Improvement In Functional Exercise Capacity Differs By Attendance Duration But Not Intake Diagnosis In A Hospital-based Phase Ii Outpatient Cardiac Rehabilitation Program.

Abstract

PURPOSE: Investigate differences and interactions between intake diagnosis and time-to-completion on functional exercise capacity (FEC) improvement in a hospital-based outpatient cardiac rehabilitation (CR) program in New Mexico. METHODS: During a 12-month span, 10 women and 39 men eligible for participation in a CR program completed all authorized 36-sessions in the Phase II CR program. Eligible diagnoses were: heart failure (HF), acute coronary syndrome (ACS), and cardiothoracic surgery (CT). A modified Atterbom protocol (2-min stages of increasing treadmill speed and incline) was used to assess differences between FEC at intake and immediately following completion of the 36-session program. Handrail support was allowed during the exercise tests as needed. FEC was determined by the attainment of an RPE of 15 (Borg 6-20 scale) and reported in METs. As part of a chart review, all data were deidentified prior to collection and analyses. Patients were separated into groups based on time-to-completion (≤4mo and >4mo) and diagnosis. Separate, group-specific independent t-tests were initially applied to examine changes in FEC by diagnosis and time-to-completion. All groups significantly improved FEC (p<.05). Consequently, ΔFEC ((post- pre/pre)*100) was calculated and analyzed. A 2 (time) by 3 (diagnosis) analysis of variance (ANOVA) was applied to assess group differences and interactions for ΔFEC. RESULTS: Forty-nine patients (61.6 ± 11.0 yr, 171.5 ± 8.9 cm, 79.7 ± 16.0 kg) completed the 36-session CR program during the 12-mo period. Group means ± SD for improvement in METs at ≤4mo (n=33) and >4mo (n=16) were 3.30 ± 1.92 METs, and 1.97 ± 1.27 METs, respectively. Group means ± SD for ΔFEC among HF (n=12), ACS (n=25), and CT (n=12) were 108.0 ± 95.5%, 60.4 ± 41.8%, and 54.1 ± 40.2%, respectively. Group means ± SD for ΔFEC at ≤4mo (n=33) and >4mo (n=16) were 82.2 ± 68.7%, and 46.5 ± 34.8%, respectively. Results indicate a significant (F (1,43)= 6.344, p = .016, partial η2 = .129) effect between ΔFEC and the time to complete the 36 sessions. CONCLUSIONS: These results highlight the effectiveness of a completed hospital-based outpatient CR program to elicit positive health outcomes across intake diagnoses. Completing the 36 sessions in 4mo or less produced the greatest improvement in FEC regardless of intake diagnosis.