JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease

Makita, Shigeru; Yasu, Takanori; Akashi, Yoshihiro; Adachi, Hitoshi; Izawa, Hideo; Ishihara, Shunichi; Iso, Yoshitaka; Ohuchi, Hideo; Omiya, Kazuto; Ohya, Yusuke; Okita, Koichi; Kimura, Yutaka; Koike, Atsushi; Kohzuki, Masahiro; Koba, Shinji; Sata, Masataka; Shimada, Kazunori; Shimokawa, Tomoki; Shiraishi, Hiroaki; Sumitomo, Naokata; Takahashi, Toshio; Takura, Tomoyuki; Tsutsui, Hiroyuki; Nagayama, Masatoshi; Hasegawa, Emiko; Fukumoto, Yoshihiro; Furukawa, Yutaka; Miura, Shin‐ichiro; Yasuda, Satoshi; Yamada, Sumio; Yamada, Yoshio; Yumino, Dai; Yoshida, Toshiko; Adachi, Takuji; Ikegame, Toshimi; Izawa, Kazuhiro P.; Ishida, Takeshi; Ozasa, Neiko; Osada, Naohiko; Obata, Hiroaki; Kakutani, Naoya; Kasahara, Yusuke; Kato, Masaaki; Kamiya, Kentaro; Kinugawa, Shintaro; Kono, Yuji; Kobayashi, Yasuyuki; Koyama, Takeo; Sase, Kazuhiro; Sato, Shinji; Shibata, Tatsuhiro; Suzuki, Norio; Tamaki, Daisuke; Yamaoka‐Tojo, Minako; Nakanishi, Masayoshi; Nakane, Eisaku; Nishizaki, Mari; Higo, Taiki; Fujimi, Kanta; Honda, Tasuku; Matsumoto, Yasuharu; Matsumoto, Noriko; Miyawaki, Ikuko; Murata, Makoto; Yagi, Shusuke; Yanase, Masanobu; Yamada, Masatoshi; Yokoyama, M; Watanabe, Noboru; Ito, Haruki; Kimura, Takeshi; Kyo, Syunei; Goto, Yoichi; Nohara, Ryuji; Hirata, Ken–ichi

doi:10.1253/circj.cj-22-0234

Cited by 74 publications

(32 citation statements)

References 517 publications

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“…The rate of CR after device implantation in Japan did not differ according to hospital volume. CR after device implantation is recommended by the 2021 Revision of the Guidelines for Cardiovascular Disease Rehabilitation, 2 and various meta‐analyses have suggested the safety and efficacy of exercise 12–17 . However, the provision of CR after device implantation in Japan may not be widespread, at least during the perioperative phase, regardless of the hospital volume.…”

Section: Discussionmentioning

confidence: 99%

“…The guidelines are yet to be established regarding CR for patients with arrhythmias, who are often restricted in their activities to prevent the occurrence of arrhythmias. In contrast, CR after device implantation is recommended by the Guideline on Rehabilitation in Patients with Cardiovascular Disease, 2 and the effects of CR on patients undergoing device implantation for arrhythmias have been recently reported 3–7 . Although there have been reports of trends in the dissemination of CR using diagnosis procedure combination (DPC) data in Japan, 8 only patients hospitalized for myocardial infarction, angina pectoris, heart failure, peripheral vascular disease, and cardiovascular surgery are eligible for the program, while the implementation status of CR after device implantation has not yet been clarified.…”

Section: Introductionmentioning

confidence: 99%

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A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

Kuhara

Matsugaki

Imamura

et al. 2022

Journal of Arrhythmia

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Background The effect of cardiac rehabilitation (CR) on patients undergoing device implantation (DI) for arrhythmias has been reported; however, the implementation status of these patients has not been clarified. This study aimed to verify the implementation status of CR for patients with heart disease who have undergone DI using real‐world data. Methods This was an observational study using a nationwide administrative database associated with the diagnosis procedure combination (DPC) system in Japan (2014–2018). Subjects were patients with heart disease (70 667 cases) who underwent DI during the above scheduled hospitalization period. The overall rate of CR and the background factors of the subjects were verified. Results The CR rate for patients with heart disease who underwent DI during hospitalization was 23%, and the CR rate for patients with comorbid heart failure who underwent DI was only 32%. It was confirmed that progressing age was associated with a higher CR implementation rate. The lower the Barthel index score at the time of admission, the higher the CR implementation rate. Conclusions CR was performed for only one‐quarter of all the patients during admission for DI and just one‐third of the patients for DI with heart failure. Most of these patients were elderly and had a decreased ability to perform activities of daily living. The DPC data are subject to various limitations, and further research is necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

