Rehabilitation Strategies for Heart Failure Management

Rehabilitation for heart failure has evolved into a multidimensional endeavour that seeks not only to improve cardiac function but also to restore overall physical capacity, quality of life and autonomy. Contemporary programmes integrate tailored exercise regimens, patient education and psychosocial support, with early initiation during hospitalisation increasingly recognised as pivotal. Aerobic and resistance training, often combined with non-pharmacological adjuncts such as non-invasive ventilation or electrical muscle stimulation, have demonstrated benefits in exercise tolerance, skeletal muscle strength and symptom burden. Digital innovations, including tele-rehabilitation platforms, have expanded accessibility and adherence, particularly for populations facing mobility or geographic barriers. Rehabilitation pathways are now stratified according to heart failure phenotype, frailty status and comorbidities, ensuring individualised intensity and progression. Emerging evidence highlights the importance of acute-phase interventions—initiated within days of decompensation—to attenuate muscle wasting and promote early functional recovery. Across chronic and acute settings, a collaborative, multidisciplinary framework underpins successful programmes, linking cardiologists, physiotherapists, nurses and dietitians. As the global burden of heart failure rises, these integrated strategies underscore a shift from purely medical management towards holistic restoration of patient function and independence.

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Rehabilitation Strategies for Heart Failure Management publication trend

The graph below shows the total number of articles in rehabilitation strategies for heart failure management across all publications each year (not limited to Nature Index journals).

Technical terms

Heart failure with preserved ejection fraction (HFpEF): A form of heart failure characterised by normal left ventricular ejection fraction but impaired relaxation and filling, leading to symptoms of congestion and exercise intolerance.

Tele-rehabilitation: Delivery of rehabilitation services via digital platforms, including remote exercise supervision, education and progress monitoring, to enhance access and adherence.

Neuromuscular electrical stimulation (NMES): Application of low-frequency electrical currents to induce muscle contractions, used as an adjunct to exercise in patients unable to perform conventional training.

Six-minute walk test (6MWT): A standardised measure of functional exercise capacity that records the distance a patient can walk in six minutes on a flat corridor.

Acute-phase rehabilitation: Initiation of rehabilitative exercises and interventions during the early hospitalisation period, aimed at mitigating muscle deconditioning and accelerating recovery.

Frailty: A clinical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors, often assessed by performance scales and gait speed.

References

1. Tele-rehabilitation for Type II diabetics with heart failure with preserved ejection fraction. Frontiers in Endocrinology (2024).
2. The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients: Results of a multicenter randomized controlled trial (ERIC-HF study). Clinical Rehabilitation (2022).
3. Efficacy and Safety of Acute Phase Intensive Electrical Muscle Stimulation in Frail Older Patients with Acute Heart Failure: Results from the ACTIVE-EMS Trial. Journal of Cardiovascular Development and Disease (2022).
4. Safety and Efficacy of Aerobic Exercise Training Associated to Non-Invasive Ventilation in Patients with Acute Heart Failure. Arquivos Brasileiros de Cardiologia (2018).