Abstract P280: Home versus Hospital-Based Exercise Training and Associated Improvements in Functional Capacity and Quality of Life in Post-event Coronary Artery Disease Patients: An Indo-Iranian Multi-center Randomized Controlled Trial
Introduction: Despite of decades of conception of Cardiac Rehabilitation (CR) programs, there is paucity on structure and effectiveness of Home-based exercise training (HmExTr) as a part of CR on functional capacity (FC) and quality of life (QOL) in post-event CAD patients. Hypothesis: Authors assessed the hypothesis that individualized HmExTr could be as effective as Hospital-based training (HsExTr) to improve FC and QOL in post-event CAD patients.
Methods: Upon Ethical Committee approval from all centers, 660 post-event CAD patients (post-CABG, PTCA and post-MI on conservative treatment) were screened in a single blinded randomized controlled trial. Low and moderate risk patients (age of 35 to 75 years old) with written informed consent were included in the study. Recruited subjects (N=180) were randomly (concealed envelope method) allocated into three groups. HsExTr (n=60) underwent exercise training three times per week in hospital. HmExTr (n=60) underwent individualized HmExTr monitored every two weeks. Control group (n=60) was given the usual medical prescription without any exercise training. FC (MET level by symptom limited Bruce protocol) and Quality of life (SF-36v2) were measured at baseline and after 12 weeks of training and data were compared using intention to treat approach. SPSS 17 was used and between/within group analysis were done using one way ANOVA by keeping level of significance at p≤0.05.
Results: Total of 180 subjects (146 Male, 34 Female) post-event CAD patients with mean age of 57.7 ± 9.3 years old enrolled in the study. At baseline there was no significant difference between groups with respect to the main outcomes. HsExTr (7.3± 1.4 to 11.5± 1.2) significantly increased FC compared to HmExTr (7.9 ± 1.7 to 11.0± 1.2) [p< 0.0001]. But there was no significant difference in changes of both physical (p=0.94) and mental (p=0.1) components of SF-36v2 between HmExTr compared to HsExTr group.
Conclusions: Individualized HmExTr could be as effective as HsExTr in improving QOL in post-event CAD patients, but HsExTr significantly improved FC when compared to HmExTr. Thus, appropriate selection of patients, and identifying the main goal of the CR for each individual patient must be kept in mind when introducing HmExTr to the post-event CAD patients.
Keyword: CAD, Exercise, Cardiac Rehabilitation, QOL, Functional Capacity
Author Disclosures: M.H. Hadadzadeh: None. A.G. Maiya: None. B. Shad: None. F. Mirbolouk: None. R. PadmaKumar: None. S.S. Borkar: None. T. Devasia: None. V.G. Raman: None. S. Nair: None. V. Guddattu: None.
- © 2015 by American Heart Association, Inc.