Exercise-based cardiac rehabilitation

Regular daily exercise has been proven to significantly improve the prognosis of patients with acute coronary syndrome (ACS), mainly by reducing cardiovascular mortality, recurrent cardiac events, and hospitalization needs In particular, exercise-based rehabilitation methods have provided significant health benefits to patients with coronary heart disease

The formulation of personalized exercise plans is crucial, as individual responses to exercise training vary significantly By identifying genetic variations associated with exercise response, more effective personalized exercise plans can be tailored to optimize the health benefits of exercise with greater genetic variation related to cardiopulmonary function benefit significantly from aerobic exercise rehabilitation programs Compared with men, women’s response to exercise training may be lower, and some women do not even observe significant improvements Therefore, developing alternative cardiac rehabilitation programs to meet the special needs of female patients is particularly important. Alternative forms of exercise, such as Tai Chi, are being studied for their application in the cardiac rehabilitation of myocardial infarction patients. ^, These research results provide clinical doctors with evidence to help them recommend the most suitable types of exercise for patients. On the basis of exercise cardiac rehabilitation has a significant positive impact on the left ventricular function of patients with acute myocardial infarction after percutaneous coronary intervention, helping to improve their cardiac function Long-term aerobic exercise helps reduce the risk of cardiovascular risk factors and cardiovascular events However, in obese patients, cardiac rehabilitation may not fully exert its maximum potential benefits, emphasizing the importance of weight control and BMI in cardiac rehabilitation

Physical activity is undoubtedly a key element of cardiac rehabilitation, but patients may reduce exercise after completing rehabilitation, leading to reduced compliance Therefore, effective intervention measures must be designed to maintain patients’ exercise habits to continue promoting heart health and reducing the risk of future cardiac events

Real-world challenges and prospective issues in outpatient cardiac rehabilitation implementation

Cardiac rehabilitation (CR) has been proven to significantly increase the health of heart disease patients, yet as exemplified by South Korea, despite extensive invasive treatments provided during the acute phase of acute coronary syndrome, the comprehensive implementation of CR falls short of expectations, revealing notable deficiencies. ^, This issue is similarly pronounced on a global scale, with data indicating that only a quarter of eligible medical insurance beneficiaries actually participate in CR programs The main obstacles include severe shortages of human resources and limitations in facility space, underscoring the need for strengthened administrative support, particularly through increased financial subsidies for CR services from health insurance A deeper analysis revealed that individual factors, environmental constraints, and multiple barriers within the health system collectively restrict the rate of patient participation in CR For example, factors such as low socioeconomic status, insufficient education levels, advanced age, lack of health insurance awareness, inconvenient transportation, and financial difficulties, along with healthcare-level issues such as the absence of automatic referral mechanisms, insufficient economic incentives, poor multidisciplinary team collaboration, and reimbursement challenges, significantly limit the accessibility of CR services Moreover, research indicates that the level of physical activity of patients after acute coronary syndrome is an important predictor of participation in CR, with less physically active patients being less likely to enroll This emphasizes the importance of developing specialized strategies for those who are inactive and at high risk, as participation in CR is very likely to lead to significant improvements in prognosis. Additionally, research also highlights the decisive role of the referral process in CR participation, indicating that factors such as income level and education can affect the referral process

Strategies and challenges in enhancing adherence to patient cardiac rehabilitation

Cardiac rehabilitation (CR) is a core intervention for improving the prognosis of patients with heart disease. Although its effectiveness has been scientifically proven, the acceptance and adherence of patients in practical applications still face many challenges Traditional center-based cardiac rehabilitation (CBCR) has shown significant efficacy but is often limited by time and economic costs, preventing widespread coverage, which restricts the maximization of its rehabilitation effects In contrast, home and remote cardiac rehabilitation (CTR) models, with their convenience and cost-effective advantages, are increasingly becoming powerful ways to improve patient adherence The latest research shows that remote cardiac rehabilitation is comparable to traditional center rehabilitation in improving cardiovascular health and significantly reduces the time and energy costs for patients due to frequent visits to rehabilitation centers

The core of enhancing adherence to CR lies in implementing personalized strategies and providing high-standard management It is crucial to customize rehabilitation plans that can be integrated into patients’ daily lives according to their individual needs and expectations For patients with acute myocardial infarction and coronary artery disease, adopting comprehensive care and a collaborative approach to normalize rehabilitation intervention measures helps improve patient acceptance In addition, modern technology, such as mobile health (mHealth) technology, not only enhances patient adherence through remote medical services and video conferencing but also provides additional care support, thereby improving overall patient satisfaction

Importantly, certain specific groups, such as elderly individuals, women, indigenous people, and residents of remote areas, have relatively lower participation rates in CR, which requires the development and implementation of targeted strategies to increase their willingness to participate Overall, by adopting innovative rehabilitation models, strengthening patient education and support, and effectively utilizing modern technology, we can effectively address adherence challenges in the CR process, thereby promoting the continuous improvement of patients’ cardiac health status.

