Cardiorehabilitation clinical efficacy depending on the duration of the rehabilitation program and the patient’s adherence
https://doi.org/10.20996/1819-6446-2024-3024
EDN: QOLCNJ
Abstract
The results of studies investigating the clinical effects of cardiac rehabilitation (CR) in patients after acute myocardial infarction (MI) and cardiovascular surgery are discussed. It is known that CR programs vary in duration and dose (number of training sessions) across different countries. Systematic analysis of studies evaluating the clinical effectiveness of the program depending on its duration is relevant. The results of studies aimed at determining the minimum number of training sessions that can lead to a reliable increase in physical performance are also described. The analysis of studies on patients’ adherence to rehabilitation programs and its impact on the final clinical effects of CR is presented. It is shown that the most noticeable result is observed when patients participate in 80% or more of the required training sessions. Patients’ high adherence to physical training (PT) depends on many reasons. In this review we describe groups of patients with low adherence to PT. One of the important conditions for maintaining adherence to CR is a high-quality approach in management of such patients, giving a clearly noticeable favorable clinical effect. At the present stage, there is a need for individualization of CR strategy and transition to new forms of CR (home rehabilitation, tele-rehabilitation, etc.). When applying different "new models" of CR, it is important to maintain their high clinical efficacy.
Keywords
Supporting agencies: The study was supported by National Me dical Research Center for Therapy and Preventive Medicine.
About the Authors
D. M. Aronov
National Medical Research Center for Therapy and Preventive Medicine. Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
David M. Aronov
Moscow
M. G. Bubnova
National Medical Research Center for Therapy and Preventive Medicine. Healthcare Ministry of Russian Federation
Russian Federation
Russian Federation
Marina G. Bubnova
Moscow
References
1. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227–37. DOI: 10.1093/eurheartj/ehab484
2. Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol. 2021;28:460-95. DOI: 10.1177/2047487320913379.
3. Benzer W, Rauch B, Schmid JP, et al. Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry. Int J Cardiol. 2017;228:58–67. DOI: 10.1016/j.ijcard.2016.11.059.
4. Ruivo J, Moholdt T, Abreu A. Overview of Cardiac Rehabilitation following post-acute myocardial infarction in European Society of Cardiology member countries Eur J Prev Cardiol. 2023;30:758-68. DOI:10.1093/eurjpc/zwad024.
5. Abreu A, Pesah E, Supervia M, et al. Cardiac rehabilitation availability and delivery in Europe: how does it differ by region and compare with other high-income countries? Eur J Prev Cardiol. 2019;26:1131–46. DOI: 10.1177/2047487319827453
6. Doll JA, Hellkamp A, Ho PM, et al. Participation in Cardiac Rehabilitation Programs Among Older Patients After Acute Myocardial Infarction. JAMA Intern Med. 2015; 175(10):1700-2. DOI: 10.1001/jamainternmed.2015.3819
7. Hammill BG, Curtis LH, Schulman KA, Whellan DJ. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation. 2010;121(1):63-70. DOI:10.1161/CIRCULATIONAHA.109.876383
8. Medina-Inojosa JR, Grace SL, Supervia M, et al. Dose of Cardiac Rehabilitation to Reduce Mortality and Morbidity: A Population-Based Study. Am Heart Assoc. 2021;10:e021356. DOI: 10.1161/JAHA.120.021356.
9. Beauchamp A, Worcester M, Ng A, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart. 2013;99(9):620-5 DOI:10.1136/heartjnl-2012-303022.
10. Lawler PR, Filion KB, Eisenberg MJ. Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and meta-analysis of randomized controlled trials. Am Heart J. 2011;162:571-84. DOI: 10.1016/j.ahj.2011.07.017
11. Anderson L, Oldridge N, Thompson DR, et al. Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016;67:1-12. DOI:10.1016/j.jacc.2015.10.044
12. Santiago de Araujo Pio C, Marzolini S, Pakosh M, et al. Effect of cardiac rehabilitation dose on mortality and morbidity: a systematic review and meta-regression analysis. Mayo Clin Proc. 2017; 92:1644–59. DOI: 10.1016/j.mayocp.2017.07.019
13. Dibben GO, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. Eur Heart J. 2023;44:452-69. DOI: 10.1093/eurheartj/ehac747
14. Sandercock G, Hurtado V, Cardoso F. Changes in cardiorespiratory fitness in cardiac rehabilitation patients: a meta-analysis. Int J Cardiol. 2013;167(3):894-902. DOI: 10.1016/j.ijcard.2011.11.068
15. Novaković M, Novak T, Cuderman TV, et al. Exercise capacity improvement after cardiac rehabilitation following myocardial infarction and its association with long-term cardiovascular events. Eur J Cardiovascular Nursing. 2022;21:76–84 DOI:10.1093/eurjcn/zvab015
16. Dorn J, Naughton J, Imamura D, Trevisanet M. for the NEHDP Project Staff. Results of a Multicenter Randomized Clinical Trial of Exercise and Long-Term Survival in Myocardial Infarction Patients. Circulation. 1999;100:1764-9. DOI: 10.1161/01.cir.100.17.1764.
17. Jae SY, Kurl S, Bunsawat K, et al. Impact of cardiorespiratory fitness on survival in men with low socioeconomic status. Eur J Prevent Cardiol. 2021;28:450-5. DOI:10.1177/2047487319901057
18. Aronov DM, Sharfnadel MG. Comparative evaluation of the effectiveness of various physical training methods with patients who have had a myocardial infarct. Byulleten’ VKNTs. 1985; 8(2):76-82.
19. Bubnova M.G., Krasnitskii V.B., Aronov D.M. et al. The phenomenon of long-term commitment (16 years) patients with physical rehabilitation after acute myocardial infarction. Cardiosomatics. 2016; 7 (2): 47–53.
20. Martin B-J, Haueret T, Arena R, et al. Cardiac Rehabilitation Attendance and Outcomes in Coronary Artery Disease Patients. Circulation. 2012;126:677-87. DOI: 10.1161/CIRCULATIONAHA.111.066738
21. Doimo S, Fabris E, Piepoli M, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes:a long-term follow-up study. Eur Heart J. 2019;40:678–85. DOI:10.1093/eurheartj/ehy417
22. Goel K, Lennon RJ, Tilbury RT, et al. Impact of Cardiac Rehabilitation on Mortality and Cardiovascular Events After Percutaneous Coronary Intervention in the Community. Circulation. 2011;123:2344-52. DOI: 10.1161/CIRCULATIONAHA.110.983536
23. Bustamante MJ, Valentino G, Krämer V, et al. Patient Adherence to a Cardiovascular Rehabilitation Program: What Factors Are Involved? International J Clinical Medicine. 2015;6:605-14. DOI: 10.4236/ijcm.2015.69081
Supplementary files
Review
For citations:
Aronov D.M., Bubnova M.G. Cardiorehabilitation clinical efficacy depending on the duration of the rehabilitation program and the patient’s adherence. Rational Pharmacotherapy in Cardiology. 2024;20(2):233-240. (In Russ.) https://doi.org/10.20996/1819-6446-2024-3024. EDN: QOLCNJ
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