Introduction
Cardiac rehabilitation can improve controllable clinical indicators in patients with heart disease, reduce risk and increase body function. It has been reported that patients receiving cardiac rehabilitation have a 20% reduction in mortality from all causes and a 27% reduction in heart mortality. Although we already know the importance of cardiac rehabilitation, it is not clear which is more effective whether center-based(CBCR) or home-based cardiac rehabilitation(HBCR). Therefore, the purpose of this study is to compare and analyze the physiological indices measured after exercise to evaluate the therapeutic effects of hospital-based exercise patients and home-based exercise patients in cardiac rehabilitation.
Method
This study was conducted on patients who underwent cardiac rehabilitation treatment for 18 months from November 2018 to April 2020, excluding patients with severe heart failure, unregulated arrhythmia, psychiatric history, and recurrent acute myocardial infarction. The subjects were those who performed CPX test and laboratory test twice or more at intervals of 3 to 6 months. Patients who underwent CBCR attended outpatient classes two or three times a week for 12-18 weeks. It was conducted up to 36 times. Each classes lasted 1 hour and the exercise termination criteria followed the ACSM guideline 8th edition. The patient who underwent HBCR received education on home-based cardiac rehabilitation before starting HBCR. About one hour a day (warm up 10-15 minutes, main exercise 30 minutes, cool down 10-15 minutes), more than 2-3 days a week aerobic exercise is carried out. Also it was recommended to use a smart band device that can be checked in real time according to the target heart rate during exercise. Afterwards, after 12 to 18 weeks of treatment, CPX tests were carried out in accordance with the American College of Cardiology/American Heart Association guidelines as before.
Results
Of the 73 patients, 51 and 22 participated in the center-based and home-based cardiac rehabilitation, respectively. No statistical differences concerning age, BMI, Hypertension, DM, underlying disease, laboratory finding between the 2 groups. (Table 1) Compared with before and after treatment, Both groups showed significant improvement of VO2/kg, VE/VCO2 slope, BR, VT, HRR, VO2/HR at post-test. In addition, VO2/kg, VT, and VO2/HR were more improved in CBCR groups than in HBCR groups when compared between groups. (Table 2)
Conclusion
In conclusion, Both HBCR and CBCR show improvement in cardiopulmonary function, as noted in several previous studies. However, in comparison between groups, we found that unlike previous studies, CBCR showed significant improvement in VO2/kg, VT, VO2/HR compared to HBCR groups. Therefore, CBCR shows more effective tendency in improving cardiopulmonary function than HBCR.
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