Lars H Tang1, Selina Kikkenborg Berg2, Jan Christensen3, Jannik Lawaetz4, Patrick Doherty5, Rod S Taylor6, Henning Langberg7, Ann-Dorthe Zwisler8. 1. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark; Bachelor's Degree Program in Physiotherapy, Dept. of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark. Electronic address: Lars.Hermann.Tang@rsyd.dk. 2. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 3. CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark; Department of Occupational Therapy and Physiotherapy, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 4. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark; Bachelor's Degree Program in Physiotherapy, Dept. of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark. 5. Department of Health Sciences, University of York, England, United Kingdom. 6. Institute of Health Research, University of Exeter Medical School, Exeter, England, United Kingdom; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; National Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Denmark; Odense University Hospital, Denmark. 7. CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark. 8. National Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Denmark; Odense University Hospital, Denmark.
Abstract
OBJECTIVE: To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. METHODS: Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between settings were compared using a time×setting interaction using a mixed effects regression model. RESULTS: Across the 158 included patients, an equivalent proportion preferred to undertake exercise rehabilitation in a centre-based setting (55%, 95% CI: 45% to 63%) compared to a home-based setting (45%, 95% CI: 37% to 53%, p=0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p=0.001) and higher exercise capacity (mean between group difference 15.9watts, 95% CI 3.7 to 28.1; p=0.011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. CONCLUSION: The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed. Copyright Â
RCT Entities:
OBJECTIVE: To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. METHODS:Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between settings were compared using a time×setting interaction using a mixed effects regression model. RESULTS: Across the 158 included patients, an equivalent proportion preferred to undertake exercise rehabilitation in a centre-based setting (55%, 95% CI: 45% to 63%) compared to a home-based setting (45%, 95% CI: 37% to 53%, p=0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p=0.001) and higher exercise capacity (mean between group difference 15.9watts, 95% CI 3.7 to 28.1; p=0.011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. CONCLUSION: The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed. Copyright Â
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