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Effects of exercise-based cardiac rehabilitation on cardiorespiratory fitness: A meta-analysis of UK studies

Ingle, Lee; Almodhy, Meshal; Sandercock, Gavin R.


Background: Exercise-based cardiac rehabilitation can promote meaningful improvements in cardiorespiratory fitness (fitness) but the magnitude of such improvements varies according to local characteristics of exercise programmes. We aimed to determine if cardiac rehabilitation, as practised in the United Kingdom (UK), could promote meaningful changes in fitness and to identify programme characteristics which may moderate these changes. Methods: Electronic and manual searches to identify UK CR studies reporting fitness at baseline and follow up. Change in fitness (Δfitness) was expressed as mean difference (95%CI) and effect size (ES). A random effects model was used to calculate the mean estimate for change in Δfitness with. Between-group heterogeneity was quantified (Q) and investigated using planned sub-group analyses. Results: We identified n=11 studies containing 16 patient groups (n=1578) which used the incremental shuttle walking test (ISWT) (distance walked) to assess fitness. The overall mean estimate for Δfitness showed a significant increase in distance walked (ES=0.48, P<0.001), but this estimate was highly heterogeneous (Q=77.1, P<0.001, I2= 81%). Sub-group analyses showed significantly greater ES (Q=3.94, P=0.046) for Δfitness in patients prescribed n>12 exercise sessions compared with those receiving n≤12 sessions. Conclusion: We found significant increases in fitness (based on ISWT) in patients attending exercise-based CR in the UK. UK studies provide approximately one-third of the exercise “dose”, and produce gains in fitness less than half the magnitude reported in international studies.

Journal Article Type Article
Publication Date Oct 15, 2016
Journal International journal of cardiology
Print ISSN 0167-5273
Electronic ISSN 1874-1754
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 221
Pages 644-651
Keywords Cardiac rehabilitation, Fitness
Publisher URL
Copyright Statement © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Additional Information This is a description of an article published in: International journal of cardiology, 2016, v.221.


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