confounding may exist despite adjustment
Limited number of outcome events
Self-reported questionnaire at 1 year may introduce recall bias
Some OCR participants attended only 1 session
Excluded patients who did not participate in early phase II CR
Timing of falls not recorded
No follow-up physical function assessments
Observational design with potential unmeasured confounding
Single-center design

Implication

May support outpatient cardiac rehabilitation for fall prevention in older CVD patients; hypothesis-generating and requires randomized confirmation.

Abstract

Background: Falls are a serious medical problem. With the aging of patients with cardiovascular disease (CVD), falls have become an important clinical outcome. However, evidence regarding falls in this population is limited, and the impact of cardiac rehabilitation (CR) remains unclear. This study investigated the incidence of falls and examined the association between outpatient CR (OCR) and falls among older patients with CVD.

Discussion

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Cite This Study

Shiota et al. (2026) conducted a cohort in Older patients (aged ≥65 years) with cardiovascular disease who participated in early phase II cardiac rehabilitation (n=110). Outpatient cardiac rehabilitation (OCR) program vs. Non-participation in outpatient cardiac rehabilitation was evaluated on Incidence and frequency of falls within 1 year after hospital discharge (Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39, 95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89, p=IRR P<0.01; RR P=0.02). Outpatient cardiac rehabilitation reduced the 1-year incidence of falls from 31.0% to 9.6% in older cardiovascular disease patients, with adjusted IRR 0.42 and RR 0.39.

synapsesocial.com/papers/699a9ceb482488d673cd2a14 https://doi.org/10.1253/circrep.cr-25-0267

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Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease ― A 1-Year Longitudinal Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease ― A 1-Year Longitudinal Study ―

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

More related papers

More from Circulation Reports

Keep reading

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Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―