Abstract
Background
Decreased sexual activity (SA) is a common problem in patients with cardiovascular
disease (CVD). Although there is evidence that cardiac rehabilitation (CR) is effective
in improving physical outcomes and overall quality of life, its effects on SA remain
unclear. In this systematic review we assessed the association between CR attendance
and SA outcomes in adults with CVD.
Methods
Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL) were systematically searched
in January 2018. Original studies that compared attendance to CR vs no attendance
to CR in adults 18 years and older with diagnosed CVD that also reported on SA outcomes
were included. A narrative synthesis was conducted because the data did not permit
meta-analysis.
Results
Fourteen studies were identified: 6 randomized controlled trials, 5 nonrandomized
controlled trials, and 3 prospective cohort studies. All CR programs included an exercise-based
component and 4 included an SA-specific component. Seven studies reported a significant
benefit in SA outcomes in the CR group, 1 study reported significant harm, and 11
studies reported a nonsignificant difference.
Conclusions
The effect of CR on SA outcomes was generally reported to be equivocal or positive.
CR showed some promise in improving sexual functioning and frequency, with mixed results
with regard to sexual resumption and satisfaction. In conclusion, it remains uncertain
if CR consistently improves sexual outcomes in adults with CVD but these data suggest
that further exploration might be justified.
Résumé
Contexte
La baisse de l’activité sexuelle (AS) est un problème très répandu chez les patients
ayant une maladie cardiovasculaire (MCV). Malgré l’existence de données probantes
sur l’efficacité de la réadaptation cardiaque (RC) pour améliorer les paramètres physiques
et la qualité de vie générale, les effets de la RC sur l’AS restent mal cernés. Dans
cette revue systématique, nous avons évalué l’association entre la participation à
un programme de RC et les résultats de celui-ci sur l’AS chez des adultes atteints
d’une MCV.
Méthodologie
Une recherche systématique a été effectuée en janvier 2018 dans les bases de données
électroniques (MEDLINE, PsycINFO, EMBASE, CINAHL). Les études originales qui comparaient
la participation à un programme de RC et l’absence de participation à un tel programme
chez des adultes âgés de 18 ans et plus ayant reçu un diagnostic de MCV et qui faisaient
également état du résultat sur l’AS ont été incluses. Une synthèse narrative a été
réalisée, car les données ne permettaient pas de faire une méta-analyse.
Résultats
Quatorze études ont été retenues : 6 essais contrôlés avec répartition aléatoire,
5 essais contrôlés sans répartition aléatoire et 3 études de cohortes prospectives.
Tous les programmes de RC comportaient un volet d’activité physique et 4 possédaient
un volet axé sur l’AS. Sept études faisaient état d’une amélioration significative
de l’AS dans le groupe RC, une étude rapportait un effet négatif important et, dans
les 11 autres études, la différence n’était pas significative.
Conclusions
L’effet de la RC sur les paramètres d’évaluation liés à l’AS généralement rapporté
dans les études était soit équivoque, soit positif. La RC s’est révélée prometteuse
jusqu’à un certain point pour améliorer le fonctionnement sexuel et la fréquence des
rapports, avec toutefois des résultats mitigés sur le plan de la reprise des relations
sexuelles et de la satisfaction à cet égard. En conclusion, il reste à déterminer
si la RC améliore de façon systématique l’AS chez les adultes atteints d’une MCV,
mais ces données semblent indiquer que des recherches plus poussées dans ce domaine
pourraient être justifiées.
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Article Info
Publication History
Accepted:
August 12,
2018
Received:
June 20,
2018
Footnotes
See editorial by Araújo et al., pages 1546–1548 of this issue.
See page 1598 for disclosure information.
Identification
Copyright
© 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
