Tae Watanabe, Kimiko Tagawa, Yu Kimura, Toshiro Kitagawa, Kiyokazu Sekikawa, Yukiko Nakano, Sanae Oriyama
Abstract
Heart failure (HF) restricts activities of daily living, impacting prognosis and quality of life. Dressing requires sustained upper-limb movements, postural transitions, and fine-motor tasks that may impose cardiovascular and autonomic demands, potentially informing on physiological tolerance during daily activities.
Introduction
Heart failure (HF) is a progressive clinical syndrome characterized by impaired cardiac function and autonomic dysregulation, leading to reduced exercise tolerance and limitations in activities of daily living (ADLs) [1–3]. In patients with HF, post-activity regulation of heart rate (HR) and blood pressure is often delayed, causing unstable hemodynamic recovery [4,5].
Materials & methods
Participants were recruited between April 2024 and July 2025. Eligible individuals included outpatients aged 60–79 years who had been treated as inpatients for HF, who were at least 6 months post-discharge, as well as age-matched HCs.
Results
The baseline characteristics of the study participants (mean age: 70.4 ± 6.1 years) are presented in Table 1. The study included 39 individuals (R-HF, n = 12; NO-HF, n = 12; and HC, n = 15).
Discussion
This study showed that even a low-intensity dressing task revealed exploratory differences in the quality of recovery (speed and stability) among patients with HF and that NO-HF and R-HF may manifest distinct vulnerability patterns. Using a single protocol, we directly compared R-HF, NO-HF, and HC while concurrently assessing the cardiovascular (HR/SBP), autonomic (HRV), behavioral (ULSC), and subjective (Borg) domains.
Conclusion
Even a low-intensity dressing task revealed exploratory differences in recovery quality among groups: HRR ranked as R-HF > NO-HF > HC. NO-HF tended to show persistently higher HR levels with higher Borg ratings, while R-HF descriptively showed a blunted HR rise with delayed HR recovery.
Citation: Watanabe T, Tagawa K, Kimura Y, Kitagawa T, Sekikawa K, Nakano Y, et al. (2026) Dressing-induced hemodynamic instability in patients with heart failure: Implications for nursing care. PLoS One 21(6): e0351501. https://doi.org/10.1371/journal.pone.0351501
Editor: Satoshi Higuchi, Showa University: Showa Daigaku, JAPAN
Received: December 3, 2025; Accepted: May 28, 2026; Published: June 11, 2026
Copyright: © 2026 Watanabe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The dataset includes potentially identifiable human participant information and cannot be shared publicly due to ethical restrictions. Data are available upon reasonable request for researchers who meet the criteria for access to confidential data, with approval from the Ethics Committee of Hiroshima University. Data are available upon request from the Ethics Committee of Hiroshima University via email (iryo-sinsa@office.hiroshima-u.ac.jp), telephone (+81-82-257-5947), or website (https://ethics.hiroshima-u.ac.jp) for researchers who meet the criteria for access to confidential data.
Funding: This study was supported by the Japan Society for the Promotion of Science (JSPS), KAKENHI (grant number 23K09973 to TW). The funders played no role in the study design, data collection and analysis, decision to publish, or manuscript preparation. There was no additional external funding received for this study.
Competing interests: The authors have declared that no competing interests exist.
