In a compelling session of the Interdisciplinary Rehabilitative Research Seminar Series, Duke Doctor of Physical Therapy (DPT) and Duke Occupational Therapy Doctorate (OTD) cohosted a presentation by Amy M. Pastva, PT, MA, PhD, professor of orthopaedic surgery and director of division research for the Duke Doctor of Physical Therapy program. Her talk, titled “The Vital Sign We Forgot: Function in Acute Heart Failure – Evidence from REHAB-HF and REHAB-HFpEF,” spotlighted a critical yet often overlooked metric in patient care: physical function.
“Vital signs are normally tracked over time, but what’s missed? Function,” Dr. Pastva emphasized. “This is critical for older adults and those handling chronic conditions.”
Acute heart failure remains the leading cause of hospitalization in older adults. When the heart fails to pump effectively, fluid builds up, impairing not only cardiac function but also the ability to perform basic self-care tasks. This decline in function contributes to reduced life expectancy and persistently high rates of hospital readmission.
Dr. Pastva’s research, conducted through the REHAB-HF clinical trial, shows that functional decline contributes to heart failure. The study emphasizes the importance of focusing on physical activity, quality of life, and cognitive function as interconnected parts of recovery.
“We need to improve,” she urged. “Today, patients must opt in for physical therapy before leaving the hospital. But our research shows that practical and individualized physical therapy (PT) should begin immediately.”
The REHAB-HF model promotes early intervention through targeted physical therapy focused on four key domains: strength, mobility, balance, and endurance. Dr. Pastva’s team has demonstrated that creating meaningful behavior change requires at least eight weeks of structured support, including transition-to-home programs and community-based exercise prescriptions.
“Patients are not too frail to participate,” she noted. “They need this intervention to prevent fragility. Low-tech, high-value treatments provided by PTs are effective and accessible.”
Currently in Phase 3, the REHAB-HF trial includes 512 participants and 151 physical therapists. The results continue to affirm that function is the vital sign we often forget—and perhaps the most important one.
“A strong body equals a strong heart,” Dr. Pastva concluded, reinforcing the transformative potential of rehabilitative care in acute heart failure management.
This seminar not only highlighted groundbreaking research but also reinforced the collaborative mission of Duke DPT and Duke OTD to advance interdisciplinary approaches in rehabilitative science.