Key result
Exercise-based cardiac rehabilitation yields moderate improvements in objectively measured physical activity and sedentary behavior.
Why the study?
Adequate physical activity after cardiac rehabilitation is required to reduce secondary cardiovascular risk, but its effect on objectively measured physical activity and sedentary behavior needed evaluation.
Does exercise-based cardiac rehabilitation improve objectively measured physical activity and sedentary behavior in adults with cardiovascular disease?
Meta-Analysis (n=1,434)
Does exercise-based cardiac rehabilitation improve objectively measured physical activity and sedentary behavior in adults with cardiovascular disease?
Participation in exercise-based cardiac rehabilitation programs leads to modest but significant improvements in objectively measured physical activity and reductions in sedentary behavior.
Answers are grounded in this paper and cite their sources.
Supports routine referral to exercise-based cardiac rehabilitation to boost activity in CVD; reinforces meta-analytic evidence with objective measures versus controls and at follow-up.
Objective: Adequate physical activity following cardiac rehabilitation (CR) is required to reduce secondary cardiovascular disease risk. The aim of this review and meta-analysis was to determine the effect of exercise-based CR on objectively measured physical activity (PA) and sedentary behavior (SB) comparing pre- to postintervention, pre- to postchange compared to a control group, and in a longer term follow-up. Methods: Five databases were searched (PubMed, MEDLINE [OVID], Scopus, SPORTDiscus, and CINAHL) from inception to January 2019. Two reviewers screened and selected 15 studies involving 1434 participants. Data were synthesized descriptively and by meta-analyses. Results: CR resulted in an improvement in activity behaviors compared with preintervention levels (standardized mean difference [SMD] 0.50, 95% CI 0.25-0.55, P < .0001). CR resulted in a greater improvement in activity behaviors in the intervention compared with the control group (SMD 0.25, 95% CI 0.02-0.49, P = .04). Increased PA was maintained (SMD 0.32, 95% CI 0.22-0.41, P < .0001). Eight out of 15 studies showed an improvement in PA outcomes while 7 reported that objectively measured PA did not change immediately following the intervention compared to preintervention levels and/or compared with the control group. Of the 7 studies that reported changes in SB, 4 observed a reduction following CR while 3 reported no change. Conclusion: Participation in exercise-based CR programs is effective in improving PA and SB. However, our descriptive synthesis indicates that only half the studies were successful in improving activity behaviors following exercise-based CR. Standard guidelines for the assessment of activity behaviors following CR would be valuable in understanding of the effects of CR on long-term activity participation.
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Meiring et al. (2020) conducted a meta-analysis in Cardiovascular disease (heart failure, coronary artery disease, acute coronary syndrome) (n=1,434). Exercise-based cardiac rehabilitation vs. Preintervention levels or non-exercise control group was evaluated on Change in objectively measured activity behaviors (physical activity and sedentary behavior) comparing pre- to postintervention (SMD 0.50, 95% CI 0.25-0.55, p=<0.0001). Exercise-based cardiac rehabilitation significantly improved objectively measured physical activity and sedentary behavior compared with preintervention levels (SMD 0.50).
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