Abstract
Background
There is little data regarding the impact of patient age on the physical and psychological
effectiveness of cardiac rehabilitation (CR). The aim of the present study was therefore
to compare the effects of an exercise-based CR program on physical and psychological
parameters in young, old, and very old patients. We also aimed to identify the features
that best predicted CR outcome.
Methods
A total of 733 patients were divided into 3 subgroups: YOUNG (< 65 years old), OLD
(between 65 and 80 years old), and VERY OLD (≥ 80 years old). Physical variables such
as peak workload and estimated peak VO2 as well as psychological variables such as scores of anxiety and depression were
evaluated for all patients before and after CR.
Results
Performance in all tests and scores for all questionnaires were significantly improved
in all patients (P < 0.05). Age was significantly correlated with all the initial values (P < 0.05) but not with post-CR values. In addition, lower initial values of peak workload
were associated with larger post-CR improvements irrespective of age. However, higher
pre-CR anxiety and depression scores were associated with greater post-CR increases
in physical performance in YOUNG and OLD patients, respectively.
Conclusions
CR induced significant improvements of physical and psychological parameters for all
patient groups. More interestingly, our results suggest that patients with the greatest
physical impairments at baseline would benefit the most from CR, whatever their age.
However, the value of initial mental state as a predictor of post-CR improvement depends
on the age of the patient.
Résumé
Contexte
Il existe peu de données sur l’incidence de l’âge du patient sur l’efficacité physique
et psychologique de la réadaptation cardiaque. Par conséquent, cette étude vise à
comparer les effets d’un programme de réadaptation cardiaque axé sur l’exercice sur
les paramètres physiques et psychologiques chez des patients jeunes, âgés et très
âgés. Nous souhaitons également déterminer les caractéristiques qui permettent le
mieux de prédire les résultats de la réadaptation cardiaque.
Méthodologie
Au total, 733 patients ont été répartis dans 3 sous-groupes : le groupe JEUNE (< 65
ans), le groupe ÂGÉ (de 65 à 80 ans) et le groupe TRÈS ÂGÉ (≥ 80 ans). Des variables
physiques telles que la charge de travail au pic et la consommation maximale d’oxygène
estimée de même que des variables psychologiques comme les scores de l’anxiété et
de la dépression ont été évaluées chez tous les patients avant et après la réadaptation
cardiaque.
Résultats
Une amélioration significative de la performance à toutes les épreuves et des scores
à tous les questionnaires a été observée chez tous les patients (p < 0,05). La corrélation était significative (p < 0,05) entre l’âge et toutes les valeurs initiales, mais non les valeurs mesurées
après la réadaptation cardiaque. De plus, les valeurs initiales les plus faibles de
la charge de travail du cœur au pic ont été associées à de plus grandes améliorations
après la réadaptation cardiaque sans égard à l’âge. Toutefois, les scores d’anxiété
et de dépression élevés avant la réadaptation cardiaque ont été associés à une performance
physique accrue après la réadaptation cardiaque chez les patients des groupes JEUNE
et ÂGÉ, respectivement.
Conclusions
La réadaptation cardiaque a été associée à des améliorations significatives des paramètres
physiques et psychologiques chez tous les groupes de patients. Fait encore plus intéressant,
nos résultats laissent supposer que les patients présentant les déficiences physiques
les plus importantes au départ bénéficieraient le plus de la réadaptation cardiaque,
peu importe leur âge. Toutefois, la valeur de l’état mental initial comme facteur
de prédiction de l’amélioration après la réadaptation cardiaque dépend de l’âge du
patient.
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Article info
Publication history
Accepted:
May 27,
2019
Received:
February 19,
2019
Footnotes
See editorial by Rouleau and Stone, pages 1272–1274 of this issue.
See page 1357 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Sorting the Wheat From the Chaff in Cardiac Rehabilitation: Who Gets Better and Why?Canadian Journal of CardiologyVol. 35Issue 10
- PreviewCardiac rehabilitation (CR) is a well-established intervention that involves exercise training, support with healthy lifestyle behaviours, and medical management to treat cardiovascular disease. Overwhelming evidence from randomized controlled trials demonstrates the efficacy of CR for reducing morbidity and mortality across cardiovascular populations with diverse demographic and clinical features.1 This evidence of improved patient outcomes has been pivotal in establishing CR as standard care for most patients with cardiovascular disease.
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