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Lourens EC, Baker RA, Krieg BM. Quality of life following cardiac rehabilitation in cardiac surgery patients. J Cardiothorac Surg 2022; 17:137. [PMID: 35642068 PMCID: PMC9153224 DOI: 10.1186/s13019-022-01893-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undergoing cardiac surgery often result in perioperative loss of health-related quality of life (HRQOL). Although participation rates in Australia is low, cardiac rehabilitation (CR) has been demonstrated to improve patient HRQOL in cardiac patients. Literature is unclear regarding the role of CR and HRQOL in the cardiac surgery (CS) patient population. METHODS A prospective non-randomised study was conducted on eligible cardiac surgery patients between December 2009 and March 2015. HRQOL was assessed using the Short Form 12 at baseline and post-operatively at 30 days and 180 days. CR participation was recorded and barriers to CR uptake was assessed using the Cardiac Rehabilitation Enrolment Obstacles (CREO) scale. RESULTS At 180 days, 107 patients participated in CR and 111 did not participate in CR. A significant improvement from baseline mental and physical HRQOL was observed in both groups at 30 days and 180 days (p < 0.002). No significant difference between group characteristics or HRQOL was observed at any time. A trend of superior improvement in mental QOL was observed in the CR group. The study is limited by poor initial uptake (218/1772 of eligible) and may be underpowered to observe a clinical difference. A significant difference in CREO scores were observed between the two groups at 30 days (13 out of 16 questions, p < 0.001) and 180 days (11 out of 16 questions, p < 0.011). CONCLUSION Literature has shown that CR may improve numerous health outcomes in cardiac and CS patients, however CR uptake in Australia is low. Mental and Physical QOL is demonstrated to improve following CS, however further research is required to delineate the role of CR and QOL in CS patients. The CREO tool utilised in this study identified numerous potentially modifiable barriers to CR uptake. Specific strategies related to the survey are suggested to improve awareness, uptake, and adherence to CR, including advocacy of home-based and telehealth services.
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Affiliation(s)
- Ernest Christian Lourens
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia.
| | - Robert Ashley Baker
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia
| | - Bronwyn M Krieg
- CTSU Quality and Outcomes, Flinders Medical Centre, Bedford Park, Adelaide, SA, 5042, Australia
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Ding EY, Erskine N, Stut W, McManus DD, Peterson A, Wang Z, Escobar Valle J, Albuquerque D, Alonso A, Botkin NF, Pack QR, McManus DD. MI-PACE Home-Based Cardiac Telerehabilitation Program for Heart Attack Survivors: Usability Study. JMIR Hum Factors 2021; 8:e18130. [PMID: 34255660 PMCID: PMC8299347 DOI: 10.2196/18130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/17/2020] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiac rehabilitation programs, consisting of exercise training and disease management interventions, reduce morbidity and mortality after acute myocardial infarction. OBJECTIVE In this pilot study, we aimed to developed and assess the feasibility of delivering a health watch-informed 12-week cardiac telerehabilitation program to acute myocardial infarction survivors who declined to participate in center-based cardiac rehabilitation. METHODS We enrolled patients hospitalized after acute myocardial infarction at an academic medical center who were eligible for but declined to participate in center-based cardiac rehabilitation. Each participant underwent a baseline exercise stress test. Participants received a health watch, which monitored heart rate and physical activity, and a tablet computer with an app that displayed progress toward accomplishing weekly walking and exercise goals. Results were transmitted to a cardiac rehabilitation nurse via a secure connection. For 12 weeks, participants exercised at home and also participated in weekly phone counseling sessions with the nurse, who provided personalized cardiac rehabilitation solutions and standard cardiac rehabilitation education. We assessed usability of the system, adherence to weekly exercise and walking goals, counseling session attendance, and disease-specific quality of life. RESULTS Of 18 participants (age: mean 59 years, SD 7) who completed the 12-week telerehabilitation program, 6 (33%) were women, and 6 (33%) had ST-elevation myocardial infarction. Participants wore the health watch for a median of 12.7 hours (IQR 11.1, 13.8) per day and completed a median of 86% of exercise goals. Participants, on average, walked 121 minutes per week (SD 175) and spent 189 minutes per week (SD 210) in their target exercise heart rate zone. Overall, participants found the system to be highly usable (System Usability Scale score: median 83, IQR 65, 100). CONCLUSIONS This pilot study established the feasibility of delivering cardiac telerehabilitation at home to acute myocardial infarction survivors via a health watch-based program and telephone counseling sessions. Usability and adherence to health watch use, exercise recommendations, and counseling sessions were high. Further studies are warranted to compare patient outcomes and health care resource utilization between center-based rehabilitation and telerehabilitation.
