Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

TY - JOUR

T1 - Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

AU - Oerkild, Bodil

AU - Frederiksen, Marianne

AU - Hansen, Jorgen Fischer

AU - Simonsen, Lene

AU - Skovgaard, Lene Theil

AU - Prescott, Eva

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. Methods: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients ≥65 years with coronary heart disease. Results: seventy-five patients participated. There were no significant differences in exercise capacity after the intervention between home and centre-based CR. Adjusted mean differences of peak VO2 = 0.9 ml/kg/min (95% CI -0.7, 2.4) and of 6 min walk test = -18.7 m (95% CI -56.4, 18.9). In addition, no differences were found in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect of either programmes were characterised by higher age, living alone and having COPD. At 12 months of follow-up, both groups had a significant decline in exercise capacity.Conclusions: home-based CR is as effective as centre-based CR in improving exercise capacity, risk factor control and health-related quality of life. However, a group of patients did not improve regardless of the type of intervention. Continued follow-up is essential in order to maintain the gained improvements.

AB - Background: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. Methods: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients ≥65 years with coronary heart disease. Results: seventy-five patients participated. There were no significant differences in exercise capacity after the intervention between home and centre-based CR. Adjusted mean differences of peak VO2 = 0.9 ml/kg/min (95% CI -0.7, 2.4) and of 6 min walk test = -18.7 m (95% CI -56.4, 18.9). In addition, no differences were found in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect of either programmes were characterised by higher age, living alone and having COPD. At 12 months of follow-up, both groups had a significant decline in exercise capacity.Conclusions: home-based CR is as effective as centre-based CR in improving exercise capacity, risk factor control and health-related quality of life. However, a group of patients did not improve regardless of the type of intervention. Continued follow-up is essential in order to maintain the gained improvements.

U2 - 10.1093/ageing/afq122

DO - 10.1093/ageing/afq122

M3 - Journal article

C2 - 20846961

SN - 0002-0729

VL - 40

SP - 78

EP - 85

JO - Age and Ageing

JF - Age and Ageing

IS - 1

ER -