# Pilot Study of a Moderate- to High-Intensity Home-based Rehabilitation Program as a Bridge to Cardiac Rehabilitation in Older Adults Hospitalized for Heart Failure

> **NIH NIH R03** · DENVER RESEARCH INSTITUTE · 2020 · $90,600

## Abstract

ABSTRACT/PROJECT SUMMARY
Heart failure (HF) accounts for over 1 million hospitalizations annually among Medicare beneficiaries, and is a
major risk factor for adverse outcomes in older adults, including hospital associated disability, rehospitalization
and mortality, and decline in functional status. Patients hospitalized for HF must not only recover from a HF
exacerbation, which in and of itself leads to adverse skeletal muscle changes, but must also recover from the
deconditioning and acute sarcopenia that occurs as a consequence of being hospitalized irrespective of
etiology. Currently, there are few rehabilitation programs aimed at the unique needs of older adults hospitalized
for HF. Cardiac rehabilitation (CR) is a comprehensive, 12-week exercise and lifestyle modification program
typically administered under supervision in a healthcare facility. However, CR is inaccessible to many older
adults hospitalized for HF due to lack of financial and social resources. Home-based CR (HBCR) is also
inaccessible to many older adults hospitalized for HF because risk of falling is too high to perform
unsupervised exercise. Among patients capable of participating in CR, the Centers for Medicare and Medicaid
Services only reimburse for CR in patients who have not been hospitalized for 6 weeks. The most vulnerable
time for rehospitalization for patients with HF is the first 30 days after discharge, leaving a significant
rehabilitation gap. The Strength, Aerobic fitness and Balance (SAB-HF Program) is designed to rehabilitate
older adults hospitalized for HF using a novel, moderate-to-high intensity interval-based exercise program. The
SAB-HF Program is more rigorous than usual rehabilitation care provided in most inpatient and post-acute care
settings, and is designed to maximize adherence with an interval-based protocol associated with lower
perceived exertion, and by administering the program in the home by a trained physical therapist. Finally, the
SAB-HF Program is designed for the express goal of transitioning patients to a HBCR program. This grant
proposes a pilot randomized trial of the SAB-HF Program versus usual care. The objective of this pilot study is
to test the feasibility, acceptability and preliminary effect of the SAB-HF Program in older (65 years) adults
hospitalized for HF. If the SAB-HF Program is feasible, then these data will lay the groundwork for a larger
efficacy trial comparing the SAB-HF Program followed by HBCR vs. HBCR alone among older adults
hospitalized for HF. Eventually, this research may lead to the creation of a comprehensive, patient-centered,
home-based rehabilitation intervention aimed at preventing worsening disability and dependence among older
adults hospitalized for HF.

## Key facts

- **NIH application ID:** 10005109
- **Project number:** 5R03AG064371-02
- **Recipient organization:** DENVER RESEARCH INSTITUTE
- **Principal Investigator:** Kelsey M Flint
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $90,600
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005109

## Citation

> US National Institutes of Health, RePORTER application 10005109, Pilot Study of a Moderate- to High-Intensity Home-based Rehabilitation Program as a Bridge to Cardiac Rehabilitation in Older Adults Hospitalized for Heart Failure (5R03AG064371-02). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10005109. Licensed CC0.

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