Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation

Tang, L. H., Kikkenborg Berg, S., Christensen, J., Lawaetz, J., Doherty, P., Taylor, R. S. , Langberg, H. and Zwisler, A.-D. (2017) Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation. International Journal of Cardiology, 232, pp. 33-39. (doi: 10.1016/j.ijcard.2017.01.126) (PMID:28159358)

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Taylor, Professor Rod
• Authors: Tang, L. H., Kikkenborg Berg, S., Christensen, J., Lawaetz, J., Doherty, P., Taylor, R. S., Langberg, H., and Zwisler, A.-D.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: International Journal of Cardiology
• Publisher: Elsevier
• ISSN: 0167-5273
• ISSN (Online): 1874-1754
• Published Online: 27 January 2017
• Copyright Holders: Copyright © 2017 Elsevier Ireland Ltd.
• First Published: First published in International Journal of Cardiology 232:33-39
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher