Cardiac Rehabilitation

Astley, Carolyn; Neubeck, Lis; Gallagher, Robyn; Berry, Narelle M.; Du, Huiyun; Hill, Martha N.; Clark, Robyn

doi:10.1097/jcn.0000000000000332

Cited by 21 publications

(9 citation statements)

References 33 publications

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“…Conflicting messages from health professionals were found to be a program‐based barrier to PA. This has been reported for cardiac rehabilitation attendance, with contradictory messages in the hospital and the physician not recommending cardiac rehabilitation barriers to attendance 40 . Increased education for cardiac health professionals on PA guidelines is recommended to avoid conflicting information, using a patient‐centered approach, behavior change techniques, and shared decision‐making, with this information included in ACS guidelines.…”

Section: Discussionmentioning

confidence: 99%

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

Freene,

Carroll,

Flynn

et al. 2024

Health Science Reports

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BackgroundPhysical activity (PA) levels of people with coronary heart disease are low in the first 30 days after percutaneous coronary intervention (PCI), increasing the risk of recurrent cardiac events. Following PCI, PA counseling delivered by a physiotherapist before discharge may increase the PA levels of patients. Preliminary work is required to determine the effects of the counseling session compared to usual care.ObjectivesTo investigate the feasibility and potential efficacy of a brief physiotherapist‐led PA counseling session immediately after an elective PCI compared to usual care for improved PA early post‐PCI.MethodsUsing concealed allocation and blinded assessments, eligible participants (n = 30) were randomized to a physiotherapist‐led PA counseling session (30 min) or usual care (nurse‐led PA advice < 5 min). The primary outcome was daily minutes of moderate‐to‐vigorous PA (accelerometry; 3 weeks). Secondary outcomes included cardiac rehabilitation intention, anxiety and depression levels (Hospital Anxiety and Depression Scale), and quality‐of‐life (MacNew questionnaire). Recruitment, retention, and attrition were assessed for feasibility. Semistructured interviews were conducted with 13 participants to determine intervention acceptability, and barriers and enablers to PA.ResultsBetween and within‐group comparisons were not significant in intention‐to‐treat analyses. All feasibility criteria were met except for retention and attrition of participants. At 3 weeks, only 25% of participants were planning to attend cardiac rehabilitation, with no between‐group differences. Increased PA at 3 weeks was associated with participants that were younger, without other chronic disease,s and more active immediately following discharge. Interviews revealed personal, environmental, and program‐based themes for barriers and enablers to PA.ConclusionsA physiotherapist‐led PA counseling session may not improve PA levels early post‐elective PCI compared to very brief PA advice delivered by nurses. A larger multicentre randomized controlled trial is feasible with minor modifications to participant follow‐up. Further research is required.

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Section: Discussionmentioning

confidence: 99%

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

Freene,

Carroll,

Flynn

et al. 2024

Health Science Reports

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“…Despite strong evidence showing a positive correlation between achieving PA recommendations and a lower CVD risk, [3][4][5] referrals to, uptake of, and long-term engagement in cardiac rehabilitation remains low globally. 1,[6][7][8][9][10] Major health care organizations recommend that CR patients consistently accumulate 30 to 60 minutes of moderate intensity PA per day on more than 5 days of the week and minimize the amount of time that is spent in sedentary behavior (SB). 3 However, even the majority of healthy older adults do not attain these levels of activity.…”

Section: Introductionmentioning

confidence: 99%

“…Despite strong evidence showing a positive correlation between achieving PA recommendations and a lower CVD risk, 3-5 referrals to, uptake of, and long-term engagement in cardiac rehabilitation remains low globally. 1,6-10…”