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Affiliation(s)
- Eric Y Ding
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Nathaniel Erskine
- Department of Anesthesiology, Duke University, Durham, NC, United States
| | - Wim Stut
- Philips Research, Eindhoven, Netherlands
| | - David D McManus
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Amy Peterson
- University of Massachusetts Memorial Marlborough Hospital, Marlborough, MA, United States
| | - Ziyue Wang
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | | | - Daniella Albuquerque
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Alvaro Alonso
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Naomi F Botkin
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Quinn R Pack
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - David D McManus
- Division of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Disparities in Cardiac Rehabilitation Participation in the United States: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Cardiopulm Rehabil Prev 2017; 37:2-10. [PMID: 27676464 DOI: 10.1097/hcr.0000000000000203] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Phase 2 cardiac rehabilitation (CR) is a class I recommendation for all patients following an acute cardiac event or cardiac surgery according to the The American Heart Association and the American College of Cardiology Foundation. Studies have shown that there are differences in cardiac rehabilitation participation rates between sociodemographic groups. The purpose of this systematic review and meta-analyses was to synthesize quantitative data on the relationship between outpatient cardiac rehabilitation (OCR) attendance and various sociodemographic factors. METHODS We conducted a search of PubMed, PsycINFO, CINAHL, Google Scholar, Dissertations & Theses A&I, and conference abstracts for observational studies conducted in the United States that fit our inclusion criteria. A total of 21 studies were included in our final review and meta-analyses. RESULTS Our meta-analyses showed that overall, attenders were younger than nonattenders (mean difference=-3.74 years, 95% CI =-5.87 to -1.61) and the odds of participation were lower among females (OR = 0.59; 95% CI = 0.51-0.69), individuals with a high school degree or less (OR = 0.67; 95% CI = 0.50-0.91), and the uninsured or self-payers (OR = 0.32; 95% CI = 0.14-0.71). Full- or part-time employees were more likely to participate than those not employed (OR = 1.45; 95% CI = 1.08-1.95). CONCLUSIONS Our systematic review and meta-analyses showed that there are significant sociodemographic disparities in CR participation. On the basis of this knowledge, clinicians and policy makers should focus on identifying and eliminating barriers to participation.
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Patient-Reported Outcomes in Cardiac Rehabilitation: WHAT DO WE KNOW ABOUT PROGRAM SATISFACTION? A REVIEW. J Cardiopulm Rehabil Prev 2017; 36:230-9. [PMID: 26398325 DOI: 10.1097/hcr.0000000000000142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Patient satisfaction has become an important indicator of quality and may be related to greater adherence to cardiac rehabilitation (CR). The objectives of this narrative review were to investigate (1) patient satisfaction with CR and its relationship to adherence or health outcomes, and (2) assessment tools applicable to CR. METHODS A literature search was conducted on key resource databases, including MEDLINE, Health and Psychosocial Instruments, and Patient-Reported Outcomes and Quality of Life Instruments. A focused Internet and gray literature search was also conducted. RESULTS OF DATA SYNTHESIS Eight studies were included. Patient satisfaction was high overall, especially related to education received. In 4 studies, patient satisfaction with treatment was compared in patients who attended CR with those who did not. In 2 of these studies where items were investigator generated, significant differences favoring CR were found. In the 2 studies where the treatment satisfaction subscale of the Seattle Angina Questionnaire was administered, no differences were observed. Only 1 study was identified, which examined the relationship of patient satisfaction with any outcome, and revealed that greater satisfaction was related to greater program adherence. There was a dearth of valid assessment tools. CONCLUSIONS Despite recommendations in CR association guidelines to consider patient satisfaction, there is an absence of research assessing it. The studies that have assessed it administered tools of questionable psychometric rigor. It remains to be determined whether patient satisfaction is related to any meaningful outcomes.
