{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:28:23Z","timestamp":1781756903988,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["498403"],"award-info":[{"award-number":["498403"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["Post graduate scholarship"],"award-info":[{"award-number":["Post graduate scholarship"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001077","name":"Royal Brisbane and Women's Hospital Foundation","doi-asserted-by":"publisher","award":["Patricia Dukes Fellowship"],"award-info":[{"award-number":["Patricia Dukes Fellowship"]}],"id":[{"id":"10.13039\/501100001077","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Frailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim of this study was to describe the characteristics, exercise participation, and outcomes of frail and not\u2010frail participants enrolled in a randomized trial of exercise training (ET) within a cardiac rehabilitation (CR) program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of EJECTION\u2010HF randomized trial (ACTRN12608000263392).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Five HF\u2010specific CR programs in Queensland, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults recently hospitalized with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>All participated in CR including home exercise prescription and monitoring; half were randomized to center\u2010based ET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>A frailty index (FI) was constructed at randomization and 6\u2010month follow\u2010up. Outcomes included ET attendance, change in 6\u2010min walk distance (6MWD), improved FI (&gt;0.09\u2009units) at 6\u00a0months, achieving physical activity (PA) guidelines at 6\u00a0months, and 12\u2009month all\u2010cause death or readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The FI was measured in 256 participants at randomization: 110 (43%) were not\u2010frail (FI 0.2 or less), 119 (46%) were frail (FI &gt;0.2 to 0.39), and 27 (11%) were very frail (FI \u22650.4). Frailty was more common with older age, female gender, decompensated HF, worse HF symptoms, and preserved ejection fraction. ET attendance did not differ by frailty group. Participants who were more frail had lower 6WMD at enrollment, but similar improvement over 6\u00a0months. Mean FI improved by 0.03\u2009units at 6\u00a0months (95% CI 0.02\u20130.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Participants who were more frail had significantly greater improvements in FI compared with not\u2010frail participants and were often able to achieve PA guidelines, both in intervention and control groups. Neither baseline frailty nor intervention was significantly associated with 12\u2010month death or readmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frail people with HF participating in CR that includes home and\/or center\u2010based ET often achieve PA guidelines, and some may have meaningful reductions in frailty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17145","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T09:19:09Z","timestamp":1617787149000},"page":"2476-2485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Frailty implications for exercise participation and outcomes in patients with heart 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