Final published version
Licence: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - UK cardiac rehabilitation fit for purpose?
T2 - A community-based observational cohort study
AU - Ibeggazene, S.
AU - Moore, C.
AU - Tsakirides, C.
AU - Swainson, M.
AU - Ispoglou, T.
AU - Birch, K.
PY - 2020/10/10
Y1 - 2020/10/10
N2 - Objectives This study aimed to characterise the exercise performed in UK cardiac rehabilitation (CR) and explore relationships between exercise dose and changes in physiological variables. Design Observational cohort study. Setting Outpatient community-based CR in Leeds, UK. Rehabilitation sessions were provided twice per week for 6 weeks. Participants Sixty patients (45 male/15 female 33-86 years) were recruited following referral to local outpatient CR. Outcome measures The primary outcome was heart rate achieved during exercise sessions. Secondary outcomes were measured before and after CR and included incremental shuttle walk test (ISWT) distance and speed, blood pressure, brachial artery flow-mediated dilatation, carotid arterial stiffness and accelerometer-derived habitual physical activity behaviours. Results The mean % of heart rate reserve patients exercised at was low and variable at the start of CR (42%±16 %) and did not progress by the middle (48%±17 %) or end (48%±16 %) of the programme. ISWT performance increased following CR (440±150 m vs 633±217 m, p0.05). Conclusion Patients in a UK CR cohort exercise at intensities that are variable but generally low. The exercise dose achieved using this CR format appears inadequate to impact markers of health. Attending CR had no effect on physical activity behaviours. Strategies to increase the dose of exercise patients achieve during CR and influence habitual physical activity behaviours may enhance the effectiveness of UK CR.
AB - Objectives This study aimed to characterise the exercise performed in UK cardiac rehabilitation (CR) and explore relationships between exercise dose and changes in physiological variables. Design Observational cohort study. Setting Outpatient community-based CR in Leeds, UK. Rehabilitation sessions were provided twice per week for 6 weeks. Participants Sixty patients (45 male/15 female 33-86 years) were recruited following referral to local outpatient CR. Outcome measures The primary outcome was heart rate achieved during exercise sessions. Secondary outcomes were measured before and after CR and included incremental shuttle walk test (ISWT) distance and speed, blood pressure, brachial artery flow-mediated dilatation, carotid arterial stiffness and accelerometer-derived habitual physical activity behaviours. Results The mean % of heart rate reserve patients exercised at was low and variable at the start of CR (42%±16 %) and did not progress by the middle (48%±17 %) or end (48%±16 %) of the programme. ISWT performance increased following CR (440±150 m vs 633±217 m, p0.05). Conclusion Patients in a UK CR cohort exercise at intensities that are variable but generally low. The exercise dose achieved using this CR format appears inadequate to impact markers of health. Attending CR had no effect on physical activity behaviours. Strategies to increase the dose of exercise patients achieve during CR and influence habitual physical activity behaviours may enhance the effectiveness of UK CR.
KW - coronary heart disease
KW - myocardial infarction
KW - rehabilitation medicine
U2 - 10.1136/bmjopen-2020-037980
DO - 10.1136/bmjopen-2020-037980
M3 - Journal article
VL - 10
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 10
M1 - e037980
ER -