Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial

Grace, Sherry; Midence, Liz; Oh, Paul; Brister, Stephanie; Chessex, Caroline; Stewart, Donna Eileen; Arthur, Heather M.

Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial

dc.contributor.author	Grace, Sherry
dc.contributor.author	Midence, Liz
dc.contributor.author	Oh, Paul
dc.contributor.author	Brister, Stephanie
dc.contributor.author	Chessex, Caroline
dc.contributor.author	Stewart, Donna Eileen
dc.contributor.author	Arthur, Heather M.
dc.date.accessioned	2025-06-04T15:40:31Z
dc.date.available	2025-06-04T15:40:31Z
dc.date.issued	2016-02-01
dc.description	© 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. This article is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.description.abstract	Objective To compare program adherence and functional capacity between women referred to supervised mixed-sex, supervised women-only, or home-based cardiac rehabilitation (CR). Patients and Methods Cardiac Rehabilitation for Heart Event Recovery (CR4HER) was a single-blind, 3 parallel-arm, pragmatic randomized controlled trial. The study took place between November 1, 2009, and July 31, 2013. Low-risk patients with coronary artery disease were recruited from 6 hospitals in Ontario, Canada. Consenting participants completed a preprogram survey, and clinical data were extracted from charts. Participants were referred to CR at 1 of 3 sites. After intake assessment, including a graded exercise stress test, eligible patients were randomized to supervised mixed-sex, supervised women-only, or home-based CR. Six months later, CR adherence and exit assessment data were ascertained. Results Of the 264 consenting patients, 169 (64.0%) were eligible and randomized. Twenty-seven (16.0%) did not attend, and 43 (25.4%) attended a different model. Program adherence was moderate overall (54.46%±35.14%). Analysis of variance revealed no significant differences based on per-protocol analysis (P=.63), but as-treated, home-based participants attended significantly more than did women-only participants (P<.05). Overall, there was a significant increase in functional capacity preprogram to postprogram (P<.001). Although there were no significant differences in functional capacity by model at CR exit based on per-protocol analysis, there was a significant difference on an as-treated basis, which sustained adjustment. Women attending mixed-sex CR attained significantly higher post-CR functional capacity than did women attending home-based programs (P<.05). Conclusion Offering women alternative program models may not promote greater CR adherence or functional capacity; however, replication is warranted. Other proven strategies such as action planning and self-monitoring should be applied. Trial Registration clinicaltrials.gov Identifier: NCT01019135.
dc.description.sponsorship	This research was funded by the Heart and Stroke Foundation of Ontario (Grant in Aid no. NA 6682).
dc.identifier.citation	Grace, S. L., Midence, L., Oh, P., Brister, S., Chessex, C., Stewart, D. E., & Arthur, H. M. (2016). Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial. Mayo Clinic Proceedings, 91(2), 140–148. https://doi.org/10.1016/j.mayocp.2015.10.021
dc.identifier.issn	1942-5546
dc.identifier.issn	0025-6196
dc.identifier.other	NCT01019135
dc.identifier.uri	https://doi.org/10.1016/j.mayocp.2015.10.021
dc.identifier.uri	https://hdl.handle.net/10315/42906
dc.language.iso	en
dc.publisher	Elsevier
dc.rights	Attribution-NonCommercial-NoDerivatives 4.0 International	en
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title	Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial
dc.type	Article