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Beatty AL, Bradley SM, Maynard C, McCabe JM. Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery. Circ Cardiovasc Qual Outcomes 2017; 10:CIRCOUTCOMES.116.003364. [DOI: 10.1161/circoutcomes.116.003364] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/24/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Alexis L. Beatty
- From the VA Puget Sound Health Care System, Seattle, WA (A.L.B., C.M.); University of Washington, Seattle (A.L.B., C.M., J.M.M.); VA Eastern Colorado Health Care System, Denver, CO (S.M.B.); University of Colorado School of Medicine, Aurora (S.M.B.); and Clinical Outcomes Assessment Program, Seattle, WA (C.M.)
| | - Steven M. Bradley
- From the VA Puget Sound Health Care System, Seattle, WA (A.L.B., C.M.); University of Washington, Seattle (A.L.B., C.M., J.M.M.); VA Eastern Colorado Health Care System, Denver, CO (S.M.B.); University of Colorado School of Medicine, Aurora (S.M.B.); and Clinical Outcomes Assessment Program, Seattle, WA (C.M.)
| | - Charles Maynard
- From the VA Puget Sound Health Care System, Seattle, WA (A.L.B., C.M.); University of Washington, Seattle (A.L.B., C.M., J.M.M.); VA Eastern Colorado Health Care System, Denver, CO (S.M.B.); University of Colorado School of Medicine, Aurora (S.M.B.); and Clinical Outcomes Assessment Program, Seattle, WA (C.M.)
| | - James M. McCabe
- From the VA Puget Sound Health Care System, Seattle, WA (A.L.B., C.M.); University of Washington, Seattle (A.L.B., C.M., J.M.M.); VA Eastern Colorado Health Care System, Denver, CO (S.M.B.); University of Colorado School of Medicine, Aurora (S.M.B.); and Clinical Outcomes Assessment Program, Seattle, WA (C.M.)
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Kureshi F, Kennedy KF, Jones PG, Thomas RJ, Arnold SV, Sharma P, Fendler T, Buchanan DM, Qintar M, Ho PM, Nallamothu BK, Oldridge NB, Spertus JA. Association Between Cardiac Rehabilitation Participation and Health Status Outcomes After Acute Myocardial Infarction. JAMA Cardiol 2016; 1:980-988. [PMID: 27760269 DOI: 10.1001/jamacardio.2016.3458] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Importance Cardiac rehabilitation (CR) improves survival after acute myocardial infarction (AMI), and referral to CR has been introduced as a performance measure of high-quality care. The association of participation in CR with patients' health status (eg, quality of life, symptoms, and functional status) is poorly defined. Objective To examine the association of participation in CR with health status outcomes after AMI. Design, Setting, and Participants A retrospective cohort study was conducted of patients enrolled in 2 AMI registries: PREMIER, from January 1, 2003, to June 28, 2004, and TRIUMPH, from April 11, 2005, to December 31, 2008. The analytic cohort was restricted to 4929 patients with data available on baseline health status, 6- or 12- month follow-up health status, and participation in CR. Data analysis was performed from 2014 to 2015. Exposures Participation in at least 1 CR session within 6 months of hospital discharge. Main Outcomes and Measures Patient health status was quantified using the Seattle Angina Questionnaire (SAQ) and the 12-Item Short-Form Health Survey (SF-12). The primary outcomes of interest were the mean differences in SAQ domain scores during the 12 months after AMI between patients who did and did not participate in CR. Secondary outcomes were the mean differences in the SF-12 summary scores and all-cause mortality. Results After successfully matching the cohorts of the 4929 patients (3328 men and 1601 women; mean [SD] age, 60.0 [12.2] years) for the propensity to participate in CR and comparing the groups using linear, mixed-effects models, mean differences in the SAQ and SF-12 domain scores were similar at 6 and 12 months between the 2012 patients participating in CR (3 were unable to be matched) and the 2894 who did not participate (20 were unable to be