Ramadi Ailar, Haennel Robert G, Stone James A, Arena Ross, Threlfall Tyler G, Hitt Elizabeth, Aggarwal Sandeep G, Haykowsky Mark, Martin Billie-Jean
Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada (Ms Ramadi, Drs Haennel and Haykowsky); Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada (Drs Stone, Aggarwal, and Martin); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (Dr Arena); Total Cardiology Rehabilitation and Risk Reduction Center, Calgary, Alberta, Canada (Drs Stone and Aggarwal, Mr Threlfall, Ms Hitt); and Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada (Drs Stone and Aggarwal).
J Cardiopulm Rehabil Prev. 2015 Jan-Feb;35(1):21-8. doi: 10.1097/HCR.0000000000000084.
Although participation in either center- or home-based cardiac rehabilitation (CR) can improve exercise capacity, the sustainability of this improvement following completion of the CR program is challenging. The purpose of this study was to compare the immediate and 1-year effectiveness of center- versus home-based CR on exercise capacity in cardiac patients who were given the choice of participating in a center-based or home-based CR program.
This was a retrospective study, which relied on the database from a large multidisciplinary CR program. A sample of 3488 cardiac patients participated either in center-based (n = 2803) or home-based (n = 685) CR. Participants underwent exercise testing at baseline, after 12 weeks of CR and again 1 year after completion of the CR programs.
Following CR, exercise capacity (ie, peak metabolic equivalents [METs]) increased significantly in both groups (P < .05). From post-CR to the 1-year followup, exercise capacity remained unchanged in home-based CR participants (P = .183), whereas the center-based CR group demonstrated a decline in exercise capacity (P < .05).
Although at the 1-year followup exercise capacity decreased in the center-based group, the observed decline did not seem to be clinically significant. The present findings indicate that when the patients were given a choice as to the delivery model (center- vs home-based) used for their CR program, they were relatively successful in retaining the improvement in exercise capacity 1 year post-CR irrespective of the exact location for their exercise training.
尽管参加中心式或居家心脏康复（CR）均可提高运动能力，但CR项目结束后这种改善的可持续性颇具挑战。本研究旨在比较中心式与居家式CR对可选择参加中心式或居家式CR项目的心脏病患者运动能力的即时及1年效果。
这是一项回顾性研究，依赖于一个大型多学科CR项目的数据库。3488名心脏病患者样本参加了中心式（n = 2803）或居家式（n = 685）CR。参与者在基线、CR 12周后以及CR项目完成1年后再次接受运动测试。
CR后，两组的运动能力（即峰值代谢当量[METs]）均显著增加（P < .05）。从CR后到1年随访，居家式CR参与者的运动能力保持不变（P = .183），而中心式CR组的运动能力有所下降（P < .05）。
尽管在1年随访时中心式组的运动能力有所下降，但观察到的下降似乎并无临床意义。目前的研究结果表明，当患者可以选择其CR项目所采用的实施模式（中心式与居家式）时，无论其运动训练的确切地点如何，他们在CR后1年相对成功地保持了运动能力的改善。
