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CR is significantly under-used globally.<ref>{{Cite journal|last=Santiago de Araújo Pio|first=Carolina|last2=Beckie|first2=Theresa M.|last3=Varnfield|first3=Marlien|last4=Sarrafzadegan|first4=Nizal|last5=Babu|first5=Abraham S.|last6=Baidya|first6=Sumana|last7=Buckley|first7=John|last8=Chen|first8=Ssu-Yuan|last9=Gagliardi|first9=Anna|last10=Heine|first10=Martin|last11=Khiong|first11=Jong Seng|date=2020-01-01|title=Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement|url=http://www.sciencedirect.com/science/article/pii/S0167527319312951|journal=International Journal of Cardiology|language=en|volume=298|pages=1–7|doi=10.1016/j.ijcard.2019.06.064|issn=0167-5273}}</ref> Rates vary widely. Under-use is caused by multi-level factors. At the health system level, this includes lack of available programs.<ref>{{Cite journal|last=Turk-Adawi|first=Karam|last2=Supervia|first2=Marta|last3=Lopez-Jimenez|first3=Francisco|last4=Pesah|first4=Ella|last5=Ding|first5=Rongjing|last6=Britto|first6=Raquel R.|last7=Bjarnason-Wehrens|first7=Birna|last8=Derman|first8=Wayne|last9=Abreu|first9=Ana|last10=Babu|first10=Abraham S.|last11=Santos|first11=Claudia Anchique|date=2019-08-01|title=Cardiac Rehabilitation Availability and Density around the Globe|url=https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30100-2/abstract|journal=EClinicalMedicine|language=English|volume=13|pages=31–45|doi=10.1016/j.eclinm.2019.06.007|issn=2589-5370}}</ref> At the provider level, there are low referral rates by physicians, who often focus more attention on better reimbursed cardiac intervention procedures than on long-term lifestyle treatments.<ref>{{Cite journal|last1=Cortés|first1=Olga|last2=Arthur|first2=Heather M.|date=February 2006|title=Determinants of referral to cardiac rehabilitation programs in patients with coronary artery disease: A systematic review |journal=American Heart Journal|volume=151|issue=2|pages=249–256|doi=10.1016/j.ahj.2005.03.034|pmid=16442885|issn=0002-8703}}</ref><ref>{{Cite journal|last1=Thomas|first1=Randal J.|last2=King|first2=Marjorie|last3=Lui|first3=Karen|last4=Oldridge|first4=Neil|last5=Piña|first5=Ileana L.|last6=Spertus|first6=John|last7=Bonow|first7=Robert O.|last8=Estes|first8=N. A. Mark|last9=Goff|first9=David C.|date=2007-10-02|title=AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services: Endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons|journal=Journal of the American College of Cardiology|volume=50|issue=14|pages=1400–1433|doi=10.1016/j.jacc.2007.04.033|pmid=17903645|issn=0735-1097}}</ref> At the patient level, factors such as transportation, distance, cost, competing responsibilities, lack of awareness and other health conditions are responsible,<ref>{{Cite journal|last=Shanmugasegaram|first=Shamila|last2=Gagliese|first2=Lucia|last3=Oh|first3=Paul|last4=Stewart|first4=Donna E|last5=Brister|first5=Stephanie J|last6=Chan|first6=Victoria|last7=Grace|first7=Sherry L|date=2012-02|title=Psychometric validation of the Cardiac Rehabilitation Barriers Scale|url=http://journals.sagepub.com/doi/10.1177/0269215511410579|journal=Clinical Rehabilitation|language=en|volume=26|issue=2|pages=152–164|doi=10.1177/0269215511410579|issn=0269-2155|pmc=PMC3351783|pmid=21937522}}</ref> but most can be mitigated.<ref>{{Cite journal|last=Santiago de Araújo Pio|first=Carolina|last2=Chaves|first2=Gabriela Ss|last3=Davies|first3=Philippa|last4=Taylor|first4=Rod S.|last5=Grace|first5=Sherry L.|date=02 01, 2019|title=Interventions to promote patient utilisation of cardiac rehabilitation|url=https://pubmed.ncbi.nlm.nih.gov/30706942/|journal=The Cochrane Database of Systematic Reviews|volume=2|pages=CD007131|doi=10.1002/14651858.CD007131.pub4|issn=1469-493X|pmc=6360920|pmid=30706942}}</ref>
CR is significantly under-used globally.<ref>{{Cite journal|last=Santiago de Araújo Pio|first=Carolina|last2=Beckie|first2=Theresa M.|last3=Varnfield|first3=Marlien|last4=Sarrafzadegan|first4=Nizal|last5=Babu|first5=Abraham S.|last6=Baidya|first6=Sumana|last7=Buckley|first7=John|last8=Chen|first8=Ssu-Yuan|last9=Gagliardi|first9=Anna|last10=Heine|first10=Martin|last11=Khiong|first11=Jong Seng|date=2020-01-01|title=Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement|url=http://www.sciencedirect.com/science/article/pii/S0167527319312951|journal=International Journal of Cardiology|language=en|volume=298|pages=1–7|doi=10.1016/j.ijcard.2019.06.064|issn=0167-5273}}</ref> Rates vary widely. Under-use is caused by multi-level factors. At the health system level, this includes lack of available programs.<ref>{{Cite journal|last=Turk-Adawi|first=Karam|last2=Supervia|first2=Marta|last3=Lopez-Jimenez|first3=Francisco|last4=Pesah|first4=Ella|last5=Ding|first5=Rongjing|last6=Britto|first6=Raquel R.|last7=Bjarnason-Wehrens|first7=Birna|last8=Derman|first8=Wayne|last9=Abreu|first9=Ana|last10=Babu|first10=Abraham S.|last11=Santos|first11=Claudia Anchique|date=2019-08-01|title=Cardiac Rehabilitation Availability and Density around the Globe|url=https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30100-2/abstract|journal=EClinicalMedicine|language=English|volume=13|pages=31–45|doi=10.1016/j.eclinm.2019.06.007|issn=2589-5370}}</ref> At the provider level, there are low referral rates by physicians, who often focus more attention on better reimbursed cardiac intervention procedures than on long-term lifestyle treatments.<ref>{{Cite journal|last1=Cortés|first1=Olga|last2=Arthur|first2=Heather M.|date=February 2006|title=Determinants of referral to cardiac rehabilitation programs in patients with coronary artery disease: A systematic review |journal=American Heart Journal|volume=151|issue=2|pages=249–256|doi=10.1016/j.ahj.2005.03.034|pmid=16442885|issn=0002-8703}}</ref><ref>{{Cite journal|last1=Thomas|first1=Randal J.|last2=King|first2=Marjorie|last3=Lui|first3=Karen|last4=Oldridge|first4=Neil|last5=Piña|first5=Ileana L.|last6=Spertus|first6=John|last7=Bonow|first7=Robert O.|last8=Estes|first8=N. A. Mark|last9=Goff|first9=David C.|date=2007-10-02|title=AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services: Endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons|journal=Journal of the American College of Cardiology|volume=50|issue=14|pages=1400–1433|doi=10.1016/j.jacc.2007.04.033|pmid=17903645|issn=0735-1097}}</ref> At the patient level, factors such as transportation, distance, cost, competing responsibilities, lack of awareness and other health conditions are responsible,<ref>{{Cite journal|last=Shanmugasegaram|first=Shamila|last2=Gagliese|first2=Lucia|last3=Oh|first3=Paul|last4=Stewart|first4=Donna E|last5=Brister|first5=Stephanie J|last6=Chan|first6=Victoria|last7=Grace|first7=Sherry L|date=2012-02|title=Psychometric validation of the Cardiac Rehabilitation Barriers Scale|url=http://journals.sagepub.com/doi/10.1177/0269215511410579|journal=Clinical Rehabilitation|language=en|volume=26|issue=2|pages=152–164|doi=10.1177/0269215511410579|issn=0269-2155|pmc=PMC3351783|pmid=21937522}}</ref> but most can be mitigated.<ref>{{Cite journal|last=Santiago de Araújo Pio|first=Carolina|last2=Chaves|first2=Gabriela Ss|last3=Davies|first3=Philippa|last4=Taylor|first4=Rod S.|last5=Grace|first5=Sherry L.|date=02 01, 2019|title=Interventions to promote patient utilisation of cardiac rehabilitation|url=https://pubmed.ncbi.nlm.nih.gov/30706942/|journal=The Cochrane Database of Systematic Reviews|volume=2|pages=CD007131|doi=10.1002/14651858.CD007131.pub4|issn=1469-493X|pmc=6360920|pmid=30706942}}</ref>


