What question did this study set out to answer?

This research aims to explore the connection between outpatient cardiac rehabilitation and the occurrence of falls in older patients with cardiovascular disease.

February 22, 2026Open Access

Association Between Outpatient Cardiac Rehabilitation and Falls in Older Patients With Cardiovascular Disease　― A 1-Year Longitudinal Study ―

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Older patients (aged ≥65 years) with cardiovascular disease who participated in early phase II cardiac rehabilitation (n=110). Intervention: Outpatient cardiac rehabilitation (OCR) program vs. Non-participation in outpatient cardiac rehabilitation. Primary outcome: Incidence and frequency of falls within 1 year after hospital discharge (Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39, 95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89, p=IRR P<0.01; RR P=0.02).

Q: What does this research mean for the field?

Outpatient cardiac rehabilitation significantly reduces the 1-year incidence of falls in older patients with cardiovascular disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

KSKenzo ShiotaOsaka City University MSMasakazu SaitohHeart Failure & Transplant KIKotaro IwatsuHeart Failure & Transplant

Key Result

Outpatient cardiac rehabilitation reduced the 1-year incidence of falls from 31.0% to 9.6% in older cardiovascular disease patients, with adjusted IRR 0.42 and RR 0.39.

Key Points

This research aims to explore the connection between outpatient cardiac rehabilitation and the occurrence of falls in older patients with cardiovascular disease.
Longitudinal study design over one year
Focused on older patients diagnosed with cardiovascular disease
Assessed incidence of falls in relation to outpatient cardiac rehabilitation
Identified the rate of falls among participants
Examined the relationship between outpatient cardiac rehabilitation and fall incidents
Findings suggested a potential association between cardiac rehabilitation and reduced fall risk

Study Design

Type

Cohort (n=110)

Multicenter

Structured PICO

Does outpatient cardiac rehabilitation reduce the incidence of falls in older patients with cardiovascular disease?

Population

110 patients with cardiovascular disease aged ≥65 years who were hospitalized and participated in early phase II cardiac rehabilitation, mean age 77.2, 36.4% female, based in Japan.

Intervention

Outpatient cardiac rehabilitation (OCR) program comprising aerobic and resistance exercises, and multidisciplinary guidance (medication, nutrition, fall prevention), attending at least once within 3 months of discharge (median 18 sessions).

Comparator

Non-OCR group (did not participate in outpatient cardiac rehabilitation).

Outcome

Incidence and frequency of falls within 1 year after hospital discharge, assessed via mailed self-reported questionnaire and medical records.patient reported

Participation in outpatient cardiac rehabilitation is associated with a significantly lower incidence and risk of falls in older patients with cardiovascular disease.

Main Result

Effect estimate: Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39 (95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89)

Absolute Event Rate: 9.6% vs 31%

p-value: p=IRR P<0.01; RR P=0.02

Limitations

Limited number of outcome events restricting adjustment for multiple confounders
Falls data collected via self-reported questionnaire once at 1 year possibly introducing recall bias
Some OCR participants attended only one session possibly attenuating effects
Exclusion of patients not participating in early phase II CR may introduce selection bias
Timing of falls not recorded preventing temporal pattern analysis
No systematic follow-up assessments of physical function or frailty after OCR
Observational single-center study design limits generalizability and residual confounding may exist despite adjustment

Abstract

Background: Falls are a serious medical problem. With the aging of patients with cardiovascular disease (CVD), falls have become an important clinical outcome. However, evidence regarding falls in this population is limited, and the impact of cardiac rehabilitation (CR) remains unclear. This study investigated the incidence of falls and examined the association between outpatient CR (OCR) and falls among older patients with CVD.

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Cite This Study

Shiota et al. (Thu,) conducted a cohort in Older patients (aged ≥65 years) with cardiovascular disease who participated in early phase II cardiac rehabilitation (n=110). Outpatient cardiac rehabilitation (OCR) program vs. Non-participation in outpatient cardiac rehabilitation was evaluated on Incidence and frequency of falls within 1 year after hospital discharge (Adjusted incidence rate ratio (IRR) 0.42; adjusted risk ratio (RR) 0.39, 95% CI IRR 95% CI 0.23–0.76; RR 95% CI 0.18–0.89, p=IRR P<0.01; RR P=0.02). Outpatient cardiac rehabilitation reduced the 1-year incidence of falls from 31.0% to 9.6% in older cardiovascular disease patients, with adjusted IRR 0.42 and RR 0.39.

synapsesocial.com/papers/699a9ceb482488d673cd2a14 https://doi.org/https://doi.org/10.1253/circrep.cr-25-0267