Evaluation of a Community Based Cardiac Rehabilitation Programme

Abstract

The transition from hospital-based (phase II) to community-based (phase III) cardiac rehabilitation (CR) is an important step in the long-term maintenance of positive health behaviour change. PURPOSE: To evaluate the effect of participation in a phase III, community-based CR (CBCR) programme on selected fitness indices in comparison to a control group that received usual care advice and to explore participant experiences and perceived benefits in transitioning from hospital-based phase II CR to CBCR. METHODS: Following completion of phase-II CR, 95 individuals were referred to a 10-week CBCR exercise programme (intervention). A total of 22 (73% male) participants were unable to attend CBCR classes and were assigned to the control group. The remaining 73 (67% male) were assigned to the CBCR exercise program. Aerobic fitness (6MWT), functional upper (hand grip) and lower (timed sit to stand) limb strength, flexibility (sit and reach test) and body composition (waist & hip girth and BMI) were measured pre and post the intervention. All participants from the intervention group were invited to attend a focus group on completion and a thematic analysis was conducted. RESULTS: A total of 51 participants (69% male) completed the 10-week program (70% compliance). There was a significant improvement (p<0.05) in the timed sit to stand (26.5±7.21 v 21.4±5.65sec), 6MWT (505±66.6 v 534±71.9m),) and waist circumference (100.9±13.09 v 98.5±13.37cm) in the intervention group. There was no significant change in any of the fitness indices in the control group. The focus groups were attended by 20 participants (60% male). The main themes identified included the strong sense of need for CBCR programmes and the reassurance provided by the link between the hospital and community provider. Physical, psychological and social benefits were described including moving from fear to confidence in their ability to exercise. CONCLUSION: Participation in a 10-week CBCR programme resulted in improved lower limb strength, aerobic fitness and waist circumference with maintenance of all other measured fitness components. Participants self-reported an increased ability and motivation to undertake exercise. This study provides an important insight into the experience and benefits, both perceived and actual, in the early transition to CBCR.