Objectives: Cardiac rehabilitation programs (CRPs) aim to restore, maintain, or improve both physiologic and psychosocial health outcomes. Different formats of programs might yield different outcomes. We evaluated the impact of different CRP formats on changes in health-related quality of life (HRQOL), functional capacity, and exercise behavior over the course of a 12-week rehabilitation phase.
Methods: Participants were 1,582 cardiac patients (73% male; M age = 61) entering 1 of 3 formal 12-week exercise-based CRP options: supervised on-site program (OS), case-managed home program (CS), or unsupervised tailored home program (HP) at the University of Ottawa Heart Institute. Participants completed a questionnaire that included the Short Form-36 Health Survey (SF-36), Hospital Anxiety and Depression Scale, and demographic variables at baseline and at a 3-month follow-up. Exercise behavior and functional capacity (VO2max) were assessed at same time points. The SF-36 examines 8 health concepts: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH).
Results: Participants in OS were younger (OS: 73% male; M age = 62; CS: 72% male; M age = 60; HP: 82% male; M age = 59) and had better HRQOL, mental health, and functional capacity profiles at intake compared to the other 2 groups.
Mixed linear modeling revealed significant improvements over the course of the 12-week rehabilitation period in PF, RP, RE, and MH, and reductions in BP for all 3 groups (P < .01). These changes were not mediated by changes in functional capacity, although improvements in functional capacity were observed in all groups (P < .001). The amount of time participants reported walking was significantly reduced once they completed the formal CRP phase (P < .001). Positive changes were also observed in physiological measures including reductions in weight, total cholesterol and LDL, and improvements in HDL. Reductions in depression were observed for all 3 groups and in anxiety for the OS and CS groups.
Conclusions: Consistent with previous studies, our results demonstrate improved HRQOL outcomes for participants of comprehensive CRPs. The results also highlight the different profiles of cardiac patients opting for different CRP options. While our results show simultaneous improvements in functional capacity and physiological outcomes, future research should more directly examine the physiological and clinical factors that mediate the changes in HRQOL outcomes and the predictors of behavior maintenance beyond a formal "rehabilitation period."