Browsing by Subject "Cardiac rehabilitation"

Now showing 1 - 4 of 4
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    Cardiac Rehabilitation for Patients With Heart Failure: JACC Expert Panel
    (Elsevier, 2021) Bozkurt, Biykem; Fonarow, Gregg C.; Goldberg, Lee R.; Guglin, Maya; Josephson, Richard A.; Forman, Daniel E.; Lin, Grace; Lindenfeld, JoAnn; O'Connor, Chris; Panjrath, Gurusher; Piña, Ileana L.; Shah, Tina; Sinha, Shashank S.; Wolfel, Eugene; ACC’s Heart Failure and Transplant Section and Leadership Council; Medicine, School of Medicine
    Cardiac rehabilitation is defined as a multidisciplinary program that includes exercise training, cardiac risk factor modification, psychosocial assessment, and outcomes assessment. Exercise training and other components of cardiac rehabilitation (CR) are safe and beneficial and result in significant improvements in quality of life, functional capacity, exercise performance, and heart failure (HF)-related hospitalizations in patients with HF. Despite outcome benefits, cost-effectiveness, and strong practice guideline recommendations, CR remains underused. Clinicians, health care leaders, and payers should prioritize incorporating CR as part of the standard of care for patients with HF.
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    Facilitating Exercise Habit Formation among Cardiac Rehabilitation Patients: A Randomized Controlled Pilot Trial
    (MDPI, 2021-06-14) Kaushal, Navin; Payer, Marie; Bérubé, Béatrice; Juneau, Martin; Bherer, Louis; Health Sciences, School of Health and Human Sciences
    Background: The importance of promoting exercise adherence among individuals with acute coronary syndrome (ACS) is imperative. However, challenges in maintaining behavior among ACS patients are also well-documented. Emerging findings in the general population have supported the use of habit-formation techniques, which include incorporating routine consistency and cues, to be effective for facilitating exercise behavior. The effectiveness of habit formation approaches, however, has not been tested on participants with ACS. The purpose of this study was to test the effectiveness of facilitating physical activity habits among patients with ACS in a two-arm, parallel design, randomized controlled pilot trial. Methods: Participants (n = 13) were older adult patients (M age = 64.20, SD = 5.35) with ACS who were referred to a cardiac rehabilitation center. The experimental group attended monthly group meetings from months 1-3 and received phone call follow-ups from months 4-6. Conclusions: The experimental group showed an increase in weekly moderate-to-vigorous level physical activity, M = 228.20 mins (SD = 112.45), compared with the control group, M = 151.17 (SD = 112.22), d = 0.61. The experimental condition also showed greater use of routine consistency (experimental: M = 4.60 (SD = 0.548); control: M = 3.76 (SD = 1.62)) and cue usage (experimental: M = 3.60 (SD = 0.471); control: M= 2.60 (SD = 0.398)) over the control condition at the six-month mark. The study supports the effectiveness of habit-building techniques among patients with ACS, with effect sizes ranging from a medium to large magnitude. Findings from this pilot study support a full clinical trial with larger sample size.
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    How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome
    (MDPI, 2022-01-28) Kaushal, Navin; Nemati, Donya; Gauthier-Bisaillon, Raphaëlle; Payer, Marie; Bérubé, Béatrice; Juneau, Martin; Bherer, Louis; Health Sciences, School of Health and Human Sciences
    Background: Adherence to cardiac rehabilitation remains a challenge despite established evidence that engaging in regular exercise is a strong preventive measure to experiencing a second cardiac event. A recent study found a six-month cardiac rehabilitation program to be effective for facilitating regular exercise behavior among patients diagnosed with acute coronary syndrome. The purpose of this study was to conduct a phenomenological investigation using Colaizzi’s descriptive technique to understand mechanisms responsible for behavior change. Methods: Data were collected and analyzed among patients with acute coronary syndrome at a cardiac rehabilitation using semi-structured interviews that were conducted over the phone across three months. Conclusion: Thematic analysis of 15 semi-structured interviews resulted in 124 statements that were analyzed. The data yielded seven themes that included “motivation to follow prescribed exercise program”, “volitional decision”, “capability of performing exercise”, “connectedness to peers”, “planning”, “habit formation”, and “adopting healthy behaviors beyond exercise”. The emerged themes align with construct definitions of the self-determination theory, which include the three psychological needs (autonomy, competence, and relatedness), in addition to autonomous motivation, which represents internally driven reasons to participate in exercise. Planning and habit formation themes support contemporary research that identifies these constructs responsible for behavioral maintenance. While these themes help explain exercise participation, the final theme, adopting healthy behaviors beyond exercise, reflects the impact of the program on having a change towards a healthier lifestyle. The findings highlight the complexity of exercise behavior, and that long-term participation is likely explained by amalgamating the self-determination theory.
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    Intensive Cardiac Rehabilitation Outcomes in Patients with Heart Failure
    (MDPI, 2023-10-31) Jafri, S. Hammad; Guglin, Maya; Rao, Roopa; Ilonze, Onyedika; Ballut, Kareem; Baloch, Zulfiqar Qutrio; Qintar, Mohammed; Cohn, Joel; Wilcox, Matthew; Freeman, Andrew M.; Kalra, Dinesh K.; Wu, Wen-Chih; Medicine, School of Medicine
    Introduction: Cardiac rehabilitation (CR) has proven to be beneficial for patients with heart failure (HF), potentially reducing morbidity and mortality while improving fitness and psychological outcomes. Intensive cardiac rehabilitation (ICR) represents an emerging form of CR that has demonstrated advantages for patients with various cardiovascular diseases. Nevertheless, the specific outcomes of ICR in patients with HF remain unknown. Objectives: The purpose of this study is to assess the effectiveness of ICR in patients with HF. Methods: This retrospective study involved 12,950 patients who participated in ICR at 46 centers from January 2016 to December 2020. Patients were categorized into two groups: the HF group, comprising 1400 patients (11%), and the non-HF group, consisting of 11,550 patients (89%). The primary endpoints included the ICR completion rate, changes in body mass index (BMI), exercise minutes per week (EMW), and depression scores (CESD). A t-test was employed to compare variables between the two groups. Results: The HF group comprises older patients, with 37% being females (compared to 44% in the non-HF group). The ICR completion rate was higher in the non-HF group. After ICR completion, adjusted analyses revealed that patients without HF demonstrated a greater improvement in BMI. There were no differences in fitness, as measured via EMW, or in depression scores, as measured via CESD, between the two groups. Conclusions: Despite the lower baseline functional status and psychosocial scores of HF patients compared to non-HF patients, patients with HF were able to attain similar or even better functional and psychosocial outcomes after ICR.