A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus?

Price, Kym Joanne; Gordon, Brett; Bird, Stephen; Benson, Amanda

doi:10.1177/2047487316657669

Cited by 329 publications

(336 citation statements)

References 68 publications

(175 reference statements)

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“…Contrary to some (but not all 20 ) guideline recommendations 16,18,15 that CR be directed by physicians however, these providers were only among the top three most frequent personnel in the Middle East and North Africa, Latin America and the Caribbean, Europe as well Central Asia (but not in East Asia, the Pacific, and North America). Also interestingly, in some regions physiotherapists were a main part of the team (n=17 of 21 papers reporting staff composition, e.g., Australia, England, Scotland, Northern Ireland, Wales, Denmark, Italy, Portugal, Spain, Mexico, Bahrain, Egypt, Qatar, UAE and Canada; e.g., 24,61,66,92 ), whereas in others, exercise specialists were more common (i.e., exercise physiologists, kinesiologists; n=7 of 21 papers reporting staff composition; North America, China and the Middle East; e.g., 24,93 ).…”

Section: Accepted M Manuscriptmentioning

confidence: 66%

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A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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Section: Accepted M Manuscriptmentioning

confidence: 66%

“…A previous review of clinical practice guidelines revealed broad variability in recommendations internationally 20 , as did a review of primary studies by our group 94 . The range of sessions prescribed spanned from a minimum of 16.5±2.1 sessions in France, to a maximum of 142.0±112.4…”

Section: Accepted Manuscriptmentioning

confidence: 82%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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“…Increased awareness of the problem of secondary prevention and understanding of the role of multidisciplinary teams have enabled the development of comprehensive cardiac rehabilitation programs, including physiotherapy, occupational therapy, education, psychological and social therapy, counseling for risk factors and pharmacotherapy [3][4][5][6]. Comprehensive cardiac rehabilitation has become a platform that connects many medical specialties, but also family members and their immediate environment.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, more and more patients may benefit from post-MI cardiac rehabilitation, which is designed to restore or even improve the patient's physical fitness [3].…”

Section: Introductionmentioning

confidence: 99%

Ocena czynników ryzyka chorób układu sercowo-naczyniowego u chorych poddawanych stacjonarnej wczesnej rehabilitacji kardiologicznej po ostrym incydencie wieńcowym

Kapko

Krzych

2017

Folia Cardiologica

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“…The current clinical practice guidelines in terms of cardiac rehabilitation recommend that physical exercise should be prescribed only after determining the VO2 max, which is considered to be the most accurate indicator of the patient's exercise capacity, as shown in a review article published by Price JK et al in European Journal of Preventive Cardiology in 2016 [4]. The rehabilitation program should be started with moderate intensity training (40-50% of VO2 max) and increased progressively up to 70-80% (high intensity training).…”

Section: Evaluation Of the Patient's Maximum Exercise Capacitymentioning

confidence: 99%

The role of cardiopulmonary exercise testing in the initial evaluation of patients wearing intracardiac devices submitted to cardiac rehabilitation

Caloian¹,

Pop²,

Gușetu³

et al. 2017

Balneo

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Cardiopulmonary exercise testing(CPET) can be used to determine the maximum exercise capacity, to identify the factors that cause a limitation of the patient's functional capacity, to evaluate symptoms triggered by physical exercise and to reveal specific complications related to intracardiac devices that might occur during the physical rehabilitation program. The rehabilitation of a patient that is wearing an intracardiac device raises some particular issues besides the ones that we meet in a conventionally treated cardiovascular patient. Several clinical studies have shown that the programming mode of the cardiac pacemakers can have a significant influence on the patients exercise capacity, a crucial element of any physical rehabilitation program. CPET is one of the most accurate and comprehensive methods for the evaluation of the pacemaker-wearing patients, being able to optimize their functional capacity and, therefore, should be recommended in all patients before inclusion in cardiac exercise rehabilitation programs.

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A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus?

Cited by 329 publications

References 68 publications

A Review of Cardiac Rehabilitation Delivery Around the World

A Review of Cardiac Rehabilitation Delivery Around the World

Ocena czynników ryzyka chorób układu sercowo-naczyniowego u chorych poddawanych stacjonarnej wczesnej rehabilitacji kardiologicznej po ostrym incydencie wieńcowym

The role of cardiopulmonary exercise testing in the initial evaluation of patients wearing intracardiac devices submitted to cardiac rehabilitation

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