Usefulness of the Edmonton Frail Scale in Assessing the Impact of Heart Failure on Frailty.

BACKGROUND/AIM: The association of frailty with heart failure (HF) is common in the elderly, and its presence is a poor prognostic factor; it increases the risk of falls, disability, hospitalization, and mortality. The aim of this prospective study was to assess the incidence of physical frailty in patients with HF and the role of physical exercise in improving physical performance. PATIENTS AND METHODS: A total of 141 patients with musculoskeletal pathology, aged over 65 years, who followed a specific physical training program were included. The patients were assigned to two groups: HF patients -group HF (n=53) and patients without HF -group N-HF (n=88). RESULTS: At cohort level, mild and moderate frailty was detected in 20.56% of patients enrolled in the study (n=29). Severe form of frailty was identified in 2.83% of cases (n=4). The prevalence of mild, moderate, and severe frailty in the two groups differed significantly (p<0.05). Patients with mild frailty and moderate frailty in the HF group represented 24.52% compared to 18.18% in the N-HF group (p=0.007). Severe frailty was present in 5.66% in the HF group, not significantly different from the N-HF group (1.13%), p=0.317. The values obtained in the functional independence and functional performance domains were significantly improved at the reassessment after 6 months. CONCLUSION: Exercise-based rehabilitation is a primary therapy for improving physical performance, reflected by increased independence related to daily activities and functional performance in HF patients.

The Contribution of Diet Therapy and Probiotics in the Treatment of Sarcopenia Induced by Prolonged Immobilization Caused by the COVID-19 Pandemic.

The prolonged immobilization associated with COVID-19 infection and the restrictions imposed by the pandemic have determined major changes in physical activity and eating habits, with a negative impact on physical performance. This study monitored non-pharmacological interventions (diet therapy and probiotics) in managing sarcopenia for patients with recent SARS-CoV-2 history (14 days). A prospective study was performed on 200 patients (between December 2020−December 2021), with SPPB score < 9, randomly divided into: Group K­DP (93 patients) with dietary therapy (protein 1.2−1.5 g/kg) and probiotics for two months; and Group K­non-DP (107 patients) without diet therapy and probiotics. All patients were included in a specific physical training program (40 min), three sessions per week. Skeletal muscle index (SMI), serum albumin, and hemoglobin were determined. The SMI was initially low for both groups without significant statistical differences (6.5 ± 0.52 kg/m2 for Group K­non-DP vs. 6.7 ± 0.57 Kg/m2 for Group K­DP, p = 0.135). After two months, significant difference between initial and final SMI values was determined for Group K­DP (6.92 ± 0.50 kg/m2 vs. 6.77 ± 0.56 kg/m2, p = 0.048). In Group K­DP, at end of study, were more patients with normal SMI (n = 32 → N = 70) values (p < 0.001) and fewer sarcopenia patients (p < 0.001). The initial serum albumin means values in the two groups (Group K­non-DP, 4.17 ± 1.04 g/dL, and Group K­DP, 3.95 ± 0.98 g/dL) were not statistically significantly different (p = 0.122). The hemoglobin level improved significantly following a hyper protein diet enriched with pro-biotics (p = 0.003). Diet therapy, consisting of increased protein intake and specific probiotics and specific physical therapy, demonstrated superiority in improving the functional status of patients with recent COVID-19 infection.