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Cardiac rehabilitation

November 03, 2023

Cardiac rehabilitation (CR) is defined by the World Health Organization (WHO) as "the sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life".[1] CR is a comprehensive model of care delivering established core components, including structured exercise, patient education, psychosocial counselling, risk factor reduction and behaviour modification, with a goal of optimizing patient's quality of life and reducing the risk of future heart problems.[2][3]

CR is delivered by a multi-disciplinary team, often headed by a physician such as a cardiologist.[4] Nurses support patients in reducing medical risk factors such as high blood pressure, high cholesterol and diabetes. Physiotherapists or other exercise professionals develop an individualized and structured exercise plan, including resistance training. A dietitian helps create a healthy eating plan. A social worker or psychologist may help patients to alleviate stress and address any identified psychological conditions; for tobacco users, they can offer counseling or recommend other proven treatments to support patients in their efforts to quit. Support for return-to-work can also be provided. CR programs are patient-centered.

Based on the benefits summarized below, CR programs are recommended by the American Heart Association / American College of Cardiology[5] and the European Society of Cardiology,[6] among other associations.[7][8] Patients typically enter CR in the weeks following an acute coronary event such as a myocardial infarction (heart attack), with a diagnosis of heart failure, or following percutaneous coronary intervention (such as coronary stent placement), coronary artery bypass surgery, a valve procedure, or insertion of a rhythm device (e.g., pacemaker, implantable cardioverter defibrillator).[9]

CR Setting edit

CR services can be provided in hospital, in an outpatient setting such as a community center, or remotely at home using the phone and other technologies.[3] Hybrid programs are also increasingly being offered.[10][11]

CR Phases edit

Inpatient program (phase I) edit

Engaging in CR before leaving the hospital can hasten patient’s recovery, as well as facilitate a smoother return to activities of daily living and roles once they return home. Many patients express anxiety about their recovery, especially after a severe illness or surgery, so Phase I CR provides an opportunity for patients to test their abilities in a safe, supervised setting.

Where available, patients receiving CR in the hospital after surgery are usually able to begin within a day or two. First steps include simple motion exercises that can be done sitting down, such as lifting the arms. Heart rate and blood oxygen levels are closely monitored by a therapist as the patient begins to walk, or exercise using a stationary bicycle. The therapist ensures that the level of aerobic and strength training are appropriate for the patient’s current status, and gradually progresses their therapeutic exercises.[12]

Outpatient program (phase II) edit

In order to participate in an outpatient program, the patient generally must first obtain a physician's referral.[13] It is recommended patients begin outpatient CR within 2–7 days following a percutaneous intervention, and 4–6 weeks after cardiac surgery.[14][15][16] This period is often very difficult for patients due to fears of over-exertion or a recurrence of heart issues.[17][15] Shorter time to start is associated with better outcomes.[18]

Participation typically begins with an intake evaluation that includes measurement of cardiac risk factors such as lipids, blood pressure, body composition, depression / anxiety, and tobacco use.[3] A functional capacity test is usually performed both to determine if exercise is safe and to support development of a customized exercise program.[13]

Risk factors are addressed and patients goals are established; a "case-manager" who may be a cardiac-trained registered nurse, physiotherapist, or an exercise physiologist works to help patients achieve their targets. During exercise, the patient's heart rate and blood pressure may be monitored to check the intensity of activity.[13]

The duration of CR varies from program to program, and can range from six weeks to several years. Globally, a median of 24 sessions are offered,[19] and it is well-established that the more the better.[20]

After CR is finished, there are long-term maintenance programs (phase III) available to interested patients,[21] as benefits are optimized with long-term adherence. Unfortunately however, patients generally have to pay out-of-pocket for these services.

Under-use of cardiac rehabilitation edit

CR is significantly under-used globally.[22] Rates vary widely.[23]

Under-use is caused by multi-level factors; a recent review is available.[24] At the health system level, this includes lack of available programs.[25] At the provider level, low referral rates are a major barrier.[26][27] At the patient level, factors such as lack of awareness, transportation, distance, cost, competing responsibilities, and other health conditions are responsible,[28] but most can be mitigated.[29] Women,[30] ethnocultural minorities,[31][32] older patients,[33] those of lower socio-economic status, with comorbidities, and living in rural areas[34] are less likely to access CR, despite the fact that these patients often need it most.[35] Cardiac patients can assess their CR barriers here, and receive suggestions on how to overcome them: https://globalcardiacrehab.com/For-Patients.

