PT Critically Appraised Topics
 

Document Type

Critically Appraised Topic

Publication Date

2010

Clinical Scenario

At the acute care hospital I am currently doing my clinical rotation, I have had the opportunity to work on the Cardiac Intensive Care Unit. On this floor, I have worked with many patients who have undergone open heart surgery. With this, the patients are provided with education including information on Cardiac Rehabilitation Phase II. I have found that many of these patients live over 60 miles from Reno. Many of these same patients do not attend Cardiac Rehabilitation Phase II because of the distance barrier and time commitment to drive over an hour one-way to participate in one hour’s worth of a supervised exercise protocol, since all three of the cardiac rehabilitation centers in northwestern Nevada are in the Reno-Sparks area. This led me to wonder if a home cardiac rehabilitation type program exists for patients following an acute cardiac event to participate in when they live in a more rural setting. This led me to my clinical question of whether there are similar benefits in aerobic capacity and exercise adherence following completion of a cardiac rehabilitation program whether it is home-based or hospital-based.

Clinical Question

Are there similar benefits in aerobic capacity and quality of life following completion of a cardiac rehabilitation program whether it is home-based or hospital-based?

Clinical Bottom Line

Overall, both articles closely matched my clinical question comparing exercise capacity and quality of life in both a hospital-based and home-based Cardiac Rehabilitation program following an acute cardiac event. Both articles demonstrated that there was no clinically important difference between groups for exercise capacity. Therefore it is inconclusive as to whether one group (hospital-based or home-based Cardiac Rehabilitation) is more effective in improving exercise capacity for patients who have had an acute cardiac event. Further studies with larger sample sizes and including a wider range of patients following an acute cardiac event need to be done for more conclusive results. At this point, home-based Cardiac Rehabilitation should be considered as an alternate to hospital-based Cardiac Rehabilitation for patients with mild to moderate cardiac risk factors who may have more difficulties attending a hospital program.

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