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Ferrara PE, Massimo Magro V, Ariani M, Codazza S, Ronconi G. The Optimization of the Post-Rehabilitation Process Heart Surgery: Our New Proposal Physiotherapy Record. Anatol J Cardiol 2024; 28:461-463. [PMID: 39194168 PMCID: PMC11426404 DOI: 10.14744/anatoljcardiol.2024.4618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024] Open
Affiliation(s)
| | - Valerio Massimo Magro
- Department of Internal Medicine and Geriatric, Specializing in Physical Medicine and Rehabilitation, University of Rome Tor Vergata, Rome, Italy
| | - Mariantonietta Ariani
- Department of Neurosciences, Sense Organs and Thorax, Catholic University of the Sacred Heart, Rome, Italy
| | - Sefora Codazza
- University Polyclinic Foundation A, Gemelli IRCCS, Rome, Italy
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Milani JGPO, Milani M, Verboven K, Cipriano G, Hansen D. Exercise intensity prescription in cardiovascular rehabilitation: bridging the gap between best evidence and clinical practice. Front Cardiovasc Med 2024; 11:1380639. [PMID: 39257844 PMCID: PMC11383788 DOI: 10.3389/fcvm.2024.1380639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 08/01/2024] [Indexed: 09/12/2024] Open
Abstract
Optimizing endurance exercise intensity prescription is crucial to maximize the clinical benefits and minimize complications for individuals at risk for or with cardiovascular disease (CVD). However, standardization remains incomplete due to variations in clinical guidelines. This review provides a practical and updated guide for health professionals on how to prescribe endurance exercise intensity for cardiovascular rehabilitation (CR) populations, addressing international guidelines, practical applicability across diverse clinical settings and resource availabilities. In the context of CR, cardiopulmonary exercise test (CPET) is considered the gold standard assessment, and prescription based on ventilatory thresholds (VTs) is the preferable methodology. In settings where this approach isn't accessible, which is frequently the case in low-resource environments, approximating VTs involves combining objective assessments-ideally, exercise tests without gas exchange analyses, but at least alternative functional tests like the 6-minute walk test-with subjective methods for adjusting prescriptions, such as Borg's ratings of perceived exertion and the Talk Test. Therefore, enhancing exercise intensity prescription and offering personalized physical activity guidance to patients at risk for or with CVD rely on aligning workouts with individual physiological changes. A tailored prescription promotes a consistent and impactful exercise routine for enhancing health outcomes, considering patient preferences and motivations. Consequently, the selection and implementation of the best possible approach should consider available resources, with an ongoing emphasis on strategies to improve the delivery quality of exercise training in the context of FITT-VP prescription model (frequency, intensity, time, type, volume, and progression).
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Affiliation(s)
- Juliana Goulart Prata Oliveira Milani
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, Brazil
| | - Mauricio Milani
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, Brazil
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Kenneth Verboven
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Biomedical Research Institute (BIOMED), Hasselt, Belgium
| | - Gerson Cipriano
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, Brazil
- Graduate Program in Human Movement and Rehabilitation of Evangelical (PPGMHR), UniEVANGÉLICA, Anápolis, Brazil
| | - Dominique Hansen
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Biomedical Research Institute (BIOMED), Hasselt, Belgium
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Chung C, Kim AR, Kim D, Kwon H, Lee SH, Jang IY, Jo MW, Kang DY, Lee SW. Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases. Sci Rep 2024; 14:3018. [PMID: 38321153 PMCID: PMC10847123 DOI: 10.1038/s41598-024-53583-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/02/2024] [Indexed: 02/08/2024] Open
Abstract
Rehabilitation improves symptoms, quality of life, and survival in patients with chronic respiratory or cardiovascular disease. We evaluated smartphone application-based rehabilitation programs for patients with chronic respiratory or cardiovascular diseases. This was a single-center prospective single arm study. Participants underwent smartphone application-based pulmonary or cardiac rehabilitation for 12 weeks. A total of 93 participants were recruited, and 75 visited after rehabilitation. Their median age was 67.0 (interquartile range, 60.0-70.8) years, and 60 (80.0%) were men. For patients with chronic respiratory disease (n = 41), VO2peak (median 13.7 to 15.4 ml/kg/min, P = 0.049), chronic obstructive pulmonary disease assessment test (median 14 to 6, P < 0.001), Euro-QoL 5-Dimension 5-Level (EQ-5D-5L) index (median 0.795 to 0.862, P = 0.001), and Health-related Quality of Life Instrument with 8 Items (HINT-8) index (median 0.784 to 0.855, P < 0.001) were significantly improved. For patients with chronic cardiovascular disease (n = 34), VO2peak (median 21.8 to 23.3, P = 0.007), EQ-5D-5L index (median 0.871 to 1.000, P = 0.037), and HINT-8 index (median 0.890 to 0.903, P < 0.001) were significantly improved. The smartphone application-based rehabilitation program improved exercise capacity and quality of life in patients with chronic respiratory or cardiovascular disease.Trial registration: https://clinicaltrials.gov/ct2/show/NCT05383950 (20/05/2022).
