Key result
Out-of-hospital cardiac rehab shows no difference in functional capacity versus in-hospital programs in an underpowered trial.
Why the study?
To analyze the effects of an outpatient cardiac rehabilitation program in a municipal sports center on functional capacity and exercise adherence compared to an in-hospital program.
Does an out-of-hospital cardiac rehabilitation program in a municipal sports center improve functional capacity, exercise adherence, and cardiovascular risk markers in patients with low- to moderate-risk ACS compared to a hospital-based program?
RCT (n=22)
Open-label
1:1
No
Does an out-of-hospital cardiac rehabilitation program in a municipal sports center improve functional capacity, exercise adherence, and cardiovascular risk markers in patients with low- to moderate-risk ACS compared to a hospital-based program?
Answers are grounded in this paper and cite their sources.
An out-of-hospital cardiac rehabilitation program in a municipal sports center showed mixed but largely comparable physiological effects compared to standard hospital-based rehabilitation in ACS patients, though results are severely limited by low statistical power from COVID-19 dropouts.
BACKGROUND: This study aimed to analyze the effects of an outpatient cardiac rehabilitation program in a municipal sports center on functional capacity and adherence to physical exercise - among other variables - compared to an in-hospital program. METHODS: Randomized clinical trial that included two parallel groups of acute coronary syndrome patients who performed a cardiac rehabilitation program that consisted of moderate physical exercise intervals along with learning healthy habits in a municipal sports center (experimental group) and in a tertiary hospital (control group) between September 2019 and June 2020. We collected the following data: compliance, anthropometrical, clinical, psychological variables, diet and tobacco habits, strength and functional capacity from ergospirometry. RESULTS: Twenty-two patients completed the cardiac rehabilitation program (experimental group=12, control group=10). Significant improvement was observed for cholesterol, the sit-and-stand test, cardiac frequency in VT1 and VT2, and watts in VT1 in the control group, and for HDL-cholesterol, triglycerides, the sit-and-stand test, and frequency, and watts in VT1 in the experimental group. Better achievement was found in the control group for cardiac frequency in VT2 (11.17 vs 2.88 bpm) and in EG for HDL-cholesterol (11.0 vs 0.63 mg/dL). CONCLUSIONS: We are unable to determine the effectiveness of the out-of-hospital cardiac rehabilitation program due to a lack of power (high number of withdrawals caused by COVID-19 lockdown). However, the experimented group achieved higher HDL-cholesterol levels, while cardiac frequency in VT2 was higher in the control group.
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Izquierdo-García et al. (2023) conducted an RCT in Acute coronary syndrome (n=22). Outpatient cardiac rehabilitation program in a municipal sports center vs. In-hospital cardiac rehabilitation program was evaluated on Functional capacity (change in maximum VO2 in mL/kg/min) (p=0.170). An out-of-hospital cardiac rehabilitation program in a municipal sports center showed no significant difference in functional capacity or physical activity adherence compared to an in-hospital program, though the study was severely underpowered due to COVID-19 dropouts.
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