Effectiveness of additional resistance and balance training and telephone support program in exercise-based cardiac rehabilitation on quality of life and physical activity: Randomized control trial

Objectives To evaluate 20 days and 3 months follow-up effectiveness of cardiac rehabilitation (CR) enhanced by resistance/balance training and telephone-support program compared to usual CR care in improving quality of life, clinical course and physical activity behavior. Design Single-centre randomized controlled trial. Setting Inpatient CR clinic Subjects 116 (76.1 +/- 6.7 years, 50% male) patients 14.5 +/- 5.9 days after valve surgery/intervention were randomized to intervention group (IG, n = 60) or control group (CG, n = 56). Intervention Additional resistance/balance training (3 days/week) during phase-II CR and telephone-support program during 3-month follow-up. CG patients were provided with usual CR care. Main measures Short Form 36 Health Survey scales, European Quality of Life 5 Dimensions 3 Level Version QoL index, visual analog scale, clinical course, and physical activity behavior assessed with standardized questionnaires. Results IG reported statistically significant higher mental component score (48.5 +/- 6.91 vs. 40.3 +/- 11.21 at the baseline, 50.8 +/- 9.76 vs. 42.6 +/- 9.82 after 20 days, 49.4 +/- 8.45 vs. 40.5 +/- 8.9 after 12 weeks follow up), general health (48.6 +/- 3.17 vs. 45.0 +/- 2.95 at the baseline, 53.6 +/- 3.02 vs. 43.8 +/- 2.55 after 20 days, 53.2 +/- 3.11 vs. 44.2 +/- 3.07 after 12 weeks) and role limitations due to emotional problems (48.5 +/- 15.2 vs. 27.7 +/- 11.5 at the baseline, 72.7 +/- 12.6 vs. 30.5 +/- 11.2 after 20 days, 66.6 +/- 14.2 vs. 36.1 +/- 11.2 after 12 weeks) in all three assessments (p < 0.05). CG patients had more documented hospital admissions (4 (8%) vs 10 (25%), p = 0.027), atrial fibrillation paroxysms (3 (6.0%) vs. 10 (35.0%), p = 0.011) and blood pressure swings (13 (26%) vs. 20 (50%), p = 0.019). IG patients chose more different physical activities (1.7 +/- 0.7 vs. 1.25 +/- 0.63, p = 0.002), spent more time being physical active every day (195.6 +/- 78.6 vs. 157.29 +/- 78.8, p = 0.002) Conclusions The addition of resistance/balance exercises and telephone-support program 12 weeks after to the CR could linked to higher physical activity levels and fewer clinical complications but did not lead to a significant improvement in quality of life.