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Heart Lung. 2018 Aug 6. pii: S0147-9563(18)30188-2. doi: 10.1016/j.hrtlng.2018.07.007. [Epub ahead of print]

Examination of clinical and psychosocial determinants of exercise capacity change in cardiac rehabilitation.

Author information

1
Centers for Preventive and Behavioral Medicine, The Miriam Hospital, 1 Hoppin St, Providence, RI 02903, United States; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02903, United States. Electronic address: Emily_Gathright@brown.edu.
2
Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02903, United States; The Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States; Providence Veterans Affairs Medical Center, Providence, RI 02908, United States.
3
Department of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Providence, RI 02903, United States.
4
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, United States; Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States; Minneapolis Medical Research Foundation, Minneapolis, MN 55404, United States.
5
The Miriam Hospital's Center for Cardiac Fitness, 208 Collyer St, Providence RI 02904, United States.
6
Providence Veterans Affairs Medical Center, Providence, RI 02908, United States; The Miriam Hospital's Center for Cardiac Fitness, 208 Collyer St, Providence RI 02904, United States; Department of Medicine, Alpert Medical School, Brown University, Providence, RI 02903, United States.

Abstract

PURPOSE:

Most cardiac rehabilitation (CR) completers improve in multiple functional and psychosocial domains. However, not all demonstrate uniform improvement in functional indicators such as exercise capacity. This study examined baseline predictors and correlates of change in exercise capacity from CR intake to completion.

METHODS:

CR participants (n = 488) completed assessment of metabolic equivalents (METs) via treadmill stress test, depressive symptoms, quality of life, and social support at intake and discharge. Associations between demographic, clinical, and psychosocial factors and MET changes was tested with linear regression.

RESULTS:

METs increased from intake to discharge (1.91 ± 1.48, p < .001). Younger age (p < .001), lower BMI (p < .001), and lower weight (p < .01) were associated with greater MET change. Greater percentage weight loss (p < .05), and self-reported improvements in physical functioning (p < .001) and bodily pain (p < .01) were concurrently related to MET change.

CONCLUSIONS:

Older CR attendees and those with higher baseline BMI may benefit from tailored intervention to ensure maximum benefit in exercise capacity.

KEYWORDS:

Cardiac rehabilitation; Exercise capacity; Metabolic equivalents

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