Strategies are now established on how we can mitigate these barriers to CR use.[36][37] It is important for inpatient units treating cardiac patients to institute automatic/systematic or electronic referral to CR (see: https://www.ahrq.gov/takeheart/index.html).[38] It is also key for healthcare providers to promote CR to patients at the bedside.[39] The National Institute for Health and Care Excellence (NICE) offer helpful recommendations on encouraging patients to attend CR.

Training more healthcare professionals to deliver CR can also help.[40] CR programs can also join a registry to assess and improve their utilization --among other quality indicators.[41][42] Offering programs tailored to under-served groups such as women may also facilitate program participation.[43][44][45]

Benefits edit

Participation in CR may be associated with many benefits.[46] For acute coronary syndrome patients, CR reduces cardiovascular mortality by 25% and readmission rates by 20%.[47][48] The potential benefit in all-cause mortality is not as clear, however there is some supportive evidence.[49]

CR is associated with improved quality of life, improved psychosocial well-being, and functional capacity,[50] and is cost-effective.[51] In low and middle-income countries, there is some evidence that CR is effective in improving functional capacity, risk factors and quality of life as well.[52]

There appears to be no difference in outcomes between supervised and home-based CR programs, and both cost about the same.[53] Home-based CR is generally safe.[54] Home-based programs with technology are similarly shown to be effective.[55][56][57]

There are specific reviews on benefits of CR in patients with specific health conditions such as valve issues,[58] atrial fibrillation,[59] heart transplant recipients,[60] and heart failure.[61]

CR Societies edit

CR professionals work together in many countries to optimize service delivery and increase awareness of CR.[62] The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR),[1] a member of the World Heart Federation, is composed of formally-named Board members of CR societies globally. Through cooperation across most CR-related associations,[63] ICCPR seeks to promote CR in low-resource settings,[64] among other aims outlined in their Charter.[65]

