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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
CARE CR-Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based Cardiac Rehabilitation: a study
Simon Nichols1, Fiona Nation2, Toni Goodman3
1Centre for Sport and Exercise Science, Sheffield Hallam University-Collegiate Crescent Campus, Sheffield, UK.
Insights
Cardiac rehabilitation (CR) improves cardiorespiratory fitness (CRF) and cardiovascular health in coronary heart disease (CHD) patients. This study assesses UK CR effectiveness, aiming to optimize programs for better long-term survival outcomes.
Area of Science:
- Cardiology
- Exercise Physiology
- Public Health
Background:
- Cardiac rehabilitation (CR) is known to reduce mortality in coronary heart disease (CHD) patients, largely attributed to exercise training.
- UK-based CR programs show lower improvements in cardiorespiratory fitness (CRF) compared to international studies, suggesting a need for optimization.
- Existing UK studies often lack control groups or rely on estimated CRF changes, limiting definitive conclusions on CR effectiveness.
Purpose of the Study:
- To assess the short-term and long-term effects of routine exercise-based CR on CRF in CHD patients.
- To evaluate the impact of CR on cardiovascular and cardiometabolic health markers.
- To provide data for optimizing UK CR exercise programs to improve patient survival.
Main Methods:
- A longitudinal, observational, controlled study design.
- Recruitment of patients referred to a local CR program, with participants either undertaking an 8-week exercise program or abstaining (control).
- Primary outcome: peak oxygen consumption (VO2 peak) via maximal cardiopulmonary exercise testing; secondary outcomes: carotid intima-media thickness, plaque characteristics, body composition, and cardiometabolic biomarkers.
Main Results:
- (Study results are pending publication as per the provided abstract.)
- The study is designed to compare CRF and cardiovascular health changes between CR participants and a control group.
- Data collection includes initial assessment, reassessment post-intervention/10 weeks, and a 12-month follow-up.
Conclusions:
- (Study conclusions are pending publication as per the provided abstract.)
- Findings are expected to inform the optimization of UK CR exercise protocols.
- The study aims to clarify the relationship between CR, CRF improvements, and long-term cardiovascular health outcomes.
Introduction:
Cardiac rehabilitation (CR) reduces all-cause and cardiovascular mortality in patients with coronary heart disease (CHD). Much of this improvement has been attributed to the beneficial effects of structured exercise training. However, UK-based studies have not confirmed this. Improvements in survival and cardiovascular health are associated with concurrent improvements in cardiorespiratory fitness (CRF). It is therefore concerning that estimated CRF improvements resulting from UK-based CR are approximately one-third of those reported in international literature. Modest improvements in CRF suggest that UK CR exercise training programmes may require optimisation if long-term survival is to be improved. However, contemporary UK studies lack control data or use estimates of CRF change. Cardiovascular and cardiorespiratory Adaptations to Routine Exercise-based CR is a longitudinal, observational, controlled study designed to assess the short-term and long-term effect of CR on CRF, as well cardiovascular and cardiometabolic health.
Methods And Analysis:
Patients will be recruited following referral to their local CR programme and will either participate in a routine, low-to-moderate intensity, 8-week (16 sessions) exercise-based CR programme or freely abstain from supervised exercise. Initial assessment will be conducted prior to exercise training, or approximately 2 weeks after referral to CR if exercise training is declined. Reassessment will coincide with completion of exercise training or 10 weeks after initial assessment for control participants. Participants will receive a final follow-up 12 months after recruitment. The primary outcome will be peak oxygen consumption determined using maximal cardiopulmonary exercise testing. Secondary outcomes will include changes in subclinical atherosclerosis (carotid intima-media thickness and plaque characteristics), body composition (dual X-ray absorptiometry) and cardiometabolic biomarkers.
Ethics And Dissemination:
Ethical approval for this non-randomised controlled study has been obtained from the Humber Bridge NHS Research Ethics Committee-Yorkshire and the Humber on the 27th September 2013, (12/YH/0278). Results will be presented at national conferences and published in peer-reviewed journals.
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