Cardiac rehabilitation is a well-established part of the management of individuals in the period after a heart attack or similar event, or after a cardiac diagnosis. It is based on the simple premise that the heart is a muscle that needs to be re-conditioned after it has been injured or stressed.

Cardiac rehabilitation can reduce the likelihood of hospital readmission, reduce the risk of further events including death, and improve quality of life. Whilst the basis of this is via the re-training of the heart via exercise prescription, the scope of programmes is much broader than this. Programmes include lifestyle education and behavioural change, as well as assistance to overcome the mental challenges that come after a cardiac diagnosis.

Improved survival rates

Irrespective of diagnosis, cardiac rehabilitation has been shown to improve survival rates. A cohort study of over 35,000 Dutch patients, of whom just over 30% undertook cardiac rehabilitation showed a substantial survival benefit in the rehab group out to 4 years – the duration of the study. The death-rate was three-times lower in the group that underwent rehabilitation when compared to the group that didn’t. Similar benefits have been shown in studies in North America – including survival benefits out to 10 years in one study. While there may be some groups, like all exercise based-interventions, who are poor- or non-responders, survival rates appear to be the most reliably improved statistic across multiple studies.

Reduction in readmission and improvement in fitness

Yet it’s not all about living longer – it’s about living ‘better.’ Whilst not shown as consistently as the survival benefits, cardiac rehab has repeatedly been shown to reduce hospital re-admission rates and improve physical fitness. The latter is associated with improved quality of life, which makes sense - being fitter allows you to do more of what you love.

If you're interested in reading more, some of the studies and articles we have discussed are referenced below.

 


 

Axis Exercise Clinic

Cardiac rehabilitation is a key part of a holistic recovery after a cardiac event. Could your patient benefit from a prescribed and monitored exercise programme? Our specialist Exercise Clinic is the perfect solution. Not only are all our programmes tailor-made for each patient taking into consideration their condition, but they will have access to a state of the art gym and monitored exercise sessions to help them through the programme.

If this sounds like something you or your patient could benefit from, make an appointment to come in and see us.

To make an appointment call 09 521 9846

 

References
1. The National Heart Foundation of New Zealand. Cardiac Rehabilitation [Internet]. New Zealand: The National Heart Foundation; 2020 [updated 2020; cited 2020 November 15]. Available from: https://www.heartfoundation.org.nz
2. Han de Vries, Hareld M.C. Kemps, Mariette M. van Engen-Verheul, Roderik A. Kraaijenhagen, Niels Peek, Cardiac rehabilitation and survival in a large representative community cohort of Dutch patients, European Heart Journal, Volume 36, Issue 24, 21 June 2015, Pages 1519–1528, https://doi.org/10.1093/eurheartj/ehv111
3. Suaya JA Stason WB Ades PA Normand SL Shepard DS . Cardiac rehabilitation and survival in older coronary patients. J Am Coll Cardiol2009;54:25–33.
4. Martin BJ Hauer T Arena R Austford LD Galbraith PD Lewin AM Knudtson ML Ghali WA Stone JA Aggarwal SG . Cardiac rehabilitation attendance and outcomes in coronary artery disease patients. Circulation2012;126:677–687.
5. Pack QR, Goel K, Lahr BD, Greason KL, Squires RW, Lopez-Jimenez F, Zhang Z, Thomas RJ. Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community-based study. Circulation. 2013 Aug 6;128(6):590-7. doi: 10.1161/CIRCULATIONAHA.112.001365. Epub 2013 Jul 8. PMID: 23836837.
6. Alban De Schutter, Sergey Kachur, Carl J Lavie, Arthur Menezes, Kelly K Shum, Sripal Bangalore, Ross Arena, Richard V Milani, Cardiac rehabilitation fitness changes and subsequent survival, European Heart Journal - Quality of Care and Clinical Outcomes, Volume 4, Issue 3, July 2018, Pages 173–179, https://doi.org/10.1093/ehjqcco/qcy018
7. Rosenberg, Karen; Zolot, Joan PA Cardiac Rehabilitation Improves Survival but Not Health Status After AMI, AJN, American Journal of Nursing: March 2017 - Volume 117 - Issue 3 - p 70 doi: 10.1097/01.NAJ.0000513295.96451.8c
8. Franklin BA, Lavie CJ, Squires RW, Milani RV. Exercise-based cardiac rehabilitation and improvements in cardiorespiratory fitness: implications regarding patient benefit. Mayo Clin Proc. 2013 May;88(5):431-7. doi: 10.1016/j.mayocp.2013.03.009. PMID: 23639495.
9. Graham HL, Lac A, Lee H, Benton MJ. Predicting Long-Term Mortality, Morbidity, and Survival Outcomes Following a Cardiac Event: A Cardiac Rehabilitation Study. Rehabilitation Process and Outcome. January 2019. doi:10.1177/1179572719827610

 

By Dr Dan Exeter on