References edit

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November 03, 2023
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Cardiac rehabilitation CR is defined by the World Health Organization WHO as the sum of activity and interventions required to ensure the best possible physical mental and social conditions so that patients with chronic or post acute cardiovascular disease may by their own efforts preserve or resume their proper place in society and lead an active life 1 CR is a comprehensive model of care delivering established core components including structured exercise patient education psychosocial counselling risk factor reduction and behaviour modification with a goal of optimizing patient s quality of life and reducing the risk of future heart problems 2 3 CR is delivered by a multi disciplinary team often headed by a physician such as a cardiologist 4 Nurses support patients in reducing medical risk factors such as high blood pressure high cholesterol and diabetes Physiotherapists or other exercise professionals develop an individualized and structured exercise plan including resistance training A dietitian helps create a healthy eating plan A social worker or psychologist may help patients to alleviate stress and address any identified psychological conditions for tobacco users they can offer counseling or recommend other proven treatments to support patients in their efforts to quit Support for return to work can also be provided CR programs are patient centered Based on the benefits summarized below CR programs are recommended by the American Heart Association American College of Cardiology 5 and the European Society of Cardiology 6 among other associations 7 8 Patients typically enter CR in the weeks following an acute coronary event such as a myocardial infarction heart attack with a diagnosis of heart failure or following percutaneous coronary intervention such as coronary stent placement coronary artery bypass surgery a valve procedure or insertion of a rhythm device e g pacemaker implantable cardioverter defibrillator 9 Contents 1 CR Setting 2 CR Phases 2 1 Inpatient program phase I 2 2 Outpatient program phase II 3 Under use of cardiac rehabilitation 4 Benefits 5 CR Societies 6 ReferencesCR Setting editCR services can be provided in hospital in an outpatient setting such as a community center or remotely at home using the phone and other technologies 3 Hybrid programs are also increasingly being offered 10 11 CR Phases editInpatient program phase I edit This section needs expansion You can help by adding to it January 2012 Engaging in CR before leaving the hospital can hasten patient s recovery as well as facilitate a smoother return to activities of daily living and roles once they return home Many patients express anxiety about their recovery especially after a severe illness or surgery so Phase I CR provides an opportunity for patients to test their abilities in a safe supervised setting Where available patients receiving CR in the hospital after surgery are usually able to begin within a day or two First steps include simple motion exercises that can be done sitting down such as lifting the arms Heart rate and blood oxygen levels are closely monitored by a therapist as the patient begins to walk or exercise using a stationary bicycle The therapist ensures that the level of aerobic and strength training are appropriate for the patient s current status and gradually progresses their therapeutic exercises 12 Outpatient program phase II edit In order to participate in an outpatient program the patient generally must first obtain a physician s referral 13 It is recommended patients begin outpatient CR within 2 7 days following a percutaneous intervention and 4 6 weeks after cardiac surgery 14 15 16 This period is often very difficult for patients due to fears of over exertion or a recurrence of heart issues 17 15 Shorter time to start is associated with better outcomes 18 Participation typically begins with an intake evaluation that includes measurement of cardiac risk factors such as lipids blood pressure body composition depression anxiety and tobacco use 3 A functional capacity test is usually performed both to determine if exercise is safe and to support development of a customized exercise program 13 Risk factors are