Women and cardiac rehabilitation: Moving beyond barriers to solutions?

Forsyth, Faye; Deaton, Christi

doi:10.1177/2047487320911843

Cited by 14 publications

(10 citation statements)

References 19 publications

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“…It is widely known that men are more adherent to CR programs and that recruitment for women is often significantly delayed [24]. For women, the barriers to CR participation are multiple and complex and possible solutions such as community and home-based physical activity and women-only cardiac rehabilitation should be offered and are actually under evaluation [25].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome

Bianchi

Maloberti

Peretti

et al. 2021

High Blood Press Cardiovasc Prev

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Introduction Cardiac rehabilitation (CR) is an effective tool for secondary prevention after acute coronary syndrome (ACS). Aim Aim of our study was to find the significant determinants of exercise capacity (evaluated with the six-minute walking test-6-MWT) and functional improvement in patients undergoing CR after an ACS. Methods The study group included 298 patients (mean age 61.6 ± 10.2 years; males 80.2%) who, after ACS, were enrolled in CR program at Niguarda Hospital in Milan from 2015 to 2018. For all patients, we collected anamnestic, clinical and instrumental cardiological data. All patients performed a 6-MWT at the beginning (6-MWT-1) and at the end (6-MWT-2) of CR program. Δ meters were used to represent functional improvement. Results Multiple linear regression models were carried out for 6-MWT-1, 6-MWT-2, Δ meters and % Δ meters. Standardized regression coefficients showed that age (β = − 0.237; p < 0.001), BMI (β = − 0.116; p = 0.006) and heart rate (β = − 0.082; p = 0.040) were determinants of exercise capacity (6MWT-1 and 2), whereas age (β = −.231; p = 0.004), sex (β = − 0.187; p = 0.008) and BMI (β = − 0.164; p = 0.022) were determinants of functional improvement (Δ meters). Conclusions Our data showed that functional improvement after CR in ACS patients is mainly related to non-cardiological variables. Instead it is related to intrinsic factors, both modifiable (BMI) and non-modifiable (age, sex).

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Section: Discussionmentioning

confidence: 99%

Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome

Bianchi

Maloberti

Peretti

et al. 2021

High Blood Press Cardiovasc Prev

View full text Add to dashboard Cite

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“…Finally, the creation of women-only or women-dominated CR groups has been proposed as a means to increase female participation and retention. The creation of women-only CR groups has been shown to improve diet compliance and decrease symptoms of depression and anxiety leading to improved CR adherence [92][93][94].…”

Section: Inclusivity and Representationmentioning

confidence: 99%

Current challenges in cardiac rehabilitation: strategies to overcome social factors and attendance barriers

Chindhy

Taub

Lavie

et al. 2020

Expert Review of Cardiovascular Therapy

109

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Introduction: Cardiac rehabilitation (CR) significantly reduces secondary cardiovascular events and mortality and is a class 1A recommendation by the American Heart Association (AHA) and American College of Cardiology (ACC). However, it remains an underutilized intervention and many eligible patients fail to enroll or complete CR programs. The aim of this review is to identify barriers to CR attendance and discuss strategies to overcome them.Areas Covered: Specific barriers to CR attendance and participation will be reviewed. This will be followed by a discussion of solutions/strategies to help overcome these barriers with a particular focus on home-based CR (HBCR).Expert Opinion: HBCR alone or in combination with center-based CR (CBCR) can help overcome many barriers to traditional CBCR participation, such as schedule flexibility, time commitment, travel distance, cost, and patient preference. Using remote coaching with indirect exercise supervision, HBCR has been shown to have comparable benefits to CBCR. At this time however, funding remains the main barrier to universal incorporation of HBCR into health systems, necessitating the need for additional cost benefit analysis and outcome studies. Ultimately the choice for HBCR should be based on patient preference and availability of resources.

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“…With the development of the internet and the popularity of mobile phones, establishing patient-centered remote rehabilitation or home-based CR might be an effective way to alleviate this problem [ 35 ]. A study suggested that transporting staff and equipment to community settings might be a good way to overcome some of these barriers [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Barriers to hospital-based phase 2 cardiac rehabilitation among patients with coronary heart disease in China: a mixed-methods study

2022

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Background Coronary heart disease (CHD) has become a leading cause of morbidity and premature death worldwide. Cardiac rehabilitation (CR) was proved to have substantial benefits for patients with CHD. The CR was divided into three phases. Phase 2 is the important part of CR which involves hospital-based structured and closely monitored exercises and activities. However, CR utilization is low worldwide. The barriers to hospital-based phase 2 CR in China have not been well identified. Aims To investigate barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in China and to explore the reasons. Methods This study employed an explanatory sequential mixed-methods design. The study was conducted in a university hospital in China from July 2021 to December 2021. Quantitative data was collected through the Cardiac Rehabilitation Barrier Scale. Qualitative data was collected through unstructured face-to-face interviews. Data analysis included descriptive statistics and inductive qualitative content analysis. Results One hundred and sixty patients completed the Cardiac Rehabilitation Barrier Scale and 17 patients participated in unstructured face-to-face interviews. The main barriers identified were distance (3.29 ± 1.565), transportation (2.99 ± 1.503), cost (2.76 ± 1.425), doing exercise at home (2.69 ± 1.509) and time constraints (2.48 ± 1.496). Six themes were identified; logistical factors, social support, misunderstanding of cardiac rehabilitation, program and health system-level factors, impression of CR team and psychological distress. The first four themes confirmed the quantitative results and provide a deeper explanation for the quantitative results. The last two themes were new information that emerged in the qualitative phase. Conclusion This study provides a better understanding of the barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in the Chinese context during the Covid-19 pandemic. Innovative programs such as home-based CR, mobile health, and hybrid programs might be considered to overcome some of these barriers. In addition, psychosocial intervention should be included in these programs to mitigate some of the barriers associated with the impression of CR team and psychological distress.

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Women and cardiac rehabilitation: Moving beyond barriers to solutions?

Cited by 14 publications

References 19 publications

Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome

Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome

Current challenges in cardiac rehabilitation: strategies to overcome social factors and attendance barriers

Barriers to hospital-based phase 2 cardiac rehabilitation among patients with coronary heart disease in China: a mixed-methods study

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