Maintenance of Exercise Capacity and Physical Activity Patterns 2 Years After Cardiac Rehabilitation

Boesch, Claudia; Myers, Jonathan; Habersaat, Anita; Ilarraza, Hermes; Kottman, Wilhard; Dubach, Paul

doi:10.1097/00008483-200501000-00004

Cited by 49 publications

(49 citation statements)

References 25 publications

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“…This is a key finding because recidivism in cardiac rehabilitation is commonplace after completion of a program, 41 and indeed, the drop-out rates in these programs are as high as 35%. 42 In our study, <10% of participants withdrew from the intervention; however, as with traditional CRP, the level of engagement with the vCRP varied with 1 participant not logging on to the website at all during the 4 months to others logging on >8 times per week.…”

Section: Summary Of the Experience Futurementioning

confidence: 99%

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

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et al. 2014

Circ: Cardiovascular Quality and Outcomes

149

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With an aging population in many Western countries and increases in risk factors such as obesity, the number of patients with cardiovascular diseases (CVDs) is increasing. 1 These patients are at greater risk of subsequent events, comorbidities, and premature mortality, therefore effective and ongoing management is needed to reduce this risk. Cardiac rehabilitation programs (CRPs) are effective at improving lifestyle behaviors and reducing risk factors in patients with CVD, as well as reducing CVD events and premature mortality, while being cost-effective.2-5 As a result, the American Heart Association, and others, have highlighted participation in CRP as an essential element of secondary prevention in patients with CVD. [6][7][8] Despite the known benefits of CRP, as little as 10% to 30% of eligible patients attend these programs. [9][10][11][12][13] The majority of these programs are limited to hospitals in large urban areas with geographical accessibility as one of the main barriers to attendance.14,15 Lack of access is more pronounced for patients in rural areas that do not have CRP, 16,17 although risk factors such as smoking and obesity are higher in rural populations 18 resulting in a greater rate of hospitalizations than urban populations.19 Home-based CRP have been developed to address the accessibility issue, and a review of these studies found no difference to hospital-based CRP with respect to improvements in CVD risk. 20 However, these programs generally consist of a mix of on-site exercise sessions, clinic or home visits, telephone calls from staff, and diaries, which still require patients to attend some sort of clinic and therefore do not accommodate patients in outlying areas.The proliferation of low-cost communications technology, such as the Internet, has opened up an array of opportunities for patient communication while bridging geographic distance. The Internet holds great promise in improving access to healthcare services as it is ubiquitous, requires little infrastructure and cost, and is readily scalable to large populations. Despite the enthusiasm for technology supported healthcare services, the evidence to support such use in cardiac rehabilitation is limited to pilot studies. [21][22][23][24] As a result, a recent American Heart Association Presidential Advisory has called for more robust research to test the feasibility and effectiveness of Internet-based CRP. 25 Our goal therefore, was to test the clinical effectiveness of a virtual CRP (vCRP) delivered exclusively using Internet-based technology. Local Challenges in ImplementationA common challenge to the implementation of CRP is the cost of their implementation despite having been demonstrated to be cost-effective.5 This challenge also holds true for technology-based solutions. Although several communication technology mediums exist (telephone, video-conferencing, and telemonitoring), we chose to use a web-based program delivered through the Internet as it is (1) commonly available in people's homes, (2) requires less capital exp...

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Section: Summary Of the Experience Futurementioning

confidence: 99%

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

Lear

Singer

Banner

et al. 2014

Circ: Cardiovascular Quality and Outcomes

149

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“…This is in contrast to sustained changes over 2 years reported after a residential rehabilitation programme in Switzerland. 135 Over the 2 years there were only a small number of cardiac events equally distributed between the home-and centre-based arms. There was a suggestion, although not statistically significant, that there may have been more deaths and MIs in the home-based group.…”

Section: Health Outcomesmentioning

confidence: 99%

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

Jolly¹,

Taylor²,

Gy³

et al. 2007

Health Technol Assess

171

262

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email.Paying by official purchase order You can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA The Birmingham Rehabilitation Uptake Maximisation Study (BRUM NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as royal colleges and NHS trusts. These suggestions are carefully prioritised by panels of independent experts (including NHS service users). The HTA Programme then commissions the research by competitive tender. Secondly, the HTA Programme provides grants for cl...

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“…Empirical evidence show that completion of cardiac rehabilitation programs is related to increased exercise tolerance (Balady et al, 1996;Milani, Lavie, & Mehra, 2004), exercise maintenance, quality of life, and leisure-time physical activity (Izawa et al, 2004), as well as improved perception of physical function (Dolansky & Moore, 2004). Given the quantity of evidence supporting the effects of cardiac rehabilitation in increasing physical activity and overcoming psychosocial barriers to exercise (Boesch et al, 2005;Lavie & Milani, 1996;Lavie et al, 1999;Song & Lee, 2001;Worcester et al, 2003), it was not surprising that cardiac rehabilitation enrollment distinguished significantly among Irregular Exercisers and Inactive participants, and between Exercise Maintainers and Inactive participants. Given the gross under-utilization of cardiac rehabilitation in many jurisdictions (Bittner et al, 1999;Bunker & Goble, 2003;Grace et al, 2002), continued efforts to increase enrollment such as automatic referral are warranted (Grace et al, 2004).…”

Section: Sociodemographic and Clinical Correlates Of Exercise Patternsmentioning

confidence: 99%

A Prospective Examination of Patterns and Correlates of Exercise Maintenance in Coronary Artery Disease Patients

et al. 2007

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This longitudinal study examined exercise behavior patterns (i.e., maintainers, irregular, and inactive) in cardiac patients, and investigate the sociodemographic, clinical, psychosocial, and environmental correlates of exercise patterns. 661 cardiac in-patients from 3 hospitals consented to participate (75% response rate) and were re-assessed 9 and 18 (81% retention) months postdischarge. Exercise patterns were assessed via the Health-Promoting Lifestyle Profile II subscale using a median split. Of 417 participants (mean age 63.1 ± 10.2) with complete data, 42.2% were classified as Exercise Maintainers, 21.3% as Irregular Exercisers, and 26.1% as Inactive. Multinomial logistic regression revealed that Exercise Maintainers were more likely to be male, have exercised prior to their diagnosis, attend cardiac rehabilitation, perceive fewer exercise barriers, and were less likely to be current-smokers, past-smokers, or attribute the cause of their disease to their own behavior. Patients more likely to maintain exercise have positive perceptions and utilize cardiac rehabilitation.

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Maintenance of Exercise Capacity and Physical Activity Patterns 2 Years After Cardiac Rehabilitation

Cited by 49 publications

References 25 publications

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

A Prospective Examination of Patterns and Correlates of Exercise Maintenance in Coronary Artery Disease Patients

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