Issue 25-2, 2026

Review

https://doi.org/10.38025/2078-1962-2026-25-2-77-90

Personalizing Physical Rehabilitation for Geriatric Patients Using Cardiorespiratory Exercise Testing: A Review

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ORCIDMariia S. Arefeva*, ORCIDElena A. Kolesnikova, ORCIDNadezda K. Runikhina, ORCIDKsenia A. Eruslanova, ORCIDOlga N. Tkacheva

Pirogov Russian National Research Medical University, Moscow, Russia


ABSTRACT

INTRODUCTION.  Increasing proportion of elderly individuals foregrounds the healthy aging paradigm, a key condition of which is requiring functional capacity preservation via multicomponent physical training. Heterogeneity, multimorbidity, polypragmasy, geriatric syndromes hinder a unified approach for personalizing aerobic exercise intensity.

AIM.  To systematize existing and potential approaches to personalizing physical rehabilitation programs for geriatric patients in order to formulate practice-oriented principles for determining individual aerobic training intensity.

MAIN CONTENT OF THE REVIEW.  A literature search was conducted in the PubMed, Web of Science, and Cochrane Library databases. Meta-analyses, systematic reviews, and original articles focusing on the personalization of physical rehabilitation for geriatric patients based on cardiopulmonary exercise testing data were selected. The search covered the period from 2015 to 2025. Various personalization methods were reviewed. Comprehensive Geriatric Assessment, while the foundation for stratifying geriatric patients, provides no objective physiological parameters. Traditional methods (calculation formulas, 6-minute walk test, Borg scale) show high subjectivity, variability, overlooking metabolic patterns. Cardiopulmonary Exercise Testing (CPET) the reference for exercise personalization. This review identifies key limitations of applying cardiac rehabilitation and sports medicine methods to geriatric patients, stemming from reduced functional reserve, multimorbidity, and geriatric-specific conditions. Methods using percentages of maximal heart rate and peak oxygen uptake are constrained by polypragmasy, inability to reach a true physiological maximum during testing in the geriatric population and other factors. As a physiologically sound alternative, the use of ventilatory thresholds (VT) is proposed. This approach is positioned as a physiologically grounded tool for determining personalized and clinically safe physical activity regimens.

CONCLUSION.  Personalization of aerobic training in geriatrics population should be implemented as a process encompassing a clinical-geriatric stratification stage followed by physiological calibration of intensity based on CPET results. The use of VT represents the most accurate and safe method to set individual training zones in geriatrics, enabling risk minimization while enhancing rehabilitation efficacy. The lack of specialized studies in the population of patients with frailty syndrome underscores the necessity for further research focused on developing physical rehabilitation programs for geriatric patients.


KEYWORDS: physical activity, cardiorespiratory endurance, 6-minute walk test, exercise tolerance/intolerance, frailty, comprehensive geriatric assessment, geriatric rehabilitation, cardiopulmonary exercise testing, ventilatory threshold, aerobic training

FOR CITATION: Arefeva M.S., Kolesnikova E.A., Runikhina N.K., Eruslanova K.A., Tkacheva O.N. Personalizing Physical Rehabilitation for Geriatric Patients Using Cardiorespiratory Exercise Testing: A Review. Bulletin of Rehabilitation Medicine. 2026; 25(2):77–90. https://doi.org/10.38025/2078-1962-2026-25-2-77-90 (In Russ.).

FOR CORRESPONDENCE:

Mariia S. Arefeva, E-mail: arefieva_ms@rgnkc.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.