Background: The growing population of the elderly is accompanied by an increase in the number of people with frailty syndrome. Apart from advanced age, the occurrence of cardiovascular diseases is also one of the agents favorable to frailty that is a factor aggravating the disease prognosis. However, it is worth noting that this is an agent changeable by, i.a., movement rehabilitation. Cardiac rehabilitation (CR) based on comprehensiveness, early implementation, and multiplicity is standard intervention in patients with cardiovascular diseases. In cardiac patients with accompanying frailty or pre-frailty syndrome, it is worth making efforts to upgrade the CR program. Methods: Studies on the effect of cardiac rehabilitation or its modifications on the level of frailty of patients with cardiovascular disease were analyzed. Results: Training programs based on endurance training should be supplemented by resistance, balance, mobility, and respiratory exercises. Furthermore, it is important to educate patients about the need to increase daily physical activity. This review presents different approaches to CR (traditional CR, multicomponent training, training with a HAL (Hybrid Assistive Limb), and prehabilitation) and their impact on frailty score. Summary: Early implemented and comprehensive rehabilitation allows for the improvement of the clinical state and for a decrease in overall frailty. It also guarantees safety during everyday activities. It is crucial for the fitness of the elderly to encourage them to increase daily physical activity and to exercises at home.

Background: Heart failure (HF) patients experience reduced functional fitness level (determining the performance of routine, daily activities) and diminished exercise capacity (linked to more effortful activities). Aim: The aim of the study is to assess this relationship using functional fitness tests compared to peak VO2 and VE/VCO2 slope in the context of exercise capacity and ventilatory response to exercise. Methods: A total of 382 men with stable HFrEF (age: 61 ± 10, NYHA class I/II/III/IV: 16/50/32/2%, LVEF: 30.5 ± 8.3%) underwent cardiopulmonary exercise testing (CPX) and a Senior Fitness Test (SFT). Afterwards, the patients were divided according to the 2capacity with peak VO2 ≥ 18 mL/kg/min, those with higher or lower ventilatory responses (VE/VCO2 slope ≥ 35 vs. <35) to the exercise were compared. Results: Patients who covered shorter distances in the 6 min walking test showed worse results in the functional tests (‘stand up and go’, ‘chair stand’ and ‘arm curl’) and CPX (lower peak VO2, shorter exercise time and higher VE/VCO2 slope). Subjects classified into Class D demonstrated the worst results in all elements of SFT; those in Class A demonstrated the best results. Significant differences that were analogous occurred also between classes B and C. Among the participants who reached peak VO2 ≥ 18 mL/kg/min (n = 170), those with VE/VCO2 slope ≥ 35 were characterized by worse physical fitness as compared to those with VE/VCO2 < 35. Conclusion: Reduced exercise tolerance led to worsening physical function in patients with HFrEF. Moreover, limitations in physical fitness seem to be distinctive for those patients showing excessive ventilatory response to exercise slope VE/VCO2 (≥35). The Senior Fitness Test may be considered as a useful tool for assessing comprehensive functional and clinical status and risk stratification in patients with HFrEF, especially those with extremely low exercise capacity.