Factors Associated With Improvement in Activities of Daily Living in Patients With Cardiovascular Disease in a Japanese Community Rehabilitation Ward　― A Multicenter Prospective Study ―

Background: Patients with cardiovascular disease (CVD) admitted to community rehabilitation wards after acute care for cardiac rehabilitation (CR) continuation show improvements in activities of daily living (ADL). However, because the determinants of ADL improvement remain unclear, we aimed to identify the factors related to ADL recovery during post-acute CR. Methods and Results: This interim analysis of the multicenter J-CREW CR registry included 198 patients with CVD (mean age: 78.1±8.8 years; 49.5% female). Data on demographics, ADL and frailty status before hospitalization, primary and comorbid conditions, nutritional risk, admission ADL, physical and cognitive function, length of stay (LOS), and rehabilitation dose were collected. The primary outcome was factors associated with Functional Independence Measure (FIM) gain, and the secondary outcome was FIM effectiveness. In the regression model (R 2 =0.435, P<0.001), admission Short Physical Performance Battery (SPPB; B=1.177, P=0.004), Mini-Mental State Examination (MMSE; B=1.272, P<0.001), and LOS (B=0.117, P<0.001) were significantly associated with FIM gain, whereas admission FIM was negatively associated (B=−0.623, P<0.001). Another model (R 2 =0.360, P<0.001) revealed comparable associations with FIM effectiveness. Conclusions: Better physical and cognitive function at admission, together with sufficient LOS, contributed to greater ADL recovery. These indices may serve as practical indicators of effective post-acute CR strategies.