Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Introduction
The ultimate aim of cardiac rehabilitation is to achieve and maintain
the optimal physical and psychosocial health of the patient (Coats
AJ, SIGN 2002, De Backer 2004). Traditionally cardiac rehabilitation
is made up of 4 phases. Outpatient formal cardiac rehabilitation
programmes occur usually 4-6 weeks cardiac post event and take
the form of a formal education and exercise programme and is
typically referred to as Phase III cardiac rehabilitation (Thow 2006).
The positive effect of participation in cardiac rehabilitation
programmes has long been established (Thompson & Bowman
1998, Kotseva et al 2004, Joliffe et al 2006) and physical fitness has
been shown to improve significantly over the course of cardiac
rehabilitation programmes (Gulanick et al 2002, Dugmore et al.
1999, Shiran 1997, Lavie & Milani 2005, Turner et al 2002). There
is great variation in the level of fitness of patients entering cardiac
rehabilitation and initial exercise capacity has been shown in some
instances to be a predictor of significant improvement in fitness
(Shiran et al 1997, Pierson et al 2004, Balady et al 1996).
The objectives of this study were to determine:
� The improvements in fitness of patients over cardiac
rehabilitation programmes
� If there was a difference in improvements in the difference
fitness categories
Methods:
This study was a single site, practice based, longitudinal
observational investigation of patients before and after attending a
structured cardiac rehabilitation programme. Over the time frame of
the study 329 patients commenced cardiac rehabilitation. All
patients who completed the full cardiac rehabilitation programme,
including the exercise sessions and who completed and returned at
least one SF-36 questionnaire ( a parallel study) are included in this
analysis, a total of 187 patients. Within this patient group data
collection was still not always complete so the sample number
varies within the analysis.
Cardiac rehabilitation programme: The patients attended the
rehabilitation programme for up to 18 days over a 6 or 8 week
period. Each day the patient had a supervised group exercise
session based on individualised exercise prescription and an
educational session on selected aspects of secondary prevention.
Fitness testing: Prior to entry into the programme patients
underwent an exercise stress test. These tests were used for
several functions; diagnostics, exercise prescription, risk
assessment and for this project, fitness assessment and progress.
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