Comprehensive cardiac rehabilitation significantly improved disease-related knowledge (MD 9.54) and self-reported exercise (MD 7.6) compared to wait-list control in patients with coronary artery disease.
RCT (n=115)
Single-blinded
Blocks of four with 1:1:1 concealed allocation
No
Does comprehensive cardiac rehabilitation improve disease-related knowledge, depressive symptoms, and heart-health behaviors compared to exercise-only rehabilitation or wait-list control in patients with coronary artery disease?
Comprehensive cardiac rehabilitation combining exercise and education significantly improves disease-related knowledge, exercise habits, and diet compared to exercise alone or wait-list control in patients with coronary artery disease.
Effect estimate: MD 9.54 (95% CI 2.31-16.77)
PURPOSE: The impact of comprehensive cardiac rehabilitation (CCR) in Latin America is not well known. Herein, the pre-specified tertiary outcomes of a cardiac rehabilitation (CR) trial are reported: disease-related knowledge, depressive symptoms, and heart-health behaviors (exercise, diet, and smoking). METHODS: This was a single-blinded, single-center (Brazil) randomized trial with three parallel arms: CCR (exercise + education) versus exercise-only CR versus wait-list control. Eligible patients were randomized in blocks of four with 1:1:1 concealed allocation. The CR program was 6 mo long. Participants randomized to exercise-only CR received 36 exercise classes; the CCR group also received 24 educational sessions, including a workbook. All outcomes were assessed at pre-test and 6-mo later (blinded). Analysis of covariance was performed by intention-to-treat (ITT) and per-protocol (PP). RESULTS: A total of 115 (89%) patients were randomized; 93 (81%) were retained. There were significant improvements in knowledge with CCR (ITT 51.2 ± 11.9 pre and 60.8 ± 13.2 post and PP; P < .01), with significantly greater knowledge with CCR versus control (ITT mean difference MD = 9.5, 95% CI, 2.3-16.8) and CCR vs exercise-only CR at post-test (ITT MD = 6.8, 95% CI, 0.3-14.0). There were also significant improvements in self-reported exercise with CCR (ITT 13.7 ± 15.8 pre and 32.1 ± 2 5.7 post and PP; P < .001), with significantly greater exercise with CCR versus control at post-test (ITT MD = 7.6, 95% CI, 3.8-11.4). Also, there were significant improvements in diet with CCR (PP: 3.4 ± 7.5 pre and 8.0 ± 7.0 post; P < .05). CONCLUSIONS: In this first-ever randomized trial of CR for coronary artery disease in Latin America, the benefits of CCR have been supported.
Ghisi et al. (Wed,) conducted a rct in Coronary artery disease (n=115). Comprehensive cardiac rehabilitation (CCR) vs. Exercise-only CR and wait-list control was evaluated on Disease-related knowledge (CADE-Q II score) (MD 9.54, 95% CI 2.31-16.77). Comprehensive cardiac rehabilitation significantly improved disease-related knowledge (MD 9.54) and self-reported exercise (MD 7.6) compared to wait-list control in patients with coronary artery disease.