The Impact of Reduced Cardiac Rehabilitation on Maximal Treadmill Exercise Time: A Randomized Controlled Trial

TitleThe Impact of Reduced Cardiac Rehabilitation on Maximal Treadmill Exercise Time: A Randomized Controlled Trial
Publication TypeJournal Article
Year of Publication2018
AuthorsFarias-Godoy, A, Chan, S, Claydon, VE, Ignaszewski, A, Mendell, J, Park, JE, Singer, J, Lear, SA
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume38
Issue1
Pagination24-30
Abstract

Purpose: Cardiac rehabilitation programs (CRPs) remain underutilized partly because of access barriers. We therefore evaluated a CRP with fewer center-based sessions (rCRP) compared with standard CRP (sCRP) with respect to changes in exercise capacity and cardiac risk factors.

Methods: In this randomized controlled noninferiority trial, primary and secondary prevention patients at low and moderate risk were randomized to an sCRP (n = 60) or an rCRP (n = 61). Over 4 months, sCRP and rCRP participants attended 32 and 10 on-site cardiac rehabilitation sessions, respectively. The primary outcome was the difference in the change in exercise capacity from baseline at 4 and 16 months between the groups measured in seconds from a maximal treadmill exercise test. Noninferiority of the rCRP was tested with mixed-effects model analysis with a cut point of 60 seconds for the upper value of the group estimate.

Results: Attendance was higher for the rCRP group (97% ± 63% vs 71% ± 22%, P = .002). Over 16 months, exercise test time increased for the sCRP (524 ± 168 to 604 ± 172 seconds, P < .01) and the rCRP (565 ± 183 to 640 ± 192 seconds, P < .01). The rCRP was not inferior to the sCRP regarding changes in treadmill time (48.47 seconds, P = .454). The rCRP was not inferior to the sCRP regarding metabolic and anthropometric risk factors.

Conclusion: Our findings suggest that, for a selected group of low-/moderate-risk patients, the number of center-based CRP exercise sessions can be decreased while maintaining reduced cardiovascular risk factors.

DOI10.1097/HCR.0000000000000269