Section: Introductionmentioning

confidence: 99%

The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis

Meiring

Tanimukai

Bradnam

2020

J Prim Care Community Health

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Objective: Adequate physical activity following cardiac rehabilitation (CR) is required to reduce secondary cardiovascular disease risk. The aim of this review and meta-analysis was to determine the effect of exercise-based CR on objectively measured physical activity (PA) and sedentary behavior (SB) comparing pre- to postintervention, pre- to postchange compared to a control group, and in a longer term follow-up. Methods: Five databases were searched (PubMed, MEDLINE [OVID], Scopus, SPORTDiscus, and CINAHL) from inception to January 2019. Two reviewers screened and selected 15 studies involving 1434 participants. Data were synthesized descriptively and by meta-analyses. Results: CR resulted in an improvement in activity behaviors compared with preintervention levels (standardized mean difference [SMD] 0.50, 95% CI 0.25-0.55, P < .0001). CR resulted in a greater improvement in activity behaviors in the intervention compared with the control group (SMD 0.25, 95% CI 0.02-0.49, P = .04). Increased PA was maintained (SMD 0.32, 95% CI 0.22-0.41, P < .0001). Eight out of 15 studies showed an improvement in PA outcomes while 7 reported that objectively measured PA did not change immediately following the intervention compared to preintervention levels and/or compared with the control group. Of the 7 studies that reported changes in SB, 4 observed a reduction following CR while 3 reported no change. Conclusion: Participation in exercise-based CR programs is effective in improving PA and SB. However, our descriptive synthesis indicates that only half the studies were successful in improving activity behaviors following exercise-based CR. Standard guidelines for the assessment of activity behaviors following CR would be valuable in understanding of the effects of CR on long-term activity participation.

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“…12 Várias barreiras interferem nesse processo, como as intrapessoais, interpessoais, institucionais, comunitárias e de políticas públicas. 13 Muitas já foram identificadas, especialmente nas regiões mais ricas e com maior disponibilidade de PRC, como Sul 9,14-17 e Sudeste. 18,19 Já nas regiões Norte e Nordeste os dados sobre barreiras para RC ainda são bastante escassos.…”

Section: Introductionunclassified

Sistemas de saúde e percepção de barreiras para admissão e aderência em programas de reabilitação cardíaca

Santos

Nogueira

et al. 2019

Acta Fisiátr.

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Além da elevada prevalência de doenças cardiovasculares (DCV), iniquidades regionais no acesso aos serviços de saúde e subutilização de programas de reabilitação cardíaca (PRC) ainda são marcantes no cenário brasileiro. Objetivo: Esse estudo visou descrever e comparar barreiras para uso de PRC em usuários de diferentes sistemas de saúde e níveis de atendimento em um estado brasileiro. Métodos: Participantes de PRC e pacientes elegíveis de enfermarias e ambulatórios foram pareados pelos sistemas de saúde que utilizavam e responderam a Escala de Barreiras para Reabilitação Cardíaca (EBRC). Os testes U de Mann-Withney e Kruskal Wallis foram usados para comparar barreiras entre os sistemas de saúde e entre níveis de atendimento, respectivamente. Resultados: Cento e quarenta (87%) pacientes participaram do estudo. A média total dos itens da escala foi 1,98±0,48 e diferiu apenas entre participantes de PRC e pacientes internados (p<0,05). Algumas barreiras de acesso, necessidades percebidas e comorbidades/estado funcional foram maiores no sistema público do que no privado (p<0,05). A falta de conhecimento sobre PRC (3.75±1.66) e a falta de referência médica (2.32±1.53) destacaram-se no domínio necessidades percebidas, que teve o maior escore médio da amostra (2.31±0.71). Conclusões: Barreiras de acesso e necessidades percebidas foram maiores para usuários de serviços públicos. Viagens e trabalho foram barreiras maiores para participantes de PRC, enquanto para pacientes internados e ambulatoriais as maiores barreiras foram necessidades percebidas. Logo, a disseminação de PRC e estratégias para referência de elegíveis devem ser estimuladas em ambos os sistemas de saúde e níveis de atendimento.

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Cardiac Rehabilitation

Abstract: These avenues provide direction for potential solutions to improve the uptake of CR and secondary prevention.

Cited by 21 publications

References 33 publications

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

Activity counseling early postelective percutaneous coronary intervention (ACE‐PCI): Mixed‐methods pilot randomized controlled trial

The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis

Sistemas de saúde e percepção de barreiras para admissão e aderência em programas de reabilitação cardíaca

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