Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction

Xu, Lin; Cai, Zekun; Xiong, Ming; Li, Ye-kuo; Li, Guoying; Deng, Yu; Hau, William Kongto; Li, Shuo; Huang, Wenhua; Qiu, Jian

doi:10.1097/md.0000000000005638

Cited by 21 publications

(29 citation statements)

References 30 publications

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“…TTE parameters, representing cardiac systolic (eg, LVEF, TAPSE) and diastolic (eg, E/A ratio, E/E’) functions are used as secondary outcomes of this trial due to the previous findings of the influence of exercise training on cardiac function 40. There is no definite information on the specific mechanisms of the influence of exercise training on cardiac function.…”

Section: Discussionmentioning

confidence: 99%

Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial (NCT03470246)

Vasankari

Halonen

Husu

et al. 2019

BMJ Open Sport Exerc Med

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IntroductionPersonalized intervention to increase physical Activity and reduce sedentary behaviour in rehabilitation after Cardiac Operations (PACO) is a smartphone-based and accelerometer-based eHealth intervention to increase physical activity (PA) and reduce sedentary behaviour (SB) among patients recovering from cardiac surgery.DesignProspective randomised controlled trial.Methods and analysisThe present protocol describes a randomised controlled clinical trial to be conducted in the Heart Centres of Kuopio and Turku university hospitals. The trial comprises 540 patients scheduled for elective coronary artery bypass grafting, aortic valve replacement or mitral valve repair. The patients will be randomised into two groups. The control group will receive standard postsurgical rehabilitation guidance. The eHealth intervention group will be given the same guidance together with personalised PA guidance during 90 days after discharge. These patients will receive personalised daily goals to increase PA and reduce SB via the ExSedapplication. Triaxial accelerometers will be exploited to record patients’ daily accumulated PA and SB, and transmit them to the application. Using the accelerometer data, the application will provide online guidance to the patients and feedback of accomplishing their activity goals. The data will also be transmitted to the cloud, where a physiotherapist can monitor individual activity profiles and customise the subsequent PA and SB goals online. The postoperative improvement in patients’ step count, PA, exercise capacity, quality of sleep, laboratory markers, transthoracic echocardiography (TTE) parameters and quality of life, and reduction in SB and incidence of major cardiac events are investigated as outcomes.ConclusionsThe PACO intervention aims to build a personalised eHealth tool for the online tutoring of cardiac surgery patients.Trial registration numberNCT03470246.

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Section: Discussionmentioning

confidence: 99%

Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial (NCT03470246)

Vasankari

Halonen

Husu

et al. 2019

BMJ Open Sport Exerc Med

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“…27 Also in concordance with the present study, a recent study showed that early HBCR in post MI patients was associated with significant improvements in LVEF as well as global longitudinal strain, global radial strain and global circumferential strain (using 3-dimensional speckle tracking echocardiography) as compared to the control group at the 4-week follow-up. 36…”

Section: Effect Of Hbcr On LV Systolic Functionmentioning

confidence: 99%

Cardiac rehabilitation after myocardial infarction: a comparison between the standard and home-based cardiac rehabilitation programs

