Clinical Trials

Inclusion Criteria:

1. older adults aged ≥70 years,
2. at least one criteria positive on the FRAIL scale,
3. hospital discharge to an independent residence,
4. primary final discharge diagnosis of coronary disease or heart failure but not requiring cardiac surgery or TAVR during the index hospitalization,
5. able to stand and walk without assistance from another person,
6. able to carry out basic activities of daily living without assistance as per Clinical Frailty Scale rating ≤5,
7. signed informed consent from the patients, and
8. approval from the treating physician that the patient is safe and appropriate to participate in this trial.

Exclusion Criteria:

1. cognitive impairment defined by a positive mini-cog test or known moderate or severe dementia,
2. more than one fall in the past six months, or a fall in the past three months prior to hospitalization,
3. high-risk for falls or unsteady for mobilization according to a clinical physical therapist's assessment (if performed) or as assessed during functional testing,
4. non-revascularized acute myocardial infarction within the past month (unless revascularization was not indicated) or uncorrected severe symptomatic aortic stenosis,
5. active severe symptoms of angina, dyspnea, or claudication at rest or with minimal activity (Canadian Cardiovascular Society class 4, New York Heart Association class 4, or Fontaine class 3-4, respectively),
6. referral to a structured cardiac rehabilitation program in the first 30 days after hospital discharge (not counting home-based physical therapy),
7. unable to return for follow-up visit, and
8. poor comprehension of the actigraphy device.