addressed and patients goals are established a case manager who may be a cardiac trained registered nurse physiotherapist or an exercise physiologist works to help patients achieve their targets During exercise the patient s heart rate and blood pressure may be monitored to check the intensity of activity 13 The duration of CR varies from program to program and can range from six weeks to several years Globally a median of 24 sessions are offered 19 and it is well established that the more the better 20 After CR is finished there are long term maintenance programs phase III available to interested patients 21 as benefits are optimized with long term adherence Unfortunately however patients generally have to pay out of pocket for these services Under use of cardiac rehabilitation editCR is significantly under used globally 22 Rates vary widely 23 Under use is caused by multi level factors a recent review is available 24 At the health system level this includes lack of available programs 25 At the provider level low referral rates are a major barrier 26 27 At the patient level factors such as lack of awareness transportation distance cost competing responsibilities and other health conditions are responsible 28 but most can be mitigated 29 Women 30 ethnocultural minorities 31 32 older patients 33 those of lower socio economic status with comorbidities and living in rural areas 34 are less likely to access CR despite the fact that these patients often need it most 35 Cardiac patients can assess their CR barriers here and receive suggestions on how to overcome them https globalcardiacrehab com For Patients Strategies are now established on how we can mitigate these barriers to CR use 36 37 It is important for inpatient units treating cardiac patients to institute automatic systematic or electronic referral to CR see https www ahrq gov takeheart index html 38 It is also key for healthcare providers to promote CR to patients at the bedside 39 The National Institute for Health and Care Excellence NICE offer helpful recommendations on encouraging patients to attend CR Training more healthcare professionals to deliver CR can also help 40 CR programs can also join a registry to assess and improve their utilization among other quality indicators 41 42 Offering programs tailored to under served groups such as women may also facilitate program participation 43 44 45 Benefits editParticipation in CR may be associated with many benefits 46 For acute coronary syndrome patients CR reduces cardiovascular mortality by 25 and readmission rates by 20 47 48 The potential benefit in all cause mortality is not as clear however there is some supportive evidence 49 CR is associated with improved quality of life improved psychosocial well being and functional capacity 50 and is cost effective 51 In low and middle income countries there is some evidence that CR is effective in improving functional capacity risk factors and quality of life as well 52 There appears to be no difference in outcomes between supervised and home based CR programs and both cost about the same 53 Home based CR is generally safe 54 Home based programs with technology are similarly shown to be effective 55 56 57 There are specific reviews on benefits of CR in patients with specific health conditions such as valve issues 58 atrial fibrillation 59 heart transplant recipients 60 and heart failure 61 CR Societies editCR professionals work together in many countries to optimize service delivery and increase awareness of CR 62 The International Council of Cardiovascular Prevention and Rehabilitation ICCPR 1 a member of the World Heart Federation is composed of formally named Board members of CR societies globally Through cooperation across most CR related associations 63 ICCPR seeks to promote CR in low resource settings 64 among other aims outlined in their Charter 65 References edit WHO Expert Committee on Rehabilitation after Cardiovascular Diseases with Special Emphasis on Developing Countries Rehabilitation after cardiovascular diseases with special emphsis on developing countries report of a WHO expert committee Geneva ISBN 9241208317 OCLC 28401958 Cowie A Buckley J Doherty P Furze G Hayward J Hinton S et al April 2019 Standards and core components for cardiovascular disease prevention and rehabilitation Heart 105 7 