Exercise is a therapy. Benefits, barriers and caveats of cardiovascular rehabilitation
A worldwide overview by Nidal Tourkmani, MD, Cardiologist; Consultant, ABL, Swiss Prestige International Medical Centre-Guangzhou, China
Cardiac Rehabilitation (CR) is the branch of cardiology supported by a multidisciplinary team and interested in improving clinical, functional, physical, and psychological status of patients who suffer from cardiac disease such as acute coronary syndrome (ACS), heart failure (HF) or those who underwent cardiac surgery or percutaneous intervention. Despite robust evidence of clinical and cost effectiveness, uptake of cardiac rehabilitation varies worldwide and by patient group, with participation rates ranging from 20% to 50% CR utilization remains low. Here it needs to increase the knowledge on the benefits of CR and find alternative models to expand the participation of patients.
- Cardiac rehab (CR) is an underutilized class I treatment that we need to implement for the benefits in terms of mortality and rehospitalizations reduction and improvement of patients' life quality as well as being cost-effective, documented in numerous guidelines, trials, reviews, etc.
- CR is a well-structured process of secondary prevention and therefore new strategies have to be developed to increase patients' adherenceto/compliance with treatments (pharmacological, lifestyles changes, behavioral, etc.)
- Evaluate alternative models to the traditional one, of the patient supervised in assigned structures/facilities, given the GAP between request and offer of rehabilitative pathways in Cardiology. GAP known in the experiences of hiagh-income countries and even more pronounced in those of low-income and middle-income countries (LMICs).
Comprehensive approaches and challenges by Guglielmo Trovato, MD, European Medical Association - EMA -, Brussels.
Physical rehabilitation is a major challenge in many chronic diseases and for counteracting the consequences of acute events, such as stroke, myocardial infarction and respiratory failure.
Physical exercise is widely warranted and encouraged also with the aim of improving fitness and healthier adaptive behaviour, along with healthy dietary prescriptions and habits.
An appropriate preliminary assessment of dietary and physical exercise patterns is useful and in general needed.
Expertise and practise among these three key factors are still not adequately offered, and a favourable cost-benefit balance is demonstrated for articulated plans.
1. Physical exercise planning is important in rehabilitation and in preventive medicine
2. This work needs specific medical expertise
3. Relationship with a comprehensive healthier behaviour counselling is warranted.