It is important for inpatient units treating cardiac patients to institute automatic or electronic referral to CR.<ref>{{Cite journal|last=Grace|first=Sherry L.|last2=Russell|first2=Kelly L.|last3=Reid|first3=Robert D.|last4=Oh|first4=Paul|last5=Anand|first5=Sonia|last6=Rush|first6=James|last7=Williamson|first7=Karen|last8=Gupta|first8=Milan|last9=Alter|first9=David A.|last10=Stewart|first10=Donna E.|last11=Investigators|first11=Cardiac Rehabilitation Care Continuity Through Automatic Referral Evaluation (CRCARE)|date=2011-02-14|title=Effect of Cardiac Rehabilitation Referral Strategies on Utilization Rates: A Prospective, Controlled Study|url=https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/416448|journal=Archives of Internal Medicine|language=en|volume=171|issue=3|pages=235–241|doi=10.1001/archinternmed.2010.501|issn=0003-9926}}</ref> It is also key for healthcare providers to promote CR to patients at the bedside.<ref>{{Cite journal|last=Santiago de Araújo Pio|first=Carolina|last2=Gagliardi|first2=Anna|last3=Suskin|first3=Neville|last4=Ahmad|first4=Farah|last5=Grace|first5=Sherry L.|date=2020-08-20|title=Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation: development and evaluation of an online course|url=https://doi.org/10.1186/s12913-020-05619-2|journal=BMC Health Services Research|volume=20|issue=1|pages=768|doi=10.1186/s12913-020-05619-2|issn=1472-6963|pmc=PMC7439558|pmid=32819388}}</ref>
It is important for inpatient units treating cardiac patients to institute automatic or electronic referral to CR. It is also key for healthcare providers to promote CR to patients at the bedside.


