Year of Award


Document Type

Professional Paper

Degree Type

Master of Science (MS)

Degree Name

Integrative Physiology and Rehabilitation Sciences

Department or School/College

Department of Integrative Physiology and Athletic Training

Committee Chair

John Quindry

Commitee Members

Charles Palmer, Whitney Larson


Cardiac Rehabilitation, Barriers, Traditional, Home-Based, Maintenance


University of Montana

Subject Categories

Exercise Physiology | Exercise Science


Cardiac rehabilitation provides medically supervised therapeutic exercise and multifaceted risk factor modification as a form of secondary prevention for cardiovascular disease, a persistent leading cause of morbidity and mortality in the United States and internationally. Despite robust evidence of compelling patient outcomes, decreased disease recurrence, and the indications from the ACC/AHA endorsing phase II cardiac rehabilitation (CR) as a crucial aspect of recovery from cardiac events and qualifying conditions, CR is widely underutilized. A variety of patient barriers can serve as mitigating factors to CR referral, enrollment, participation, and completion contributing to, in part, the underutilization of CR. Barriers to CR have been observed in both traditional hospital-based (TCR) and alternative home-based (HBCR) Phase II settings. Furthermore, data suggests that some barriers to exercise persist into Phase III CR, ongoing independent maintenance, following Phase II CR completion. To date, few studies have comprehensively described patient barriers to HBCR and Phase III CR.

This professional paper addressed the identified common patient barriers to TCR, HBCR, and Phase III CR by conducting an extensive literature review. Within this work, identified barriers were categorized by type including intrapersonal, interpersonal, environmental, organizational, and socio-cultural barriers. Intrapersonal barriers emerged as primary mitigating factors to CR participation in TCR, HBCR, and Phase III CR, though it was unclear if certain barriers were more impactful than others. Collectively, this professional paper provided a baseline of the complex and interrelated barriers that limit TCR, HBCR, and Phase III CR participation.



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