Effects of a Hybrid Model of Cardiac Rehabilitation on Patient Outcomes
- Conditions
- Cardiac SurgeryValve ReplacementCoronary Artery Bypass Graft CABGStent
- Interventions
- Other: Exercise Component Of Cardiac Rehabilitation (Hybrid Model) Intensity Recovery Progression Protocol (IRPP)
- Registration Number
- NCT06030115
- Lead Sponsor
- Good Shepherd Integrated Healthcare Systems
- Brief Summary
Determine if the standard of care at a cardiac rehabilitation center using what the investigators term to be "hybrid model" on the exercise component of cardiac rehabilitation is associated with improved adherence and outcomes. Discuss the hybrid model in comparison to traditional cardiac rehabilitation and layout a template on how to incorporate this hybrid model. Discuss factors that may lead to poor adherence and attendance to cardiac rehabilitation.
- Detailed Description
Purpose: The aim of this prospective cohort study was to determine the effectiveness of an individualized physical therapist (PT) driven hybrid model of the exercise component of cardiac rehabilitation (CR) that uses a novel intensity-recovery progression protocol (IRPP) and cardiac testing template (CTT) to assess achieved heart rate intensity (AHRI%), heart rate recovery (HRR%), and intensity-recovery total (IR%) as indicators to guide treatment.
Methods: Assessment of a subjective questionnaire, vital signs, treadmill 6-minute walk (6MW), 1-minute sit-to-stand (1STS), 1-minute step (1ST), and 1-minute agility square tests (1AST) were assessed on 100 participants during the 36-visit program. The hybrid model was led by a PT, was longer in duration, added high intensity interval training (HIIT) to continuous aerobic exercise training (CAET) and resistance training, and used a 1:1 treatment ratio. Treatment intensity and progression were measured based on clinical decision making through the IRPP and CTT.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- Underwent cardiac surgery (CABG, PCI with stent placement, and valve replacement)
- Surgery was within the previous 365 days
- Could independently ambulate into the facility.
- Implantable cardioverter defibrillator (ICD)
- Pacemaker (PPM)
- Heart Transplant
- Left ventricular assist device (LVAD)
- All other cardiac procedures not listed within inclusion criteria
- Diagnosed a-fib
- Participants who attended cardiac rehabilitation before
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Cardiac Rehab Patients Exercise Component Of Cardiac Rehabilitation (Hybrid Model) Intensity Recovery Progression Protocol (IRPP) All participants referred to the clinic meeting the inclusion and exclusion criteria who wanted to participate in the study.
- Primary Outcome Measures
Name Time Method Six Minute Walk Test Six Minutes Treadmill Six Minute Walk Test
Heart Rate Recovery (HRR%) One minute Heart rate observed one minute after outcome measurements (six minute walk test, timed sit to stand test, timed step test, timed agility square test). Completed every 5 visits from date of initiation up to 1 year after initiation or until visit 36 achieved (whichever comes first).
Timed Sit To Stand Test One Minute A standardized test measuring how many times an individual can stand from a standardized seated position in one minute using hand support to push off.
Achieved Target Heart Rate (AHRI%) One minute Heart rate achieved during outcome measurements (six minute walk test, timed sit to stand test, timed step test, timed agility square test). Completed every 5 visits from date of initiation up to 1 year after initiation or until visit 36 achieved (whichever comes first). Participants expected to attend the program at a frequency of 2x a week for 36 total visits.
Timed Step Test One Minute A test measuring how many repetitions an individual can go up and down a standardized step while using bilateral arm support on a rail.
Timed Agility Square Test One Minute Using agility ladder square to go in and out of designated two boxes
Intensity Recovery Total Score (IR%) One minute The total of the AHRI + HRR during objective measurements (six minute walk test, timed sit to stand test, timed step test, timed agility square test). Completed every 5 visits from date of initiation up to 1 year after initiation or until visit 36 achieved (whichever comes first).
Subjective Questionnaire From date of initiation of study up to 1 year after initiation. Collected on Visit 1, Visit 15, Visit 30 for each participant, who were expected to attend the program at a frequency of 2x a week for 36 total sessions. Three questions (where higher scores denote better outcomes) Question 1: Rate your endurance (using a visual analog scale from 0-100% marked every 10%)? Question 2: Estimate how many stairs you could go up using arm support before you would have to take a break? Question 3: Estimate how many hours of exercise you completed in the previous 7 days?
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Good Shepherd Integrated Healthcare Systems
🇺🇸Las Vegas, Nevada, United States