In a nutshell
This study compared two cardiac rehab programs for patients with heart disease. One program is supervised in a hospital, while the other is done at home without supervision. They found that patients doing the rehab program at home started the program more quickly and had better outcomes.
Some background
After a heart attack or bypass surgery, cardiac rehab is recommended. This includes a program of exercise, diet, and education to restore heart health. This program can take place in a healthcare facility (facility-based cardiac rehabilitation – FBCR) or it can be done at home (home-based cardiac rehabilitation – HBCR).
FBCR involves frequent visits to the hospital, typically up to three times per week. Not all patients can undertake this program which can require a lot of travel. HBCR is an alternative for patients who cannot make it to the hospital but it is not known if it is as effective.
Methods & findings
This study involved 237 patients who had a recent heart attack or a procedure to prevent heart attack such as bypass surgery. Patients were assigned to either FBCR (116 patients) or HBCR (127 patients). Patients in the FBCR group attended the hospital for supervised rehab sessions 1-3 times per week. Patients in the HBCR group did their rehab at home and had weekly phone calls to monitor their progress. At the end of three months, participants were assessed using a test called the 6-minute walk test (6MWT). The 6MWT involves measuring the distance a patient can walk in 6 minutes.
86 participants in the HBCR group and 93 participants in the FBCR group completed the study. On average patients in the FBCR group had to wait 52 days longer for their first rehab session than the HBCR group. Patients in the HBCR group improved their distance walked on the 6-minute walk test by 101 m on average. Patients in the FBCR group improved their distance by an average of 40 m.
More patients in the HBCR group reported improvements in quality of life (44% vs 12% in the FBCR group), functional status and self-efficacy. One patient in the HBCR was hospitalized for a broken foot after a fall in the bathroom at home.
The bottom line
This study showed that home-based rehab is at least as effective as hospital-based rehab for heart patients.
The fine print
A large number of patients failed to complete both rehab programs, which may affect the results. More studies are needed.
Published By :
Journal of the American Heart Association
Date :
Sep 21, 2020
