Implementation and evaluation of the Norwegian Ullevaal model as a cardiac rehabilitation model in primary care

Abstract

Purpose: To describe the Norwegian Ullevaal model, customised for cardiac patients in primary care, and to evaluate the feasibility of the model through patient outcomes after the 12 week outpatient cardiac rehabilitation programme.Materials and methods: A descriptive interventional cohort study with pre-post design. Patients referred to cardiac rehabilitation (n = 273) were enrolled. Group-based high-intensity interval training was offered twice weekly. The primary outcome measure was change in peak oxygen uptake. Quality of life was measured using the COOP-WONCA questionnaire.Results: A total of 87% completed the 12 weeks exercise based rehabilitation programme and there were no adverse events during testing or exercise training. Peak oxygen uptake improved significantly from 31.6 ± 7.5 to 34.1 ± 7.8 ml/kg/min. Mean difference was 4.1 ml/kg/min (95% confidence interval, 3.74.5). COOP-WONCA was significantly improved in all domains.Conclusions: The Norwegian Ullevaal model was effective and safe, and resulted in significant and clinically meaningful improvements in cardiopulmonary fitness and quality of life.Implications for rehabilitationCardiac rehabilitation programmes giving at least 3.5 ml/kg/min improvements of peak oxygen uptake are shown to be beneficial.The detailed description of the Norwegian Ullevaal model, applied as a cardiac rehabilitation programme in primary care, may help clinicians with planning and initiating of group-based high intensity cardiac rehabilitation, as well as implementing evidence based science into practice.The findings from this study provide preliminary evidence in support of alternative exercise prescriptions compared to present modalities for cardiac rehabilitation in primary care.