Effective treatment of cardiac rehabilitation: A Synthesis of Findings from 14 Studies

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Original Abstract of the Article

Main Research Findings

Cardiac rehabilitation (CR) is recommended for all cardiac patients, including those who have undergone cardiac surgery. 9 CR has been shown to improve exercise capacity, cardiac function, and health-related quality of life. 13 However, in Germany, CR is predominantly offered as a comprehensive inpatient treatment lasting for 3 weeks, and there is not enough evidence to suggest that it is superior to the international practice of long-term outpatient rehabilitation. 5 Furthermore, participation in CR is low, and many patients do not complete the full course of treatment. 12 This is largely influenced by socioeconomic factors, but also due to patients' lack of understanding of the importance of their care and a lack of motivation to maintain attendance. 12

Treatment Summary

CR treatments include exercise therapy, education, counseling, and psychotherapy. 13 , 12 , 14 Exercise therapy can be center-based CR, home-based CR, tele-based CR, or combined CR. 10 Education includes a new patient education strategy called 'learning and coping'. 7 Psychotherapy includes cognitive behavioral therapy. 14 Music therapy may also enhance the effectiveness of CR. 4

Benefits and Risks

Benefit Summary

The benefits of CR include improved exercise capacity, improved cardiac function, improved health-related quality of life, and reduced risk of death. 13 , 10 Specifically, center-based CR has been shown to reduce the risk of death. 10

Risk Summary

The risks of CR include the risk of heart failure or sudden death during exercise, but these risks are low when properly managed. 13

Comparison between Studies

Commonalities of Studies

Many studies agree that CR can improve the health of cardiac patients. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Differences between Studies

The method and content of CR delivery, the patients targeted, and the evaluation criteria vary among studies. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Consistency and Contradictions of Results

While CR can improve the health of cardiac patients, not all studies have produced consistent results. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 Specifically, in Germany, long-term outpatient rehabilitation may be more effective than a comprehensive 3-week inpatient treatment. 5

Points to Note for Real-Life Application

Although CR can improve the health of cardiac patients, it is not suitable for all patients. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 When considering participation in CR, it is essential to consult with a physician and choose a program that suits your individual needs. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Limitations of Current Research

Research on CR is still not sufficient. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 Future research should investigate the long-term effects of CR and its effectiveness in various patient populations in more detail. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Future Directions of Research

CR is an effective treatment that can improve the health of cardiac patients. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 However, research on CR is still not sufficient. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 Future research should investigate the long-term effects of CR and its effectiveness in various patient populations in more detail. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Conclusion

CR is an effective treatment that can improve the health of cardiac patients. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2 When considering participation in CR, it is essential to consult with a physician and choose a program that suits your individual needs. 9 , 13 , 5 , 12 , 11 , 4 , 6 , 1 , 7 , 10 , 8 , 14 , 3 , 2

Treatment List

Exercise therapy, education, counseling, psychotherapy, music therapy

Literature analysis of 14 papers
Positive Content
13
Neutral Content
0
Negative Content
1
Article Type
9
5
3
2
14
1.

The effects of exercise in a coronary rehabilitation programme.

Author: NewtonM, MutrieN, McArthurJ D

Improved psychological function

This study compared the effects of a 10-week exercise-based cardiac rehabilitation program to routine care in 22 patients who had recently had a heart attack. While there was no significant improvement in physical function in the rehabilitation group, this group showed statistically significant improvements in psychological well-being. The study suggests that exercise-based cardiac rehabilitation may have psychological benefits for patients recovering from heart attacks.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

A randomized control trial of cardiac rehabilitation.

Author: BurgessA W, LernerD J, D'AgostinoR B, VokonasP S, HartmanC R, GaccioneP

Psycho-social rehab
Reduced distress

A study comparing a comprehensive cardiac rehabilitation program with standard care for 180 patients after acute myocardial infarction (MI) found no significant difference in return to work rates between the groups. While the intervention group showed less psychological distress and dependence on family support, the difference in return-to-work rate was not statistically significant. The study concluded that factors like initial cardiac status, family support, and work-related obstacles were more influential in determining the time to return to work. This suggests that while comprehensive rehabilitation programs addressing multiple aspects of recovery can be beneficial, interventions focusing on psychosocial adjustment may be particularly important for improving outcomes for MI patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

[Individual outcome-oriented cardiologic rehabilitation treatment].

Author: KaroffM

Improved reintegration
Reduced anxiety
Reduced depression

This study found that cardiac rehabilitation programs, followed by intensive aftercare, significantly improved long-term (2 years) outcomes for heart patients. These programs not only improved physical performance but also enhanced self-confidence and reduced anxiety and depression. This resulted in a lower rate of patients needing early retirement or disability benefits. The study concludes that these programs are beneficial for patients and also have positive economic implications for insurance providers.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

4.

Effects of music therapy on health-related outcomes in cardiac rehabilitation: a randomized controlled trial.

Author: MandelSusan E, HanserSuzanne B, SecicMichelle, DavisBeth A

Improved anxiety
Improved blood pressure
Improved general health
Improved social functioning

Music therapy in addition to cardiac rehabilitation may improve some health-related outcomes in patients undergoing cardiac rehabilitation.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Medium-term effects of cardiac rehabilitation in Germany: systematic review and meta-analysis of results from national and international trials.

