Skip to main content

Advertisement

SpringerLink
Log in

Long-term results of a three-week intensive cardiac out-patient rehabilitation program in motivated patients with low social status

  • ORIGINAL PAPER
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Summary

The short-term benefits of cardiac rehabilitation (CR) are well established. In contrast, well-documented long-term results are rare. The objective of this longitudinal multi-centre observational study was to examine the effects of intensive out-patient CR in a larger patient cohort, especially for patients with low social status. We present the final results 24 months after CR.

Methods

The study group of 327 patients (288 men, 39 women, aged 56.0±10.8 years, coronary artery disease in 295, other cardiac diseases in 32) participated in a 3- week CR programme followed by clinical re-evaluations 6 (III), 12 (IV) an 24 (V) months later.

Results

The improvement in mean maximal performance of 100.5±31.4 to 123.1±36.2 W (p<0.01) achieved during CR was further improved to 128.7±40.9 W (p < 0,01) after 24 months. Of the patients, 61.2% reported regular physical activity during the 24 months of the study. The lipid management achieved by CR was maintained over 24 month. At I 65%, at II 84.4% and at V 82.4% of the patients with coronary artery disease (CAD) were undergoing lipid lowering therapy. BMI increased from 26.8±3.0 to 27.6±3.6 kg/m2 (p < 0.01) during follow-up. Of the patients, 23.2% were active smokers at V. Cardiovascular diagnosis remained unaltered in 74.3% of patients. The obtained results are interesting with respect to the social status of the patients since 68% were general laborers. The results confirm the long-term effectiveness of an intensive 3-week out-patient CR programme. Most of the benefits achieved by CR appear to be sustainable in this population for at least 2 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anonymous (2000) A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report. The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. JAMA 283:3244–3254

    Article  Google Scholar 

  2. Anonymous (2001) Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries; principal results from EUROASPIRE II Euro Heart Survey Programme. Eur Heart J 22:554–572

    Article  Google Scholar 

  3. Baessler A, Hengstenberg C, Holmer S, Fischer M, Mayer B, Hubauer U et al (2001) Long-term effects of in-hospital cardiac rehabilitation on the cardiac risk profile. A case-control study in pairs of siblings with myocardial infarction. Eur Heart J 22:1111–1118

    Article  PubMed  CAS  Google Scholar 

  4. Baigi A, Fridlund B, Marklund B, Oden A (2002) Cardiovascular mortality focusing on socio-economic influence: the low-risk population of Halland compared to the population of Sweden as a whole. Public Health 116:285–288

    PubMed  CAS  Google Scholar 

  5. Bjarnason-Wehrens B, Benesch L, Bischoff KO, Buran-Kilian B, Gysan D, Hollenstein U et al (2003) Effects of a phase II cardiac rehabilitation program performed on an outpatient basis. Herz 28:404–412

    Article  PubMed  Google Scholar 

  6. Bjarnason-Wehrens B, Predel HG, Graf C, Rost R (1999) Ambulatory cardiac phase II rehabilitation – “the Cologne model“ – including 3-yearoutcome after termination of rehabilitation. Herz 24(Suppl 1):9–23

    Article  PubMed  Google Scholar 

  7. Blue CL, Wilbur J, Marston-Scott M (2001) Exercise among blue-collar workers: application of the theory of planned behavior. Res Nurs Health 24:481–493

    Article  PubMed  CAS  Google Scholar 

  8. Boudrez H, De Backer G (2000) Recent findings on return to work after an acute myocardial infarction or coronary artery bypass grafting. Acta Cardiol 55:341–349

    Article  PubMed  CAS  Google Scholar 

  9. Budde HG, Keck M (2001) Predictors of return to work after inpatient cardiac rehabilitation under workers’ compensation plan. Rehabilitation (Stuttg) 40:208–216

    Article  PubMed  CAS  Google Scholar 

  10. Conroy RM, Cahill S, Mulcahy R, Johnson H, Graham IM, Hickey N (1986) The relation of social class to risk factors, rehabilitation, compliance and mortality in survivors of acute coronary heart disease. Scand J Soc Med 14:51–56

    PubMed  CAS  Google Scholar 

  11. Gysan DB, Heinzler R, Schmidt K (1997) Primary results and long-term outcome of an ambulatory, cardiac rehabilitation model (phase II) after myocardial infarct, dilatation treatment and heart operation. Z Kardiol 86:691–702

    Article  PubMed  CAS  Google Scholar 

  12. Hambrecht R, Niebauer J, Marburger C, Grunze M, Kalberer B, Hauer K et al (1993) Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions. J Am Coll Cardiol 22:468–477

    Article  PubMed  CAS  Google Scholar 

  13. Hambrecht R, Wolf A, Gielen S, Linke A, Hofer J, Erbs S et al (2000) Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med 342:454–460

    Article  PubMed  CAS  Google Scholar 

  14. Hedback B, Perk J, Hornblad M, Ohlsson U (2001) Cardiac rehabilitation after coronary artery bypass surgery: 10-year results on mortality, morbidity and readmissions to hospital. J Cardiovasc Risk 8:153–158

    Article  PubMed  CAS  Google Scholar 

  15. Hedblad B, Jonsson S, Nilsson P, Engstrom G, Berglund G, Janzon L (2002) Obesity and myocardial infarction- vulnerability related to occupational level and marital status. A 23-year follow-up of an urban male Swedish population. J Intern Med 252:542–550

    Article  PubMed  CAS  Google Scholar 

  16. Jacob S (2006) The importance of rehabilitation with cardiovascular diabetic patients after surgical interventions.]. Clin Res Cardiol 95 (Suppl 1):i103–i109

