Abstract

Cardiac rehabilitation (CR) is a highly recommended secondary prevention measure for patients with diagnosed cardiovascular disease. Unfortunately, participation rates are low due to enrollment and adherence issues. As such, new CR delivery strategies are of interest, as to improve overall CR delivery. The goal of the study was to obtain a better understanding of the short-term progression of functional capacity throughout multidisciplinary CR, measured as the change in walking distance between baseline six-minute walking test (6MWT) and four consecutive follow-up tests. One-hundred-and-twenty-nine patients diagnosed with cardiovascular disease participated in the study, of which 89 patients who completed the whole study protocol were included in the statistical analysis. A one-way repeated measures ANOVA was conducted to determine whether there was a significant change in mean 6MWT distance (6MWD) throughout CR. A three-way-mixed ANOVA was performed to determine the influence of categorical variables on the progression in 6MWD between groups. Significant differences in mean 6MWD between consecutive measurements were observed. Two subgroups were identified based on the change in distance between baseline and end-of-study. Patients who increased most showed a linear progression. In the other group progression leveled off halfway through rehabilitation. Moreover, the improvement during the initial phase of CR seemed to be indicative for overall progression. The current study adds to the understanding of the short-term progression in exercise capacity of patients diagnosed with cardiovascular disease throughout a CR program. The results are not only of interest for CR in general, but could be particularly relevant in the setting of home-based CR.

Highlights

  • Cardiac rehabilitation (CR) is an evidence-based intervention that uses a multidisciplinary approach to improve secondary prevention outcomes in cardiovascular patients [1,2,3,4,5]

  • The European Association of Preventive Cardiology (EAPC) accreditation program focusses on developing minimum standards for the evaluation of quality of a CR program, including characterization of eligible patients, ideal timing of CR and defining necessary components of CR [14]

  • Several studies and meta-analyses have shown that home-based CR and center-based CR have similar effects on clinical primary outcomes, including total mortality, exercise capacity, and health-related quality of life

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Summary

Introduction

Cardiac rehabilitation (CR) is an evidence-based intervention that uses a multidisciplinary approach to improve secondary prevention outcomes in cardiovascular patients [1,2,3,4,5]. The European Association of Preventive Cardiology (EAPC) accreditation program focusses on developing minimum standards for the evaluation of quality of a CR program, including characterization of eligible patients, ideal timing of CR and defining necessary components of CR [14] These standardization procedures are wanted within home-based CR. Several studies and meta-analyses have shown that home-based CR and center-based CR have similar effects on clinical primary outcomes, including total mortality, exercise capacity, and health-related quality of life. These analyses report the heterogeneity of CR programs among studies as a major limitation, further emphasizing the need for standardization procedures [17,18,19]. Wearable telemonitoring solutions support patients in following personalized treatment recommendations (i.e., exercise training, diet, medication . . . ), both in home- and center-based CR programs [15]

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