Cardiac rehabilitation for women: a systematic review.

PURPOSE

Current cardiac rehabilitation (CR) evidence was systematically evaluated to identify program components that may yield improvements in physiological and psychosocial outcomes in women.

METHODS

A search was conducted in the electronic databases: MEDLINE, Embase, CINAHL, Scopus, Sport Discus and Cochrane Library. Search terms included women, heart disease, exercise therapy, and cardiac rehabilitation. A systematic elimination process was used with specific inclusion/exclusion criteria. Included articles were independently evaluated by four reviewers for level of evidence and internal validity. Specific recommendations were made based on trends in the literature and strength of supporting evidence.

RESULTS

Thirty-seven articles were included with a combined sample of 3,807 subjects. Ten studies included an analysis of physiological effects of exercise. Aerobic, resistance, and combined exercise interventions all yield physiological benefits. CR yielded favourable health-related quality of life outcomes and women benefited from psychosocial support in both formal and informal environments.

CONCLUSIONS

The following recommendations are based on the review: 1) For patients with good cardiac function, community/home-based programs are as effective as supervised programs (Level II, B); 2) resistance training should be included as an adjunct to aerobic training (Level I, A); 3) programs need to address the specific educational needs of women (Level I, A) and a stronger emphasis needs to be placed on social support (Level II, B).