{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:50:02Z","timestamp":1790790602779,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21H03309, JP20H03907, JP21H03159, JP21K08123"],"award-info":[{"award-number":["JP21H03309, JP20H03907, JP21H03159, JP21K08123"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["21AA2007"],"award-info":[{"award-number":["21AA2007"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Whether acute-phase cardiac rehabilitation (CR) is beneficial for short-term improvement in activities of daily living (ADL) in patients hospitalized for acute heart failure (AHF) remains unclear. Aim: To investigate the association of acute-phase initiation of CR with short-term improvement in ADL in patients hospitalized for AHF. Methods: We retrospectively analyze data from the Diagnosis Procedure Combination Database, a nationwide inpatient database. Patients hospitalized for HF between January 2010 and March 2018 are included. Propensity score matching and generalized linear models are built to examine the association between improvement in ADL and acute-phase CR initiation, defined as the initiation of CR within two days of admission. Results: Among 306,826 eligible patients, CR is initiated in 45,428 patients (14.8%) within two days of hospital admission. Propensity score matching creates 45,427 pairs. CR initiation within two days of hospital admission is associated with ADL improvement (risk ratio: 1.018; 95% confidence interval: 1.004\u20131.032), particularly in elderly patients, females, and individuals with low ADL at admission, body mass index of 18.5\u201324.9 kg\/m2, and New York Heart Association class IV. Conclusions: Our analyses highlight the possibility that acute-phase CR initiation may result in short-term improvement in ADL in patients hospitalized for AHF.<\/jats:p>","DOI":"10.3390\/jcdd9040097","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T21:27:51Z","timestamp":1648416471000},"page":"97","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Acute-Phase Initiation of Cardiac Rehabilitation for Short-Term Improvement in Activities of Daily Living in Patients Hospitalized for Acute Heart Failure"],"prefix":"10.3390","volume":"9","author":[{"given":"Kensuke","family":"Ueno","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"},{"name":"Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara 252-0373, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara 252-0373, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"},{"name":"Department of Advanced Cardiology, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"},{"name":"Department of Advanced Cardiology, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-3347","authenticated-orcid":false,"given":"Norifumi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3091-114X","authenticated-orcid":false,"given":"Nobuaki","family":"Michihata","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, The University of Tokyo, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, The University of Tokyo, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issei","family":"Komuro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jacc.2012.09.038","article-title":"Rehospitalization for heart failure: Problems and perspectives","volume":"61","author":"Gheorghiade","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart Disease and Stroke Statistics-2019 update: A report from the american heart association","volume":"139","author":"Benjamin","year":"2019","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cardfail.2008.09.006","article-title":"Quality of Life and Depressive Symptoms in the Elderly: A Comparison Between Patients with Heart Failure and Age- and Gender-Matched Community Controls","volume":"15","author":"Jaarsma","year":"2009","journal-title":"J. Card. Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.ahj.2014.07.008","article-title":"Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population","volume":"168","author":"Cheng","year":"2014","journal-title":"Am. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ijcard.2021.08.041","article-title":"Acute-phase initiation of cardiac rehabilitation and clinical outcomes in hospitalized patients for acute heart failure","volume":"340","author":"Kaneko","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1016\/j.amjcard.2016.03.046","article-title":"Comparison of frequency of frailty and severely impaired physical function in patients \u226560 years hospitalized with acute decompensated heart failure versus chronic stable heart failure with reduced and preserved left ventricular ejection fraction","volume":"117","author":"Reeves","year":"2016","journal-title":"Am. J. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.amjcard.2014.12.044","article-title":"Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults \u226565 years with heart failure","volume":"115","author":"Lo","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3557","DOI":"10.1002\/ehf2.13392","article-title":"Standardized gait speed ratio in elderly patients with heart failure","volume":"8","author":"Ozawa","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ueda, K., Kasao, M., Shimamura, M., Haruta, H., Nitta, S., Kaneko, M., Uemura, Y., Morita, H., Komuro, I., and Shirai, T. (2016). Impact of oral treatment on physical function in older patients hospitalized for heart failure: A randomized clinical trial. