Who is likely to benefit from phase II cardiac rehabilitation?

摘要

Purpose: To ascertain which patients are most likely to benefit from a phase II cardiac rehabilitation (CR) program. Methods: A retrospective chart review was conducted on 425 patients who completed a 6-minute walk test (6MWT), body weight (BW), and the Medical Outcomes Short Form Health Survey physical (PCS) and mental (MCS) component scores before and after CR. These variables were compared between patients who attended 24 or less and 25 or more sessions and between tertiles on the basis of initial 6MWT and the relative change in 6MWT. Results: The entire cohort of patients improved their 6MWT 20.1 ± 16.3% with CR (P < .001). On average, patients experienced a modest reduction in BW (P = .03) and had higher PCS and MCS scores (P < .001 for both) after CR. The improvement in 6MWT was inversely related to initial walk distance (r = -0.465, P < .001). Patients in the lowest initial 6MWT tertile exhibited greater improvement in the 6MWT than those in the highest tertile (28 ± 20 vs 13 ± 10%, P < .001). Patients who attended 25 or more sessions demonstrated greater 6MWT (20 ± 18 vs 18 ± 14%, P = .012) and reductions in BW (-1.3 ± 2.8 vs -0.5 ± 2.5 kg, P = .003) than those attending 24 or fewer sessions. Patients exhibiting greater than 23% improvement in 6MWT lost more BW (-1.4 ± 2.9 vs -0.6 ± 2.5 kg, P = .006) and exhibited greater PCS (10.2 ± 9.8 vs 6.3 ± 9.4, P = .004) than those exhibiting <12% improvement. Conclusions: Most patients benefit physically and mentally from CR. Patients with lower initial functional ability and who attend 25 or more sessions enjoy the greatest improvements in walking ability and perception of physical health and function.