A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society.

This was a secondary analysis of a trial designed for cardiovascular outcomes, not for functional capacity, fatigue, or participation, so the findings are exploratory and could partly reflect chance. Patients excluded from analysis were younger, more likely to smoke, and less likely to use statins, so results may apply mainly to more adherent patients. Patients and testers were not blinded, which could affect self-reported fatigue and participation. The face-to-face program included group exercise and lifestyle counseling coached by different professionals, so the contribution of any single component cannot be separated. The walking gain was not maintained at 18 months. The participation restriction score was heavily skewed, so it was simplified for analysis.

The authors declared no conflicts. The study was co-financed by Capri Cardiac Rehabilitation Rotterdam, which financed the face-to-face counseling intervention, and by Zilveren Kruis healthcare insurance, which financed the telephonic counseling intervention.

Do not read the 12.49 m walking gain as proof that lifestyle counseling alone works. The face-to-face program also included group exercise, and the gain was not present at 18 months.