Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials
ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017...
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| Veröffentlicht in: | Open heart 2018-12, Vol.5 (2), p.e000880-e000880 |
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| creator | Smart, Neil A King, Nicola Lambert, Jeffrey D Pearson, Melissa J Campbell, John L Risom, Signe S Taylor, Rod S |
| description | ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p |
| doi_str_mv | 10.1136/openhrt-2018-000880 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6307588</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2164556164</sourcerecordid><originalsourceid>FETCH-LOGICAL-b472t-29586825b721851c72731d8f408d9d090252cb23791611b4e830c17c52cbc1633</originalsourceid><addsrcrecordid>eNqNkk1v1DAQhiMEolXpL0BClrhwSfFH4jgckFBVWqRKXOBsOc6EeOXYqe1s2R_K_8HZXaqFExd_zDx-Zzx6i-I1wVeEMP7ez-DGkEqKiSgxxkLgZ8U5xTUrGafV85PzWXEZ4yYzhNYct_xlccYwJ6wi-Lz4dfMTgjYRyk5F6JFWoTdKowCj6ow1SSXjHTLTHPwWIoIjnsFZaZN2SLkejaBsGssAVqUs8rAou6b8gKwZABmHZvCzBfRo0ohUCkZZNJguGGv3BT4gheIuJpjyda2-NfC4l54gqVI5ZXfRxFUx5KifzNrsmnfelSehvXR8VbwY8gaXx_2i-P755tv1XXn_9fbL9af7sqsamofX1oILWncNJaImuqENI70YKiz6tsctpjXVHWVNSzghXQWCYU0avUY14YxdFB8PuvPSTdBrcCkoK-dgJhV20isj_844M8offis5w00tRBZ4dxQI_mGBmGT-hoY8FQd-iZISXtU1z2tG3_6DbvwS8mBWqm4J5S1vM8UOlA4-xgDDUzMEy9U58ugcuTpHHpyTX705_cfTmz8-ycDVAeimzX8p_gaBY9Sy</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2159126969</pqid></control><display><type>article</type><title>Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials</title><source>BMJ Open Access Journals</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free E- Journals</source><creator>Smart, Neil A ; King, Nicola ; Lambert, Jeffrey D ; Pearson, Melissa J ; Campbell, John L ; Risom, Signe S ; Taylor, Rod S</creator><creatorcontrib>Smart, Neil A ; King, Nicola ; Lambert, Jeffrey D ; Pearson, Melissa J ; Campbell, John L ; Risom, Signe S ; Taylor, Rod S</creatorcontrib><description>ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.</description><identifier>ISSN: 2053-3624</identifier><identifier>ISSN: 2398-595X</identifier><identifier>EISSN: 2053-3624</identifier><identifier>DOI: 10.1136/openhrt-2018-000880</identifier><identifier>PMID: 30613410</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Body mass index ; Cardiac arrhythmia ; Cardiac function ; Cardiology ; Cardiovascular disease ; Exercise ; Fitness training programs ; Heart failure ; Heart rate ; Mental health ; Meta-Analysis ; Mortality ; Patients ; Physical fitness ; Quality of life ; Rehabilitation ; Stroke ; Studies ; Systematic review ; Yoga</subject><ispartof>Open heart, 2018-12, Vol.5 (2), p.e000880-e000880</ispartof><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2018 Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0 Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-29586825b721851c72731d8f408d9d090252cb23791611b4e830c17c52cbc1633</citedby><cites>FETCH-LOGICAL-b472t-29586825b721851c72731d8f408d9d090252cb23791611b4e830c17c52cbc1633</cites><orcidid>0000-0003-4774-9054</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://openheart.bmj.com/content/5/2/e000880.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://openheart.bmj.com/content/5/2/e000880.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27526,27527,27901,27902,53766,53768,77344,77375</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30613410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smart, Neil A</creatorcontrib><creatorcontrib>King, Nicola</creatorcontrib><creatorcontrib>Lambert, Jeffrey D</creatorcontrib><creatorcontrib>Pearson, Melissa J</creatorcontrib><creatorcontrib>Campbell, John L</creatorcontrib><creatorcontrib>Risom, Signe S</creatorcontrib><creatorcontrib>Taylor, Rod S</creatorcontrib><title>Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials</title><title>Open heart</title><addtitle>Open Heart</addtitle><description>ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.