title: The sustainability of exercise capacity changes in home versus center-based cardiac rehabilitation.
abstract: OBJECTIVE
  Although participation in either center- or home-based cardiac rehabilitation (CR) can improve exercise capacity, the sustainability of this improvement following completion of the CR program is challenging. The purpose of this study was to compare the immediate and 1-year effectiveness of center- versus home-based CR on exercise capacity in cardiac patients who were given the choice of participating in a center-based or home-based CR program.
  
  
  METHODS
  This was a retrospective study, which relied on the database from a large multidisciplinary CR program. A sample of 3488 cardiac patients participated either in center-based (n = 2803) or home-based (n = 685) CR. Participants underwent exercise testing at baseline, after 12 weeks of CR and again 1 year after completion of the CR programs.
  
  
  RESULTS
  Following CR, exercise capacity (ie, peak metabolic equivalents [METs]) increased significantly in both groups (P < .05). From post-CR to the 1-year followup, exercise capacity remained unchanged in home-based CR participants (P = .183), whereas the center-based CR group demonstrated a decline in exercise capacity (P < .05).
  
  
  CONCLUSIONS
  Although at the 1-year followup exercise capacity decreased in the center-based group, the observed decline did not seem to be clinically significant. The present findings indicate that when the patients were given a choice as to the delivery model (center- vs home-based) used for their CR program, they were relatively successful in retaining the improvement in exercise capacity 1 year post-CR irrespective of the exact location for their exercise training.
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada (Ms Ramadi, Drs Haennel and Haykowsky); Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada (Drs Stone, Aggarwal, and Martin); Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago (Dr Arena); Total Cardiology Rehabilitation and Risk Reduction Center, Calgary, Alberta, Canada (Drs Stone and Aggarwal, Mr Threlfall, Ms Hitt); and Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada (Drs Stone and Aggarwal).
authors.forename: Ailar
authors.initials: A
authors.lastname: Ramadi
authors.forename: Robert G
authors.initials: RG
authors.lastname: Haennel
authors.forename: James A
authors.initials: JA
authors.lastname: Stone
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.forename: Tyler G
authors.initials: TG
authors.lastname: Threlfall
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hitt
authors.forename: Sandeep G
authors.initials: SG
authors.lastname: Aggarwal
authors.forename: Mark
authors.initials: M
authors.lastname: Haykowsky
authors.forename: Billie-Jean
authors.initials: BJ
authors.lastname: Martin
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D000072038:Cardiac Rehabilitation; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008055:Lipids