matched). At 6 months, the mean difference was -0.76 (95% CI, -2.05 to 0.52) for the SAQ quality of life score, -1.53 (95% CI, -2.57 to -0.49) for the SAQ angina frequency score, 0.38 (95% CI, -0.51 to 1.27) for the SAQ treatment satisfaction score, -0.42 (95% CI, -1.65 to 0.79) for the SAQ physical limitation score, 0.50 (95% CI, -0.22 to 1.22) for the SF-12 physical component score, and 0.13 (95% CI, -0.53 to 0.79) for the SF-12 mental component score. At 12 months, the mean difference was -0.89 (95% CI, -2.20 to 0.43) for the SAQ quality of life score, -1.05 (95% CI, -2.12 to 0.02) for the SAQ angina frequency score, 0.38 (95% CI, -0.54 to 1.29) for the SAQ treatment satisfaction score, -0.14 (95% CI, -1.41 to 1.14) for the SAQ physical limitation score, 0.17 (95% CI, -0.57 to 0.92) for the SF-12 physical component score, and 0.12 (95% CI, -0.56 to 0.80) for the SF-12 mental component score. In contrast, the hazard rate of all-cause mortality (up to 7 years) associated with participating in CR was 0.59 (95% CI, 0.46-0.75). Conclusions and Relevance In a cohort of 4929 patients with AMI, we found that those who did and did not participate in CR had similar reported health status during the year following AMI; however, participation in CR did confer a significant survival benefit. These findings underscore the need for increased use of validated patient-reported outcome measures to further examine if and how health status can be maximized for patients who participate in CR.
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Affiliation(s)
- Faraz Kureshi
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - Kevin F Kennedy
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Philip G Jones
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Randal J Thomas
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Suzanne V Arnold
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - Praneet Sharma
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - Timothy Fendler
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - Donna M Buchanan
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - Mohammed Qintar
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
| | - P Michael Ho
- Division of Cardiovascular Diseases, University of Colorado-Denver
| | | | - Neil B Oldridge
- University of Wisconsin School of Medicine and Public Health, Milwaukee7Aurora Cardiovascular Services, Milwaukee, Wisconsin
| | - John A Spertus
- Division of Cardiovascular Diseases and Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, Missouri2School of Medicine, University of Missouri-Kansas City
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Dayan V, Ricca R. [Cardiac rehabilitation after coronary artery bypass surgery]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2014; 84:286-92. [PMID: 25240582 DOI: 10.1016/j.acmx.2014.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 01/29/2014] [Accepted: 03/12/2014] [Indexed: 11/26/2022] Open
Abstract
Ischemic heart disease is the leading cause of death worldwide with an increase in the incidence in younger populations. Today revascularization strategies are capable of alleviating acute ischemia and/or chronic ischemia. These can be performed percutaneously or through surgery. Even if we improve myocardial perfusion by these methods, the main determinant in maintaining patency of coronary arteries and bypass is a correctly instituted secondary prevention. This is the main focus of cardiac rehabilitation proposals. Although much has been published about the role of cardiac rehabilitation after percutaneous revascularization, there is little work able to synthesize the current state of cardiac rehabilitation in patients undergoing coronary artery bypass surgery. The aim of this paper is to review the effect of rehabilitation in the return to work, survival, functional capacity, depression and anxiety, as well as compare centralized vs. home rehabilitation in this patient population.
