Impact of Tailored Multidisciplinary Cardiac Rehabilitation on Patients With Cardiovascular Diseases and Multimorbidity in Convalescent Rehabilitation Hospitals in Japan　― A Multicenter, Prospective Observational Study ―

Background: Data on cardiac rehabilitation (CR) outcomes in patients with cardiovascular disease (CVD), frailty, and multimorbidity in post-acute settings are limited. This study aimed to evaluate the feasibility and efficacy of individualized, multidisciplinary CR in convalescent rehabilitation hospitals (cRHs). Methods and Results: This multicenter, prospective, observational study included 72 consecutive patients transferred from acute care hospitals. Personalized CR programs were implemented in cRHs. Primary outcomes were changes in the Barthel Index (BI) and functional independence measure (FIM) scores. Secondary outcomes included assessments of physical and cognitive function, and nutritional status. Mean participant age was 78.6±11.8 years. Prior to admission, 51.4% experienced acute decompensated heart failure (ADHF). The average length of stay was 59.5±39.2 days. BI and FIM scores improved from admission to discharge. The following parameters improved: Short Physical Performance Battery, knee extensor strength, comfortable gait speed, 6-min walk distance, New York Heart Association classification, and cognitive function (Mini-Mental State Examination). Discharge dispositions included 53 (73.6%) home discharges, and 19 (26.4%) outpatient CR post-discharges. Patients with post-ADHF and patients with other conditions both showed functional improvements, but ∆BI and ∆FIM were lower in the post-ADHF group. Conclusions: Tailored multidisciplinary CR in cRHs effectively improves daily living activities and physical and cognitive outcomes in patients with CVD with complex conditions. Expanded use of these hospitals may help address clinical challenges.