Kuhara

Matsugaki

Imamura

et al. 2022

Journal of Arrhythmia

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“…We kept in mind that this list should consist of a multi-component exercise program, such as resistance training, aerobic exercises, and balance exercises, based on the exercise statement for older adults [ 21 , 22 ]. Furthermore, exercise risk management and discontinuation criteria followed the guidelines of the Japanese Association of Cardiac Rehabilitation [ 23 ] and the Japanese Association of Rehabilitation Medicine [ 24 ], based on vital checks, visual checks, palpation, and medical interviews, without the use of medical equipment.…”

Section: Methodsmentioning

confidence: 99%

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities

Mashizume

Yama²,

Sasaki³

et al. 2023

IJERPH

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Appropriate goal setting for frail older adults is important because it drives effective rehabilitation. However, more insights into the types and degrees of frailty and goal-setting trends should be obtained. We conducted a multicenter prospective study to qualitatively examine the relation between each frailty domain (physical, social, and cognitive) and the goals of 201 subjects (median age: 79, 43.8% male) who began rehabilitation at a long-term care prevention facility. Goal setting was determined by the specific, measurable, achievable, relevant, and time to goal (SMART) framework up to three months, categorized according to the International Classification of Functioning, Disability, and Health. The results showed that approximately 90% of the subjects had frailty in at least one domain, and about half had frailties in two or more domains. In total, 176 (87.6%) subjects had goals corresponding to activities and participation. The tendency to set goals to improve mobility was confirmed when the number of overlapping frailties was high, especially those in the physical and social domains. Those with milder frailties were more likely to establish goals targeting improvements in community, social, and civic life. These findings will lead to the development of practical goal-setting guidelines for frail older adults.

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“…The questionnaire was developed by 4 medical and nursing care experts in CR (two doctors and PT/OT involved in CR, including a councilor of the Japanese Association of CR) based on the official Japanese Circulation Society (JCS) guidelines for HF, 14 , 18 and comprised a total of 19 questions and 57 items. The questionnaire was filled in by a responder from each of the accepting and non-accepting facilities for patients with HF.…”

Section: Methodsmentioning

confidence: 99%

Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation　― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―

et al. 2023

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Background: The purpose of this study was to investigate the actual conditions of cardiac rehabilitation (CR) for elderly patients with heart failure (HF) in outpatient rehabilitation (OR) facilities using long-term care insurance systems. Methods and Results: This was a cross-sectional web-based questionnaire survey conducted at 1,258 facilities in the Kansai region (6 prefectures) of Japan from October to December 2021. In all, 184 facilities responded to the web-based questionnaire (response rate 14.8%). Of these facilities, 159 (86.4%) accepted patients with HF. Among the patients with HF, 94.3% were aged ≥75 years and 66.7% were classified as New York Heart Association functional class I/II. Facilities treating patients with HF generally provided exercise therapy, patient education, and disease management, which were components of CR. Many facilities not currently treating patients with HF responded positively stating they will accept HF patients in the future. However, a few facilities responded by stating that they are waiting for clearer evidence demonstrating the beneficial effect of OR on patients with HF. Conclusions: The present results show the possibility that outpatient CR can be performed for elderly patients with HF in other than medical insurance.

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JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease

Cited by 74 publications

References 517 publications

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities

Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation　― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―

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JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease

Cited by 74 publications

References 517 publications

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

A survey of the implementation rate of cardiac rehabilitation for patients with heart disease undergoing device implantation in Japan

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities

Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation ― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―

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Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation　― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―