We’ve reviewed the results of the three RCTs assessing the effect of cardiac
rehabilitation on various functional measures. The specific measures discussed include peak VO2 and Total Work Capacity (TWC). We will first discuss the measure of peak VO2 and then move on to discuss the measure of TWC.
Both of the studies which assess peak VO2 favor cardiac rehabilitation. Moreover, both Lee et al. and Giallauria et al. report a statistically significant increase in peak VO2 in the CR group compared to the control group.48,50
The specific percent improvement in peak VO2 does vary somewhat, with Lee et al, reporting a 12.6% improvement while Giallauria et al. report a 23.3% improvement. 48 (p1398-1399), 50(p628) For various reasons, it is difficult to compare the percent improvement in peak VO2 across studies. First, the patient populations in these two studies are quite different, particularly in terms of participant age, sex, and fitness level.48 (p1397-
1398), 50(p626-628)
Second, the interventions themselves are somewhat different.48 (p1396), 50(p627) And third, the sample size for both studies is quite small, with only 39 total participants in Lee et al.’s study and 44 total participants in Giallauria et al.’s study.48 (p1395), 50(p625)
For all of these reasons, it is not surprising that the percent improvement in peak VO2 is somewhat different between these two studies. Still, it is important to note that both studies show marked improvements in peak VO2 following CR.
30 The other functional outcome reported was TWC, assessed by Marchionni, Fattirolli, Fumagelli, et al. It is, however, difficult to discuss this measure at length because no specific TWC values are provided and only age-stratified results are available. Still, although Marchionni et al. are assessing a different functional outcome from Lee et al. and Giallauria et al, this study also shows marked functional improvement after cardiac rehabilitation.49(p2205)
In conclusion, each of these randomized controlled trials shows a strong association between cardiac rehabilitation and functional improvement, measured by either peak VO2 or TWC. Cardiac rehabilitation thus seems to be beneficial, by and large, for patients who have suffered a heart attack. The question remains of whether cardiac rehabilitation is equally beneficial for men and women. And although no RCTs have been designed to address this question, we are hopeful that our observational research, in the context of previous observational studies, will begin to provide an answer to this question.
31
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