Fall Prevention as a Benefit of Participation in Outpatient Cardiac Rehabilitation

Abstract

Purpose/Hypothesis : Cardiac rehabilitation programs are designed to be an important component of the comprehensive care for patient with cardiovascular disease. The emphasis of these programs is primary and secondary prevention through risk reduction, development and compliance with healthy behaviors, reduction of disability and implementation of an active lifestyle. Individualized exercise programs aim to improved cardiovascular fitness and overall strength and endurance. It is well know that patients with cardiovascular disease often have associated changes in musculoskeletal strength and endurance putting them at higher risk for falls and further decline in function and activities of daily living (ADLs). This study aims to determine if completion of a cardiac rehabilitation program can reduce the risk of falls and future debility for patients with cardiovascular disease. Number of Subjects : Forty-three consecutive patients (13 women and 30 men with mean age of 63.5 years) admitted to outpatient cardiac rehabilitation. Materials/Methods : All subjects assessed using the timed-up-and-go (TUG) during their initial intake. Upon completion of the program patients were once again assessed. Results : Of the 43 patients initially assessed, 31 competed the program and were used in the analysis. Paired t-test revealed significant improvements (p<0.05) in mean TUG scores from 9.06 seconds (std error 0.469) to 7.66 seconds (std error 0.448). Conclusions : This study demonstrates that completion of an outpatient cardiac rehabilitation program can significantly improve TUG scores demonstrating a decrease in fall risk as an additional benefit of the program. Limitations of this study include small sample size, patient attrition and lack of a standardized treatment in cardiac rehabilitation. Data collection is ongoing in the hope that we will be better able to describe the effects of various cardiac diagnosis on function and balance of our patients. Clinical Relevance : The benefits of participation in cardiac rehabilitation programs have been well established. The emphasis of these programs is to optimize cardiovascular risk reduction, encourage health behaviors and promote an active lifestyle. However, as the population ages the number of comorbidities and risk factors in patients continues to increase. Patients entering cardiac rehabilitation programs have TUG scores above the norm of for community dwelling older adults (9.06 seconds and 8 seconds) putting them at increased risk for falls as well as functional decline and decline in ADLs. Cardiac rehabilitation programs should include assessment and treatment of balance as well as strength and endurance to promote improved overall function and independence in patients with cardiovascular disease.