Title : The pro MOHI study: Individually prescribed progressive Moderate-To-High Intensity aerobic and resistance training in a hybrid cardiac rehabilitation exercise program on physical function, psychological status, health status and quality of life in patients
Abstract:
Introduction
Cardiac rehabilitation for post-CABG patients is evolving, with traditional centre-based programs showing benefits but facing challenges like low participation rates. Promising home-based alternatives lack standardized protocols, limiting widespread adoption. The Hybrid Cardiac Rehabilitation Exercise Program (Hybrid CREP) integrates elements from both models to enhance patient engagement and adherence. Central to this program is Progressive Moderate-to-High intensity (ProMoHi) aerobic and resistance training, aimed at broadening outcome assessments beyond conventional metrics such as the six-minute walk test. Initial findings suggest improvements in patient satisfaction and cost-effectiveness; however, standardized guidelines and comprehensive research are essential to optimize effectiveness across diverse clinical settings.
Aims
This prospective pilot randomized controlled trial aims to assess the safety and efficacy of personalized exercise regimens, including ProMoHi aerobic and resistance training, in post-CABG patients. It compares the Hybrid ProMoHi CREP approach to standard care CREP, evaluating physical function, psychological well-being, and quality of life outcomes.
Methods
Participants aged 18 and older scheduled for CABG surgery due to coronary artery disease will be recruited preoperatively and randomized 1:1 into either the Hybrid ProMoHi or standard care group within a centre-based CREP postoperatively. Primary outcomes, including exercise capacity, muscular strength, and quality of life, will be evaluated using the 6-Minute Walk Test, Unsupported Upper Limb Exercise Test, Jamar Handgrip Test, 30-Second Sit-to-Stand Test, and EuroQol-5D-5L. Secondary measures will include safety, feasibility, health status, health-related quality of life, and psychological parameters. Assessments will occur at baseline (preoperatively) and at 2, 6, and 10 weeks postoperatively, totalling 11 evaluations.
Discussion
The outcomes of this pilot study will assess the feasibility of conducting a larger randomized controlled trial integrating Hybrid ProMoHi CREP into existing centre-based CREP frameworks. Emphasizing progressive moderate-to-high intensity aerobic and resistance training, this approach holds promise for enhancing rehabilitation outcomes post-CABG, potentially setting new standards in cardiac rehabilitation practices.
Audience Take Away :
1.Challenges and Evolutions in Cardiac Rehabilitation: Traditional center-based programs for post-CABG patients have benefits but struggle with low participation rates. Home-based alternatives lack standardized protocols, hindering widespread adoption.
2.Introduction of Hybrid Cardiac Rehabilitation Exercise Program (Hybrid CREP): This program integrates elements from both traditional center-based and home-based models to enhance patient engagement and adherence.
3.Focus on Progressive Moderate-to-High Intensity (ProMoHi) Training: The Hybrid CREP emphasizes ProMoHi aerobic and resistance training, aiming to broaden outcome assessments beyond conventional metrics like the six-minute walk test.
4.Preliminary Findings: Initial results suggest improvements in patient satisfaction and cost-effectiveness. However, standardized guidelines and comprehensive research are needed to optimize effectiveness across different clinical settings.
5.Study Aims: The prospective pilot randomized controlled trial aims to assess the safety and efficacy of personalized exercise regimens, including ProMoHi training, compared to standard care CREP. It evaluates physical function, psychological well-being, and quality of life outcomes.
6.Methods: Details on participant recruitment, randomization, and outcome measures, including primary assessments (exercise capacity, muscular strength, quality of life) using specific tests (e.g., 6-Minute Walk Test, Handgrip Test) and secondary measures (safety, feasibility, psychological parameters). Assessments occur at baseline (preoperatively) and multiple points postoperatively.
7.Discussion: The pilot study outcomes will gauge the feasibility of integrating Hybrid ProMoHi CREP into existing center-based frameworks. The approach, focusing on progressive moderate-to-high intensity training, has the potential to enhance rehabilitation outcomes post-CABG and may influence future standards in cardiac rehabilitation practices.
This research abstract offers several potential benefits to its audience:
Clinical Application for Healthcare Professionals: Healthcare professionals involved in cardiac rehabilitation, particularly those working with post-CABG patients, will gain insights into a novel approach (Hybrid ProMoHi CREP) that combines elements of center-based and home-based rehabilitation programs. They will learn about the potential efficacy of Progressive Moderate-to-High intensity (ProMoHi) aerobic and resistance training in improving patient outcomes such as exercise capacity, muscular strength, and quality of life. This knowledge can directly inform their practice, potentially leading to better rehabilitation strategies and patient care.
Research Expansion for Academics and Researchers: Faculty and researchers in healthcare and rehabilitation fields can use this research as a basis to expand their own studies. It provides a structured approach (pilot randomized controlled trial) to assess the safety, efficacy, and feasibility of innovative rehabilitation programs. The findings could spur further investigations into optimizing rehabilitation protocols and developing standardized guidelines, thereby advancing the field of cardiac rehabilitation.
Teaching Tool: The detailed methodology and outcomes discussed in the abstract can serve as a valuable teaching resource. Educators can use it to illustrate research design, randomized controlled trials, outcome measures in rehabilitation, and the integration of exercise science principles into clinical practice. Students can learn about evidence-based practices and the process of evaluating healthcare interventions.
Practical Solution for Healthcare Designers: For designers and developers of cardiac rehabilitation programs or healthcare interventions, this research provides practical insights. The Hybrid ProMoHi CREP offers a potential model for designing more effective rehabilitation protocols that can be integrated into existing center-based frameworks. This could simplify program development by providing a structured approach backed by preliminary evidence of effectiveness.
Improving Efficiency and Accuracy: Implementing the Hybrid ProMoHi CREP could streamline rehabilitation processes by potentially increasing patient adherence and satisfaction. It may lead to more efficient use of healthcare resources and improved accuracy in assessing rehabilitation outcomes beyond traditional metrics. This could ultimately enhance the overall quality of care provided to post-CABG patients.
New Information and Innovation: The emphasis on ProMoHi training and its impact on broader outcomes (beyond traditional metrics) provides new information that could challenge existing practices and stimulate innovation in cardiac rehabilitation. This research contributes to expanding the understanding of how exercise intensity and personalized regimens can influence recovery and long-term health outcomes post-CABG.
In summary, this research abstract not only addresses clinical effectiveness and patient outcomes but also offers opportunities for academic research, teaching enhancement, and practical application in healthcare design and delivery. It has the potential to influence rehabilitation practices, improve patient care, and inspire further studies in cardiac rehabilitation and related fields.