510 515 doi 10 1136 heartjnl 2018 314206 PMC 6580752 PMID 30700518 a b c Grace SL Turk Adawi KI Contractor A Atrey A Campbell N Derman W et al September 2016 Cardiac rehabilitation delivery model for low resource settings Heart 102 18 1449 1455 doi 10 1136 heartjnl 2015 309209 PMC 5013107 PMID 27181874 Supervia M Turk Adawi K Lopez Jimenez F Pesah E Ding R Britto RR et al August 2019 Nature of Cardiac Rehabilitation Around the Globe EClinicalMedicine 13 46 56 doi 10 1016 j eclinm 2019 06 006 PMC 6733999 PMID 31517262 Smith SC Benjamin EJ Bonow RO Braun LT Creager MA Franklin BA et al November 2011 AHA ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease 2011 update a guideline from the American Heart Association and American College of Cardiology Foundation Circulation 124 22 2458 2473 doi 10 1161 CIR 0b013e318235eb4d PMID 22052934 Piepoli MF Hoes AW Agewall S Albus C Brotons C Catapano AL et al August 2016 2016 European Guidelines on cardiovascular disease prevention in clinical practice The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice constituted by representatives of 10 societies and by invited experts Developed with the special contribution of the European Association for Cardiovascular Prevention amp Rehabilitation EACPR European Heart Journal 37 29 2315 2381 doi 10 1093 eurheartj ehw106 PMC 4986030 PMID 27222591 Guha S Sethi R Ray S Bahl VK Shanmugasundaram S Kerkar P et al April 2017 Cardiological Society of India Position statement for the management of ST elevation myocardial infarction in India Indian Heart Journal 69 Suppl 1 S63 S97 doi 10 1016 j ihj 2017 03 006 PMC 5388060 PMID 28400042 Quality statement 7 developmental Options for cardiac rehabilitation Chronic heart failure in adults Quality standards NICE www nice org uk Retrieved 2022 09 06 Grace SL Turk Adawi KI Contractor A Atrey A Campbell NR Derman W et al 2016 11 01 Cardiac Rehabilitation Delivery Model for Low Resource Settings An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement Progress in Cardiovascular Diseases Controversies in Hypertension 59 3 303 322 doi 10 1016 j pcad 2016 08 004 PMID 27542575 Keteyian SJ Ades PA Beatty AL Gavic Ott A Hines S Lui K et al January 2022 A Review of the Design and Implementation of a Hybrid Cardiac Rehabilitation Program AN EXPANDING OPPORTUNITY FOR OPTIMIZING CARDIOVASCULAR CARE Journal of Cardiopulmonary Rehabilitation and Prevention 42 1 1 9 doi 10 1097 HCR 0000000000000634 PMID 34433760 S2CID 237306143 Heindl B Ramirez L Joseph L Clarkson S Thomas R Bittner V 2022 01 01 Hybrid cardiac rehabilitation The state of the science and the way forward Progress in Cardiovascular Diseases 70 175 182 doi 10 1016 j pcad 2021 12 004 PMID 34958846 S2CID 245480348 Wang TJ Chau B Lui M Lam GT Lin N Humbert S September 2020 Physical Medicine and Rehabilitation and Pulmonary Rehabilitation for COVID 19 American Journal of Physical Medicine amp Rehabilitation 99 9 769 774 doi 10 1097 PHM 0000000000001505 PMC 7315835 PMID 32541352 a b c Supervia M Turk Adawi K Lopez Jimenez F Pesah E Ding R Britto RR et al August 2019 Nature of Cardiac Rehabilitation Around the Globe EClinicalMedicine 13 46 56 doi 10 1016 j eclinm 2019 06 006 PMC 6733999 PMID 31517262 Zhang Y Cao H Jiang P Tang H February 2018 Cardiac rehabilitation in acute myocardial infarction patients after percutaneous coronary intervention A community based study Medicine 97 8 e9785 doi 10 1097 MD 0000000000009785 PMC 5841979 PMID 29465559 a b Shajrawi A Granat M Jones I Astin F November 2020 Physical Activity and Cardiac Self Efficacy Levels During Early Recovery After Acute Myocardial Infarction A Jordanian Study The Journal of Nursing Research 29 1 e131 doi 10 1097 JNR 0000000000000408 PMC 7808357 PMID 33136697 Dafoe W Arthur H Stokes H Morrin L Beaton L September 2006 Universal access but when Treating the right patient at the right time access to cardiac rehabilitation The Canadian Journal of Cardiology 22 11 905 911 doi 10 1016 s0828 282x 06 70309 9 PMC 2570237 PMID 16971975 Astin F Closs SJ McLenachan J Hunter S Priestley C January 2009 Primary angioplasty for heart attack mismatch between expectations and reality Journal of Advanced Nursing 65 1 72 83 doi 10 1111 j 1365 2648 2008 04836 x PMID 19032516 Cardiac rehabilitation wait times and relation to patient outcomes European Journal