</description><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac function</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Exercise</subject><subject>Fitness training programs</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Mental health</subject><subject>Meta-Analysis</subject><subject>Mortality</subject><subject>Patients</subject><subject>Physical fitness</subject><subject>Quality of life</subject><subject>Rehabilitation</subject><subject>Stroke</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Yoga</subject><issn>2053-3624</issn><issn>2398-595X</issn><issn>2053-3624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkk1v1DAQhiMEolXpL0BClrhwSfFH4jgckFBVWqRKXOBsOc6EeOXYqe1s2R_K_8HZXaqFExd_zDx-Zzx6i-I1wVeEMP7ez-DGkEqKiSgxxkLgZ8U5xTUrGafV85PzWXEZ4yYzhNYct_xlccYwJ6wi-Lz4dfMTgjYRyk5F6JFWoTdKowCj6ow1SSXjHTLTHPwWIoIjnsFZaZN2SLkejaBsGssAVqUs8rAou6b8gKwZABmHZvCzBfRo0ohUCkZZNJguGGv3BT4gheIuJpjyda2-NfC4l54gqVI5ZXfRxFUx5KifzNrsmnfelSehvXR8VbwY8gaXx_2i-P755tv1XXn_9fbL9af7sqsamofX1oILWncNJaImuqENI70YKiz6tsctpjXVHWVNSzghXQWCYU0avUY14YxdFB8PuvPSTdBrcCkoK-dgJhV20isj_844M8offis5w00tRBZ4dxQI_mGBmGT-hoY8FQd-iZISXtU1z2tG3_6DbvwS8mBWqm4J5S1vM8UOlA4-xgDDUzMEy9U58ugcuTpHHpyTX705_cfTmz8-ycDVAeimzX8p_gaBY9Sy</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Smart, Neil A</creator><creator>King, Nicola</creator><creator>Lambert, Jeffrey D</creator><creator>Pearson, Melissa J</creator><creator>Campbell, John L</creator><creator>Risom, Signe S</creator><creator>Taylor, Rod S</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4774-9054</orcidid></search><sort><creationdate>20181201</creationdate><title>Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials</title><author>Smart, Neil A ; King, Nicola ; Lambert, Jeffrey D ; Pearson, Melissa J ; Campbell, John L ; Risom, Signe S ; Taylor, Rod S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-29586825b721851c72731d8f408d9d090252cb23791611b4e830c17c52cbc1633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac function</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Exercise</topic><topic>Fitness training programs</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Mental health</topic><topic>Meta-Analysis</topic><topic>Mortality</topic><topic>Patients</topic><topic>Physical fitness</topic><topic>Quality of life</topic><topic>Rehabilitation</topic><topic>Stroke</topic><topic>Studies</topic><topic>Systematic review</topic><topic>Yoga</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smart, Neil A</creatorcontrib><creatorcontrib>King, Nicola</creatorcontrib><creatorcontrib>Lambert, Jeffrey D</creatorcontrib><creatorcontrib>Pearson, Melissa J</creatorcontrib><creatorcontrib>Campbell, John L</creatorcontrib><creatorcontrib>Risom, Signe S</creatorcontrib><creatorcontrib>Taylor, Rod S</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Open heart</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smart, Neil A</au><au>King, Nicola</au><au>Lambert, Jeffrey D</au><au>Pearson, Melissa J</au><au>Campbell, John L</au><au>Risom, Signe S</au><au>Taylor, Rod S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials</atitle><jtitle>Open heart</jtitle><addtitle>Open Heart</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>5</volume><issue>2</issue><spage>e000880</spage><epage>e000880</epage><pages>e000880-e000880</pages><issn>2053-3624</issn><issn>2398-595X</issn><eissn>2053-3624</eissn><abstract>ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30613410</pmid><doi>10.1136/openhrt-2018-000880</doi><orcidid>https://orcid.org/0000-0003-4774-9054</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Body mass index Cardiac arrhythmia Cardiac function Cardiology Cardiovascular disease Exercise Fitness training programs Heart failure Heart rate Mental health Meta-Analysis Mortality Patients Physical fitness Quality of life Rehabilitation Stroke Studies Systematic review Yoga |
| title | Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials |
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