More Evidence of Comprehensive Cardiac Rehabilitation Benefits, Even for All-Cause Mortality: Need to Increase Use Worldwide

Abstract

See article by Huang et al., pages 162e171 of this issue.

Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients With Coronary Artery Disease: A Randomized Clinical Trial

“…[4][5][6] Cardiovascular rehabilitation (CR) including moderate-to-vigorous intensity continuous exercise training (MICT) after coronary revascularization is a class IA 7,8 recommendation to improve functional capacity, 9,10 QoL, 10,11 and depression symptoms, 10,12,13 and to reduce risk of myocardial infarction, all-cause hospitalization, and mortality. 11 The health benefits of exercise-based CR 14,15 including MICT 16 are well established. However, compared with MICT, growing evidence suggests that nonconventional exercise interventions, such as high-intensity interval training (HIIT) and Nordic walking (NW) are more effective in improving functional capacity measured using a 6-minute walk test (6MWT), 10,17,18 an important predictor of cardiovascular events in patients with CAD.…”

Exercise Modalities and Intensity to Improve Functional Capacity and Psychological/Mental Health in Cardiac Rehabilitation: A Role for Nordic Walking?

“…Cardiac rehabilitation (CR) and exercise training programs are guideline-recommended therapy after major cardiovascular disease (CVD) events, and these programs are associated with considerable improvements in functional capacity and measured levels of cardiorespiratory fitness (CRF), major CVD risk factors, psychologic factors, and quality of life (QoL), as well as major CVD morbidity and mortality and allcause mortality. [1][2][3][4] Although CR involves more than just exercise, improvements in functional capacity/CRF, whether measured by the criterion standard of cardiopulmonary gas exchange and peak oxygen consumption (VO 2 ) or estimated by speed and incline on the treadmill (estimated metabolic equivalents [METs]), or by 6-minute walk tests (6MWT) or shuttle tests, explain most of the improvements in CVD and all-cause mortality. [5][6][7][8][9] There is extensive work comparing the exercise modalities of high-intensity interval training (HIIT) and moderate -to vigorous intensity continuous training (MICT) on physical health and CRF as peak VO 2 in patients with coronary artery disease (CAD) undergoing supervised CR programs (16 studies; n ¼ 748).…”

Participant Exercise-Session Attendance in Community-Based, Bridging, and Hospital-Based Cardiac Rehabilitation: A Retrospective Case-Control Study

“…2 Cardiac rehabilitation programs employ a comprehensive approach to patient care, through education, lifestyle assessments, medication management, group support sessions, and structured exercise training. 3,4 Despite the known benefits of cardiac rehabilitation, program participation rates are often suboptimal. 5 Numerous patient and system factors may influence program participation, including lack of referral, difficulties with transportation to the cardiac rehabilitation centre, the need to return to work, and patient preferences.…”

“… 2 Cardiac rehabilitation programs employ a comprehensive approach to patient care, through education, lifestyle assessments, medication management, group support sessions, and structured exercise training. 3 , 4 Despite the known benefits of cardiac rehabilitation, program participation rates are often suboptimal. 5 …”