==Benefits==
==Benefits==
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Another Cochrane review of six randomised controlled trials in adults with atrial fibrillation found that exercise-based rehabilitation may improve physical exercise capacity, but there was no effect on health-related quality of life. Due to the limited number of trials, the authors could not estimate the impact on mortality or serious adverse events.<ref>{{Cite journal|last1=Risom|first1=Signe S.|last2=Zwisler|first2=Ann-Dorthe|last3=Johansen|first3=Pernille P.|last4=Sibilitz|first4=Kirstine L.|last5=Lindschou|first5=Jane|last6=Gluud|first6=Christian|last7=Taylor|first7=Rod S.|last8=Svendsen|first8=Jesper H.|last9=Berg|first9=Selina K.|date=2017-02-09|title=Exercise-based cardiac rehabilitation for adults with atrial fibrillation|journal=The Cochrane Database of Systematic Reviews|volume=2|pages=CD011197|doi=10.1002/14651858.CD011197.pub2|issn=1469-493X|pmid=28181684|pmc=6464537}}</ref> There are also Cochrane reviews on effects in valve patients,<ref>{{Cite web|title=Exercise-based cardiac rehabilitation for adults after heart valve surgery|url=https://www.cochrane.org/CD010876/VASC_exercise-based-cardiac-rehabilitation-adults-after-heart-valve-surgery|access-date=2020-09-23|website=www.cochrane.org|language=en}}</ref> among others.
Another Cochrane review of six randomised controlled trials in adults with atrial fibrillation found that exercise-based rehabilitation may improve physical exercise capacity, but there was no effect on health-related quality of life. Due to the limited number of trials, the authors could not estimate the impact on mortality or serious adverse events.<ref>{{Cite journal|last1=Risom|first1=Signe S.|last2=Zwisler|first2=Ann-Dorthe|last3=Johansen|first3=Pernille P.|last4=Sibilitz|first4=Kirstine L.|last5=Lindschou|first5=Jane|last6=Gluud|first6=Christian|last7=Taylor|first7=Rod S.|last8=Svendsen|first8=Jesper H.|last9=Berg|first9=Selina K.|date=2017-02-09|title=Exercise-based cardiac rehabilitation for adults with atrial fibrillation|journal=The Cochrane Database of Systematic Reviews|volume=2|pages=CD011197|doi=10.1002/14651858.CD011197.pub2|issn=1469-493X|pmid=28181684|pmc=6464537}}</ref> There are also Cochrane reviews on effects in valve patients,<ref>{{Cite web|title=Exercise-based cardiac rehabilitation for adults after heart valve surgery|url=https://www.cochrane.org/CD010876/VASC_exercise-based-cardiac-rehabilitation-adults-after-heart-valve-surgery|access-date=2020-09-23|website=www.cochrane.org|language=en}}</ref> among others.