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Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Ah-Ram Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Dongbum Kim
- LifeSemantics Corp., Seoul, Republic of Korea
| | - Hee Kwon
- LifeSemantics Corp., Seoul, Republic of Korea
| | - Seong Ho Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Park YS, Song IS, Jang S, Nam CM, Park E. Impact of Cardiac Rehabilitation Health Insurance Coverage on Cardiac Rehabilitation Use in Korea Using an Interrupted Time Series. J Am Heart Assoc 2024; 13:e031395. [PMID: 38293924 PMCID: PMC11056114 DOI: 10.1161/jaha.123.031395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/17/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Since 2017, the cardiac rehabilitation (CR) program in Korea has been included in the coverage provided by the National Health Insurance to alleviate financial burden. Our study aimed to identify changes in the CR program use according to the implementation of CR coverage. METHODS AND RESULTS We obtained data from the electronic medical records of a tertiary hospital in Seoul, Korea from January 2014 to February 2020. Data from 2988 patients with acute coronary syndrome who underwent percutaneous coronary intervention were included. To examine the CR use trend among patients undergoing percutaneous coronary intervention, the electronic medical records data of the patients were aggregated quarterly, resulting in a maximum of 24 repeated measures for each patient. Segmented regression is often used to estimate the effects of interventions in an interrupted time series. Policy implementation led to a prompt increase in the probability of CR use (odds ratio [OR], 3.99 [95% CI, 2.89-5.51]). After the implementation of CR coverage, no significant change in CR use (OR, 0.97 [95% CI, 0.92-1.01]) was observed. After percutaneous coronary intervention, more patients opted for CR, especially those receiving education compared with exercise (education: OR, 87.44 [95% CI, 36.79-207.83] versus exercise: OR, 1.99 [95% CI, 1.43-2.76]). CONCLUSIONS The implementation of CR coverage resulted in a rapid increase in the probability of CR use. Use of the educational program was higher than that of the exercise program. Given the persistently low use of CR, it is imperative to stimulate its adoption by increasing its availability.
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Affiliation(s)
- Yu Shin Park
- Department of Public HealthGraduate School, Yonsei UniversitySeoulRepublic of Korea
- Institute of Health Services ResearchYonsei UniversitySeoulRepublic of Korea
| | - In Sun Song
- Department of Health PolicyGraduate School of Public Health, Yonsei UniversitySeoulSouth Korea
| | - Suk‐Yong Jang
- Institute of Health Services ResearchYonsei UniversitySeoulRepublic of Korea
- Department of Healthcare ManagementGraduate School of Public Health, Yonsei UniversitySeoulSouth Korea
| | - Chung Mo Nam
- Department of Public HealthGraduate School, Yonsei UniversitySeoulRepublic of Korea
- Department of Preventive MedicineYonsei University College of MedicineSeoulRepublic of Korea
| | - Eun‐Cheol Park
- Institute of Health Services ResearchYonsei UniversitySeoulRepublic of Korea
- Department of Preventive MedicineYonsei University College of MedicineSeoulRepublic of Korea
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Kim KH, Han JY. Fact Sheet on Cardiac Rehabilitation for Cardiovascular Disease in South Korea. Ann Rehabil Med 2023; 47:318-325. [PMID: 37907223 PMCID: PMC10620486 DOI: 10.5535/arm.23050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023] Open
Abstract
Cardiovascular disease (CVD) poses a significant health challenge globally, including in Korea, due to its status as a leading cause of death and its impact on cardiopulmonary function. Cardiac rehabilitation (CR) is a well-established program that not only aids in restoring cardiopulmonary function, but also improves physical and social conditions. The benefits of CR are widely recognized, and it is implemented globally. While the effectiveness of CR has been proven in Korea, it is underutilized. This fact sheet summarizes the current status of CR in Korea, including the prevalence of CVD, the clinical practice guidelines for CR programs, and the challenges of implementing CR in Korea.