    Article  PubMed  Google Scholar 

  17. Jacob S, Lauruschkat AH, Lippmann- Grob B (2006) Heart-Diabetes-Network – A concept for improved care for diabetic cardiovascular patients following cardiac surgical intervention.]. Clin Res Cardiol 95(Suppl 1):i125–i129

    Article  PubMed  Google Scholar 

  18. Jobin J (2005) Long-term effects of cardiac rehabilitation and the paradigms of cardiac rehabilitation. J Cardiopulm Rehabil 25:103–106

    Article  PubMed  Google Scholar 

  19. Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S (2001) Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev CD001800

  20. Karoff M, Muller-Fahrnow W, Kittel J, Vetter HO, Gulker H, Spyra C (2002) Outpatient cardiological rehabilitation- acceptance and conditions related to choice of setting. Rehabilitation (Stuttg) 41:167–174

    Article  PubMed  CAS  Google Scholar 

  21. Karoff M, Roseler S, Lorenz C, Kittel J (2000) Intensified after-care – a method for improving occupational reintegration after myocardial infarct and/or bypass operation. Z Kardiol 89:423–433

    Article  PubMed  CAS  Google Scholar 

  22. Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P et al (2002) Prediction of long-term prognosis in 12 169 men referred for cardiac rehabilitation. Circulation 106:666–671

    Article  PubMed  Google Scholar 

  23. Mark DB, Lam LC, Lee KL, Clapp- Channing NE, Williams RB, Pryor DB et al (1992) Identification of patients with coronary disease at high risk for loss of employment. A prospective validation study. Circulation 86:1485–1494

    PubMed  CAS  Google Scholar 

  24. Maurischat C, Mittag O (2004) Assessing the work-role quality and its significance in predicting return to work. Rehabilitation (Stuttg) 43:1–9

    Article  PubMed  CAS  Google Scholar 

  25. Meinertz T, Heitzer T (2002) Primary and secondary prevention of coronary heart disease: smoking. Z Kardiol 91(Suppl 2):3–11

    Article  PubMed  Google Scholar 

  26. Mittag O, Kolenda KD, Nordman KJ, Bernien J, Maurischat C (2001) Return to work after myocardial infarction/ coronary artery bypass grafting: patient’s and physician’s initial viewpoints and outcome 12 months later. Soc Sci Med 52:1441–1450

    Article  PubMed  CAS  Google Scholar 

  27. Muller-Nordhorn J, Gehring J, Kulig M, Binting S, Klein G, Gohlke H et al (2003) Return to work after cardiologic rehabilitation. Soz Praventivmed 48:370–378

    PubMed  Google Scholar 

  28. Niebauer J, Hambrecht R, Velich T, Hauer K, Marburger C, Kalberer B et al (1997) Attenuated progression of coronary artery disease after 6 years of multifactorial risk intervention: role of physical exercise. Circulation 96:2534–2541

    PubMed  CAS  Google Scholar 

  29. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K et al (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 116:682–692

    Article  PubMed  Google Scholar 

  30. Trappe HJ, Lollgen H (2000) Guidelines for ergometry. German Society of Cardiology-Heart and Cardiovascular Research. Z Kardiol 89:821–831

    Article  PubMed  CAS  Google Scholar 

  31. Tzou W, Vitcenda M, McBride P (2004) Smoking status after cardiac events and participation in outpatient cardiac rehabilitation. J Cardiopulm Rehabil 24:94–99

    Article  PubMed  Google Scholar 

  32. Voller H, Klein G, Gohlke H, Dovifat C, Binting S, Muller-Nordhorn J et al (2000) Secondary prevention in coronary patients after inpatient rehabilitation. Dtsch Med Wochenschr 125:1457–1461

    Article  PubMed  CAS  Google Scholar 

  33. von Hodenberg E, Breidenbach T, Melichercik J (2006) The importance of cholesterol-lowering in patients after coronary-artery bypass surgery. Clin Res Cardiol 95(Suppl 1):i78–i82

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Cardiology and Sports Medicine, German Sport University Cologne, 50933, Cologne, Germany

    Birna Bjarnason-Wehrens & D. Bott

  2. Fachklinik Rhein-Ruhr, Essen, Germany

    L. Benesch

  3. Kardiologische ambulante Rehabilitation Oberberg, Kreiskrankenhaus Waldbröl, Waldbröl, Germany

    K. O. Bischoff & R. Wilkniss

  4. Ambulante Kardiale Rehabilitation, Praxis Dr. Hötzel, Dr. Buran-Kilian, Dr. Aupperle, Bonn, Germany

    B. Buran-Kilian

  5. Ambulante Kardiale Rehabilitation, Praxis Dr. Gysan, Dr. Heizler, Dr. May, Köln, Germany

    D. Gysan

  6. Klinik Roderbirken, Leichlingen, Germany

    U. Hollenstein & W. Mayer-Berger

  7. Rheinklinik St. Joseph, Zentrum für kardiologische Rehabilitation, Duisburg, Germany

    G. Sauer

Authors
  1. Birna Bjarnason-Wehrens
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Bott
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Benesch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. O. Bischoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Buran-Kilian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Gysan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. U. Hollenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. W. Mayer-Berger
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R. Wilkniss
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. G. Sauer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bjarnason-Wehrens, B., Bott, D., Benesch, L. et al. Long-term results of a three-week intensive cardiac out-patient rehabilitation program in motivated patients with low social status. Clin Res Cardiol 96, 77–85 (2007). https://doi.org/10.1007/s00392-007-0461-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-007-0461-0

Key words

Search

Navigation