Year of Award

2021

Document Type

Professional Paper

Degree Type

Master of Science (MS)

Degree Name

Health and Human Performance (Exercise Science Option)

Department or School/College

Integrative Physiology and Athletic Training

Committee Chair

Dr. John C. Quindry

Commitee Members

Dr. Kathleen Sondag Dr. Matthew Bundle Dr. Charles Palmer

Keywords

cardiac rehab, cardiac rehabilitation, alternative, outpatient, home-based

Subject Categories

Other Rehabilitation and Therapy

Abstract

Phase II outpatient cardiac rehabilitation (CR) is an intervention offered to patients that have been diagnosed with heart disease, undergone various procedures such as stenting or valve replacement, or to those with claudication diseases. Home-based cardiac rehabilitation (HBCR) is an alternative approach to traditional outpatient phase II CR, that is an emergent area of study with preliminary evidence showing in some outcomes that it approximates traditional CR. As there is current interest in the study of HBCR, this paper examines outcomes of mortality, risk factor modification, exercise capacity, and cardiac function to determine the extent to which this intervention may be a suitable alternative to traditional phase II outpatient CR. In this review, outcomes in HBCR are compared to usual care control groups (participants who are non-participants or non-referrals to CR) to identify outcomes that change following a HBCR intervention. Following comparisons of HBCR and usual care controls, the former is then compared to traditional phase II outpatient CR to present areas of significant improvement between the interventions. After examining the various outcomes in the most relevant 28 manuscripts from a large literary search, preliminary evidence indicates HBCR is, in many respects (e.g. Peak VO2, 6MWD, METs, resting SBP, RHR, LVEF, TC, HDL, LDL, and mortality), equivalent to traditional outpatient phase II CR in eliciting an exercise response. Traditional phase II outpatient CR has an advantage in adherence and safety due to direct patient monitoring, coverage and reimbursement of health care, and standardized guidelines in terms of outcomes. HBCR is advantageous in situations with barriers to adherence or participation such as travel, frailty due to advancing age, and additional comorbidities or health issues.

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