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Affiliation(s)
- Ki-Hong Kim
- Department of Physical & Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Jae-Young Han
- Department of Physical & Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea
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Chung C, Kim AR, Jang IY, Jo MW, Lee S, Kim D, Kwon H, Kang DY, Lee SW. Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases: a randomised controlled trial study protocol. BMJ Open 2023; 13:e072698. [PMID: 37730392 PMCID: PMC10514628 DOI: 10.1136/bmjopen-2023-072698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/27/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Rehabilitation is well known to improve clinical symptoms and decrease the risk of mortality in patients with chronic respiratory or cardiovascular diseases. We will evaluate the efficacy of smartphone application-based rehabilitation programmes in patients with chronic respiratory or cardiovascular diseases. METHODS AND ANALYSIS This single-centre single-blind randomised controlled trial will recruit a total of 162 participants from Asan Medical Center (81 patients each for pulmonary and cardiac rehabilitation, respectively). Participants will be assigned to the pulmonary or cardiac rehabilitation groups based on their underlying disease. Participants will be allocated randomly into the intervention or control groups at the ratio of 2:1 (54 and 27 patients). The intervention group will be provided with a smartphone application and undergo smartphone application-based rehabilitation for 12 weeks. The control group will receive the usual outpatient medical treatment without rehabilitation. Participants will be evaluated at baseline and at the end of the rehabilitation. The primary outcomes will be exercise capacity, such as maximal oxygen consumption on cardiopulmonary exercise test for both groups, chronic obstructive pulmonary disease assessment test for the pulmonary rehabilitation group, and Health-related Quality of Life Instrument with 8 Items questionnaires for the cardiac rehabilitation group. The secondary outcomes will include quality of life questionnaires, symptom scores, pulmonary function test and limb muscle test. ETHICS AND DISSEMINATION The study protocol was approved by the Institutional Review Board of Asan Medical Center. Written informed consent will be obtained from all participants prior to inclusion. The findings from this study will be disseminated through peer-reviewed scientific journals and conferences. TRIAL REGISTRATION NUMBER NCT05610358.
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Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea (the Republic of)
| | - Ah-Ram Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Min-Woo Jo
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Seongho Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Dongbum Kim
- LifeSemantics Corp, Seoul, Korea (the Republic of)
| | - Hee Kwon
- LifeSemantics Corp, Seoul, Korea (the Republic of)
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
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Evaluation of the efficacy of Tian dan shu gan rehabilitation exercise in improving the short-term quality of life of patients with acute myocardial infarction after percutaneous coronary intervention. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Abstract
Objective: To evaluate the efficacy of Tian dan shu gan rehabilitation exercise in improving the short-term survival quality of patients after percutaneous coronary intervention (PCI) and explore whether patients’ symptoms, physical function, cognitive function, and psychosocial function are improved after this exercise.
Methods: Patients with acute myocardial infarction who underwent PCI in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from August to November 2020 were selected. A total of 110 patients were selected by the convenience sampling method. Patients in the control group were given routine nursing measures after PCI for coronary heart disease, and patients in the experimental group received Tian dan shu gan rehabilitation exercise in addition to routine nursing.
Results: After 3 wk, the quality of life in the experimental group was improved compared with that in the control group, and the differences in symptom scores, physical functions, cognitive functions, and psychosocial functions were statistically significant (P < 0.01). After 3 wk of Tian dan shu gan rehabilitation exercise, patients with body mass index (BMI) between 27 and 29.9 had the highest score of body function, which was statistically significantly better compared with that of other groups (P < 0.001). Patients who had remained bachelors for a long period of time had the highest score of symptoms, which was statistically significant compared with the other groups (P < 0.001). The nursing satisfaction of the experimental group was 96.3%.
Conclusions:
Tian dan shu gan rehabilitation exercise was effective in improving the short-term quality of life of patients with acute myocardial infarction after PCI, and the nursing satisfaction rate was high, use of which should be further extended to more clinical patients.
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Kim C, Sung J, Han JY, Jee S, Lee JW, Lee JH, Kim WS, Bang HJ, Baek S, Joa KL, Kim AR, Lee SY, Kim J, Kim CR, Kwon OP. A Comparison of Barrier Factors between Hospitals with and without Cardiac Rehabilitation Programs in Korea: A Nation-Wide Survey Research. J Clin Med 2022; 11:jcm11092560. [PMID: 35566686 PMCID: PMC9100867 DOI: 10.3390/jcm11092560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022] Open
Abstract
The percentage of patients undergoing cardiac rehabilitation programs (CRP) is very low (30–40%), and hospitals providing CRP are either insufficient or lacking, even in countries with advanced medical care; therefore, this study aims to investigate the barriers, as well as compare the differences between hospitals, with or without CRP. We conducted a survey, in which the questionnaire was distributed through post or email to 607 specialists who work at 164 hospitals performing percutaneous coronary interventions (PCI). The results were as follows: (1) of the 164 hospitals, 132 responded (response rate: 80.5%). While all 47 hospitals with CRP responded (100%), from among the 117 hospitals without CRP, 85 responded (72.7%). (2) Of the 607 specialists, 227 responded (response rate: 36.9%). The response rates according to specialties were as follows: cardiologists (28.9%), cardiac surgeons (24.5%), and physiatrists (64.1%). (3) While the specialists at hospitals with CRP identified patient referral, transportation, and cost as the major barriers, for those at hospitals without CRP, all items were considered barriers, especially the items related to equipment, space, workforce, and budget as being more serious barriers. Therefore, in order to actively promote CRP, it is suggested that governments consider the customized support system according to the performance of CRPs.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Korea;
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Jae-Young Han
- Department of Physical Medicine and Rehabilitation, Chonnam National University Medical School and Hospital, Gwangju 61469, Korea
- Correspondence: ; Tel.: +82-62-220-5186
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon 35015, Korea;
| | - Jang Woo Lee
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea;
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong A University College of Medicine, Busan 49201, Korea;
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (W.-S.K.); (O.P.K.)
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea;
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon 24289, Korea;
| | - Kyung-Lim Joa
- Department of Rehabilitation Medicine, Inha University Hospital, Incheon 22332, Korea;
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, School of Medicine Kyungpook National University, Daegu 41944, Korea;
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju 63241, Korea;
| | - Jihee Kim
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan 54538, Korea;
| | - Chung Reen Kim
- Department of Rehabilitation Medicine, Ulsan University College of Medicine, Ulsan 44033, Korea;
| | - Oh Pum Kwon
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea; (W.-S.K.); (O.P.K.)
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Kim C, Sung J, Han JY, Jee S, Lee JW, Lee JH, Kim WS, Bang HJ, Baek S, Joa KL, Kim AR, Lee SY, Kim J, Kim CR, Kwon OP. Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study. J Korean Med Sci 2022; 37:e109. [PMID: 35411729 PMCID: PMC9001186 DOI: 10.3346/jkms.2022.37.e109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/17/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. METHODS The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation. The questionnaires were sent to regional public and private medical institutions and public health management institutions. RESULTS In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. CONCLUSION Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.
