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UBC Theses and Dissertations

Comparing the effectiveness of a traditional versus an alternative outpatient cardiac rehabilitation model Gabelhouse, Jacqueline Brigitte Monique


It has been demonstrated that participation in cardiac rehabilitation (CR) elicits improvements in health related quality of life (HRQOL), exercise tolerance, cardiac risk factors, and all-cause mortality rates in patients with cardiovascular disease (CVD). Despite the aforementioned benefits associated with CR, enrollment and participation rates remain low (30%) due to a number of barriers including accesibility, financial constraints, time conflicts, the referral process, and participant interests. Due to the sub-optimal enrollment of CR programs, alternative CR models have been developed to provide greater flexibility for patients in terms of accessibility, interests, affordability and preferences. However, little is known about the effectiveness of this alternative model, or more specifically, whether these alternative models result in similar positive benefits associated with traditional cardic rehabilitation models (TM). Thus, the purpose of this study was to compare the effectiveness of a traditional model (TM) to an alternative, hybrid model (HYM) for CR in terms of health related quality of life and secondary outcome measures (i.e., physical activity, resting blood pressure, cholesterol profile, blood sugars, metabolic equivalents, smoking status, fruit and vegetable intake, depressive symptoms, and anthropometrics). This study was a prospective, two-armed non-randomized intervention consisting of 125 cardiac patients from the Central Okanagan. Participants choose to enroll in a TM (n=72) or an alternative HYM (n=53) CR program. Of 125 participants, 88% completed the programs. Mean age of the participants was 67.1±10.6 years and 70.4% were male. The results of the two way-analysis of variance (ANOVA) showed no significant interaction between models. However, statistically significant improvements were observed over time in HRQOL (p<.001). The secondary outcome measures found statistically significant improvements over time for physical activity (p<.001), systolic blood pressure (p<.001), total cholesterol (p<.001), low density lipoprotein (p<.001), METs (p<.001), reductions in smoking status (p=.043), dietary behaviors (p<.001), depressive symptoms (p<.001), and waist circumference (p<.001). Study results indicate that an 8 week HYM in a CR setting may be as effective as a TM for changing health promoting behaviours specific to those with CVD.

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