Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:232

Article

Tang, Lars H.^1,2,3  Berg, Selina Kikkenborg¹  Christensen, Jan^2,4  Lawaetz, Jannik^1,2,3  Doherty, Patrick⁵  Taylor, Rod S.^6,7,8,9  Langberg, Henning²  Zwisler, Ann-Dorthe^8,9 

[1] Copenhagen Univ Hosp, Rigshosp, Heart Ctr, Dept Cardiol, Copenhagen, Denmark

[2] Univ Copenhagen, Dept Publ Hlth, Sect Social Med, CopenRehab, Copenhagen, Denmark

[3] Metropolitan Univ Coll, Fac Hlth & Technol, Dept Rehabil & Nutr, Bachelors Degree Program Physiotherapy, Copenhagen, Denmark

[4] Copenhagen Univ Hosp, Dept Occupat Therapy & Physiotherapy, Rigshosp, Copenhagen, Denmark

[5] Univ York, Dept Hlth Sci, York, N Yorkshire, England

[6] Univ Exeter, Med Sch, Inst Hlth Res, Exeter, Devon, England

[7] Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark

[8] Univ Southern Denmark, Natl Ctr Rehabil & Palliat Care, Odense, Denmark

[9] Odense Univ Hosp, Odense, Denmark

关键词: Exercise training;    Cardiac rehabilitation;    Exercise setting;    Patient preference;    Heart valve diseases;    Atrial fibrillation;   

DOI  :  10.1016/j.ijcard.2017.01.126

来源: Elsevier

【 摘 要 】

Objective: To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. Methods: Patients participating in a randomised controlled trial following either heart valve surgery, or radio-frequency ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24 months after hospital discharge. Outcomes between settings were compared using a time x setting interaction using a mixed effects regression model. Results: Across the 158 included patients, an equivalent proportion preferred to undertake exercise rehabilitation in a centre-based setting (55%, 95% CI: 45% to 63%) compared to a home-based setting (45%, 95% CI: 37% to 53%, p = 0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p = 0.001) and higher exercise capacity (mean between group difference 15.9 watts, 95% CI 3.7 to 28.1; p= 0.011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p = 0.004), there was no evidence of a significant difference in outcomes between settings. Conclusion: The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed. (C) 2017 Published by Elsevier Ireland Ltd.

【 授权许可】

Free