Authors (including presenting author) :
LeeWS(1), PunSD(2), TamYL(2), LeeKW(3), ChanCS(4), LuiPS(5), MakHK(6), LeePY(7), KoCM(7), YiuKH(1)
Affiliation :
(1) Cardiac Team, Department of Medicine, North District Hospital (2) Cardiac Care Unit, Department of Medicine, North District Hospital (3) Physiotherapy, North District Hospital (4) Occupational therapy, North District Hospital (5) Dietetics, North District Hospital (6) Pharmacy, North District Hospital (7) Department of Medicine, North District Hospital
Introduction :
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, emphasizing the need for effective secondary prevention strategies. Cardiac rehabilitation (CR) programs play an important role in reducing recurrent cardiac events, improving functional capacity and enhancing quality of life. North District Hospital (NDH) has recently initiated a pilot Phase II Cardiac Rehabilitation Program, which spans 12 sessions over 6 weeks, aimed at providing comprehensive, multidisciplinary care to patients with post-cardiac event. This program includes tailored exercise prescriptions, behavioral modification, patient education, pharmacological and nutritional counselling.
Objectives :
To evaluate patient engagement in, feasibility and outcomes associated with, participation in the pilot Phase II CR Program.
Methodology :
This was a retrospective, observational study. Adults with CR-eligible criteria (Post PCI/ PPCI, complete revascularization, left ventricular ejection fraction> 40%, independent premorbid status) were recruited from Cardiac Care Unit (CCU) between February and December 2024. Centre based exercise-training and education sessions with tele-rehabilitation sessions via HA-Go application were provided. Baseline intake survey about knowledge and app log-in data were used to extract engagement data, which were evaluated by UCLA health CR quiz . Patient engagement and feasibility were measured by program completion rate and knowledge improved. Efficacy was measured by changes in physical function, which was reflected by body mass index (BMI), waist circumference, 6-minute walk test (6MWT), fat and skeletal muscle mass and hand grip strength; self-efficacy, which was reflected by Cardiac Exercise Self-Efficacy Instrument (CESEI), Cardiac Self Efficacy Scale (CSES); behavioural changes by Self Care of Coronary Heart Disease Inventory (SCCHDI) and psychosocial wellbeing, which was reflected by WHO-5 -Wellbeing index (WHO5) , Depression, Anxiety and Stress Scale 21 (DASS21), and the National Audit of CR Quality of life questionnaire (NACRQoL), after the program. Standard descriptive statistics were used to summarize patients’ characteristics. Data were processed using Wilcoxon signed rank test.
Result & Outcome :
In total, 9 out of 11 participants (89% male, 11% female) completed the 12-sessions course over 10 months. 91% of the participants utilized HA-Go application for tele-rehabilitation sessions. There was significant reduction in BMI (pre: 23.55, post: 23.19, p=0.028), waist circumference (pre: 34.71inches, post: 33.81inches, p=0.024) and fat mass (pre: 14.14kg, post:12.17kg, p=0.043). Significant improvement was also found in CESEI score (pre: 57, post: 75, p=0.011), CSES score (pre:3.74, post: 4.62, p=0.008) and UCLA health CR quiz score (pre:13.11, post: 23.22, p=0.008). Significant increase was found in maintenance and monitoring scale of SCCHDI (p=0.011), NACRQoL scores (pre: 31.63, post: 38.22, p=0.017) and WHO5 score (pre: 17.27, post:21.33, p=0.012) were increased after completion of the programme. Reduced anxiety (p=0.017), depression (p=0.027) as well as stress (p=0.013) in DASS21 were also noted. An improving trend was observed in skeletal muscle mass (pre: 27.84kg, post: 27.93kg, p=0.866), 6MWT distance (pre: 487.00m, post: 504.67m, p=0.26) and hand grip strength (pre: 39.37, post: 40.67, p=0.214), though the differences were not statistically significant. No adverse events were reported in the study period. Conclusions: The pilot Phase II CR program at NDH demonstrated statistically significant improvements in functional capacity and psychological well-being among participants. The program achieved high patient engagement and patients reported high levels of satisfaction. They showed substantial improvement in knowledge of cardiac disease. These findings suggest the program is effective, feasible and well-received, supporting the expansion of its coverage in the future to benefit a larger patient population.
