ABSTRACT
To determine the effects of combined in-patient rehabilitation with a home-based program on function and quality of life. Tertiary care, university teaching hospital, randomized controlled trial. Thirty admitted patients with congestive heart failure with New York Heart Association class II -IV. A five step individualised phase-1 cardiac rehabilitation program followed by a structured home based rehabilitation for eight weeks was given to the experimental group while the control group only received physician directed advice. Six minute walk distance was assessed at discharge and follow-up, while quality of life [SF36] was assessed at admission, discharge, and follow-up. Independent t-test, paired t-test and repeated measures ANOVA with Bonferroni post-hoc analysis. At admission patients in both the groups were comparable. After the phase-1 cardiac rehabilitation, there was a change in the six minute walk distance between control and experimental group [310 m vs. 357 m, respectively; P = 0.001]. Following the eight week home-based program, there was a greater increase in six minute walk distance in the experimental group when compared to the control group [514 m vs. 429 m; P < 0.001]. Quality of life as measured by the SF-36 at the end of 8-weeks showed a statistically significant difference [P < 0.05] in the experimental group for both the mental and physical components. Early in-patient rehabilitation followed by an eight week home based exercise program improves function and quality of life in patients with congestive heart failure
Subject(s)
Humans , Male , Female , Inpatients , Home Care Services , Quality of Life , WalkingABSTRACT
Exercise training as a part of cardiac rehabilitation aims to restore patient with heart disease to health. However, left ventricular ejection fraction [LVEF] is clinically used as a predictor of long-term prognosis in coronary artery disease [CAD] patients, there is a scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on LVEF. To investigate the effectiveness of exercise-based cardiac rehabilitation on LVEF in early post-event CAD patients. In a single blinded, randomized controlled trial, post-coronary event CAD patients from the age group of 3575 years, surgically [Coronary artery bypass graft or percutaneous coronary angioplasty] or conservatively treated, were recruited from Golsar Hospital, Iran. Exclusion criteria were high-risk group [AACVPR-99] patients and contraindications to exercise testing and training. Forty-two patients were randomized either into Study or Control. The study group underwent a 12-week structured individually tailored exercise program either in the form of Center-based [CExs] or Home-based [HExs] according to the ACSM-2005 guidelines. The control group only received the usual cardiac care without any exercise training. LVEF was measured before and after 12 weeks of exercise training for all three groups. Differences between and within groups were analyzed using the general linear model, two-way repeated measures at alpha=0.05. Mean age of the subjects was 60.5 +/- 8.9 years. There was a significant increase in LVEF in the study [46.9 +/- 5.9 to 61.5 +/- 5.3] group compared with the control [47.9 +/- 7.0 to 47.6 +/- 6.9] group [P=0.001]. There was no significant difference in changes in LVEF between the HExs and CExs groups [P=1 .0]. A 12-week early [within 1 month post-discharge] structured individually tailored exercise training could significantly improve LVEF in post-event CAD patients