Hospital-Based Versus Hybrid Cardiac Rehabilitation Program in Coronary Bypass Surgery Patients in Western Iran

Najafi, Fatemeh; Nalini, Mahdi

doi:10.1097/hcr.0000000000000087

Cited by 17 publications

(25 citation statements)

References 31 publications

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“…The full-text versions of the remaining articles were reviewed for eligibility resulting in the exclusion of 224 for the reasons noted. Ultimately, 62 studies were included from the search, reporting on 60 unique patient samples 23 25–86…”

Section: Resultsmentioning

confidence: 99%

Exercise-based rehabilitation for major non-communicable diseases in low-resource settings: a scoping review

et al. 2019

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IntroductionWhile there is substantial evidence for the benefits of exercise-based rehabilitation in the prevention and management of non-communicable disease (NCD) in high-resource settings, it is not evident that these programmes can be effectively implemented in a low-resource setting (LRS). Correspondingly, it is unclear if similar benefits can be obtained. The objective of this scoping review was to summarise existing studies evaluating exercise-based rehabilitation, rehabilitation intervention characteristics and outcomes conducted in an LRS for patients with one (or more) of the major NCDs.MethodsThe following databases were searched from inception until October 2018: PubMed/Medline, Embase, CINAHL, Cochrane Library, PsycINFO and trial registries. Studies on exercise-based rehabilitation for patients with cardiovascular disease, diabetes, cancer or chronic respiratory disease conducted in an LRS were included. Data were extracted with respect to study design (eg, type, patient sample, context), rehabilitation characteristics (eg, delivery model, programme adaptations) and included outcome measures.ResultsThe search yielded 5930 unique citations of which 60 unique studies were included. Study populations included patients with cardiovascular disease (48.3%), diabetes (28.3%), respiratory disease (21.7%) and cancer (1.7%). Adaptations included transition to predominant patient-driven home-based rehabilitation, training of non-conventional health workers, integration of rehabilitation in community health centres, or triage based on contextual or patient factors. Uptake of adapted rehabilitation models was 54%, retention 78% and adherence 89%. The majority of the outcome measures included were related to body function (65.7%).ConclusionsThe scope of evidence suggests that adapted exercise-based rehabilitation programmes can be implemented in LRS. However, this scope of evidence originated largely from lower middle-income, urban settings and has mostly been conducted in an academic context which may hamper extrapolation of evidence to other LRS. Cost-benefits, impact on activity limitations and participation restrictions, and subsequent mortality and morbidity are grossly understudied.

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Section: Resultsmentioning

confidence: 99%

Exercise-based rehabilitation for major non-communicable diseases in low-resource settings: a scoping review

et al. 2019

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“…A total of 13 papers were further included for data extraction, of which six articles were included in the final analysis ( Fig. 1) [2,5,11,[18][19][20]. Five studies were conducted between 2011 and 2017, and one study was conducted in the United States in 2000.…”

Section: Search Results and Baseline Characteristicsmentioning

confidence: 99%

“…Cardiac rehabilitation (CR) is a secondary prevention measure that involves physical exercise, health education, behavioural change, risk factor modification, and nutritional and lifestyle counselling [3,4]. Growing evidence has shown that it can reduce morbidity and mortality and enhance the patients' quality of life [5][6][7][8]; therefore, it has become a class I recommendation in several guidelines for patients after cardiac events or surgery and those with heart failure (HF) [9,10]. Despite all the known health benefits of CR programmes, the patients' commitment and adherence are still low [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Hybrid versus traditional cardiac rehabilitation models: a systematic review and meta-analysis

Wu¹,

Chen³

2018

Kardiol Pol

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“…Hybrid CR is one of the most cost-effective models which strongly influences the control of cardiac risk factors [ 4 5 ], improvement of exercise capacity, commitment to treatment, reducing complications and improving patient's quality of health [ 6 7 ]. Despite this, there are few studies that demonstrate its effect on reducing the risk of angina and other related psychological symptoms.…”

Section: Introductionmentioning

confidence: 99%

A hybrid cardiac rehabilitation is as effective as a hospital-based program in reducing chest pain intensity and discomfort

et al. 2017

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BackgroundHealth care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients.MethodsIn this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA.ResultsThe results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05).ConclusionsTraditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.

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Hospital-Based Versus Hybrid Cardiac Rehabilitation Program in Coronary Bypass Surgery Patients in Western Iran

Abstract: A well-designed hybrid CRP can be a viable alternative for hospital-based CRP in low- and middle-income countries where there are no appropriate health facilities in remote areas.

Cited by 17 publications

References 31 publications

Exercise-based rehabilitation for major non-communicable diseases in low-resource settings: a scoping review

Exercise-based rehabilitation for major non-communicable diseases in low-resource settings: a scoping review

Hybrid versus traditional cardiac rehabilitation models: a systematic review and meta-analysis

A hybrid cardiac rehabilitation is as effective as a hospital-based program in reducing chest pain intensity and discomfort

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