Considerations for individualization and challenges of diversity in cardiac rehabilitation

The implementation of CR for patients with acute myocardial infarction involves diverse issues, which not only affect participation rates but also involve the effectiveness of rehabilitation, the adaptability of target populations, and the customization of rehabilitation strategies in many key aspects. First, although CR plays a significant role in improving patients’ cardiopulmonary endurance and quality of life, the overall participation rate is not ideal and is largely limited by the uneven distribution of medical resources, especially for residents in remote areas, where access to medical services is particularly challenging. ^, Notably, with the advancement of biomedical technology, remote CR has become possible, indicating that rehabilitation plans can be effectively implemented even in areas with scarce medical resources Furthermore, the selection of CR strategies must consider the differences between individuals. For example, elderly patients may show a more significant improvement in exercise tolerance after participating in long-term rehabilitation programs exceeding six weeks, whereas middle-aged patients may be more responsive to short-term rehabilitation programs Additionally, the choice of appropriate rehabilitation model is crucial. Regular rehabilitation models under the guidance of hospitals can more effectively improve cardiopulmonary function in a shorter time than can completely home-based rehabilitation In terms of training intensity, moderate-intensity continuous exercise is superior to high-intensity interval training (HIIT) because of its long-term impact on the resting heart rate in patients who have recently experienced a myocardial infarction, particularly in promoting cardiovascular health Finally, gender differences are also an important factor to consider in CR. Female patients with acute myocardial infarction may face greater cardiovascular risks during the rehabilitation process because of higher levels of trimethylamine N-oxide (TMAO), but this risk can be effectively controlled through lifestyle adjustments related to CR, thereby reducing the occurrence of future cardiovascular events

Role of cardiac rehabilitation in facilitating cardiac function recovery

The primary objective of cardiac rehabilitation programs is to employ a comprehensive strategy that includes aerobic exercise, health education, and psychological intervention to promote the repair and enhancement of patients’ cardiac functions. Numerous studies have confirmed that moderate cardiac rehabilitation training can significantly reduce the incidence of angina and arrhythmias after myocardial infarction, highlighting the pivotal role of cardiac rehabilitation in preventing the recurrence of cardiovascular diseases and providing patients with a safer and more efficient path to recovery Further research has indicated that cardiac rehabilitation can effectively improve the left ventricular ejection fraction (LVEF), a key indicator of the pumping function of the heart, which is crucial for patients Specifically, patients who participated in cardiac rehabilitation programs preasented a significant increase in LVEF compared with the control group not involved in such programs, enhancing their cardiac function reserve and exercise tolerance

Moreover, there is a positive correlation between the frequency of exercise training in cardiac rehabilitation and an increase in the skeletal muscle index (SMI) as well as an improvement in cardiorespiratory fitness (CRF) This suggests that as rehabilitation training continues, patients’ muscle strength and cardiorespiratory endurance can be significantly enhanced, laying a solid foundation for improvements in their daily quality of life. Additionally, for patients who have undergone repeat percutaneous coronary interventions, a second round of cardiac rehabilitation is closely related to a reduction in adverse clinical outcomes These findings reveal that the benefits of cardiac rehabilitation may have a cumulative effect, emphasizing the importance of continuous and regular rehabilitation training in improving patients’ long-term prognosis.

Role of cardiac rehabilitation in enhancing patient quality of life

The goal of cardiac rehabilitation is not only to improve cardiac function but also to improve the quality of life of patients comprehensively. Studies have revealed that home-based cardiac rehabilitation exercises significantly increase the cardiac function, reduce the risk of postoperative complications, and strengthen the body’s antioxidant capacity, exercise capacity, and overall quality of life for patients with acute myocardial infarction This finding highlights the key role of home rehabilitation in achieving comprehensive recovery for patients, integrating rehabilitation activities with daily life so that patients can participate more conveniently and achieve better rehabilitation outcomes.

