Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 232, Issue -, Pages 33-39Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2017.01.126
Keywords
Exercise training; Cardiac rehabilitation; Exercise setting; Patient preference; Heart valve diseases; Atrial fibrillation
Categories
Funding
- Danish Council for Strategic Research [10-092790]
- Faculty of Health and Technology at Metropolitan University College
- Association of Danish Physiotherapists
- National Institute for Health Research [NF-SI-0514-10155] Funding Source: researchfish
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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.
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