Effects of comprehensive cardiac rehabilitation on functional capacity in a middle-income country: a randomised controlled trial

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dc.creatorGabriela Suellen da Silva Chaves
dc.creatorGabriela Lima de Melo Ghisi
dc.creatorSherry Grace
dc.creatorPaul Oh
dc.creatorAntonio Luiz Pinho Ribeiro
dc.creatorRaquel Rodrigue Britto
dc.date.accessioned2022-05-12T17:12:32Z
dc.date.accessioned2025-09-08T23:17:30Z
dc.date.available2022-05-12T17:12:32Z
dc.date.issued2019
dc.description.sponsorshipCNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
dc.description.sponsorshipFAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.description.sponsorshipOutra Agência
dc.identifier.doihttp://dx.doi.org/10.1136/heartjnl-2018-313632
dc.identifier.issn1468-201X
dc.identifier.urihttps://hdl.handle.net/1843/41609
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofHeart
dc.rightsAcesso Restrito
dc.subjectReabilitação cardíaca
dc.subjectCapacidade funcional
dc.subjectPaíses em desenvolvimento
dc.subjectCardiopatias
dc.titleEffects of comprehensive cardiac rehabilitation on functional capacity in a middle-income country: a randomised controlled trial
dc.typeArtigo de periódico
local.citation.epage413
local.citation.issue5
local.citation.spage406
local.citation.volume105
local.description.resumoObjective: Despite the growing epidemic of cardiovascular diseases in middle-income countries, there is insufficient evidence about cardiac rehabilitation (CR) in these countries. Thus, the effects of comprehensive CR on functional capacity and risk factors were investigated in Brazil, to test the hypothesis that it results in better outcomes than exercise-only or no CR. Methods: Single-blinded, randomised controlled trial with three parallel arms: comprehensive CR (exercise+education) versus exercise-only CR versus wait-list control. Eligible coronary patients were randomised in blocks of four with 1:1:1 concealed allocation. Participants randomised to exercise-only CR received 36 exercise classes; comprehensive CR group also received 24 educational sessions. The primary outcome was incremental shuttle walk test (ISWT) distance; secondary outcomes were cardiovascular risk factors. All outcomes were assessed at baseline and 6 months later. Analysis of covariance was performed on the basis of intention-to-treat (ITT) and per-protocol. Results: 115 (88.5%) patients were randomised; 93 (80.9%) were retained. There were improvements in ISWT distance from pretest to post-test with comprehensive (from 358.4±132.6 to 464.8±121.6 m; mean change=106.4; p<0.001) and exercise-only (from 391.5±118.8 to 488.1±106.3 m; mean change=96.5, p<0.001) CR, with significantly greater functional capacity with comprehensive CR versus control (ITT: mean difference=75.6±30.7 m, 95% CI 1.4 to 150.2). There were also reductions in systolic blood pressure with comprehensive CR (ITT: reduction of 6.2±17.8 mm Hg, p=0.04). There were no significant differences for other outcomes. Conclusion: Results showed clinically significant improvements in functional capacity and blood pressure with CR, and significantly greater functional capacity with comprehensive CR compared with usual care.
local.identifier.orcidhttps://orcid.org/0000-0001-7946-3718
local.identifier.orcidhttps://orcid.org/0000-0001-7063-3610
local.identifier.orcidhttps://orcid.org/0000-0002-0603-6958
local.identifier.orcidhttps://orcid.org/0000-0002-2740-0042
local.identifier.orcidhttp://orcid.org/0000-0002-9533-3654
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://heart.bmj.com/content/105/5/406

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