Inclusion Criteria:  Patients awaiting heart valve surgery for repair or replacement Both gender Mild to moderate valvular diseases NYHA grade I and II Pre-frail to moderately frail patients with a CFS of 4-6 Patients with an estimated 6-8 weeks of surgical waiting list time. Able to perform 6MWT at baseline with RPE<13  Exclusion Criteria:  Patients with severe left ventricular obstructive disease (severe aortic or mitral stenosis and dynamic left ventricular outflow obstruction). Patients with unstable or recently unstable cardiac syndrome Other than valve surgeries e.g. CABG Hospitalization for arrhythmias/ congestive heart failure