Performance Measures for Short-Term Cardiac Rehabilitation in Patients of Working Age: Results of the Prospective Observational Multicenter Registry OutCaRe.
Beate Zoch-Lesniak, Jeanette Dobberke, Axel Schlitt and 6 others
PMID 33543072WHAT IT FOUND
During short-term cardiac rehab for patients under 65, smoking status, blood pressure, exercise training load, well-being, depression, physical health and self-rated health prognosis changed and were recorded often enough to track immediate outcomes.
Key findings
01Smoking behavior, lifestyle change motivation, systolic and diastolic blood pressure, endurance training load, PHQ-9, WHO-5, IRES-24 physical health, mental health and pain, and self-assessed health prognosis met the study's criteria for feasible and modifiable performance measures.
02Smoking behavior fell from 37.9% at admission to 18.2% at discharge, and endurance training load improved by 21.1 watts.
03Pension desire and work capacity did not meet the study's change criterion, and no occupational measure was considered suitable for 3-week cardiac rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was observational and did not compare patients with a control group, so pre-post changes cannot show that cardiac rehabilitation caused improvement. Patients received cardiologist counseling, risk-factor modification strategies, exercise training and sports therapy, psychosocial interventions, and vocational assessment and counseling together, so the contribution of any single component cannot be separated. Blood pressure, LDL cholesterol, fasting glucose and other non-questionnaire measures were not standardized across clinics and could differ between centers. Some clinics recruited a convenience sample rather than checking all eligible patients, which may have introduced selection bias. The thresholds for feasibility and modifiability were chosen by the researchers rather than being fixed by an external standard. Many parameters had missing data, so they were not feasible for routine performance measurement. Smoking behavior was self-reported and could have been misclassified. The study did not assess reliability of the quality indicators, such as agreement between different assessors. Participants were younger than 65 years, mostly in inpatient cardiac rehabilitation in Germany, so results may not transfer to older patients, outpatient programs or other countries.
The easy way to misread this
Do not read the pre-post changes as proof that cardiac rehabilitation caused improvement. Patients received cardiologist counseling, risk-factor modification strategies, physician-supervised exercise training and sports therapy, psychosocial interventions, and vocational assessment and counseling together, and the study had no control group.