Abstract
Background/objectives
Improving patients' cardiorespiratory fitness is an important therapeutic outcome
in cardiac rehabilitation. The ability of cardiac rehabilitation to reduce mortality
and morbidity has been evidenced through several meta-analyses. Whether cardiac rehabilitation
can increase cardiorespiratory fitness and which factors may influence such gains
are less well quantified.
Methods
We performed detailed literature searches of electronic databases and manually searched
papers concerning changes in cardiorespiratory fitness in cardiac rehabilitation patients.
We performed random-effects meta-analysis of mean improvements in cardiorespiratory
fitness and subgroup analyses to determine potential sources of heterogeneity.
Results
Data from 31 studies produced 48 groups (n=3827) with a mean improvement of 1.55 (95% CI 1.21–1.89) METs, (p<0.001); equivalent to standardised effect size of ES=0.97 (95% CI 0.80–1.13). As this value was highly heterogeneous (Q=852, p<0.001) we performed subgroup analyses on the effect size data. Gains in fitness were
highest in patients receiving >36 exercise sessions in studies where fitness was assessed using the Naughton Protocol.
Patient characteristics associated with the highest fitness gains were age (being
young) and sex (being male training in a male-only exercise group). Changes in fitness
were unrelated to programme type (comprehensive or exercise-only), duration or study
design. There was no association with patient's baseline fitness levels.
Conclusion
This is the first meta-analysis of changes in cardiovascular fitness in cardiac rehabilitation
patients and shows clinically significant improvements in a large sample of patients
from a variety of rehabilitation programmes. This analysis helps describe the characteristics
of cardiac rehabilitation programmes which can increase patients' cardiorespiratory
fitness.
Keywords
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Article info
Publication history
Published online: December 30, 2011
Accepted:
November 26,
2011
Received:
November 8,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Improved fitness as a measure of success of cardiac rehabilitation: Do those who get fitter live longer?International Journal of CardiologyVol. 167Issue 3
- PreviewCardiac rehabilitation programs are multifaceted interventions that focus primarily on exercise training and are designed to optimize physical, psychological, and social functioning in a broad spectrum of patients with cardiovascular disease [1]. In large studies and meta-analyses of patients with coronary artery disease, cardiac rehabilitation has been demonstrated to reduce the rates of all-cause and cardiovascular mortality [2–7]. As a result, it is widely promoted by various health care organizations and is strongly advocated by position statements all over the world [8–15].
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