Fit, Female or Fifty–Is Cardiac Rehabilitation “Fit” for Purpose for All? A Systematic Review and Meta-Analysis With Meta-Regression

Frontiers in Cardiovascular Medicine

article

Martin Smith¹  Jessica Orchard²  Andre La Gerche³  Robyn Gallagher⁴  Jane Fitzpatrick⁵ 

[1] Australasian College of Sport and Exercise Physicians;Agnes Ginges Centre for Molecular Cardiology, Centenary Institute and The University of Sydney;Clinical Research Department, Baker Heart and Diabetes Institute;Faculty of Medicine and Health, The University of Sydney;Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne

关键词: exercise;    exercise prescription;    cardiac rehabilitation;    women;    young;    risk factors;   

DOI  :  10.3389/fcvm.2022.764882

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Aims Cardiac rehabilitation (CR) is an evidence-based intervention promoting risk factor modification following coronary artery disease events but the relative benefits for patient subgroups is not clear. This review synthesizes the available evidence on the effectiveness of modern CR programs and determines outcomes for age, sex and prior level of fitness. Methods MEDLINE, CINAHL, and EMBASE were examined for RCT and cohort studies involving exercise prescription or phase II or III CR following Myocardial Infarction (MI), Percutaneous Coronary Intervention (PCI) and cardiac surgery from January 2010 to February 2021. Outcomes assessed included peakVO 2 max, 6-min walk test and Metabolic Equivalent of Task. Meta-regression was used to determine CR impact for change in fitness and age and sex influences. Results The mean age of study participants was 59.5 years and 82.7% were male. Females, younger people and those of average or above cardiorespiratory fitness were substantially under-represented in data and attendance, with 13% of study groups with a mean age <55 years. At entry, 73% were below average for fitness vs. age-matched normative values. Fitness improved across all groups following CR with no evidence of sex or age independently affecting outcomes. Conclusions Modest improvements in fitness in all groups were shown, but the benefits of CR can be far greater. A modern, innovative approach to CR will likely lead to more substantial benefits. This may require a “Precision Medicine” model which tailors exercise prescription to different populations to ensure all CR participant's needs are met. This will ensure that CR is more flexible and accessible for all.

【 授权许可】

CC BY