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0167933"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s10741-011-9258-y","article-title":"Frailty and multiple comorbidities in the elderly patient with heart failure: Implications for management","volume":"17","author":"Murad","year":"2012","journal-title":"Heart Fail. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1253\/circj.CJ-19-0136","article-title":"Short-term change in gait speed and clinical outcomes in older patients with acute heart failure","volume":"83","author":"Tanaka","year":"2019","journal-title":"Circ. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2793","DOI":"10.1253\/circj.CJ-18-0279","article-title":"Prognostic impact of the preservation of activities of daily living on post-discharge outcomes in patients with acute heart failure","volume":"82","author":"Uemura","year":"2018","journal-title":"Circ. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1007\/s00134-015-3763-8","article-title":"Early physical rehabilitation in intensive care patients with sepsis syndromes: A pilot randomised controlled trial","volume":"41","author":"Kayambu","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/j.jocn.2011.10.021","article-title":"A prospective, randomized, single-blinded trial on the effect of early rehabilitation on daily activities and motor function of patients with hemorrhagic stroke","volume":"19","author":"Bai","year":"2012","journal-title":"J. Clin. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ohbe, H., Nakamura, K., Uda, K., Matsui, H., and Yasunaga, H. (2021). Effect of early rehabilitation on physical function in patients undergoing coronary artery bypass grafting: A nationwide inpatient database study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040618"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1161\/STROKEAHA.116.015147","article-title":"Impact of rehabilitation on outcomes in patients with ischemic stroke: A nationwide retrospective cohort study in Japan","volume":"48","author":"Yagi","year":"2017","journal-title":"Stroke"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1080\/14767058.2019.1623197","article-title":"Association between rehabilitation during hospitalization and perinatal outcomes among pregnant women with threatened preterm birth","volume":"34","author":"Shigemi","year":"2021","journal-title":"J. Matern. Fetal. Neonatal. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1253\/circrep.CR-20-0053","article-title":"Characteristics and outcomes of super-elderly patients (aged \u226590 years) hospitalized for heart failure\u2014Analysis of a nationwide inpatient database","volume":"2","author":"Kaneko","year":"2020","journal-title":"Circ. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1038\/s41440-020-0505-2","article-title":"Association between the number of hospital admissions and in-hospital outcomes in patients with heart failure","volume":"43","author":"Kaneko","year":"2020","journal-title":"Hypertens. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1253\/circj.CJ-20-0314","article-title":"Association of cancer with outcomes in patients hospitalized for heart failure","volume":"84","author":"Kaneko","year":"2020","journal-title":"Circ. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00380-020-01699-6","article-title":"Reverse J-shaped relationship between body mass index and in-hospital mortality of patients hospitalized for heart failure in Japan","volume":"36","author":"Itoh","year":"2021","journal-title":"Heart Vessels"},{"key":"ref_22","first-page":"61","article-title":"Functional evaluation: The Barthel index","volume":"14","author":"Mahoney","year":"1965","journal-title":"MD State Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1016\/S0140-6736(09)60658-9","article-title":"Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial","volume":"373","author":"Schweickert","year":"2009","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1093\/aje\/kwn164","article-title":"Constructing inverse probability weights for marginal structural models","volume":"168","author":"Cole","year":"2008","journal-title":"Am. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1056\/NEJMoa2026141","article-title":"Physical rehabilitation for older patients hospitalized for heart failure","volume":"385","author":"Kitzman","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ahj.2020.09.009","article-title":"Early rehabilitation in older patients hospitalized with acute decompensated heart failure: A retrospective cohort study","volume":"230","author":"Takada","year":"2020","journal-title":"Am. Heart J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1097\/HCR.0000000000000422","article-title":"Effectiveness of early rehabilitation for acute heart failure: A retrospective cohort study","volume":"39","author":"Suzuki","year":"2019","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.2522\/ptj.20050036","article-title":"Effects of physical training on functional status in patients with prolonged mechanical ventilation","volume":"86","author":"Chiang","year":"2006","journal-title":"Phys. