Michael L Puthoff1, Brenda Youngs. 1. Physical Therapy Department, St Ambrose University, Davenport, Iowa (Dr Puthoff); and Cardiac Rehabilitation, Genesis Medical Center, Davenport, Iowa (Ms Youngs).
Abstract
PURPOSE: The purposes of this study were to identify the number of participants who enter cardiac rehabilitation with an activity limitation and assess whether a cardiac rehabilitation program leads to improvements in activity, demonstrated through changes in gait speed and the 5-times-sit-to-stand test (FTSST). METHODS: This study utilized a 1-group pretest-posttest design. Gait speed and FTSST were measured at the start and end of cardiac rehabilitation. Paired sample t tests were performed to assess changes pre- and postrehabilitation. Subgroup analysis was done on patients who presented with an activity limitation on admission (gait speed <1.0 m/s or FTSST time >12 seconds) to determine whether this subgroup experienced greater changes. RESULTS: On admission, 60.2% of participants presented with an activity limitation using FTSST as the criterion. At the completion of cardiac rehabilitation, participants demonstrated improvements in gait speed and FTSST, but improvements were less than the minimal detectable change (MDC) for the outcome measures. Those who presented with an activity limitation on admission had greater improvements and surpassed the MDC. Even after cardiac rehabilitation, more than 30% of participants still had an activity limitation. CONCLUSIONS: Patients entering cardiac rehabilitation present with activity limitations and most, but not all, will make gains through a standard course of cardiac rehabilitation. Clinicians and researchers should consider how cardiac rehabilitation programs can be modified to assess the presence of activity limitation and maximize improvements in function to enhance participation in society.
PURPOSE: The purposes of this study were to identify the number of participants who enter cardiac rehabilitation with an activity limitation and assess whether a cardiac rehabilitation program leads to improvements in activity, demonstrated through changes in gait speed and the 5-times-sit-to-stand test (FTSST). METHODS: This study utilized a 1-group pretest-posttest design. Gait speed and FTSST were measured at the start and end of cardiac rehabilitation. Paired sample t tests were performed to assess changes pre- and postrehabilitation. Subgroup analysis was done on patients who presented with an activity limitation on admission (gait speed <1.0 m/s or FTSST time >12 seconds) to determine whether this subgroup experienced greater changes. RESULTS: On admission, 60.2% of participants presented with an activity limitation using FTSST as the criterion. At the completion of cardiac rehabilitation, participants demonstrated improvements in gait speed and FTSST, but improvements were less than the minimal detectable change (MDC) for the outcome measures. Those who presented with an activity limitation on admission had greater improvements and surpassed the MDC. Even after cardiac rehabilitation, more than 30% of participants still had an activity limitation. CONCLUSIONS:Patients entering cardiac rehabilitation present with activity limitations and most, but not all, will make gains through a standard course of cardiac rehabilitation. Clinicians and researchers should consider how cardiac rehabilitation programs can be modified to assess the presence of activity limitation and maximize improvements in function to enhance participation in society.