P-1195 - Impact of different cardiac rehabilitation (CR) programs on quality of life and depression in women with ischemic heart disease (IHD)

Abstract

Introduction: Women with IHD demonstrate lower quality of life and higher tendency to IHD related depression. Current CR programs are not as well suited to women's as men's needs. Men expect practical while women social and emotional assistance. Objectives: Use of Tai Chi exercises in outpatient CR of women with IHD increases its effectiveness leading to essential improvement of mental state. Aims: Valuation of effectiveness of different CR programs in quality of life (QoL) and depression level (DL) in women with IHD. Methods: Randomized, clinical trial included 68 women between 50 to 71 (average 62,07±6,00) with IHD confirmed by angiography and/or at least 1-2 months after myocardial infarction in stable disease, 24 MMSE points, EF>45%, no pharmacologically treated mental disorders. Patients participated in 12 weeks' CR program, in three groups: C-classical CR, P-classical CR and cognitive behavior psychotherapy, T-Tai Chi training. Stages: I-1-4 week-trainings 3 times/week, II-5-12 week-therapy in previous form, 2 times/week and 1 time/week cycloergometer. Evaluation of QoL and DL before the intervention, after 4 th and 12 th week, using Beck Depression Inventory and SF36 test examining physical (PCS) and mental (MCS) component summary of QoL. Results: In all valuations no statistical differences between the groups in DL and QoL. Only in T group confirmed improvement in both tests. MCS improved after 1 st and PCS after 2 nd CR stage. Conclusions: Supplementation of cardiac rehabilitation programs with Tai Chi elements has positive impact on QoL and depression level in women with IHD.

Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis

“…Tai Chi had a better effect than brisk walking in enhancing physical functioning, such as balance and flexibility, among older women. 65,66 Tai Chi-based cardiac rehabilitation is appealing to women and may encourage cardiac rehabilitation adherence.…”

Nature, availability, and utilization of women-focused cardiac rehabilitation: a systematic review

“…Ultimately, 28 studies (53 publications) that met the eligibility criteria were included (Fig. 1 ) [ 21 , 23 , 25 , 35 – 84 ].

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“…With regard to design, 11 (39.3%) of the included studies were randomized trials, some with more than 2 arms. Five (45.4%) had UC control arms; Of those 9 with AC, these included: traditional supervised CR, hybrid models (i.e., supervised sessions transitioning to remote), home-based CR, structured exercise only, education only, Tai Chi, relaxation therapy, and cognitive-behavioral psychotherapy [ 83 , 84 ]. The remaining 17 studies were prospective cohort (n = 14, 82.4%; of which n = 8 had control groups), mixed-methods (n = 2, 11.8%) or descriptive (n = 1, 5.8%) in design.…”

“…(& 0% HF). Males for comparison: no Women-focused CR : 7 randomized, 7 (100.0%) enrolled, 6 (85.7%) completed; AC : 7 randomized, 7 (100.0%) enrolled, 6 (85.7%) completed Wojcieszczyk et al [ 83 , 84 ] 2012; Poland AC1: Traditional CR (29 sessions = 3×/wk for 4wks, then 2×/wk for 8 wks, then 1×/wk for 1 wk; cycle ergometer), AC2: Traditional CR and cognitive behavior psychotherapy; 1 centre N = 68 (100% female); mean age: 62.07 ± 6.00 years; ethnocultural background: NR, CHD type: MI (& 0% HF). Males for comparison: no NR When program utilization data were not available, information from each assessment point was extracted as a proxy AC active comparison, AC1 active comparison control group 1, AC2 active comparison control group 2, AT aerobic training, CDs compact discs, CHD coronary heart diseases, CR cardiac rehabilitation, HF heart failure, LSD least significant difference, MI myocardial infarction, NR not reported, UC usual care, n/a not applicable, PMR progressive muscle relaxation, SA stable angina, SD standard deviation, wks weeks …”

Outcomes and cost of women-focused cardiac rehabilitation: A systematic review and meta-analysis

“…Of the included studies, 11 (34.4%) were randomized trials, of which 6 had 2 parallel arms, 4 were 3-armed trials [29][30][31][32] and 1 was 4-armed [33] (Table 1). Five (45.4%) had usual care (UC) control arms; Of those 9 with active comparisons (AC), these included: traditional supervised CR, hybrid models (i.e., supervised sessions transitioning to remote), home-based CR, structured exercise only, education only, Tai Chi, relaxation therapy, and cognitive-behavioral psychotherapy.…”