== CR Societies ==
CR professionals work together in many countries to optimize service delivery and increase awareness of CR. The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) is comprised of formally-named Board members of CR societies globally. Through cooperation across most CR-related associations, ICCPR seeks to promote CR in low-resource settings, among other aims outlined in their Charter.<ref>{{Cite journal|last=Grace|first=Sherry L.|last2=Warburton|first2=Darren R.|last3=Stone|first3=James A.|last4=Sanderson|first4=Bonnie K.|last5=Oldridge|first5=Neil|last6=Jones|first6=Jennifer|last7=Wong|first7=Nathan|last8=Buckley|first8=John P.|date=March/April 2013|title=International Charter on Cardiovascular Prevention and Rehabilitation: A CALL FOR ACTION|url=https://journals.lww.com/jcrjournal/Fulltext/2013/03000/International_Charter_on_Cardiovascular_Prevention.10.aspx|journal=Journal of Cardiopulmonary Rehabilitation and Prevention|language=en-US|volume=33|issue=2|pages=128–131|doi=10.1097/HCR.0b013e318284ec82|issn=1932-7501}}</ref>


== References ==
== References ==

Revision as of 20:03, 23 September 2020

File:Heart attack.jpg
Plaque build-up can lead to myocardial infarction.

Cardiac rehabilitation (CR) is a branch of rehabilitation medicine or physical therapy dealing with optimizing physical function in patients with cardiac disease or recent cardiac surgeries.

Cardiac rehabilitation is defined by the World Health Organization (WHO) as "The sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life".[1]

CR is a comprehensive model of care including established core components,[2] including structured exercise, patient education, psychosocial counselling, risk factor reduction and behaviour modification, with a goal of optimizing patient's quality of life while helping to reduce the risk of future heart problems.[3]

CR is delivered by a multi-disciplinary team, often headed by a physician such as a cardiologist. Nurses support patients in reducing medical risk factors such as high blood pressure, high cholesterol and diabetes. A dietitian helps create a healthy eating plan, and a social worker or psychologist may help to alleviate stress or, for smokers, may give counseling on how to quit.[4] Support for return-to-work can also be provided. CR programs are very patient-centered.

Based on the benefits summarized below, CR programs are recommended by the American Heart Association, American College of Cardiology and the European Society of Cardiology, among others. CR services can be provided during hospitalization for the event,[5] in an outpatient setting[4] or remotely using telephone or new technology.[6]

Phases

Patients typically enter cardiac rehabilitation in the weeks following an acute coronary event such as a myocardial infarction (heart attack), coronary artery bypass surgery, with a diagnosis of heart failure,[7] replacement of a heart valve, percutaneous coronary intervention (such as coronary stent placement), placement of a pacemaker, or placement of an implantable cardioverter defibrillator.[4]

Inpatient program

Where available, patients receiving CR in the hospital after surgery are usually able to begin within a day or two. First steps include simple motion exercises that can be done sitting down, such as lifting the arms and legs. Heart rate is monitored and continues being monitored as the patient begins to walk.[5]

Outpatient program

Most patients wishing to participate in outpatient CR are able to begin within 4–6 weeks after surgery. In order to participate in an outpatient program, the patient must first obtain a physician's referral.[8] Participation typically begins with an intake evaluation that includes measurement of cardiac risk factors such as lipid measures, blood pressure, body weight, and smoking status. An exercise stress test is usually performed both to determine if exercise is safe and to allow for the development of a custom exercise program. During exercise, the patient's heart rate and blood pressure are monitored to check the intensity of activity.[4]

Short and long-term risk factors and goals are established, and patients are closely monitored by a "case-manager" who may be a cardiac-trained Registered Nurse, Physiotherapist, or an exercise physiologist.

