Authors: (including presenting author): :
Lee WWY(1), Ko LKY(1), Chu AL(1), Lee HCH(1), Uy JCH(1), Ip SYW(1), Chao CYL(1), Chan NY(2), Lam SK(2), Leung CYY(1)
Affiliation: :
(1) Physiotherapy Department, Princess Margaret Hospital, (2) Department of Medicine and Geriatrics, Princess Margaret Hospital
Keyword 1: :
Cardiac Rehabilitation
Keyword 2: :
Physiotherapy
Keyword 3: :
Cardiovascular diseases
Keyword 4: :
Heart failure
Introduction: :
Cardiovascular diseases (CVD) remain a leading cause of morbidity and mortality worldwide. A phase II cardiac rehabilitation day program (CRDP) was launched at Princess Margaret Hospital (PMH) since October 2023 to target patients in Kowloon West Cluster (KWC) with CVD, including those with acute myocardial infarction (AMI) and ischaemic heart disease (IHD) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The systolic function, as reflected by left ventricular ejection fraction (LVEF), may be normal or impaired in this target group of clienteles. The program comprised of 12 sessions of physiotherapist-led exercise training including warm-up, structured aerobic and resistance training tailored to individual fitness levels. All participants wore telemetry devices for continuous, real-time ECG monitoring during exercise. This allowed physiotherapists and nurses to closely track heart rate and rhythm, ensuring appropriate exercise intensity and patient safety. In addition, there were 6 sessions of educational talk delivered by multidisciplinary team to facilitate safe return to activities of daily living.
Objectives: :
To compare and evaluate the effects of CRDP on exercise-related outcomes in CVD patients with normal (≥50%) and impaired (< 50%) LVEF.
Methodology: :
This was a retrospective study design. CVD patients who participated in the CRDP at physiotherapy department of PMH in the period of October 2023 to September 2025 were included for analysis. Outcomes on demographic variables, exercise capacity as measured using Six-minute Walk Test (6MWT), hand grip strength (HGS) in the dominant hand, and exercise self-efficacy as measured by the Hong Kong Chinese version of the Cardiac Exercise Self-Efficacy Instrument (CESEI-C) at baseline and upon completion of the CRDP were retrieved for analysis and compared among participants with normal versus impaired LVEF.
Result & Outcome: :
Two hundred and eighty-two CVD patients (219 male, 63 female) with a mean age of 64.8±9.0 years completed the CRDP. Majority of the patients suffered from AMI (45.7%), followed by IHD (44.7%) and others (9.6%). The primary intervention received were PCI (81.2%), CABG (6.7%) and others (12.1%). Prior to program enrollment, echocardiography showed that 215 patients (76.2%) had normal LVEF while 67 patients (23.8%) had impaired LVEF. For the group with normal LVEF, the mean 6MWT distance increased from 437.8±88.6m to 471.4±82.8m (p< 0.001); mean HGS from 30.4±9.0kgf to 32.1±9.1kgf (p< 0.001); and median (IQR) CESEI-C score from 56(48-64) to 66(58-72) (p< 0.001) upon completion of the program. For the group with impaired LVEF, the mean 6MWT distance improved from 448.9±89.6m to 484.3±85.3m (p=0.02); mean HGS from 30.2±8.4kgf to 31.4±8.7kgf (p< 0.001); and median (IQR) CESEI-C score from 57(51-63.5) to 65(60-72) (p< 0.001). No statistically significant between-group differences were detected in post-program outcomes. The results demonstrated that CRDP significantly enhanced exercise capacity, muscle strength, and exercise self-efficacy in CVD patients regardless of LVEF status, affirming its broad applicability. Future expansion of the program to include heart failure patients is warranted, as the benefits observed in those with impaired LVEF suggest potential efficacy for this population.
