Physical activity intervention for elderly patients with reduced physical performance after acute coronary syndrome (HULK study): rationale and design of a randomized clinical trial

226 (planned) elderly patients (≥70 years) admitted to the hospital for acute coronary syndrome (ACS) with reduced physical performance (Short Physical Performance Battery [SPPB] score 4-9) at time of discharge and confirmed 30-days post-discharge, in Italy. Key exclusions: Short portable mental status questionnaire < 4, life expectancy < 12 months, not discharged home, NYHA III-IV, LVEF < 30%, severe valvulopathy, multivessel/left main CAD candidate for CABG, planned staged PCI, or physical impairment preventing physical activity.

Early, tailored, low-cost physical activity intervention including 4 supervised sessions (at inclusion, 60, 90, and 120 days post-discharge) and a home-based program of continuous moderate walking (30-60 min/day, 3-7 days/week) and calisthenics, added to standard of care.

Standard of care, including a 15-minute counseling session on aerobic physical activity, an informational brochure, and an accelerometer to assess home physical activity.

Short Physical Performance Battery (SPPB) score at 6 months.surrogate