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Affiliation(s)
- Chul Kim
- Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Young Han
- Department of Physical Medicine and Rehabilitation, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jang Woo Lee
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong A University College of Medicine, Busan, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University, College of Medicine, Cheongju, Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Kyung Lim Joa
- Department of Physical Medicine and Rehabilitation, Inha University Hospital, Incheon, Korea
| | - Ae Ryoung Kim
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - So Young Lee
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
| | - Jihee Kim
- Department of Rehabilitation Medicine, Wonkwang University Hospital, Wonkwang University Medical School, Iksan, Korea
| | - Chung Reen Kim
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Oh Pum Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea. J Clin Med 2021; 10:jcm10215079. [PMID: 34768598 PMCID: PMC8585050 DOI: 10.3390/jcm10215079] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Regional Cardiocerebrovascular Centers (RCCs)—a Korean government initiative—seek to reduce medical gaps across regions, and their cardiac rehabilitation (CR) programs are expected to model post-acute care for the Korean CR program. Accordingly, this study aimed to evaluate the current status of CR programs in the RCCs. We distributed surveys on the CR condition, activity, and barriers to 12 RCCs in different provinces. The results revealed significant gaps in the annual number of acute myocardial infarction admissions, and CR candidates, capacity, and density across the 12 RCCs. The CR capacity (50–500) and density (0.42–7.36) indicated particularly large gaps. Twelve RCCs had the necessary facilities, equipment and personnel for CR assessments and management, with high CR referral (97%) and patient education (78%) rates. However, the inpatient CR exercise training (56%) participation rate was inadequate, with much lower enrollment (47%) and adherence (17%) rates to the outpatient CR program and large differences across centers. Therefore, this study’s results will provide the evidence required to establish special national health strategies to overcome the CR barriers of patient, doctor/hospital, and policy factors for activating Korean CR programs.
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Min K, Beom J, Kim BR, Lee SY, Lee GJ, Lee JH, Lee SY, Won SJ, Ahn S, Bang HJ, Cha Y, Chang MC, Choi JY, Do JG, Do KH, Han JY, Jang IY, Jin Y, Kim DH, Kim DH, Kim IJ, Kim MC, Kim W, Lee YJ, Lee IS, Lee IS, Lee J, Lee CH, Lim SH, Park D, Park JH, Park M, Park Y, Ryu JS, Song YJ, Yang S, Yang HS, Yoo JS, Yoo JI, Yoo SD, Choi KH, Lim JY. Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures. Ann Rehabil Med 2021; 45:225-259. [PMID: 34233406 PMCID: PMC8273721 DOI: 10.5535/arm.21110] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. METHODS Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. RESULTS A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. CONCLUSION This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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Affiliation(s)
- Kyunghoon Min
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Bo Ryun Kim
- Department of Physical Medicine and Rehabilitation, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | | | - Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Jae Won
- Department of Rehabilitation Medicine, Yeouido Saint Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sangwoo Ahn
- Physical Therapy, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yonghan Cha
- Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea
| | - Jung-Yeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jong Geol Do
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Hee Do
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
| | - Jae-Young Han
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Youri Jin
- Department of Food and Nutrition Services, Hanyang University Hospital, Seoul, Korea
| | - Dong Hwan Kim
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Du Hwan Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - In Jong Kim
- Howareyou Rehabilitation Clinic, Seoul, Korea
| | - Myung Chul Kim
- Department of Physical Therapy, Eulji University, Seongnam, Korea
| | - Won Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Jung Lee
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Goyang, Korea
| | - In Seok Lee
- Nutrition Team, Kyung Hee University Medical Center, Seoul, Korea
| | - In-Sik Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - JungSoo Lee
- Department of Rehabilitation Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Chang-Hyung Lee
- Department of Physical Medicine and Rehabilitation, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Myungsook Park
- Department of Nursing, Konkuk University, Chungju, Korea
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University, Seoul, Korea
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Jin Song
- Occupational Therapy, Department of Rehabilitation Medicine, Asan Medical Center, Seoul, Korea
| | - Seoyon Yang
- Department of Rehabilitation Medicine, Ewha Woman’s University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hee Seung Yang
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Jun-il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Seung Don Yoo
- Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Baek S, Ha Y, Mok J, Park HW, Son HR, Jin MS. Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study. Ann Rehabil Med 2020; 44:481-492. [PMID: 33440096 PMCID: PMC7808795 DOI: 10.5535/arm.20084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/27/2020] [Accepted: 06/10/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed. METHODS Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65-74 years) and old-old (≥75 years) female subjects were compared. RESULTS Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05). CONCLUSION We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.
