Impact of COVID-19 lockdown restrictions on cardiac rehabilitation participation and behaviours in the United Kingdom

Abstract

Background COVID-19 lockdown measures led to the suspension of centre-based cardiac rehabilitation (CR). We aimed to describe the impact of lockdown on CR behaviours and perceptions of efficacy in a sample of CR participants. Methods An online survey was conducted amongst CR participants from May to October 2020, COVID-19-related lockdown restrictions. Anthropometric data, participant-determined levels of motivation and self-perceived efficacy, CR practices etc., pre- and post-lockdown, were collected. Results The probability of practicing CR in public gyms and hospitals decreased 15-fold (47.2% pre-, 5.6% post-lockdown; OR[95% CI] 0.065[0.013; 0.318], p < 0.001), and 34-fold (47.2% pre, 2.8% post; OR[95% CI] 0.029[0.004; 0.223], p < 0.001), respectively. Amongst participants, 79.5% indicated that their CR goals had changed and were 78% less likely to engage in CR for socialization after lockdown (47.2% pre, 16.7% post; OR[95% CI] 0.220[0.087; 0.555]; p = 0.002). The probability of receiving in-person supervision decreased by 90% (94.4% pre, 16.7% post; OR[95% CI] 0.011[0.002; 0.056]), while participants were almost 7 times more likely to use online supervision (11.1% pre, 44.4% post; OR[95% CI] 6.824[2.450; 19.002]) (both p < 0.001). Fifty percent indicated that their enjoyment of CR was lower than before lockdown and 27.8% reported they would be less likely to continue with CR in the newer format. Conclusions Lockdown was associated with considerable changes in how CR was practiced, motivation levels and willingness to continue with CR. Further research is warranted to develop and improve strategies to implement in times when individuals cannot attend CR in person and not only during pandemics.

Experiences of People with Cardiovascular Disease during COVID-19 in Sweden: A Qualitative Study

“…However, in order to stay healthy, the participants tried to exercise regularly or went to the gym, which was allowed if a distance was kept. Those who were in need of specialized physiotherapy had to manage on their own as these services had closed down, in line with other countries [ 29 , 30 ]. Some managed to continue with physical activity and even increased their outdoor activities, such as taking walks or cycling.…”

“…Others, especially those in need of specialized care, found it hard to motivate themselves to perform physical activity outdoors. Having access to digital support from specialized health professionals might have been beneficial for our participants, although a few studies indicate that home-based programs by telephone or video are not as effective and motivating as face-to-face contact [ 29 , 30 ]. Moreover, the attitude towards the situation during the pandemic differed among those who were living alone and those who were in a relationship.…”

Exercise-based cardiac rehabilitation adaptation protocol during Covid-19 pandemic achieved similar results as compared to non-pandemic usual practice: a single center experience

“…The Covid-19 pandemic is predicted to make enduring impact on cardiac rehabilitation worldwide, therefore the sustainability of program and safe environments for exercise are important by performing adaptive protocols based on the respective policies of each center, region, or nation. [13][14][15][16] Some limitations of this study were as follows (1) the retrospective method of the research may not be adequate to fully evaluate the results of different sessions among groups, (2) the limited sample size of subjects who participate in the study, (3) the single center analysis which needs more data from multicenter studies and (4) the potential bias by selecting subjects who motivated to perform EBCR in both periods and also performed unscheduled exercise at home. The best research method to evaluate the effectiveness of adaptation protocol is by performing randomizedcontrol trials.…”

A study of physically active versus inactive persons living with congestive heart failure during the covid-19 pandemic

“…Groupbased outpatient CR programs were suspended, as they are primarily hosted in hospitals, community centers and public gyms and were considered "non-essential" healthcare services. [29,30] While these restrictions were necessary to curb the spread of this virus, they greatly impacted the level of PA undertaken by healthy individuals as well as individuals with chronic disease. Ammar et al (2020) examined the impact of the covid-19 induced home confinement utilizing an online survey which included the International Physical Activity Questionnaire (IPAQ).…”