The duration of the program varies from patient to patient and can range from six weeks to several years;[4] globally, a median of 24 sessions are offered.[9] Even after CR is finished, there are long-term maintenance programs that should not be minimized, as benefits are maintained only with long-term adherence.

Under-use

CR is significantly under-used globally.[10] Rates vary widely. Under-use is caused by multi-level factors. At the health system level, this includes lack of available programs.[11] At the provider level, there are low referral rates by physicians, who often focus more attention on better reimbursed cardiac intervention procedures than on long-term lifestyle treatments.[12][13] At the patient level, factors such as transportation, distance, cost, competing responsibilities, lack of awareness and other health conditions are responsible,[14] but most can be mitigated.[15]

It is important for inpatient units treating cardiac patients to institute automatic or electronic referral to CR.[16] It is also key for healthcare providers to promote CR to patients at the bedside.[17]

Benefits

Participation in CR is associated with many benefits. A Cochrane review of 147 studies demonstrated that for myocardial infarction and heart failure patients, reduces cardiovascular mortality by 25% and readmission rates by 20%. However, there was no benefit in all-cause mortality.[18][19] A more recent network meta-analysis however, where the complex components of CR are better considered, showed significant reductions in all-cause mortality with CR.[20]

CR is also associated with improved quality of life,[21] as well as better psychosocial well-being, cardiorespiratory fitness. CR is cost-effective.

There appears to be no difference in outcomes between supervised and home-based programs, and both cost about the same.[22]

Another Cochrane review of six randomised controlled trials in adults with atrial fibrillation found that exercise-based rehabilitation may improve physical exercise capacity, but there was no effect on health-related quality of life. Due to the limited number of trials, the authors could not estimate the impact on mortality or serious adverse events.[23] There are also Cochrane reviews on effects in valve patients,[24] among others.

CR Societies

CR professionals work together in many countries to optimize service delivery and increase awareness of CR. The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) is comprised of formally-named Board members of CR societies globally. Through cooperation across most CR-related associations, ICCPR seeks to promote CR in low-resource settings, among other aims outlined in their Charter.[25]