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Affiliation(s)
- Sora Baek
- Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yuncheol Ha
- Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Jaemin Mok
- Kangwon Regional Cardiocerebrovascular Center, Kangwon National University Hospital, Chuncheon, Korea
- Division of Public Health, Kangwon National University Hospital, Chuncheon, Korea
| | - Hee-won Park
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyo-Rim Son
- Hongcheon County Hypertension and Diabetes Registration and Education Center, Hongcheon-gun, Korea
| | - Mi-Suk Jin
- Hongcheon Public Health Center, Hongcheon-gun, Korea
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13
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Factors associated with health-related quality of life in Chinese patients with heart failure: a cross-sectional study. Collegian 2020. [DOI: 10.1016/j.colegn.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kim SH, Ro JS, Kim Y, Leigh JH, Kim WS. Underutilization of Hospital-based Cardiac Rehabilitation after Acute Myocardial Infarction in Korea. J Korean Med Sci 2020; 35:e262. [PMID: 32743992 PMCID: PMC7402922 DOI: 10.3346/jkms.2020.35.e262] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/27/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) after acute myocardial infarction (AMI) is recommended as a mandatory intervention in several national clinical practice guidelines published in America, Europe, and Korea to reduce recurrence and mortality. However, underutilization of CR is an established worldwide issue. In Korea, the promotion of CR is expected due to coverage by National Health Insurance. Nevertheless, the national status of CR use has not been reported. This retrospective cohort study aimed to investigate the current status of CR use in patients with AMI using nationwide data from the National Health Insurance Service of Korea. METHODS Patients with AMI admitted with the diagnosis of 'I21' code (from International Classification of Diseases, 10th revision, Clinical Modification) from July 1st, 2017 to June 30th, 2018 were included. CR use was defined as CR treatment or evaluation being performed during an outpatient follow-up period within 6 months after discharge. Participation rate and density were calculated nationally and by administrative division. Logistic regression analysis was performed to identify the influencing factors of CR participation. RESULTS Nationally, 1.5% of AMI patients (960/64,982) underwent CR during outpatient treatment after discharge. CR density was approximately 10. Logistic regression analysis revealed that influencing factors included old age, female sex, rural residence, and low Charlson comorbidity index. CONCLUSION Hospital-based CR after AMI is underutilized despite its coverage by the National Health Insurance. More CR facilities have to be installed according to the needs of CR in various regions.
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Affiliation(s)
- Sun-Hyung Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jun-soo Ro
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Jang WY, Kang DO, Park Y, Lee J, Kim W, Choi JY, Roh SY, Jang Y, Park SH, Kim WS, Na JO, Choi CU, Rha SW, Park CG, Seo HS, Kim EJ. Validation of FRIEND and ACSM Equations for Cardiorespiratory Fitness: Comparison to Direct Measurement in CAD Patients. J Clin Med 2020; 9:jcm9061889. [PMID: 32560313 PMCID: PMC7356312 DOI: 10.3390/jcm9061889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/29/2020] [Accepted: 06/10/2020] [Indexed: 01/05/2023] Open
Abstract
The regression equation of the American College of Sports Medicine (ACSM) was a preferred method for estimating maximal oxygen consumption (VO2max). Recently, a more precise equation from the fitness registry and the importance of exercise national database (FRIEND) for healthy people was developed. This study compared VO2max estimated by the ACSM and FRIEND equations to VO2max directly measured in coronary artery disease (CAD) patients. Overall, 293 CAD patients who participated in cardiac rehabilitation between June 2015 and December 2018 were analyzed. Directly measured VO2max values were compared to the ACSM and FRIEND equations. The directly measured VO2max was significantly different from the estimated VO2max by ACSM equation (24.16 vs. 28.7 mL/kg/min, p < 0.001), which was overestimated by 20% in men and 16% in women. However, there was no statistically significant difference between the directly measured VO2max and the estimated VO2max by the FRIEND equation. (24.16 vs. 24.15 mL/kg/min, p = 0.986). In CAD patients, the estimated VO2max from the ACSM equation was significantly higher than the directly measured VO2max. In addition, estimated cardiorespiratory fitness (CRF) by the FRIEND equation showed similar results with directly measured CRF. As a result, the FRIEND equation can predict CRF more accurately than the ACSM.
