Factors affecting adherence to physical training in the outpatient phase of rehabilitation, in patients after coronary artery bypass grafting.
Study Goal
The researchers aimed to evaluate the effectiveness of home-based exercise (dosed walking) compared to monitored bicycle ergometer exercise in improving exercise tolerance, lipid profiles, and quality of life in post-coronary bypass patients.
Results Summary
The study found that home-based walking improved exercise tolerance, lipid concentrations, reduced obesity, decreased depression severity, and enhanced quality of life, similar to monitored bicycle exercise. However, overall adherence to physical rehabilitation programs remained low regardless of the type.
Population
67 men under 75 years old with ischemic heart disease who had undergone coronary bypass surgery.
Effective Dosage
Dosed walking (specific dosage not detailed).
Duration
3 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
3-month program of home-based physical exercise | neutral | - | patients after coronary bypass | - | demonstrated the effectiveness | #1 |
exercise on a bicycle ergometer at the rehabilitation center | increase | exercise tolerance | patients after coronary bypass | - | had increased | #2 |
home-based exercise by dosed walking | increase | exercise tolerance | patients after coronary bypass | - | had increased | #3 |
exercise on a bicycle ergometer at the rehabilitation center | increase | blood lipid concentrations | patients after coronary bypass | - | improved | #4 |
home-based exercise by dosed walking | increase | blood lipid concentrations | patients after coronary bypass | - | improved | #5 |
3-month physical rehabilitation programs | decrease | number of obese patients | patients after coronary bypass | - | decreased | #6 |
3-month physical rehabilitation programs | decrease | depression severity | patients after coronary bypass | - | decreased | #7 |
3-month physical rehabilitation programs | increase | quality of life (physical and psychological components) | patients after coronary bypass | - | improved | #8 |
3-month physical rehabilitation programs | increase | compliance with drug therapy | patients after coronary bypass | - | increased | #9 |
physical rehabilitation programs | decrease | training attendance | patients who had undergone coronary bypass | - | insufficiently adherent | #10 |
outpatient 3-month physical rehabilitation programs | neutral | - | - | - | increase the effectiveness of coronary bypass | #11 |
outpatient 3-month physical rehabilitation programs | increase | - | - | - | improved adherence to modifying cardiovascular risk factors | #12 |
outpatient 3-month physical rehabilitation programs | increase | exercise tolerance | - | - | increased | #13 |
outpatient 3-month physical rehabilitation programs | increase | - | - | - | optimization of the psychological status and quality of life | #14 |
outpatient 3-month physical rehabilitation programs | increase | compliance with drug therapy | - | - | improved | #15 |
home-based 3-month physical rehabilitation programs | no change | level of exercise tolerance | - | - | remained low | #16 |
Aim To evaluate the outpatient physical exercise (PE) compliance and the affecting factors in patients after coronary bypass (CB).Material and methods The study included 67 men with ischemic heart disease younger than 75 years who had had CB. All patients were randomized to 2 groups: group 1 exercised on a bicycle ergometer at the rehabilitation center, under the monitoring of medical staff; patients of group 2 performed home-based exercise (HBE) by dosed walking. In the preoperative period, at one month after CB, and after 3 months of exercise, the following was evaluated: clinical condition of patients in different groups, plasma concentrations of lipids, body weight index, waist circumference, echocardiography and bicycle ergometry data, and questionnaire data (SF-36, Bek's Depression Inventory). At 3 months of follow-up, the outpatient exercise compliance and the affecting factors were also evaluated.Results The study demonstrated the effectiveness of the proposed alternative 3-month program of home-based PE. Both the patients exercising on a bicycle and those performing HBE had increased exercise tolerance (ET) and improved blood lipid concentrations. The number of obese patients decreased. Also, depression severity decreased, quality of life (physical and psychological components) improved, and compliance with drug therapy increased in both groups. Analysis of the training attendance in the recommended period showed that patients who had undergone CB were insufficiently adherent to physical rehabilitation programs, regardless of the program type (home-based or monitored). The highest PE adherence was observed in men with the following characteristics: married, working urban residents, with a previous history of cardiovascular diseases, who had regularly taken medications in the preoperative period, and who also had higher quality of life.Conclusion The proposed outpatient 3-month physical rehabilitation programs increase the effectiveness of CB, which is evident as improved adherence to modifying cardiovascular risk factors, increased ET, optimization of the psychological status and quality of life, and improved compliance with drug therapy. However, despite the proposed alternative, home-based 3-month physical rehabilitation programs aimed at increasing the treatment compliance, the level of ET remained low. This requires further improvement of methods for monitoring and motivation of patients to physical rehabilitation and psychological support that would start already at the preoperative stage.