References

  1. ^ WHO Expert Committee on Rehabilitation after Cardiovascular Diseases, with Special Emphasis on Developing Countries. Rehabilitation after cardiovascular diseases, with special emphsis on developing countries : report of a WHO expert committee. Geneva. ISBN 9241208317. OCLC 28401958.
  2. ^ Grace, Sherry L; Turk-Adawi, Karam I; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L; Oldridge, Neil; Sarkar, Bidyut K; Yeo, Tee Joo; Lopez-Jimenez, Francisco (2016-09-15). "Cardiac rehabilitation delivery model for low-resource settings". Heart. 102 (18): 1449–1455. doi:10.1136/heartjnl-2015-309209. ISSN 1355-6037. PMC 5013107. PMID 27181874.
  3. ^ Mampuya, Warner M. (2012-01-31). "Cardiac rehabilitation past, present and future: an overview". Cardiovascular Diagnosis and Therapy. 2 (1): 38–49–49. doi:10.3978/j.issn.2223-3652.2012.01.02. ISSN 2223-3660. PMC 3839175. PMID 24282695.
  4. ^ a b c d e "What is Cardiac Rehabilitation?". American Heart Association. Retrieved 13 January 2012.
  5. ^ a b Zarret, Barry L.; Moser, Marvin; Cohen, Lawrence S. (1992). "Chapter 28" (PDF). Yale University School of Medicine Heart Book. Yale University School of Medicine. pp. 349–358 [351]. Retrieved 13 January 2012. Cardiac rehabilitation begins during hospitalization, not after discharge. Today's heart-attack patient who is free of complications is likely to be up and about in a day or two.
  6. ^ Phillips, P (2014). "Telephone follow-up for patients eligible for cardiac rehab: A systematic review". British Journal of Cardiac Nursing. 9 (4): 186–97. doi:10.12968/bjca.2014.9.4.186.
  7. ^ Long, Linda; Mordi, Ify R; Bridges, Charlene; Sagar, Viral A; Davies, Edward J; Coats, Andrew JS; Dalal, Hasnain; Rees, Karen; Singh, Sally J; Taylor, Rod S (2019). "Exercise-based cardiac rehabilitation for adults with heart failure". Cochrane Database of Systematic Reviews. 1: CD003331. doi:10.1002/14651858.CD003331.pub5. ISSN 1465-1858. PMC 6492482. PMID 30695817.
  8. ^ "Cardiac Rehabilitation". Washington Hospital Healthcare System. Archived from the original on 14 October 2011. Retrieved 14 January 2012.
  9. ^ Chaves Gabriela; Turk-Adawi Karam; Supervia Marta; Santiago de Araújo Pio Carolina; Abu-Jeish Abdel-hadi; Mamataz Taslima; Tarima Sergey; Lopez Jimenez Francisco; Grace Sherry L. (2020-01-01). "Cardiac Rehabilitation Dose Around the World". Circulation: Cardiovascular Quality and Outcomes. 13 (1): e005453. doi:10.1161/CIRCOUTCOMES.119.005453.
  10. ^ Santiago de Araújo Pio, Carolina; Beckie, Theresa M.; Varnfield, Marlien; Sarrafzadegan, Nizal; Babu, Abraham S.; Baidya, Sumana; Buckley, John; Chen, Ssu-Yuan; Gagliardi, Anna; Heine, Martin; Khiong, Jong Seng (2020-01-01). "Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement". International Journal of Cardiology. 298: 1–7. doi:10.1016/j.ijcard.2019.06.064. ISSN 0167-5273.
  11. ^ Turk-Adawi, Karam; Supervia, Marta; Lopez-Jimenez, Francisco; Pesah, Ella; Ding, Rongjing; Britto, Raquel R.; Bjarnason-Wehrens, Birna; Derman, Wayne; Abreu, Ana; Babu, Abraham S.; Santos, Claudia Anchique (2019-08-01). "Cardiac Rehabilitation Availability and Density around the Globe". EClinicalMedicine. 13: 31–45. doi:10.1016/j.eclinm.2019.06.007. ISSN 2589-5370.
  12. ^ Cortés, Olga; Arthur, Heather M. (February 2006). "Determinants of referral to cardiac rehabilitation programs in patients with coronary artery disease: A systematic review". American Heart Journal. 151 (2): 249–256. doi:10.1016/j.ahj.2005.03.034. ISSN 0002-8703. PMID 16442885.
  13. ^ Thomas, Randal J.; King, Marjorie; Lui, Karen; Oldridge, Neil; Piña, Ileana L.; Spertus, John; Bonow, Robert O.; Estes, N. A. Mark; Goff, David C. (2007-10-02). "AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services: Endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons". Journal of the American College of Cardiology. 50 (14): 1400–1433. doi:10.1016/j.jacc.2007.04.033. ISSN 0735-1097. PMID 17903645.