of Physical and Rehabilitation Medicine 2015 June 51 3 301 9 www minervamedica it Retrieved 2023 04 05 Chaves G Turk Adawi K Supervia M Santiago de Araujo Pio C Abu Jeish AH Mamataz T et al January 2020 Cardiac Rehabilitation Dose Around the World Variation and Correlates Circulation Cardiovascular Quality and Outcomes 13 1 e005453 doi 10 1161 CIRCOUTCOMES 119 005453 PMID 31918580 S2CID 210133397 Santiago de Araujo Pio C Marzolini S Pakosh M Grace SL November 2017 Effect of Cardiac Rehabilitation Dose on Mortality and Morbidity A Systematic Review and Meta regression Analysis Mayo Clinic Proceedings 92 11 1644 1659 doi 10 1016 j mayocp 2017 07 019 hdl 10315 38072 PMID 29101934 S2CID 40193168 Chowdhury M Heald FA Sanchez Delgado JC Pakosh M Jacome Hortua AM Grace SL July 2021 The effects of maintenance cardiac rehabilitation A systematic review and Meta analysis with a focus on sex Heart amp Lung 50 4 504 524 doi 10 1016 j hrtlng 2021 02 016 hdl 10315 38987 PMID 33836441 S2CID 233201693 Santiago de Araujo Pio C Beckie TM Varnfield M Sarrafzadegan N Babu AS Baidya S et al January 2020 Promoting patient utilization of outpatient cardiac rehabilitation A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement International Journal of Cardiology 298 1 7 doi 10 1016 j ijcard 2019 06 064 hdl 10034 622555 PMID 31405584 Grace SL Kotseva K Whooley MA July 2021 Cardiac Rehabilitation Under Utilized Globally Current Cardiology Reports 23 9 118 doi 10 1007 s11886 021 01543 x hdl 10315 38989 PMID 34269894 S2CID 235916856 Stewart C Ghisi GL Davis EM Grace SL 2023 Cardiac Rehabilitation Barriers Scale CRBS In Krageloh CU Alyami M Medvedev ON eds International Handbook of Behavioral Health Assessment Cham Springer International Publishing pp 1 57 doi 10 1007 978 3 030 89738 3 39 1 ISBN 978 3 030 89738 3 Turk Adawi K Supervia M Lopez Jimenez F Pesah E Ding R Britto RR et al August 2019 Cardiac Rehabilitation Availability and Density around the Globe EClinicalMedicine 13 31 45 doi 10 1016 j eclinm 2019 06 007 PMC 6737209 PMID 31517261 Ghisi GL Polyzotis P Oh P Pakosh M Grace SL June 2013 Physician factors affecting cardiac rehabilitation referral and patient enrollment a systematic review Clinical Cardiology 36 6 323 335 doi 10 1002 clc 22126 PMC 3736151 PMID 23640785 Ghanbari Firoozabadi M Mirzaei M Nasiriani K Hemati M Entezari J Vafaeinasab M et al 2020 01 01 Cardiac Specialists Perspectives on Barriers to Cardiac Rehabilitation Referral and Participation in a Low Resource Setting Rehabilitation Process and Outcome 9 1179572720936648 doi 10 1177 1179572720936648 PMC 8282146 PMID 34497466 Shanmugasegaram S Gagliese L Oh P Stewart DE Brister SJ Chan V Grace SL February 2012 Psychometric validation of the cardiac rehabilitation barriers scale Clinical Rehabilitation 26 2 152 164 doi 10 1177 0269215511410579 PMC 3351783 PMID 21937522 Santiago de Araujo Pio C Chaves GS Davies P Taylor RS Grace SL February 2019 Interventions to promote patient utilisation of cardiac rehabilitation The Cochrane Database of Systematic Reviews 2 2 CD007131 doi 10 1002 14651858 CD007131 pub4 PMC 6360920 PMID 30706942 Samayoa L Grace SL Gravely S Scott LB Marzolini S Colella TJ July 2014 Sex differences in cardiac rehabilitation enrollment a meta analysis The Canadian Journal of Cardiology 30 7 793 800 doi 10 1016 j cjca 2013 11 007 hdl 10315 27523 PMID 24726052 Midence L Mola A Terzic CM Thomas RJ Grace SL November December 2014 Ethnocultural diversity in cardiac rehabilitation Journal of Cardiopulmonary Rehabilitation and Prevention 34 6 437 444 doi 10 1097 HCR 0000000000000089 PMID 25357126 Koehler Hildebrandt AN Hodgson JL Dodor BA Knight SM Rappleyea DL September 2016 Biopsychosocial Spiritual Factors Impacting Referral to and Participation in Cardiac Rehabilitation for African American Patients A SYSTEMATIC REVIEW Journal of Cardiopulmonary Rehabilitation and Prevention 36 5 320 330 doi 10 1097 HCR 0000000000000183 PMID 27496250 S2CID 10829735 Grace SL Shanmugasegaram S Gravely Witte S Brual J Suskin N Stewart DE 2009 Barriers to cardiac rehabilitation DOES AGE MAKE A DIFFERENCE Journal of Cardiopulmonary Rehabilitation and Prevention 29 3 183 187 doi 10 1097 HCR 0b013e3181a3333c PMC 2928243 PMID 19471138 Leung YW Brual J Macpherson A Grace SL November 2010 Geographic issues in cardiac rehabilitation