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Feasibility of home-based cardiac rehabilitation in frail older patients: a clinical perspective

Physiotherapy Theory and Practice, 2023, Vol.39 (3), p.560-575

2022 The Author(s). Published with license by Taylor & Francis Group, LLC. 2022 ;ISSN: 0959-3985 ;EISSN: 1532-5040 ;DOI: 10.1080/09593985.2022.2025549

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  • Title:
    Feasibility of home-based cardiac rehabilitation in frail older patients: a clinical perspective
  • Author: Terbraak, Michel ; Verweij, Lotte ; Jepma, Patricia ; Buurman, Bianca ; Jørstad, Harald ; Scholte Op Reimer, Wilma ; van der Schaaf, Marike
  • Subjects: cardiac rehabilitation ; Cardiovascular diseases ; comorbidity ; frail older patients ; home-based
  • Is Part Of: Physiotherapy Theory and Practice, 2023, Vol.39 (3), p.560-575
  • Description: Home-based cardiac rehabilitation (CR) is an attractive alternative for frail older patients who are unable to participate in hospital-based CR. Yet, the feasibility of home-based CR provided by primary care physiotherapists (PTs) to these patients remains uncertain. To investigate physiotherapists' (PTs) clinical experience with a guideline-centered, home-based CR protocol for frail older patients. A qualitative study examined the home-based CR protocol of a randomized controlled trial. Observations and interviews of the CR-trained primary care PTs providing home-based CR were conducted until data saturation. Two researchers separately coded the findings according to the theoretical framework of Gurses. The enrolled PTs (n = 8) had a median age of 45 years (IQR 27-57), and a median work experience of 20 years (IQR 5-33). Three principal themes were identified that influence protocol-adherence by PTs and the feasibility of protocol-implementation: 1) feasibility of exercise testing and the exercise program; 2) patients' motivation and PTs' motivational techniques; and 3) interdisciplinary collaboration with other healthcare providers in monitoring patients' risks. Home-based CR for frail patients seems feasible for PTs. Recommendations on the optimal intensity, use of home-based exercise tests and measurement tools, and interventions to optimize self-regulation are needed to facilitate home-based CR.
  • Publisher: Taylor & Francis
  • Language: English
  • Identifier: ISSN: 0959-3985
    EISSN: 1532-5040
    DOI: 10.1080/09593985.2022.2025549
  • Source: Taylor & Francis Open Access
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