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tanaka, S., Kamiya, K., Matsue, Y., Yonezawa, R., Saito, H., Hamazaki, N., Matsuzawa, R., Nozaki, K., Yamashita, M., and Wakaume, K. (2022). Effects of electrical muscle stimulation on physical function in frail older patients with acute heart failure: A randomized controlled trial. Eur. J. Prev. Cardiol.","DOI":"10.1093\/eurjpc\/zwac022"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/eurjhf\/hfr017","article-title":"Exercise training in heart failure: From theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation","volume":"13","author":"Piepoli","year":"2011","journal-title":"Eur. J. Heart Fail."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S382","DOI":"10.1016\/j.cjca.2016.06.001","article-title":"Heart Failure: Exercise-based cardiac rehabilitation: Who, when, and how intense?","volume":"32","author":"Haykowsky","year":"2016","journal-title":"Can. J. Cardiol."},{"key":"ref_32","unstructured":"Makita, S., Yasu, T., Akashi, Y., Adachi, H., Izawa, H., and Ishihara, S. (2021). JCS\/JACR 2021 guideline on rehabilitation in patients with cardiovascular disease. Circ. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"R38","DOI":"10.1186\/cc13746","article-title":"Early mobilization of patients receiving extracorporeal membrane oxygenation: A retrospective cohort study","volume":"18","author":"Abrams","year":"2014","journal-title":"Crit. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.jacc.2018.12.072","article-title":"Impact of exercise rehabilitation on exercise capacity and quality-of-life in heart failure: Individual participant meta-analysis","volume":"73","author":"Taylor","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.jacc.2011.06.054","article-title":"Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: Results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study","volume":"58","author":"Edelmann","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.jacc.2005.09.052","article-title":"Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: A randomized trial","volume":"47","author":"Chiappa","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1161\/01.CIR.85.6.2119","article-title":"Controlled trial of physical training in chronic heart failure. Exercise performance, hemodynamics, ventilation, and autonomic function","volume":"85","author":"Coats","year":"1992","journal-title":"Circulation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ijcard.2016.12.145","article-title":"Effect of exercise training on endothelial function in heart failure patients: A systematic review meta-analysis","volume":"231","author":"Pearson","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1002\/ejhf.101","article-title":"Effects of exercise training on depression in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Tu","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1016\/j.jacc.2007.02.055","article-title":"A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: The benefit depends on the type of training performed","volume":"49","author":"Haykowsky","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/j.jacc.2012.06.036","article-title":"10-year exercise training in chronic heart failure: A randomized controlled trial","volume":"60","author":"Belardinelli","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1152\/japplphysiol.90558.2008","article-title":"Skeletal muscle proteolysis in response to short-term unloading in humans","volume":"105","author":"Tesch","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1001\/jama.297.16.1772-b","article-title":"Effect of 10 days of bed rest on skeletal muscle in healthy older adults","volume":"297","author":"Kortebein","year":"2007","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.jchf.2016.12.019","article-title":"A novel rehabilitation intervention for older patients with acute decompensated heart failure: The REHAB-HF pilot study","volume":"5","author":"Reeves","year":"2017","journal-title":"JACC Heart Fail."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.je.2016.09.009","article-title":"Validity of diagnoses, procedures, and laboratory data in Japanese administrative data","volume":"27","author":"Yamana","year":"2017","journal-title":"J. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"\u015awi\u0105tkiewicz, I., Di Somma, S., De Fazio, L., Mazzilli, V., and Taub, P.R. (2021). Effectiveness of intensive cardiac rehabilitation in high-risk patients with cardiovascular disease in real-world practice. Nutrients, 13.","DOI":"10.3390\/nu13113883"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ambrosetti, M., Abreu, A., Corr\u00e0, U., Davos, C.H., Hansen, D., Frederix, I., Iliou, M.C., Pedretti, R.F., Schmid, J.P., and Vigorito, C. (2020). Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur. J. Prev. Cardiol., 2047487320913379.","DOI":"10.1177\/2047487320913379"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/9\/4\/97\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:43:34Z","timestamp":1760136214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/9\/4\/97"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,25]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["jcdd9040097"],"URL":"https:\/\/doi.org\/10.3390\/jcdd9040097","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,25]]}}}