Post-intervention durability of standalone digital behavior change interventions for physical activity in adults: a focused mini review and quantitative synthesis.

Japan’s rapidly aging population has led to a significant increase in the number of patients with cardiovascular disease (CVD) presenting with preexisting declines in activities of daily living (ADL), frailty, sarcopenia, and multimorbidity. These conditions often result in complex disabilities that often delay the achievement of acute-phase rehabilitation goals. Furthermore, approximately 20% of older adults experience hospitalization-associated disability (HAD) following acute care, and HAD has been reported in 10–20% of older patients with CVD. According to the Japanese J-Proof HF registry, 37.1% of older patients with heart failure developed HAD, and the presence of HAD was a major prognostic factor associated with an increased risk of 1-year death. In addition, in patients with heart failure or acute coronary syndrome and in those who have undergone cardiovascular surgery, poor ADL status at discharge from acute-care hospitals has been identified as a predictor of death and unplanned readmission. Therefore, preventing further ADL decline in patients with CVD is important, but within the limited length of hospital stay (LOS) in acute-care hospitals, sufficient recovery of ADL is not always achieved. For these patients, community rehabilitation wards, which can provide sustained and intensive cardiac rehabilitation (CR) during the post-acute phase, have attracted increasing attention.