Moreover, cardiac rehabilitation is associated with a lower midterm mortality rate for patients, further confirming the significant benefits of cardiac rehabilitation in extending patients’ lifespan and enhancing their quality of life Additionally, outpatient cardiac rehabilitation programs have been proven to effectively reduce aortic afterload in patients with acute myocardial infarction and improve the diastolic and systolic function of the left ventricle, which is highly important for increasing patient quality of life and reducing the burden of disease

Comprehensive value and importance of cardiac rehabilitation

Cardiac rehabilitation significantly improves the physiological and psychological conditions of patients through comprehensive scientific assessment and customized treatment plans Studies indicate that patients who participate in cardiac rehabilitation within one month after discharge have a reduced risk of myocardial infarction, emphasizing the significant benefits of cardiac rehabilitation in preventing the recurrence of cardiac events This comprehensive plan further significantly reduces the overall mortality and cardiovascular mortality of patients, as well as the risk of recurrence of myocardial infarction and stroke, through effective reduction of risk factors and precise control of drug treatment

The positive effects of cardiac rehabilitation are enduring. Studies have shown that after 12 months of follow-up, cardiac rehabilitation exercise has been proven to reduce the risk of cardiac death and all-cause mortality in patients with ST-segment elevation myocardial infarction, thereby improving patient prognosis The benefits of cardiac rehabilitation are universally applicable and not limited by the patient’s sex, age, or socioeconomic background. Studies have noted that participation in cardiac rehabilitation is associated with a 32% reduction in all-cause mortality, emphasizing that cardiac rehabilitation should be a standard recommendation for all patients with coronary artery disease, especially for more vulnerable and prone elderly patients

The benefits of cardiac rehabilitation are also reflected in the significant improvement in patients’ cardiac function. Exercise-based cardiac rehabilitation programs can effectively enhance the left ventricular function of patients after the first percutaneous coronary treatment for myocardial infarction and have a positive effect on the left ventricular function and structural remodeling of patients after acute myocardial infarction Moreover, cardiac rehabilitation can significantly improve the diastolic function of the heart in patients with acute coronary syndrome, and at the community level, physical activity-based rehabilitation projects effectively reduce the risk of major adverse cardiac events(MACEs) and improve patients’ cardiac function and physical strength Cardiac rehabilitation not only focuses on patients’ physical health but also includes key areas such as psychosocial counseling, smoking cessation education, medication adherence, and nutritional guidance This comprehensive approach is essential for enhancing patients’ self-management ability and rehabilitation adherence, and home rehabilitation has been proven to significantly improve the cardiac function, exercise endurance, and life expectancy of patients with acute coronary syndrome In addition, cardiac rehabilitation has also had a positive impact on overweight and obese patients, with studies showing that patients who participated in cardiac rehabilitation lost an average of 3% or more of their body weight within 12 weeks This finding further confirms the effectiveness of cardiac rehabilitation in promoting overall health for patients.

Moreover, cardiac rehabilitation is also very beneficial for the elderly patient population. In the elderly population aged 65 years and above, modern exercise-based cardiac rehabilitation (EBCR) programs are associated with significant functional improvement, indicating that cardiac rehabilitation is not only suitable for young patients but also significantly enhances the quality of life of elderly individuals

Innovations in cardiac rehabilitation pathways and practices

Innovations in the field of cardiac rehabilitation are steering its development toward a more personalized and patient-centered approach. These innovative strategies have not only improved therapeutic outcomes but also significantly enhanced patient engagement and quality of life.

The cardiac rehabilitation sector has integrated technology with personalized services, exemplified by the Corrie Hybrid CR project, a technology-driven multi-component intervention emphasizing health equity, providing an effective alternative to traditional center-based cardiac rehabilitation for patients post-cardiac events or surgery Personalized precision medical models offer customized exercise plans that cater to diverse patient groups, making cardiac rehabilitation services more flexible and accessible

The integration of telemedicine, particularly the use of video consultations, has provided additional support for medication and lifestyle adherence in ST-segment elevation myocardial infarction (STEMI) patients, offering benefits beyond conventional care Home-based cardiac rehabilitation has a positive impact on health-related quality of life and physical activity, comparable to or even greater than that of traditional center-based rehabilitation Additionally, stratified nursing care programs in cardiac rehabilitation provide appropriate care services to meet the specific needs of patients with severe coronary artery disease during their rehabilitation process

Emerging technologies such as 5G IoT platforms and digital health interventions (DHIs) play a key role in the field of cardiac rehabilitation, aiming to improve patient outcomes and reduce readmission risk. ^, Cardiac rehabilitation programs further encompass psychological support and education for patients, including personalized psychoeducation and enhanced cardiac rehabilitation plans, which significantly improve patients’ psychological status and rehabilitation outcomes

These innovative approaches highlight significant advancements in the field of cardiac rehabilitation. By merging modern technology and personalized services, they pave the way for a more comprehensive and effective rehabilitation path for heart disease patients.