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Affiliation(s)
- Victor Dayan
- Cátedra de Cirugía Cardiaca, Centro Cardiovascular Universitario, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
| | - Roberto Ricca
- Cátedra de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
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Morris DB, Wilson KG, Clinch JJ, Ammerman DJ, Fergusson D, Graham ID, Porath AJ, Offman A, Boland I, Watters J, Hébert PC. Identification of Domains Relevant to Health-related Quality of Life in Patients Undergoing Major Surgery. Qual Life Res 2013; 15:841-54. [PMID: 16721644 DOI: 10.1007/s11136-005-5506-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2005] [Indexed: 11/25/2022]
Abstract
This study examined themes relevant to health-related quality of life as identified by patients undergoing major surgery and by health care providers. Semi-structured interviews were conducted with 52 patients undergoing major abdominal, cardiac, orthopedic, thoracic, or vascular surgical procedures and 33 health professionals from various disciplines. A total of 58 themes were identified by content analysis. These themes were categorized into 6 domains. These were: physical well-being (14 themes), emotional well-being (13 themes), concern about quality of care (12 themes), social well-being (12 themes), cognitive preparation (4 themes), and spiritual well-being (3 themes). In general, we found that most aspects of health-related quality of life were common across various major surgical procedures and between patients and health care providers. However, when we examined the coverage of these themes in seven commonly-used health-related quality of life instruments, we found that many of the most frequently mentioned themes were not assessed with the available measures. A new evaluative instrument tailored to patients undergoing major surgery may therefore be warranted.
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Affiliation(s)
- Daniel B Morris
- Clinical Epidemiology Program, Ottawa Health Research Institute, 501 Smyth Road, 201, Ottawa, ON, K1H 8L6, Canada
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Patients with Type 2 Diabetes Undergoing Coronary Artery Bypass Graft Surgery: Predictors of Outcomes. Eur J Cardiovasc Nurs 2009; 8:48-56. [DOI: 10.1016/j.ejcnurse.2008.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Revised: 04/08/2008] [Accepted: 04/15/2008] [Indexed: 01/04/2023]
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Brügemann J, Poels BJJ, Oosterwijk MH, van der Schans CP, Postema K, van Veldhuisen DJ. A randomised controlled trial of cardiac rehabilitation after revascularisation. Int J Cardiol 2007; 119:59-64. [PMID: 17023076 DOI: 10.1016/j.ijcard.2006.07.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 07/02/2006] [Indexed: 01/08/2023]
Abstract
BACKGROUND It is unclear if psycho-education on top of physical training is of additional value regarding quality of life in revascularised patients. DESIGN Prospective randomised study comparing two types of cardiac rehabilitation: exercise based versus a more comprehensive approach including psychological therapy. METHODS One hundred and thirty-seven male patients who underwent an uncomplicated coronary revascularisation procedure and who were mentally in a good condition, were randomised to one of two types of cardiac rehabilitation: physical training plus information about their disease ('Fit' program) during 6 weeks or comprehensive cardiac rehabilitation which, on top of the Fit-program, included weekly psycho-education sessions and relaxation therapy ('Fit-Plus' program) for 8 weeks. One hundred and four patients were analysed. Quality of life was measured by the 'Leiden Quality of Life questionnaire' and by the RAND-36 (quality of life) questionnaire. RESULTS Quality of life improved in both treatment groups in the course of time up to 9 months after cardiac rehabilitation and there was no difference between the two types of cardiac rehabilitation. Exercise capacity improved likewise, blood lipid profile was unaffected and energy intake decreased in each treatment group but, again, there were no inter-group differences. CONCLUSION After an uncomplicated revascularisation procedure, physical training plus information results in a comparable outcome on quality of life when compared to a more comprehensive program including additional psycho-education and relaxation therapy.
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Affiliation(s)
- Johan Brügemann
- Department of Cardiology, University Medical Center Groningen Thoraxcentre, University of Groningen, Hanzeplein 1, PO Box 30.001 9700 RB Groningen, The Netherlands.