  14. ^ Shanmugasegaram, Shamila; Gagliese, Lucia; Oh, Paul; Stewart, Donna E; Brister, Stephanie J; Chan, Victoria; Grace, Sherry L (2012-02). "Psychometric validation of the Cardiac Rehabilitation Barriers Scale". Clinical Rehabilitation. 26 (2): 152–164. doi:10.1177/0269215511410579. ISSN 0269-2155. PMC 3351783. PMID 21937522. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  15. ^ Santiago de Araújo Pio, Carolina; Chaves, Gabriela Ss; Davies, Philippa; Taylor, Rod S.; Grace, Sherry L. (02 01, 2019). "Interventions to promote patient utilisation of cardiac rehabilitation". The Cochrane Database of Systematic Reviews. 2: CD007131. doi:10.1002/14651858.CD007131.pub4. ISSN 1469-493X. PMC 6360920. PMID 30706942. {{cite journal}}: Check date values in: |date= (help)
  16. ^ Grace, Sherry L.; Russell, Kelly L.; Reid, Robert D.; Oh, Paul; Anand, Sonia; Rush, James; Williamson, Karen; Gupta, Milan; Alter, David A.; Stewart, Donna E.; Investigators, Cardiac Rehabilitation Care Continuity Through Automatic Referral Evaluation (CRCARE) (2011-02-14). "Effect of Cardiac Rehabilitation Referral Strategies on Utilization Rates: A Prospective, Controlled Study". Archives of Internal Medicine. 171 (3): 235–241. doi:10.1001/archinternmed.2010.501. ISSN 0003-9926.
  17. ^ Santiago de Araújo Pio, Carolina; Gagliardi, Anna; Suskin, Neville; Ahmad, Farah; Grace, Sherry L. (2020-08-20). "Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation: development and evaluation of an online course". BMC Health Services Research. 20 (1): 768. doi:10.1186/s12913-020-05619-2. ISSN 1472-6963. PMC 7439558. PMID 32819388.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  18. ^ Anderson Lindsey (2014). "Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews". Reviews (12): CD011273. doi:10.1002/14651858.CD011273.pub2. hdl:10871/19152. PMC 7087435. PMID 25503364.
  19. ^ Anderson, Lindsey; Sharp, Georgina A.; Norton, Rebecca J.; Dalal, Hasnain; Dean, Sarah G.; Jolly, Kate; Cowie, Aynsley; Zawada, Anna; Taylor, Rod S. (2017). "Home-based versus centre-based cardiac rehabilitation". The Cochrane Database of Systematic Reviews. 6: CD007130. doi:10.1002/14651858.CD007130.pub4. ISSN 1469-493X. PMC 4160096. PMID 28665511.
  20. ^ Kabboul, Nader N.; Tomlinson, George; Francis, Troy A.; Grace, Sherry L.; Chaves, Gabriela; Rac, Valeria; Daou-Kabboul, Tamara; Bielecki, Joanna M.; Alter, David A.; Krahn, Murray (2018/12). "Comparative Effectiveness of the Core Components of Cardiac Rehabilitation on Mortality and Morbidity: A Systematic Review and Network Meta-Analysis". Journal of Clinical Medicine. 7 (12): 514. doi:10.3390/jcm7120514. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  21. ^ Francis, Troy; Kabboul, Nader; Rac, Valeria; Mitsakakis, Nicholas; Pechlivanoglou, Petros; Bielecki, Joanna; Alter, David; Krahn, Murray (2019-03-01). "The Effect of Cardiac Rehabilitation on Health-Related Quality of Life in Patients With Coronary Artery Disease: A Meta-analysis". Canadian Journal of Cardiology. 35 (3): 352–364. doi:10.1016/j.cjca.2018.11.013. ISSN 0828-282X. PMID 30825955.
  22. ^ Anderson, Lindsey; Sharp, Georgina A; Norton, Rebecca J; Dalal, Hasnain; Dean, Sarah G; Jolly, Kate; Cowie, Aynsley; Zawada, Anna; Taylor, Rod S (2017-06-30). "Home‐based versus centre‐based cardiac rehabilitation". The Cochrane Database of Systematic Reviews. 2017 (6). doi:10.1002/14651858.CD007130.pub4. ISSN 1469-493X. PMC 6481471. PMID 28665511.
  23. ^ Risom, Signe S.; Zwisler, Ann-Dorthe; Johansen, Pernille P.; Sibilitz, Kirstine L.; Lindschou, Jane; Gluud, Christian; Taylor, Rod S.; Svendsen, Jesper H.; Berg, Selina K. (2017-02-09). "Exercise-based cardiac rehabilitation for adults with atrial fibrillation". The Cochrane Database of Systematic Reviews. 2: CD011197. doi:10.1002/14651858.CD011197.pub2. ISSN 1469-493X. PMC 6464537. PMID 28181684.
  24. ^ "Exercise-based cardiac rehabilitation for adults after heart valve surgery". www.cochrane.org. Retrieved 2020-09-23.
  25. ^ Grace, Sherry L.; Warburton, Darren R.; Stone, James A.; Sanderson, Bonnie K.; Oldridge, Neil; Jones, Jennifer; Wong, Nathan; Buckley, John P. (March/April 2013). "International Charter on Cardiovascular Prevention and Rehabilitation: A CALL FOR ACTION". Journal of Cardiopulmonary Rehabilitation and Prevention. 33 (2): 128–131. doi:10.1097/HCR.0b013e318284ec82. ISSN 1932-7501. {{cite journal}}: Check date values in: |date= (help)
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