Fast-track equivalent to traditional cardiac rehabilitation? Pilot study outcome
Sammanfattning
The exercise dose required to achieve benefits from cardiac rehabilitation (CR) is unknown and
benefits
may be independent of exercise supervision frequency. This randomized pilot study examined
equivalence
in two CR models, hypothesizing 10% difference between models. Subjects undertook 6 weeks
of supervised low-/moderate-intensity exercise training. Fast-track (n ¼ 25) included once-weekly
exercise
sessions and a one-off 7 h education session. Traditional (n ¼ 36) included twice-weekly exercise
and education sessions. Six-Minute Walk Test distance (6MWD), Timed Up and Go test time (TUGTT),
Depression, Anxiety and Stress Scale (DASS-21) score and secondary outcomes were assessed
pre-CR,
post-CR and 6 months post-CR. Attendance was 100%, 79% and 82%, respectively. Missing data were
imputed using last-observation-carried-forward methodology. Although intention-to-treat analysis
found
minimal between-group differences [7 m, p ¼ 0.76 (6MWD); 0.27 s, p ¼ 0.35 (TUGTT); and 14.6, p ¼
0.09
(DASS-21)] and similar proportions of subjects achieved a minimal clinically important difference and
predicted values for 6MWD and TUGTT post-CR, the effect size was greater for fast-track subjects. A
> 10% difference was noted for several secondary outcomes, mostly in favour of the traditional
CR model. In conclusion, this pilot study identifies appropriate methodology to assess equivalence
in
CR models and suggests that one supervised exercise session may be as effective as two sessions
for
common outcome measurements.