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Affiliation(s)
- Won Young Jang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Catholic University of Korea St. Vincent Hospital, The Catholic University of Korea College of Medicine, Suwon 16247, Korea;
| | - Dong Oh Kang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Yoonjee Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Jieun Lee
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Woohyeun Kim
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Jah Yeon Choi
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Seung-Young Roh
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Yuna Jang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Se-Hyun Park
- Sport Science Center, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Woo-Sub Kim
- Department of rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea;
| | - Jin Oh Na
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Cheol Ung Choi
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Seung-Woon Rha
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Chang Gyu Park
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Hong Seog Seo
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Eung Ju Kim
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
- Correspondence: ; Tel.: +82-2-2626-3022
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Kim C, Choi I, Cho S, Han JY, Kim AR, Kim WS, Jee S, Lee JH, Joo MC, Bang HJ, Joa KL, Han EY, Baek S, Shim JI, Choi JA. Cardiac rehabilitation and 5-year mortality after acute myocardial infarction. Report from 11 tertiary hospitals in Korea (ETHIK Study). Eur J Phys Rehabil Med 2020; 56:489-495. [PMID: 32383573 DOI: 10.23736/s1973-9087.20.06081-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The participation rate for cardiac rehabilitation (CR) remains low in some Europe and Asia including Korea. AIM To investigate effects of CR on prognosis improvements in terms of recurrence, readmission, revascularization, and mortality rates in patients with acute myocardial infarction (AMI) in Korea. DESIGN A retrospective cohort study. SETTING Eleven Tertiary Hospitals In Korea (ETHIK Study). POPULATION Data from a total of 7299 patients between January 2012 and December 2015 were collected, of which data from 7136 patients were linked to insurance claims data. In the final analysis, 6743 patients were included. METHODS Patients who participated in the CR program while receiving outpatient treatment were classified into CR group. Those who did not participate in CR programs were classified into the non-CR group. RESULTS Kaplan-Meier survival analyses showed five-year survival rate of 96.9% in the CR group and 93.3% in the non-CR group. The hazard ratio (HR) for total 5-year mortality in the CR group was approximately 0.41 (95% CI: 0.27-0.63) times that of the non-CR group, indicating a reduction in the risk of mortality by approximately 59% in propensity score weighted cohort of 1878 patients. The HR for major adverse cardiac events (MACE) with respect to 5-year mortality, MI recurrence, revascularization, and readmission due to cardiovascular disease in CR group was 0.96 times that of non-CR group (95% CI: 0.83-1.12), without significant difference between the two groups. CONCLUSIONS In this study, 5-year mortality decreased by 59% in patients with AMI who had participated in CR compared to those who did not. CLINICAL REHABILITATION IMPACT This finding should be very helpful in emphasizing the need for CR in a country like Korea where CR has not yet been actively implemented.
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Affiliation(s)
- Chul Kim
- InJe University Sanggye Paik Hospital, Seoul, South Korea
| | - Insun Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Songhee Cho
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Jae-Young Han
- Chonnam National University Medical School and Hospital, Gwangju, South Korea -
| | - Ae-Ryoung Kim
- KyungPook National University Hospital, Daegu, South Korea
| | - Won-Seok Kim
- Seoul National University College of Medicine, Bundang Hospital, Seoul National University, Seongnam, Korea
| | - Sungju Jee
- Chungnam National University Hospital, Daejeon, South Korea
| | - Jong H Lee
- Dong-A University College of Medicine, Dong-A Medical Center, Busan, South Korea
| | - Min C Joo
- Wonkwang University Hospital, Jeonbuk-Do, South Korea
| | - Heui J Bang
- Chungbuk National University Hospital, Chungbuk-Do, South Korea
| | | | - Eun Y Han
- Jeju University Hospital, Jeju-Do, South Korea
| | - Sora Baek
- Kangwon National University School of Medicine, Kangwon National University Hospital, Gangwon-Do, South Korea
| | - Jung-Im Shim
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Jin A Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
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