ORIGINAL PAPER
The impact of professional status on the effects of and adherence to the outpatient followed by home-based telemonitored cardiac rehabilitation in patients referred by a social insurance institution
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Medical University of Gdańsk, Gdańsk, Poland
(Department of Rehabilitation)
Corresponding author
Dominika Szalewska
Medical University of Gdańsk, Department of Rehabilitation, Dębinki 7, 80-211 Gdańsk, Poland
Int J Occup Med Environ Health. 2015;28(4):761-70
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ABSTRACT
Objectives: Legislators and policymakers have expressed strong interest in intervention programs to reduce dependence
on social disability benefits. Hybrid: ambulatory followed by home-based cardiac telerehabilitation – hybrid cardiac rehabilitation
(HCR) seems to be a novel alternative for standard cardiac rehabilitation for patients with cardiovascular
diseases (CVD) as a form of pension prevention paid by the Social Insurance Institution (SII). The kind of professional
status may bias the motivation to return to work after HCR. The aim of our study was to evaluate whether the professional
status can affect the effects of HCR. Material and Methods: One hundred fifty-two patients with CVD referred
by the SII for a 5-week HCR were qualified for the study. Patients (87.7% males), aged 57.31±5.61 years, were divided
into 2 subgroups: W) white-collar employees (N = 22) and B) blue-collar employees (N = 130). To evaluate functional
capacity, an exercise test on a treadmill was used. Results: The number of days of absence in the cardiac rehabilitation
program did not differ between the groups (mean ± standard deviation – B: 1.09±3.10 days, W: 1.95±3.64 days).
There were significant improvements (p < 0.05) in measured variables after HCR in both (W and B) groups (max workload:
8.21±2.88 METs (measured in metabolic equivalents) vs. 9.6±2.49 METs, 7.76±2.51 METs vs. 8.73±2.7 METs, resting
heart rate (RHR): 77±16.22 bpm vs. 69.94±12.93 bpm, 79.59±14 bpm vs. 75.24±11.87 bpm; double product, i.e., product
of heart rate and systolic BP (DP rest) 10 815.22±2968.24 vs. 9242.94±1923.08, 10 927.62±2508.47 vs. 9929.7±2304.94).
In group B, a decrease in systolic blood pressure (BP syst. – 137.03±17.14 mm Hg vs. 131.82±21.13 mm Hg), heart rate
recovery in the 1st minute after the end of peak exercise (HRR1) (99.38±19.25 vs. 93.9±19.48) and New York Heart Association
(NYHA) class (1.22±0.53 vs. 1.11±0.36) was observed. In group W, a decrease in diastolic blood pressure (BP diast.)
at rest was observed (88.28±9.79 mm Hg vs. 83.39±8.95 mm Hg). The decrease in resting HR was significantly greater in
group W (69.94±12.93 vs. 75.24±11.87, p = 0.034). Conclusions: Hybrid cardiac rehabilitation is feasible and safe with high
adherence to the program regardless of the patient’s professional status. Professional status did not influence the beneficial
effect of HCR on exercise tolerance.