Evaluation of a Hybrid Cardiovascular Rehabilitation Program in Acute Coronary Syndrome Low-Risk Patients Organised in Both Cardiac Rehabilitation and Sport Centres: A Model Feasibility Study

Abstract

The aim of the study was to investigate the efficiency, the feasibility, and the safety of a hybrid cardiovascular rehabilitation program in low-risk acute coronary syndrome (ACS) patients. Sixty low-risk patients with stable clinical status who experienced an ACS in the previous 3 months were included in a 3-week rehabilitation program. The patients were randomized either to a group performing the rehabilitation totally in a rehabilitation centre or partially (only the first 5 days) and then in sport centres equipped for supervised adapted physical activities. The sport centres were located in the vicinity of the patient’s home. Both rehabilitation programs entailed endurance and resistance training and educational therapy. Before and after rehabilitation, cardiorespiratory functions were measured. Similar and significant improvements in peak V.O2 and power output were seen in patients after both types of rehabilitation (p < 0.05). No particular complications were associated with both of our programs. We conclude that a hybrid rehabilitation program in low-risk ACS patients is feasible, safe, and as beneficial as a traditional program organised in a rehabilitation centre, at least in a short-term. A longitudinal follow-up should nevertheless be organised to examine the long-term impacts of this hybrid rehabilitation program.

Hybrid Cardiac Rehabilitation Program in a Low-Resource Setting

“…Two recent studies also found similar conclusions regarding comparable effects including feasibility, safety, and effectiveness outcomes, such as quality of life, mental health, and functional capacity. Pakrad et al, in a study involving 107 patients with coronary artery bypass graft in Iran, compared a 12-session supervised CR program over 1 month with the same program supplemented by 3 months of smartphone-delivered care involving 24 contacts through a mobile app.…”

“…A strength of HYCARET is that although we integrated technology in a more basic yet arguably feasible and adoptable manner through telephone calls and text messages, we also ensured an equivalent 3-month follow-up period for both groups to eliminate alternative explanations for our findings. A study by Meslet et al 46 in France involved 60 patients recovering from an acute coronary syndrome within the past 3 months. Unlike HYCARET, that study compared a fully center-based CR control group with a partially center-based CR group.…”

“…The current trial contributes to the literature in several ways. It was designed with a noninferiority hypothesis, which distinguishes it from the previously mentioned trials, 45 , 46 in which a superiority hypothesis was assumed and, in most cases, equivalence conclusions were reached. Also, from a more clinical point of view, fatal and nonfatal cardiovascular events served as the main outcome, and there was a long, 1-year follow-up; these are unique strengths in the cardiac rehabilitation and exercise field.…”

“…Two recent studies 45,46 The current trial contributes to the literature in several ways. It was designed with a noninferiority hypothesis, which distinguishes it from the previously mentioned trials, 45,46 in which a superiority hypothesis was assumed and, in most cases, equivalence conclusions were reached.…”