Article type
Year
Abstract
Objective: To determine the effectiveness of exercise based cardiac rehabilitation programmes on mortality, morbidity, health related quality of life, and risk factors in patients with coronary heart disease (CHD).
Methods: A systematic review of the literature was carried out with quantitative synthesis. The comparison groups were exercise only interventions versus usual care, and multiple rehabilitation with an exercise component versus usual care. A search of 10 databases, including Medline, Embase, Cinahl and the Cochrane Controlled Trials Register was conducted. 4000 citations were reviewed with 289 abstracts assessed independently by two reviewers for inclusion. 40 studies were identified that fitted the inclusion criteria. Only randomised controlled trials were considered, and studies with follow up periods of at least 6 months. Two reviewers extracted data independently. Trial quality was assessed in terms of randomisation method, blinding of outcome assessors and the description and number of dropouts. The following outcome measures were assessed: Mortality - all-cause and cardiac: myocardial infarction (MI) and cardiovascular disease (CVD). Morbidity - cardiac events: MI, coronary artery bypass grafts (CABG), percutaneous transluminal coronary angioplasty (PTCA), CVD events: stroke, trans-ischaemic attack (TIA). Primary cardiac risk factors - smoking behaviour, blood pressure and blood lipid levels. Health-related quality of life. Physical activity levels of strength and stamina. In addition information was collected on age, sex, type of CHD, when the intervention was received post event (acute versus chronic condition), length and intensity of intervention, and quality assessment of studies, as a secondary objective to determine the effects of these on the outcomes listed above.
Results: Preliminary summary findings are presented. Both groups of interventions show a significant decrease in both all cause and cardiac mortality, with no significant effects on the recurrence of MI. There are small but significant reductions in total cholesterol, LDL cholesterol and triglycerides in both groups of interventions.
Conclusions: Preliminary data confirm the benefits of exercise based cardiac rehabilitation. Further work is underway to look at the effectiveness of the interventions in different groups of patients with metaregression.
Methods: A systematic review of the literature was carried out with quantitative synthesis. The comparison groups were exercise only interventions versus usual care, and multiple rehabilitation with an exercise component versus usual care. A search of 10 databases, including Medline, Embase, Cinahl and the Cochrane Controlled Trials Register was conducted. 4000 citations were reviewed with 289 abstracts assessed independently by two reviewers for inclusion. 40 studies were identified that fitted the inclusion criteria. Only randomised controlled trials were considered, and studies with follow up periods of at least 6 months. Two reviewers extracted data independently. Trial quality was assessed in terms of randomisation method, blinding of outcome assessors and the description and number of dropouts. The following outcome measures were assessed: Mortality - all-cause and cardiac: myocardial infarction (MI) and cardiovascular disease (CVD). Morbidity - cardiac events: MI, coronary artery bypass grafts (CABG), percutaneous transluminal coronary angioplasty (PTCA), CVD events: stroke, trans-ischaemic attack (TIA). Primary cardiac risk factors - smoking behaviour, blood pressure and blood lipid levels. Health-related quality of life. Physical activity levels of strength and stamina. In addition information was collected on age, sex, type of CHD, when the intervention was received post event (acute versus chronic condition), length and intensity of intervention, and quality assessment of studies, as a secondary objective to determine the effects of these on the outcomes listed above.
Results: Preliminary summary findings are presented. Both groups of interventions show a significant decrease in both all cause and cardiac mortality, with no significant effects on the recurrence of MI. There are small but significant reductions in total cholesterol, LDL cholesterol and triglycerides in both groups of interventions.
Conclusions: Preliminary data confirm the benefits of exercise based cardiac rehabilitation. Further work is underway to look at the effectiveness of the interventions in different groups of patients with metaregression.