utilization a narrative review Health amp Place 16 6 1196 1205 doi 10 1016 j healthplace 2010 08 004 PMC 4474644 PMID 20724208 Ruano Ravina A Pena Gil C Abu Assi E Raposeiras S van t Hof A Meindersma E et al November 2016 Participation and adherence to cardiac rehabilitation programs A systematic review International Journal of Cardiology 223 436 443 doi 10 1016 j ijcard 2016 08 120 PMID 27557484 Santiago de Araujo Pio C Chaves GS Davies P Taylor RS Grace SL February 2019 Interventions to promote patient utilisation of cardiac rehabilitation The Cochrane Database of Systematic Reviews 2 2 CD007131 doi 10 1002 14651858 cd007131 pub4 PMC 6360920 PMID 30706942 Aljehani R Grace SL Aburub A Turk Adawi K Ghisi GL April 2023 Translation Cross Cultural Adaptation and Psychometric Validation of the Arabic Version of the Cardiac Rehabilitation Barriers Scale CRBS A with Strategies to Mitigate Barriers Healthcare 11 8 1196 doi 10 3390 healthcare11081196 PMID 37108029 Grace SL Russell KL Reid RD Oh P Anand S Rush J et al February 2011 Effect of cardiac rehabilitation referral strategies on utilization rates a prospective controlled study Archives of Internal Medicine 171 3 235 241 doi 10 1001 archinternmed 2010 501 PMID 21325114 Santiago de Araujo Pio C Gagliardi A Suskin N Ahmad F Grace SL August 2020 Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation development and evaluation of an online course BMC Health Services Research 20 1 768 doi 10 1186 s12913 020 05619 2 PMC 7439558 PMID 32819388 Babu AS Heald FA Contractor A Ghisi GL Buckley J Mola A et al May 2022 Building Capacity Through ICCPR Cardiovascular Rehabilitation Foundations Certification CRFC Evaluation of Reach Barriers and Impact Journal of Cardiopulmonary Rehabilitation and Prevention 42 3 178 182 doi 10 1097 hcr 0000000000000655 PMID 34840246 Grace SL Elashie S Sadeghi M Papasavvas T Hashmi F de Melo Ghisi G et al July 2023 Pilot testing of the International Council of Cardiovascular Prevention and Rehabilitation Registry International Journal for Quality in Health Care 35 3 doi 10 1093 intqhc mzad050 PMC 10329404 PMID 37421311 Turk Adawi K Ghisi GL Tran C Heine M Raidah F Contractor A Grace SL May 2023 First report of the International Council of Cardiovascular Prevention and Rehabilitation s Registry ICRR Expert Review of Cardiovascular Therapy 21 5 357 364 doi 10 1080 14779072 2023 2199154 PMID 37024997 Mamataz T Ghisi GL Pakosh M Grace SL June 2022 Outcomes and cost of women focused cardiac rehabilitation A systematic review and meta analysis Maturitas 160 32 60 doi 10 1016 j maturitas 2022 01 008 PMID 35550706 S2CID 246424701 Mamataz T Ghisi GL Pakosh M Grace SL September 2021 Nature availability and utilization of women focused cardiac rehabilitation a systematic review BMC Cardiovascular Disorders 21 1 459 doi 10 1186 s12872 021 02267 0 PMC 8458788 PMID 34556036 Ghisi GL Kin SM Price J Beckie TM Mamataz T Naheed A Grace SL December 2022 Women Focused Cardiovascular Rehabilitation An International Council of Cardiovascular Prevention and Rehabilitation Clinical Practice Guideline The Canadian Journal of Cardiology 38 12 1786 1798 doi 10 1016 j cjca 2022 06 021 hdl 10315 40876 PMID 36085185 S2CID 251967685 Taylor RS Dalal HM McDonagh ST March 2022 The role of cardiac rehabilitation in improving cardiovascular outcomes Nature Reviews Cardiology 19 3 180 194 doi 10 1038 s41569 021 00611 7 PMC 8445013 PMID 34531576 Exercise based rehabilitation for coronary heart disease www cochrane org Retrieved 2022 09 06 Anderson L Sharp GA Norton RJ Dalal H Dean SG Jolly K et al June 2017 Home based versus centre based cardiac rehabilitation The Cochrane Database of Systematic Reviews 6 6 CD007130 doi 10 1002 14651858 CD007130 pub4 PMC 4160096 PMID 28665511 Kabboul NN Tomlinson G Francis TA Grace SL Chaves G Rac V et al December 2018 Comparative Effectiveness of the Core Components of Cardiac Rehabilitation on Mortality and Morbidity A Systematic Review and Network Meta Analysis Journal of Clinical Medicine 7 12 514 doi 10 3390 jcm7120514 PMC 6306907 PMID 30518047 Francis T Kabboul N Rac V Mitsakakis N Pechlivanoglou P Bielecki J et al March 2019 The Effect of Cardiac Rehabilitation on Health Related Quality of Life in Patients With Coronary Artery Disease A Meta analysis The Canadian Journal of Cardiology 