Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Effects of comprehensive cardiac rehabilitation on functional capacity in a middle-income country: a randomised controlled trial [with consumer summary]
da Silva Chaves GS, de Melo Ghisi GL, Grace SL, Oh P, Ribeiro AL, Britto RR
Heart 2019 Mar;105(5):406-413
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Despite the growing epidemic of cardiovascular diseases in middle-income countries, there is insufficient evidence about cardiac rehabilitation (CR) in these countries. Thus, the effects of comprehensive CR on functional capacity and risk factors were investigated in Brazil, to test the hypothesis that it results in better outcomes than exercise-only or no CR. METHODS: Single-blinded, randomised controlled trial with three parallel arms: comprehensive CR (exercise plus education) versus exercise-only CR versus wait-list control. Eligible coronary patients were randomised in blocks of four with 1:1:1 concealed allocation. Participants randomised to exercise-only CR received 36 exercise classes; comprehensive CR group also received 24 educational sessions. The primary outcome was incremental shuttle walk test (ISWT) distance; secondary outcomes were cardiovascular risk factors. All outcomes were assessed at baseline and 6 months later. Analysis of covariance was performed on the basis of intention-to-treat (ITT) and per-protocol. RESULTS: 115 (88.5%) patients were randomised; 93 (80.9%) were retained. There were improvements in ISWT distance from pretest to post-test with comprehensive (from 358.4 +/- 132.6 to 464.8 +/- 121.6 m; mean change 106.4; p < 0.001) and exercise-only (from 391.5 +/- 118.8 to 488.1 +/- 106.3 m; mean change 96.5, p < 0.001) CR, with significantly greater functional capacity with comprehensive CR versus control (ITT mean difference 75.6 +/- 30.7 m, 95% CI 1.4 to 150.2). There were also reductions in systolic blood pressure with comprehensive CR (ITT reduction of 6.2 +/- 17.8 mmHg, p = 0.04). There were no significant differences for other outcomes. CONCLUSION: Results showed clinically significant improvements in functional capacity and blood pressure with CR, and significantly greater functional capacity with comprehensive CR compared with usual care. TRIAL REGISTRATION NUMBER: NCT02575976.
Reproduced with permission from the BMJ Publishing Group.

Full text (sometimes free) may be available at these link(s):      help