Khorshid¹,

Zaki²,

Menshawy³

et al. 2019

JCCR

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Background: Cardiovascular disease (CVD) has emerged as the leading cause of death worldwide. Multiple meta-analyses have demonstrated that cardiac rehabilitation (CR) reduces mortality in patients with coronary artery disease. Despite guidelines recommending the use of CR programs for patients with ST segment elevation myocardial infarction (STEMI) participation in these programs continues to be low which had led to the development of alternative models of CR. Objective: To evaluate the efficacy of home-based cardiac rehabilitation (HBCR) program in patients presenting with STEMI in a comparison with the standard inhospital CR program. Methods: The study included 70 Patients referred for cardiac rehabilitation unit at Ain shams university hospitals after STEMI successfully treated by primary PCI. Patients were subdivided into two (2) groups according to patients' preference to different modalities of cardiac rehabilitation: a. Group (A): 35 patients who underwent regular in-hospital cardiac rehabilitation b. Group (B): 35 patients who couldn't undergo regular in-hospital cardiac rehabilitation and preferred to undergo home-based cardiac rehabilitation Outcome measures were assessed at baseline and after completion of the CR program in the form of: a. 12 hr fasting lipid profile (TC, HDL, LDL and TGs). b. Transthoracic echocardiographic examination for assessment of Ejection fraction (EF%) by 2D modified biplane Simpson's method c. Symptom limited treadmill exercise stress test using Modified Bruce protocol: The following parameters were recorded: Resting blood pressure, resting heart rate (HR) and maximum achieved HR, HR recovery at 1 minute (HRR1), HR reserve and metabolic equivalents of task (METs) achieved. Results: No significant differences between both groups regarding baseline lipid profile, EF% and Exercise test parameters before starting the CR program. There was a statistically significant improvement in Lipid profile, EF% and Exercise test parameters (METs, Exercise time, peak HR, HR reserve and HRR) after completion of the CR program in both groups with no statistically significant difference between both groups regarding delta changes in the studied parameters. Conclusion: Home-based cardiac rehabilitation does not have inferior outcomes compared to hospital-based supervised program in post MI patients and may offer an alternative model of CR for individuals less able to access center-based cardiac rehabilitation.

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“…Dyslipidemia, high blood pressure, obesity, diabetes, smoking, psychosocial stress, less fruit and vegetable intake, alcohol consumption, and less physical activity are the main risk factors for myocardial infarction in Chinese men and women 2 . Therefore, efforts, for example, as early revascularization therapies and secondary prevention are made to improve the quality of life of patients after acute myocardial infarction 3 but outcomes of these efforts are not satisfactory 4 and do not have large impact on success of cure of patients 5 . Cardiac rehabilitation is an outpatient model of secondary prevention and is designed to reduce the burdens of cardiovascular diseases 6 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of cardiac rehabilitation (exercise + education), exercise only, and usual care for patients with coronary artery disease: A non‐randomized retrospective analysis

Wang

et al. 2021

Pharmacology Res & Perspec

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Cardiac rehabilitation program is well‐established but the Rehabilitation After Myocardial Infarction Trial (RAMIT) is reported that it does not affect mortality and morbidity of patients after myocardial infarction during follow‐up period. The objectives of the study were to compare functional walking capacity, risk factor control, and morbidities in follow‐up for cardiac rehabilitation (exercise + education), exercise only, and usual care among patients with coronary artery disease. A total of 492 male and female patients (age range: 45–73 years) with coronary artery disease after myocardial infarction or underwent percutaneous coronary intervention or coronary artery bypass grafting surgeries referred to cardiac rehabilitation were included in the study. Patients were participating in a cardiac rehabilitation program (exercise + education, CRP cohort, n = 125), exercise only (USC cohort, n = 182), or usual care (NCR cohort, n = 185). Data regarding incremental shuttle walk test, lipid profile, the Patient Health Questionnaire 9, and morbidities in follow‐up of patients were retrospectively collected and analyzed. After completion of 1 year, cardiac rehabilitation program (p < 0.0001, q = 20.939) and exercise (p < 0.0001, q = 6.059) were successfully increased incremental shuttle walk test. After completion of 1 year, cardiac rehabilitation program reduced low‐density lipoprotein (p = 0.007, q = 3.349) and depressive symptoms (p < 0.0001, q = 5.649). Morbidities were reported fewer in the patients of CRP cohort than those of USC (p = 0.003, q = 3.427) and NCR (p = 0.003, q = 4.822) cohorts after completion of 1 year of program. Cardiac rehabilitation program (exercise +education) improved functional walking capacity, controlled risk factors, and reduced morbidities of patients with coronary artery disease than exercise only and usual care (Level of evidence: III).

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Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction

Cited by 21 publications

References 30 publications

Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial (NCT03470246)

Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial (NCT03470246)

Cardiac rehabilitation after myocardial infarction: a comparison between the standard and home-based cardiac rehabilitation programs

Comparison of cardiac rehabilitation (exercise + education), exercise only, and usual care for patients with coronary artery disease: A non‐randomized retrospective analysis

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