35 3 352 364 doi 10 1016 j cjca 2018 11 013 PMID 30825955 S2CID 73474249 Shields GE Wells A Doherty P Heagerty A Buck D Davies LM September 2018 Cost effectiveness of cardiac rehabilitation a systematic review Heart 104 17 1403 1410 doi 10 1136 heartjnl 2017 312809 PMC 6109236 PMID 29654096 Mamataz T Uddin J Ibn Alam S Taylor RS Pakosh M Grace SL 2021 07 13 Effects of cardiac rehabilitation in low and middle income countries A systematic review and meta analysis of randomised controlled trials Progress in Cardiovascular Diseases 70 119 174 doi 10 1016 j pcad 2021 07 004 PMC 9187522 PMID 34271035 S2CID 236000955 Anderson L Sharp GA Norton RJ Dalal H Dean SG Jolly K et al June 2017 Home based versus centre based cardiac rehabilitation The Cochrane Database of Systematic Reviews 6 6 CD007130 doi 10 1002 14651858 CD007130 pub4 PMC 6481471 PMID 28665511 Thomas RJ Beatty AL Beckie TM Brewer LC Brown TM Forman DE et al July 2019 Home Based Cardiac Rehabilitation A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation the American Heart Association and the American College of Cardiology Circulation 140 1 e69 e89 doi 10 1161 CIR 0000000000000663 PMID 31082266 S2CID 153312127 Chong MS Sit JW Karthikesu K Chair SY December 2021 Effectiveness of technology assisted cardiac rehabilitation A systematic review and meta analysis International Journal of Nursing Studies 124 104087 doi 10 1016 j ijnurstu 2021 104087 PMID 34562846 S2CID 237636685 Ramachandran HJ Jiang Y Tam WW Yeo TJ Wang W May 2022 Effectiveness of home based cardiac telerehabilitation as an alternative to Phase 2 cardiac rehabilitation of coronary heart disease a systematic review and meta analysis European Journal of Preventive Cardiology 29 7 1017 1043 doi 10 1093 eurjpc zwab106 PMC 8344786 PMID 34254118 Jin K Khonsari S Gallagher R Gallagher P Clark AM Freedman B et al April 2019 Telehealth interventions for the secondary prevention of coronary heart disease A systematic review and meta analysis European Journal of Cardiovascular Nursing 18 4 260 271 doi 10 1177 1474515119826510 PMID 30667278 S2CID 58601002 Abraham LN Sibilitz KL Berg SK Tang LH Risom SS Lindschou J et al May 2021 Exercise based cardiac rehabilitation for adults after heart valve surgery The Cochrane Database of Systematic Reviews 5 5 CD010876 doi 10 1002 14651858 CD010876 pub3 PMC 8105032 PMID 33962483 Risom SS Zwisler AD Johansen PP Sibilitz KL Lindschou J Gluud C et al February 2017 Risom SS ed Exercise based cardiac rehabilitation for adults with atrial fibrillation The Cochrane Database of Systematic Reviews Chichester UK John Wiley amp Sons Ltd 2 2 CD011197 doi 10 1002 14651858 cd011197 PMID 28181684 Anderson L Nguyen TT Dall CH Burgess L Bridges C Taylor RS April 2017 Exercise based cardiac rehabilitation in heart transplant recipients The Cochrane Database of Systematic Reviews 4 4 CD012264 doi 10 1002 14651858 CD012264 pub2 PMC 6478176 PMID 28375548 Dibben GO Dalal HM Taylor RS Doherty P Tang LH Hillsdon M September 2018 Cardiac rehabilitation and physical activity systematic review and meta analysis Heart 104 17 1394 1402 doi 10 1136 heartjnl 2017 312832 PMC 6109237 PMID 29654095 Grace Sherry L 2023 01 02 Evidence is indisputable that cardiac rehabilitation provides health benefits and event reduction time for policy action European Heart Journal 44 6 470 472 doi 10 1093 eurheartj ehac690 ISSN 0195 668X Turk Adawi K Supervia M Ghisi G Cuenza L Yeo TJ Chen SY et al July 2023 The impact of ICCPR s Global Audit of Cardiac Rehabilitation where are we now and where do we need to go EClinicalMedicine 61 102092 doi 10 1016 j eclinm 2023 102092 PMID 37528847 Grace Sherry L Taylor Rod S Gaalema Diann E Redfern Julie Kotseva Kornelia Ghisi Gabriela July 2023 Cardiac Rehabilitation JACC Advances 2 5 100412 doi 10 1016 j jacadv 2023 100412 ISSN 2772 963X Grace SL Warburton DR Stone JA Sanderson BK Oldridge N Jones J et al March April 2013 International Charter on Cardiovascular Prevention and Rehabilitation a call for action Journal of Cardiopulmonary Rehabilitation and Prevention 33 2 128 131 doi 10 1097 HCR 0b013e318284ec82 PMC 4559455 PMID 23399847 Retrieved from https en wikipedia org w index php title Cardiac rehabilitation amp oldid 1178694624, wikipedia, wiki, book, books, library,

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