BACKGROUND: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. METHODS: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients ≥ 65 years with coronary heart disease. RESULTS:seventy-five patients participated. There were no significant differences in exercise capacity after the intervention between home and centre-based CR. Adjusted mean differences of peak VO₂ = 0.9 ml/kg/min (95% CI -0.7, 2.4) and of 6 min walk test = -18.7 m (95% CI -56.4, 18.9). In addition, no differences were found in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect of either programmes were characterised by higher age, living alone and having COPD. At 12 months of follow-up, both groups had a significant decline in exercise capacity. CONCLUSIONS: home-based CR is as effective as centre-based CR in improving exercise capacity, risk factor control and health-related quality of life. However, a group of patients did not improve regardless of the type of intervention. Continued follow-up is essential in order to maintain the gained improvements.
RCT Entities:
BACKGROUND: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. METHODS: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients ≥ 65 years with coronary heart disease. RESULTS: seventy-five patients participated. There were no significant differences in exercise capacity after the intervention between home and centre-based CR. Adjusted mean differences of peak VO₂ = 0.9 ml/kg/min (95% CI -0.7, 2.4) and of 6 min walk test = -18.7 m (95% CI -56.4, 18.9). In addition, no differences were found in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect of either programmes were characterised by higher age, living alone and having COPD. At 12 months of follow-up, both groups had a significant decline in exercise capacity. CONCLUSIONS: home-based CR is as effective as centre-based CR in improving exercise capacity, risk factor control and health-related quality of life. However, a group of patients did not improve regardless of the type of intervention. Continued follow-up is essential in order to maintain the gained improvements.
Authors: Randal J Thomas; Alexis L Beatty; Theresa M Beckie; LaPrincess C Brewer; Todd M Brown; Daniel E Forman; Barry A Franklin; Steven J Keteyian; Dalane W Kitzman; Judith G Regensteiner; Bonnie K Sanderson; Mary A Whooley Journal: J Cardiopulm Rehabil Prev Date: 2019-07 Impact factor: 2.081
Authors: Cecilie Røe; Erik Bautz-Holter; Nada Andelic; Helene Lundgaard Søberg; Boya Nugraha; Christoph Gutenbrunner; Andrea Boekel; Marit Kirkevold; Grace Engen; Juan Lu Journal: Arch Rehabil Res Clin Transl Date: 2022-04-13
Authors: Randal J Thomas; Alexis L Beatty; Theresa M Beckie; LaPrincess C Brewer; Todd M Brown; Daniel E Forman; Barry A Franklin; Steven J Keteyian; Dalane W Kitzman; Judith G Regensteiner; Bonnie K Sanderson; Mary A Whooley Journal: J Am Coll Cardiol Date: 2019-05-13 Impact factor: 24.094
Authors: Lindsey Anderson; Georgina A Sharp; Rebecca J Norton; Hasnain Dalal; Sarah G Dean; Kate Jolly; Aynsley Cowie; Anna Zawada; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2017-06-30