Strategies to Optimize Recovery in Frail Patients With Cardiovascular Disease Through Exercise-Based Cardiac Rehabilitation

Abstract

Cardiovascular disease (CVD) remains a critical global health challenge, with frailty in older adults further exacerbating the risk of adverse outcomes. Exercise-based cardiac rehabilitation (EBCR) offers a promising approach to improving cardiovascular function, reducing mortality, and enhancing quality of life in individuals with CVD. However, frail patients often encounter unique barriers, including reduced muscle strength, impaired mobility, and logistical challenges, which hinder their participation in traditional EBCR programs. Resistance training has been shown to improve muscle strength, balance, and functional independence while reducing fall risk, making it a key intervention for frail individuals. Aerobic exercise, when introduced gradually, further enhances cardiovascular endurance and overall resilience. Telehealth exercise strategies can provide an effective means of overcoming logistical barriers by fostering adherence and enabling real-time adjustments to exercise regimens, despite challenges such as digital literacy. This narrative review highlights innovative strategies integrating personalized exercise regimens and telehealth solutions to address the unique needs of frail patients. By prioritizing adaptable, accessible, and evidence-based strategies, an evolved EBCR approach holds the potential to significantly improve long-term health outcomes and quality of life for this vulnerable population. © 2025 Elsevier B.V., All rights reserved.