Authors: (including presenting author): :
Lam SK, Chan NY
Affiliation: :
Department of Medicine & Geriatrics, Princess Margaret Hospital
Keyword 1: :
Phase II cardiac rehabilitation
Keyword 2: :
Ischemic heart disease
Keyword 3: :
Community rehabilitation service
Introduction: :
Cardiac rehabilitation (CR) had proven benefits for patient with ischemic heart disease (IHD). In Hong Kong, majority of phase II CR program was provided at hospital based and mainly targeted on post-Acute Myocardial Infraction (AMI) patient. With development of community rehabilitation service at District Health Centre (DHC), cardiac team of Princess Margaret Hospital (PMH) collaborated with Kwai Tsing DHC (Former operated by Kwai Tsing Safe Community and Health City Association) to pilot a phase II CR program for chronic IHD patient with completed percutaneous coronary intervention (PCI) done. The pilot program consists of eight individual treatment session comprising supervised exercise training by physiotherapist, lifestyle modification by occupational therapist and diet consultation by dietitian
Objectives: :
To evaluate the efficacy and safety of community-based phase II CR program in chronic IHD patient with complete coronary revascularization.
Methodology: :
A retrospective longitudinal study design was employed. Chronic IHD patients with complete PCI done in PMH were screened and counselled by cardiac nurse. A pre-training echocardiogram and treadmill exercise test were arranged for risk stratification. With pre-agreed inclusion and exclusion recruitment criteria, eligible patients were invited to join the pilot phase II CR program in Kwai Tsing DHC. Demographic and clinical data of patient were collected and analyzed. Outcome measures included body weight, waist circumference, Six-minute Walk Test (6MWT) and exercise self-efficacy as measured by Hong Kong Chinese version of Cardiac Exercise Self-Efficacy Instrument (CESEI-C) were compared at baseline and upon completion of pilot program.
Result & Outcome: :
Between July 2021 to April 2025, a total of 105 chronic IHD patients (75 male, 30 female) with a mean age 63.13 ± 9.12 jointed and completed the pilot program. There was no adverse event reported throughout the reviewed period. Upon completion of the pilot program, the mean body weight from 69.76 ± 11.34kg to 69.32 ± 11.45kg (p=0.88), mean waist circumference from 96.37± 10.18cm to 94.73 ± 9.75cm (p=0.008), mean 6MWT from 432.63 ± 99.85m to 504.83 ± 124.54m (p< 0.001), median (IQR) CESEI-C score from 53.08 ± 11.24 to 59.03 ± 9.24 (P=0.008). The findings show that patient with better weight control, reduce waist circumference, improved functional outcome and self-efficacy in performing exercise after completion of the pilot program. In conclusion, the results provide valuable evidence to elucidate efficacy and safety to implement community-based phase II CR service for chronic IHD patient.
