Home-Based Cardiac Rehabilitation Among Patients Unwilling to Participate in Hospital-Based Programs

Abstract

Home-Based CR of Patients That Declined Traditional CR 33C ardiac rehabilitation (CR) is well recognized as an essential intervention for the secondary prevention of coronary artery disease, heart failure (HF), and future heart-related complications. 1 Benefits of CR include improvements in morbidity, physical activity (PA) level, exercise capacity, and quality of life as well as decreased rate of hospital admissions. 2 A viable alternative to traditional, center-based cardiac rehabilitation (CBCR) is asynchronous home-based cardiac rehabilitation (HBCR). 3 Similar to CBCR, HBCR has already been well established and shown to deliver similar outcomes and safety profile. 4 However, unlike traditional CR programs, HBCR has the additional benefits of being more cost-effective and easily accessible. 5,6 Previous research 7,8 has found that patients who are referred by their physicians to CR are often unwilling to actively participate in the traditional CR. The reasons for this unwillingness to participate in CR are varied and can be broken down into person-specific factors and reasons which are related to the CR program. Documented person-specific factors such as older age, female sex, patients with comorbidities, unemployed persons, lower education levels, and lower incomes were correlated to lower participation rates. Specific reasons, which were related to the CR program, included distance from CR facilities, lack of adequate transportation, and program hours. 9 Other studies have documented outright patient refusal to initiate a traditional CR program, citing factors such as a general

Evaluating the Effects of an Enhanced Strength Training Program in Remote Cardiological Rehabilitation: A Shift from Aerobic Dominance—A Pilot Randomized Controlled Trial

“…A crucial objective of our study was to identify a more effective approach conducive to improved adherence to cardiac rehabilitation goals. Our prior research [ 51 , 52 ], alongside other studies [ 53 ], has indicated that remote rehabilitation programs successfully achieve compliance with aerobic objectives but consistently fall short in terms of adherence to prescribed strength training.…”

The Importance of the Diaphragm Muscle in Cardiac Rehabilitation after Myocardial Infarction

“…The cardiopulmonary test does not evaluate diaphragm function The international guidelines for RC give strong indications on the fact that, before undertaking a rehabilitation cycle, the patient must undergo a cardiopulmonary exercise test (CPET), measuring peak oxygen consumption (VO2peak), both for people who will follow a procedure in specialized centers and for physical activity carried out at home [17,47]. The test allows you to obtain data under stress; the objective is to identify a suitable CR path for each patient [9].…”