Author: MittagOskar, SchrammSusanne, BöhmenStephan, HüppeAngelika, MeyerThorsten, RaspeHeiner

Inpatient rehabilitation

Comprehensive inpatient rehabilitation treatment is not superior to international practice of long-term outpatient rehabilitation. For most outcomes, effect sizes in national studies are poorer than those from international interventions or, in the case of blood pressure and depression, even poorer than international controls.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR): study protocol for a randomised clinical trial.

Author: SibilitzKirstine Laerum, BergSelina Kikkenborg, HansenTina Birgitte, RisomSigne Stelling, RasmussenTrine Bernholdt, HassagerChristian, KøberLars, SteinbrüchelDaniel, GluudChristian, WinkelPer, ThygesenLau Caspar, HansenJane Lindschou, SchmidJean Paul, ConraadsViviane, BrockiBarbara Christina, ZwislerAnn-Dorthe

Improved mental health
Improved physical capacity
Reduced hospitalization

Heart valve disease is a common and potentially life-threatening condition. This study will investigate the effectiveness of a cardiac rehabilitation program in improving physical capacity, mental health, and reducing hospitalizations and healthcare costs after heart valve surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

LC-REHAB: randomised trial assessing the effect of a new patient education method--learning and coping strategies--in cardiac rehabilitation.

Author: LynggaardVibeke, MayOle, BeauchampAlison, NielsenClaus Vinther, WittrupInge

Cardiac rehabilitation
Heart failure
Ischemic heart disease

This study investigates the effectiveness of a new patient education program called "learning and coping" for improving adherence to cardiac rehabilitation. The study compares the effectiveness of this program to standard care for cardiac rehabilitation. The study also describes the theoretical underpinnings of this new educational approach.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Update to the study protocol, including statistical analysis plan for a randomized clinical trial comparing comprehensive cardiac rehabilitation after heart valve surgery with control: the CopenHeartVR trial.

Author: SibilitzKirstine Laerum, BergSelina Kikkenborg, HansenTina Birgitte, RisomSigne Stelling, RasmussenTrine Bernholdt, HassagerChristian, KøberLars, GluudChristian, ThygesenLau Caspar, LindschouJane, SchmidJean Paul, TaylorRod S, ZwislerAnn-Dorthe

Cardiac rehabilitation program
Heart valve diseases

This research examines the benefits of a comprehensive cardiac rehabilitation program for patients after heart valve surgery. Heart valve diseases are common and can significantly impact daily life. The study explores the potential of cardiac rehabilitation to improve physical capacity, mental health, and reduce hospitalization costs.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Cardiac rehabilitation for patients having cardiac surgery: a systematic review.

Author: BlokzijlFredrike, DieperinkWillem, KeusFrederik, RenemanMichiel F, MarianiMassimo A, van der HorstIwan C

Improved CR outcomes

Cardiac rehabilitation (CR) is recommended for all cardiac patients, including those after cardiac surgery. More research is needed to fully understand the effects of CR for patients after cardiac surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Efficacy of Different Types of Exercise-Based Cardiac Rehabilitation on Coronary Heart Disease: a Network Meta-analysis.

Author: XiaTian-Li, HuangFang-Yang, PengYong, HuangBao-Tao, PuXiao-Bo, YangYong, ChaiHua, ChenMao

Improved exercise capacity
Reduced mortality
None reported

Center-based cardiac rehabilitation (CR) significantly reduced all-cause mortality in patients with coronary heart disease (CHD) compared to usual care. Further research is needed to determine the efficacy of home- and tele-based CR.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

A systematic review and meta-analysis of the effects of cardiac rehabilitation interventions on cognitive impairment following stroke.

Author: JeffaresIsabelle, MerrimanNiamh A, RohdeDaniela, McLoughlinAffraic, ScallyBrendan, DoyleFrank, HorganFrances, HickeyAnne

Cardiac/cardiovascular rehabilitation programs
Stroke rehabilitation

This review examines the use of cardiac rehabilitation programs for stroke patients. The study investigates whether these programs are used internationally, whether they include cognitive interventions, and the impact of rehabilitation on cognitive function after stroke.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Effect of a Virtual Reality-Enhanced Exercise and Education Intervention on Patient Engagement and Learning in Cardiac Rehabilitation: Randomized Controlled Trial.

Author: GulickVictoria, GravesDaniel, AmesShannon, KrishnamaniPavitra Parimala

CR treatment

Cardiac rehabilitation (CR) is proven to improve health outcomes, but many people who could benefit from it don't participate. Even those who start CR often don't finish the program. This is often due to financial and social barriers, but also because patients don't understand the importance of CR or aren't motivated to keep attending.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Cardiac rehabilitation in heart failure with severely reduced ejection fraction: effects on mortality.

Author: Hosseini MohammadiNegin Sadat, Shaki KatouliMohammad Hasan, MasoudkabirFarzad, MeysamieAlipasha, TavakoliKiarash, Vasheghani-FarahaniAli

Cardiac rehabilitation for congestive heart failure

This review examined the outcomes of cardiac rehabilitation in patients with severely depressed cardiac function, highlighting the potential benefits for exercise capacity, quality of life, and overall health.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Cognitive-behavioral rehabilitation in patients with cardiovascular diseases: a randomized controlled trial (CBR-CARDIO, DRKS00029295).

Author: BethgeMatthias, Thome-SoósFriederike, RašoLuka Marko, WeierLisa, BenninghovenDieter

Cardiovascular disease treatment

This study discussed the development of a cognitive-behavioral rehabilitation program for patients with cardiovascular disease and mild or moderate mental illness, highlighting the potential benefits of psychological treatments within cardiac rehabilitation.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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