Long-term follow-up after cardiac rehabilitation

Moholdt, Trine; Aamot, Inger Lise; Granøien, Ingrid; Gjerde, Lisbeth; Myklebust, Gitte; Walderhaug, Liv; Hole, Torstein; Graven, Torbjørn; Stølen, Tomas; Mølmen-Hansen, Harald Edvard; Støylen, Asbjørn; Skogvoll, Eirik; Slørdahl, Stig A.; Wisløff, Ulrik

doi:10.1016/j.ijcard.2011.08.025

Cited by 58 publications

(21 citation statements)

References 11 publications

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“…We do not know of earlier studies investigating home-based AIT in cardiac patients without first attending a residential or policlinic rehabilitation program. However, we have in two previous studies [4], [9] found a quite high adherence rate to home-based AIT after an initial organised program. In both these previous studies, the patients managed to maintain or increase their VO 2peak during the follow-up period.…”

Section: Discussionmentioning

confidence: 57%

“…Higher exercise intensities elicit larger improvements in peak oxygen uptake (VO 2peak ) in healthy subjects [2], [3]. Although some studies indicate otherwise [4], [5], several recent randomized controlled trials have confirmed this also in coronary heart disease (CHD) patients [6]–[9]. We have used aerobic interval training (AIT) with exercise intensity at about 90% of individual heart rate maximum for four minutes, repeated four times, to improve VO 2peak and left ventricular function in CHD patients [4], [6]–[8].…”

Section: Introductionmentioning

confidence: 99%

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Home-Based Aerobic Interval Training Improves Peak Oxygen Uptake Equal to Residential Cardiac Rehabilitation: A Randomized, Controlled Trial

et al. 2012

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Aerobic capacity, measured as the peak oxygen uptake, is a strong predictor of survival in cardiac patients. Aerobic interval training (AIT), walking/running four times four minutes at 85–95% of peak heart rate, has proven to be effective in increasing peak oxygen uptake in coronary heart disease patients. As some patients do not attend organized rehabilitation programs, home-based exercise should be an alternative. We investigated whether AIT could be performed effectively at home, and compared the effects on peak oxygen uptake with that observed after a standard care, four-week residential rehabilitation. Thirty patients undergoing coronary artery bypass surgery were randomized to residential rehabilitation or home-based AIT. At six months follow-up, peak oxygen uptake increased 4.6 (±2.7) and 3.9 (±3.6) mL·kg−1 min−1 (both p<0.005, non-significant between-group difference) after residential rehabilitation and AIT, respectively. Quality of life increased significantly in both groups, with no statistical significant difference between groups. We found no evidence for a different treatment effect between patients randomized to home-based AIT compared to patients attending organized rehabilitation (95% confidence interval −1.8, 3.5). AIT patients reported good adherence to exercise training. Even though these first data indicate positive effects of home-based AIT in patients undergoing coronary artery bypass surgery, more studies are needed to provide supporting evidence for the application of this rehabilitation strategy.Trial RegistrationClinicalTrials.gov NCT00363922

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Home-Based Aerobic Interval Training Improves Peak Oxygen Uptake Equal to Residential Cardiac Rehabilitation: A Randomized, Controlled Trial

et al. 2012

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“…However, neither group deteriorated with respect to exercise capacity during follow-up. This was to us unexpected as exercise capacity has been found to decrease in CAD patients after discharge from formal rehabilitation when the patients were not aware of the last follow-up test [18].…”

Section: Discussionmentioning

confidence: 91%

“…A decline in VO 2peak of 2.0 mL·kg −1 ·min −1 (SD 4.0) could be expected after 12 months without formal rehabilitation [18]. We anticipated that the intervention program would give an increase of 2.0 mL·kg −1 ·min −1 after 12 months, giving a difference of 4.0 mL·kg −1 ·min −1 compared to usual care.…”

Section: Methodsmentioning

confidence: 99%

“…Unfortunately, most beneficial effects from physical activity are lost quite rapidly if regular exercise is discontinued. In line with this, peak oxygen uptake (VO 2peak ) has been found to decline at six months, and more so at 30 months, after discharge from cardiac rehabilitation in patients with CAD [7]. Thus, there is a need for studies to assess interventions that may help patients adhere to regular and effective exercise training after ending a formalized cardiac rehabilitation exercise program [8].…”

Section: Introductionmentioning

confidence: 91%

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Peak Oxygen Uptake after Cardiac Rehabilitation: A Randomized Controlled Trial of a 12-Month Maintenance Program versus Usual Care

et al. 2014

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BackgroundExercise capacity is a strong predictor of survival in patients with coronary artery disease (CAD). Exercise capacity improves after cardiac rehabilitation exercise training, but previous studies have demonstrated a decline in peak oxygen uptake after ending a formal rehabilitation program. There is a lack of knowledge on how long-term exercise adherence can be achieved in CAD patients. We therefore assessed if a 12-month maintenance program following cardiac rehabilitation would lead to increased adherence to exercise and increased exercise capacity compared to usual care.Materials and MethodsTwo-centre, open, parallel randomized controlled trial with 12 months follow-up comparing usual care to a maintenance program. The maintenance program consisted of one monthly supervised high intensity interval training session, a written exercise program and exercise diary, and a maximum exercise test every third month during follow-up. Forty-nine patients (15 women) on optimal medical treatment were included following discharge from cardiac rehabilitation. The primary endpoint was change in peak oxygen uptake at follow-up; secondary endpoints were physical activity level, quality of life and blood markers of cardiovascular risk.ResultsThere was no change in peak oxygen uptake from baseline to follow-up in either group (intervention group 27.9 (±4.7) to 28.8 (±5.6) mL·kg (-1) min (−1), control group 32.0 (±6.2) to 32.8 (±5.8) mL·kg (−1) min (−1), with no between-group difference, p = 0.22). Quality of life and blood biomarkers remained essentially unchanged, and both self-reported and measured physical activity levels were similar between groups after 12 months.ConclusionsA maintenance exercise program for 12 months did not improve adherence to exercise or peak oxygen uptake in CAD patients after discharge from cardiac rehabilitation compared to usual care. This suggests that infrequent supervised high intensity interval training sessions are inadequate to improve peak oxygen uptake in this patient group.Trial RegistrationClinicalTrials.gov NCT01246570

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Long‐term Exercise Adherence After High‐intensity Interval Training in Cardiac Rehabilitation: A Randomized Study

Aamot

Karlsen

Dalen

et al. 2015

Physiotherapy Res Intl

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Long-term follow-up after cardiac rehabilitation

Cited by 58 publications

References 11 publications

Home-Based Aerobic Interval Training Improves Peak Oxygen Uptake Equal to Residential Cardiac Rehabilitation: A Randomized, Controlled Trial

Home-Based Aerobic Interval Training Improves Peak Oxygen Uptake Equal to Residential Cardiac Rehabilitation: A Randomized, Controlled Trial

Peak Oxygen Uptake after Cardiac Rehabilitation: A Randomized Controlled Trial of a 12-Month Maintenance Program versus Usual Care

Long‐term Exercise Adherence After High‐intensity Interval Training in Cardiac Rehabilitation: A Randomized Study

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