Exercise-based cardiac rehabilitation adaptation protocol during Covid-19 pandemic achieved similar results as compared to non-pandemic usual practice: a single center experience

https://doi.org/10.19106/JMedSci005404202207

Anggoro Budi Hartopo(1*), Irsad Andi Arso(2), Ade Meidian Ambari(3), Bambang Dwiputra(4), Basuni Radi(5)

(1) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(2) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(3) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(4) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(5) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(*) Corresponding Author

Abstract


During the Covid-19 pandemic, exercise-based cardiac rehabilitation (EBCR) faced challenges. Adaptation protocols were implemented to circumvent these challenges. The study aimed to investigate whether the adaptation protocols of EBCR during Covid-19 period influenced the result of cardiac rehabilitation. This was a retrospective cohort study. The subjects were patients who underwent an EBCR program in Dr. Sardjito General Hospital. Yogyakarta, Indonesia. The registry of cardiac rehabilitation was obtained and divided into two periods: non-Covid-19 period and Covid-19 period. During the non-Covid-19 period, 3 EBCR sessions per wk (10-12 total sessions) were performed. During the Covid-19 period, EBCR was reduced to 2 sessions per wk (10-12 total sessions). The functional capacities were evaluated as metabolic equivalents (METs) and exercise test time (min) by treadmill test. A total of 122 subjects completed the EBCR. There were no significant differences in METs and exercise minute achieved between two time periods. Among subjects with different sessions per wk, namely 2, 3, and 4-5 sessions per wk, there were no significant differences in METs (7.01±1.89; 7.23±1.74; and 7.33±2.13, p=0.813) and minutesachieved (6.72±1.94; 6.96±1.96; and 6.81±1.84, p=0.848) in the end sessions. In conclusion, the adaptation of EBCR protocols during the Covid-19 period by reducing the number of sessions per wk has similar results as compared to the usual regular EBCR practice.

Keywords


cardiac rehabilitation; exercise therapy; Covid-19; metabolic equivalent; retrospective study

Full Text:

PDF


References

Moulson N, Bewick D, Selway T, Harris J, Suskin N, Oh P, et al. Cardiac rehabilitation during the Covid-19 era: guidance on implementing virtual care. Can J Cardiol 2020; 36(8):1317-21.
https://doi.org/10.1016/j.cjca.2020.06.006
2.Yeo TJ, Wang YTL, Low TT. Have a heart during the Covid-19 crisis: making the case for cardiac rehabilitation in the face of an ongoing pandemic. Eur J Prev Cardiol 2020; 27(9):903-5.
https://doi.org/10.1177/2047487320915665
3.Turk-Adawi K, Supervia M, Lopez-Jimenez F, Pesah E, Ding R, Britto RR, et al. Cardiac rehabilitation availability and density around the globe. EClinical Medicine 2019;13:31-45.
4.Ghisi GLM, Xu Z, Liu X, Gallagher R, Babu AS, Yeung C, et al. Impacts of the Covid-19 pandemic on cardiac rehabilitation delivery around the world. Glob Heart 2021; 16(1):43.
https://doi.org/10.5334/gh.939
5.Nugraha B, Wahyuni LK, Laswati H, Kusumastuti P, Tulaar AB, Gutenbrunner C. Covid-19 pandemic in Indonesia: Situation and challenges of rehabilitation medicine in Indonesia. Acta Med Indones, 2020;52(3):299-305.
6.Calabrese M, Garofano M, Palumbo R, Di Pietro P, Izzo C, et al. Exercise training and cardiac rehabilitation in Covid-19 patients with cardiovascular complications: state of art. Life (Basel) 2021;11(3):259. doi: 10.3390/life11030259.
7.Pecci C, Ajmal M. Cardiac rehab in the Covid-19 pandemic. Am J Med 2021; 134(5):559-60.
https://doi.org/10.1016/j.amjmed.2021.01.007
8.Besnier F, Gayda M, Nigam A, Juneau M, Bherer L. Cardiac rehabilitation during quarantine in Covid-19 pandemic: challenges for center-based programs. Arch Phys Med Rehabil 2020; 101(10):1835-8.
https://doi.org/10.1016/j.apmr.2020.06.004
9.Ribeiro F, Santos M. Exercise-based cardiac rehabilitation in Covid-19 times: one small step for health care systems, one giant leap for patients. Rev Esp Cardiol (Engl Ed) 2020; 73(11):969-70.
https://doi.org/10.1016/j.rec.2020.07.002
10.Scherrenberg M, Falter M, Dendale P. Patient experiences and willingness-to-pay for cardiac telerehabilitation during the first surge of the Covid-19 pandemic: single-centre experience. Acta Cardiol, 2021;76(2):151-157. doi: 10.1080/00015385.2020.1846920.
11.Scherrenberg M, Frederix I, De Sutter J, Dendale P. Use of cardiac telerehabilitation during Covid-19 pandemic in Belgium. Acta Cardiol, 2021;76(7):773-776. doi: 10.1080/00015385.2020.1786625.
12.Sari DM, Wijaya LCG Cardiac rehabilitation via telerehabilitation in Covid-19 pandemic situation. Egypt Heart J, 2021;73(1):31. doi: 10.1186/s43044-021-00156-7.
13.Scherrenberg M, Falter M, Dendale P. Providing comprehensive cardiac rehabilitation during and after the Covid-19 pandemic. Eur J Prev Cardiol 2021; 28(5):520-1.
https://doi.org/10.1093/eurjpc/zwaa107
14.Stefanakis M, Batalik L, Papathanasiou J, Dipla L, Antoniou V, Pepera G. Exercise-based cardiac rehabilitation programs in the era of Covid-19: a critical review. Rev Cardiovasc Med, 2021;22(4):1143-1155. doi: 10.31083/j.rcm2204123.
15.Kirwan R, Perez de Heredia F, McCullough D, Butler T, Davies IG. Impact of Covid-19 lockdown restrictions on cardiac rehabilitation participation and behaviours in the United Kingdom. BMC Sports Sci Med Rehabil, 2022;14(1):67. doi: 10.1186/s13102-022-00459-5.
16.Ambrosetti M, Abreu A, Cornelissen V, Hansen D, Iliou MC, Kemps H, et al. Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the Covid-19 era. Eur J Prev Cardiol 2021; 28(5):541-57.
https://doi.org/10.1093/eurjpc/zwaa080



DOI: https://doi.org/10.19106/JMedSci005404202207

Article Metrics

Abstract views : 970 | views : 904


Bookmark and Share


Copyright (c) 2022 Anggoro Budi Hartopo, Irsad Andi Arso, Ade Meidian Ambari, Bambang Dwiputra, Basuni Radi

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.