title: Comparison between hybrid and standard centre-based cardiac rehabilitation in female patients after myocardial infarction: a pilot study.
abstract: BACKGROUND
  Despite the known benefits of cardiac rehabilitation (CR) for patients with stable coronary artery disease, it is neglected, especially in women. Home-based programmes may increase adherence to CR.
  
  
  OBJECTIVE
  To compare the effectiveness of centre-based CR with a hybrid model of training, partly out-patient and partly home-based and tele-monitored, in terms of physical capacity and adherence in post-myocardial infarction (MI) women with preserved left ventricular function.
  
  
  METHODS
  53 post-MI female patients, aged 51.3 ± 7.6 years underwent an eight-week training programme (TP) consisting of 24 interval trainings. The first ten trainings were performed in a hospital, then 33 patients (Gruop A) continued them in the centre, the remaining 20 (Group B) did tele-monitored walking training at home (hybrid model). Before and after completing CR, all patients underwent a symptom-limited treadmill exercise stress test during which the analysis included: workload (METs), duration (min), heart rate (HR, bpm), double product (mm Hg/min) at rest and during effort, and HR recovery in the first minute after test. Adherence was reported as the number of trainings completed and the number of dropouts in two CR models.
  
  
  RESULTS
  After CR, only workload (Group A: 6.5 ± 1.1 vs. 7.0 ± 1.4, p < 0.05; Group B: 7.4 ± 1.1 vs. 8.3 ± 1.4, p < 0.01) and duration (Group A: 4.7 ± 1.1 vs. 5.1 ± 1.2, p < 0.01; Group B: 8.1 ± 3.9 vs. 9.3 ± 4.2, p < 0.01) improved significantly in both groups. Comparing CR effects between both groups, no significant differences were observed. All patients completed TP.
  
  
  CONCLUSIONS
  In post-MI women, a hybrid model of training improved physical capacity and was a similarly effective form of CR as a centre-based approach. A home-based tele-monitored programme facilitated our patients' adherence to CR.
authors.affiliation: Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Warsaw, Poland. drkubacka@wp.pl.
authors.forename: Iwona
authors.initials: I
authors.lastname: Korzeniowska-Kubacka
authors.forename: Maria
authors.initials: M
authors.lastname: Bilińska
authors.forename: Barbara
authors.initials: B
authors.lastname: Dobraszkiewicz-Wasilewska
authors.forename: Ryszard
authors.initials: R
authors.lastname: Piotrowicz
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000534:rehabilitation*; D010045:Outpatients; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*