Nienke ter Hoeve1, Bionka M A Huisstede2, Henk J Stam3, Ron T van Domburg4, Madoka Sunamura5, Rita J G van den Berg-Emons6. 1. N. ter Hoeve, MSc, Capri Cardiac Rehabilitation Centre, Rotterdam, the Netherlands, and Erasmus University Medical Centre, Department of Rehabilitation Medicine, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. n.terhoeve@erasmusmc.nl. 2. B.M.A. Huisstede, PhD, Erasmus University Medical Centre, Department of Rehabilitation Medicine, and University Medical Center Utrecht, Department of Rehabilitation, Nursing Science & Sports, Utrecht, the Netherlands. 3. H.J. Stam, MD, PhD, Erasmus University Medical Centre, Department of Rehabilitation Medicine. 4. R.T. van Domburg, PhD, Erasmus University Medical Centre, Department of Cardiology. 5. M. Sunamura, MD, Capri Cardiac Rehabilitation Centre, Rotterdam, the Netherlands. 6. H.J.G. van den Berg-Emons, PhD, Erasmus University Medical Centre, Department of Rehabilitation Medicine.
Abstract
BACKGROUND: Optimal physical activity levels have health benefits for patients with acute coronary syndrome (ACS) and are an important goal of cardiac rehabilitation (CR). PURPOSE: The purpose of this study was to systematically review literature regarding short-term effects (<6 months after completion of CR) and long-term effects (≥6 months after completion) of standard CR on physical activity levels in patients with ACS. DATA SOURCES: PubMed, EMBASE, CINAHL, and PEDro were systematically searched for relevant randomized clinical trials (RCTs) published from 1990 until 2012. STUDY SELECTION: Randomized clinical trials investigating CR for patients with ACS reporting physical activity level were reviewed. DATA EXTRACTION: Two reviewers independently selected articles, extracted data, and assessed methodological quality. Results were summarized with a best evidence synthesis. Results were categorized as: (1) center-based/home-based CR versus no intervention, (2) comparison of different durations of CR, and (3) comparison of 2 types of CR. DATA SYNTHESIS: A total of 26 RCTs were included. Compared with no intervention, there was, at most, conflicting evidence for center-based CR and moderate evidence for home-based CR for short-term effectiveness. Limited evidence and no evidence were found for long-term maintenance for center-based and home-based CR, respectively. When directly compared with center-based CR, moderate evidence showed that home-based CR has better long-term effects. There was no clear evidence that increasing training volume, extending duration of CR, or adding an extra intervention to CR is more effective. LIMITATIONS: Because of the variety of CR interventions in the included RCTs and the variety of outcome measures in the included RCTs, pooling of data was not possible. Therefore, a best evidence synthesis was used. CONCLUSIONS: It would appear that center-based CR is not sufficient to improve and maintain physical activity habits. Home-based programs might be more successful, but the literature on these programs is limited. More research on finding successful interventions to improve activity habits is needed.
BACKGROUND: Optimal physical activity levels have health benefits for patients with acute coronary syndrome (ACS) and are an important goal of cardiac rehabilitation (CR). PURPOSE: The purpose of this study was to systematically review literature regarding short-term effects (<6 months after completion of CR) and long-term effects (≥6 months after completion) of standard CR on physical activity levels in patients with ACS. DATA SOURCES: PubMed, EMBASE, CINAHL, and PEDro were systematically searched for relevant randomized clinical trials (RCTs) published from 1990 until 2012. STUDY SELECTION: Randomized clinical trials investigating CR for patients with ACS reporting physical activity level were reviewed. DATA EXTRACTION: Two reviewers independently selected articles, extracted data, and assessed methodological quality. Results were summarized with a best evidence synthesis. Results were categorized as: (1) center-based/home-based CR versus no intervention, (2) comparison of different durations of CR, and (3) comparison of 2 types of CR. DATA SYNTHESIS: A total of 26 RCTs were included. Compared with no intervention, there was, at most, conflicting evidence for center-based CR and moderate evidence for home-based CR for short-term effectiveness. Limited evidence and no evidence were found for long-term maintenance for center-based and home-based CR, respectively. When directly compared with center-based CR, moderate evidence showed that home-based CR has better long-term effects. There was no clear evidence that increasing training volume, extending duration of CR, or adding an extra intervention to CR is more effective. LIMITATIONS: Because of the variety of CR interventions in the included RCTs and the variety of outcome measures in the included RCTs, pooling of data was not possible. Therefore, a best evidence synthesis was used. CONCLUSIONS: It would appear that center-based CR is not sufficient to improve and maintain physical activity habits. Home-based programs might be more successful, but the literature on these programs is limited. More research on finding successful interventions to improve activity habits is needed.
Authors: Krzysztof Milewski; Andrzej Małecki; Dominika Orszulik-Baron; Mateusz Kachel; Piotr Hirnle; Marek Orczyk; Rafał Dunal; Grzegorz Mikołajowski; Adam Janas; Zbigniew Nowak; Karol Kozak; Wojciech Roskiewicz; Katarzyna Nierwińska; Andrzej Izworski; Adam Rybicki; Piotr P Buszman; Ryszard Piotrowicz; Pawel E Buszman Journal: Cardiol J Date: 2018-12-19 Impact factor: 2.737
Authors: Youngdeok Kim; Justin M Canada; Jonathan Kenyon; Hayley E Billingsley; Ross Arena; Carl J Lavie; Salvatore Carbone Journal: Mayo Clin Proc Date: 2022-06-23 Impact factor: 11.104
Authors: Jamie L Jackson; Kristen R Fox; Joseph R Rausch; Taylor N Swenski; Steven P Neville; Noelle C Marousis; Christina X Korth; Clifford L Cua; Vidu Garg; Kathryn Vannatta Journal: Ann Behav Med Date: 2022-07-12
Authors: Rutger W M Brouwers; Jos J Kraal; Simone C J Traa; Ruud F Spee; Laurence M L C Oostveen; Hareld M C Kemps Journal: BMC Cardiovasc Disord Date: 2017-01-31 Impact factor: 2.298
Authors: Grace Olivia Dibben; Hasnain M Dalal; Rod S Taylor; Patrick Doherty; Lars Hermann Tang; Melvyn Hillsdon Journal: Heart Date: 2018-04-13 Impact factor: 5.994