Functional capacity and patient-reported outcome measures after cardiac rehabilitation: a prospective study with 6-month follow-up

AIMS: This exploratory study aimed to assess the changes in functional capacity and patient-reported outcome measures (PROMs) experienced by outpatients undergoing cardiac rehabilitation; and factors associated with health-related quality of life. METHODS: We prospectively included all consecutive patients diagnosed with various cardiac conditions who had undergone a 10-week multidisciplinary cardiac rehabilitation programme from October 2020 to October 2022. The primary outcomes were functional capacity, including the 6-minute walk test, maximal short-term exercise capacity, estimated metabolic equivalent of task (eMET) and maximal quadriceps isometric strength at entry and discharge; and PROMs including the Hospital Anxiety and Depression Scale (HADS), quality of life (HeartQoL), and level of work, sport and leisure physical activity (Baecke) at entry, discharge and at 6 months. Secondarily, we assessed factors associated with heart-related quality of life over the 6-month period using multi-level mixed-effects generalised linear models adjusted for age, sex and time point. RESULTS: Among the 273 included patients, 81% were men and the median age was 63 years (range: 57–69). From programme entry to discharge, median values significantly increased for the 6-minute walk test (+60 m, 95% CI: 50–65), maximal short-term exercise capacity (+50 W, 95% CI: 50–50), eMET (+0.9, 95% CI: 0.7–1.1), maximal left quadriceps isometric strength (+3 Nm, 95% CI: 2–4) and maximal right quadriceps isometric strength (+4 Nm, 95% CI: 2.4–4.7). The median scores of depression, anxiety, physical and emotional heart-related quality of life and leisure activity were significantly improved from entry to the 6-month follow-up. The physical domain of quality of life was associated with the 6-minute walk test (coefficient: 1.001, 95% CI: 1.00–1.001) and anxiety score (coefficient: 0.97, 95% CI: 0.96–0.99) while the emotional domain was associated with level of depression (coefficient: 0.95, 95% CI: 0.94–0.97) and anxiety (coefficient: 0.98, 95% CI: 0.97–0.99). CONCLUSIONS: Our study showed that functional capacity significantly improved at discharge from the cardiac rehabilitation programme, as did the symptoms of anxiety and depression, quality of life and leisure-time physical activity at 6 months. The 6-minute walk test and symptoms of depression or anxiety were found to be significantly associated with quality of life. A cardiac rehabilitation programme could be proposed to eligible cardiac patients to improve their outcomes.