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Abstract
The purpose of this study is to determine the relationship between adherence to cardiac rehabilitation (CR) and improvements in health-related quality of life (HRQL) with a 12-week, Phase-II CR program. Previously collected data from 153 CR patients (114 males, 39 females; 69.1 years of age +/- 11.5) were utilized to complete this retrospective study. Patients completed the Medical Outcomes Survey Short Form-36 to assess HRQL at the beginning of CR (N = 153), at 3 months (N = 152), and at 1 year (N = 94). Pearson correlation coefficients were generated to assess the relationship between CR attendance and HRQL. Paired sample t-tests helped determine the effect of CR on HRQL at 3 months and 1 year. No relationship was found between CR adherence and improvements in HRQL. Significant improvements in HRQL were found among all patients from baseline to 3 months and 1 year. Study findings demonstrate the effectiveness of CR in improving patient short- and long-term HRQL regardless of patient adherence rate.
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Affiliation(s)
- Jeffrey L Alexander
- Department of Cardiac and Pulmonary Rahabilitation, Banner Baywood Heart Hospital, Mesa, AZ 85206, USA.
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Bartels MN, Whiteson JH, Alba AS, Kim H. Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 1. Cardiac Rehabilitation Review. Arch Phys Med Rehabil 2006; 87:S46-56. [PMID: 16500192 DOI: 10.1016/j.apmr.2005.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Accepted: 11/23/2005] [Indexed: 10/25/2022]
Abstract
UNLABELLED Cardiac rehabilitation includes not only the rehabilitation of people with ischemic heart disease but also those with congestive heart failure, heart transplantation, congenital heart disease, and other conditions. New advances in medical treatment have arisen, and there are new approaches in treatment, including alternative medicine and complementary care. New surgical approaches that help restore cardiac function have also been introduced, and rehabilitation professionals must be aware of these advances and be able to incorporate this knowledge into the practice of rehabilitation medicine. OVERALL ARTICLE OBJECTIVES (a) To identify major categories of cardiac disease, (b) to elucidate appropriate interventions and support for patients with coronary artery disease, (c) to describe the new interventions available for the treatment of cardiac disease, and (d) to describe the appropriate role of cardiac rehabilitation for people with various forms of cardiac disease.
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Affiliation(s)
- Matthew N Bartels
- Rehabilitation Medicine Department, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA.
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Dolansky MA, Moore SM. Effects of cardiac rehabilitation on the recovery outcomes of older adults after coronary artery bypass surgery. ACTA ACUST UNITED AC 2004; 24:236-44. [PMID: 15286528 DOI: 10.1097/00008483-200407000-00005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to examine differences in lower extremity function as well as perception of physical and mental function between adults 70 years of age or older who participated in a phase 2 cardiac rehabilitation program (CRP) (n = 32) and those who did not participate in a CRP (n = 33) after coronary artery bypass surgery (CABS). METHODS In this two-group longitudinal comparative study, recovery outcomes measured at baseline (6 weeks) and 6 months after CABS were compared between older adults who participated and those who did not participate in a CRP. RESULTS In study groups that were equivalent before the CRP, analysis of covariance (controlling for baseline scores) showed that 6 months after hospital discharge, those who participated in a CRP had greater lower extremity strength (F = 3.9; P =.04), greater ankle range of motion (F = 4.2; P =.02), better dynamic balance (F = 8.2; P =.003), better static balance (F = 3.3; P =.04), better gait (F = 4.7; P =.02), and perceptions of better physical function (F = 14.8; P =.00). The results remained the same when control was used for the effects of social support, self-efficacy, depression, comorbidity, cardiac functional status, and gender for all the variables except static balance. No difference related to perception of mental function was found between the study groups (F =.10; P =. 74). CONCLUSIONS Participation in a CRP by older individuals improves lower extremity function (an important dimension in preventing disability) and perception of physical function. Cardiac rehabilitation programs can be used to optimize the recovery outcomes of older individuals after CABS.
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Affiliation(s)
- Mary A Dolansky
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA.
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Franklin BA, Berra K. The case for cardiac rehabilitation after coronary revascularization: achieving realistic outcome assessments. JOURNAL OF CARDIOPULMONARY REHABILITATION 2002; 22:418-20. [PMID: 12464829 DOI: 10.1097/00008483-200211000-00006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Barry A Franklin
- Department of Medicine, Division of Cardiology, William Beaumont Hospital, Royal Oak, Mich, USA.
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