Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation. (1st April 2017)

• Record Type: Journal Article
• Authors: Tang, Lars H.; Kikkenborg Berg, Selina; Christensen, Jan; Lawaetz, Jannik; Doherty, Patrick; Taylor, Rod S.; Langberg, Henning; Zwisler, Ann-Dorthe
• Is Part Of: International journal of cardiology. Volume 232(2017)
• Page Start: 33
• Page End: 39
• Publication Date: 2017-04-01
• Subjects: Exercise training -- Cardiac rehabilitation -- Exercise setting -- Patient preference -- Heart valve diseases -- Atrial fibrillation; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.01.126
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: 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 radiofrequency 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 × 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.