Home- and Hospital-Based Cardiac Rehabilitation Exercise

Abstract

Exercise reduces morbidity and mortality for patients with heart disease. Despite clear guidelines and known benefits, most cardiac patients do not meet current exercise recommendations. Physician endorsement positively affects patient participation in hospital-based Phase II cardiac rehabilitation programs, yet the importance of physician recommendation for home-based cardiac rehabilitation exercise is unknown. A prospective observational design was used to examine predictors of both home-based and Phase II rehabilitation exercise in a sample of 251 patients with coronary heart disease. Regression analyses were done to examine demographic and clinical characteristics, physical functioning, and patient's report of physician recommendation for exercise. Patients with a strong physician referral, who were married and older, were more likely to participate in Phase II exercise. Increased strength of physician recommendation was the unique predictor of home-based exercise. Further research is needed to examine how health professionals can motivate cardiac patients to exercise in home and outpatient settings.

Cardiac rehabilitation via telerehabilitation in COVID-19 pandemic situation

“…The second phase begins as soon as patients are allowed to be discharged. The phase II or center-based cardiac rehabilitation (CBCR) phase is a program that provides resources and an environment, i.e., a supportive community for patients to complete their comprehensive rehabilitation program [10]. The CR program generally consists of 3 sessions per week for ± 8 weeks.…”

“…The benefits gained from phase II (CBCR) will be subsided within a few weeks if they stop exercising [8]. Therefore, home-based cardiac rehabilitation (HBCR) may overcome this problem and be used as an adjunct or alternative to CBCR [10].…”

“…Table 3 Characteristics of patients based on risk stratification [7,9] Low risk for exercise participation [10]. In the HBCR program, patients can still participate and perform exercises independently at home or any local fitness center [3].…”

“…Physician support indeed influences patient participation in CR programs. Patient characteristics may be the significant predictors when referring patients to join CR programs [2,10].…”

“…Of all patients who were referred to CR, only 30-34% participated [10]. The low rate of patient participation is influenced by several factors, including lack of physician referral or low level of physician support, low socioeconomic status, lack of education, racial/ethnic minority status, barriers in transportation, current routine activities at home, older age, female gender, lack of friends, and the presence of depression.…”