Cardiac rehabilitation and physical activity: Systematic review and meta-analysis
dc.contributor.author | Dibben, GO | |
dc.contributor.author | Dalal, HM | |
dc.contributor.author | Taylor, RS | |
dc.contributor.author | Doherty, P | |
dc.contributor.author | Tang, LH | |
dc.contributor.author | Hillsdon, M | |
dc.date.accessioned | 2019-03-06T08:54:18Z | |
dc.date.issued | 2018-04-13 | |
dc.description.abstract | Objective To undertake a systematic review and meta-analysis to assess the impact of cardiac rehabilitation (CR) on physical activity (PA) levels of patients with heart disease and the methodological quality of these studies. Methods Databases (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO and SportDiscus) were searched without language restriction from inception to January 2017 for randomised controlled trials (RCTs) comparing CR to usual care control in adults with heart failure (HF) or coronary heart disease (CHD) and measuring PA subjectively or objectively. The direction of PA difference between CR and control was summarised using vote counting (ie, counting the positive, negative and non-significant results) and meta-analysis. Results Forty RCTs, (6480 patients: 5825 CHD, 655 HF) were included with 26% (38/145) PA results showing a statistically significant improvement in PA levels with CR compared with control. This pattern of results appeared consistent regardless of type of CR intervention (comprehensive vs exercise-only) or PA measurement (objective vs subjective). Meta-analysis showed PA increases in the metrics of steps/day (1423, 95% CI 757.07 to 2089.43, p<0.0001) and proportion of patients categorised as physically active (relative risk 1.55, 95% CI 1.19 to 2.02, p=0.001). The included trials were at high risk of bias, and the quality of the PA assessment and reporting was relatively poor. Conclusion Overall, there is moderate evidence of an increase in PA with CR participation compared with control. High-quality trials are required, with robust PA measurement and data analysis methods, to assess if CR definitely leads to important improvements in PA. | en_GB |
dc.description.sponsorship | University of Exeter | en_GB |
dc.identifier.citation | Vol. 104, pp. 1394 - 1402 | en_GB |
dc.identifier.doi | 10.1136/heartjnl-2017-312832 | |
dc.identifier.uri | http://hdl.handle.net/10871/36299 | |
dc.language.iso | en | en_GB |
dc.publisher | BMJ Publishing Group | en_GB |
dc.rights | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ | en_GB |
dc.title | Cardiac rehabilitation and physical activity: Systematic review and meta-analysis | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2019-03-06T08:54:18Z | |
dc.identifier.issn | 1355-6037 | |
dc.description | This is the final version. Available from BMJ Publishing Group via the DOI in this record. | en_GB |
dc.identifier.journal | Heart | en_GB |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | en_GB |
dcterms.dateAccepted | 2018-03-14 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2018-03-14 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2019-03-06T08:51:49Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2019-03-06T08:54:21Z | |
refterms.panel | C | en_GB |
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Except where otherwise noted, this item's licence is described as © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/