ArticleEuropean journal of physiotherapy2024
Home-based cardiac rehabilitation in older adults: expert-recommendations for physiotherapist-led care to improve daily physical functioning and reduce comorbidity-related barriers.
Article in European journal of physiotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Effects of an eHealth Cardiac Exercise Rehabilitation Platform for Patients After Percutaneous Coronary Intervention Based on the Persuasive Systems Design Model: Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Balance and Mobility Impairment in Older Adults with Cardiovascular Disease Before and After Rehabilitation: A Narrative Review.Journal of clinical medicine · 2026Review
- Barriers and Facilitators to the Initiation of Home-Based Exercise Rehabilitation After Radiofrequency Catheter Ablation for Atrial Fibrillation: A TDF-Based Qualitative Study.Patient preference and adherence · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
Background: Cardiac rehabilitation (CR) can reduce mortality and improve physical functioning in older patients, but current programs do not support the needs of older patients with comorbidities or frailty, for example due to transport problems and physical limitations. Home-exercise-based cardiac rehabilitation (HEBCR) programs may better meet these needs, but physiotherapy guidelines for personalising HEBCR for older, frail patients with cardiovascular disease are lacking. Purpose: To provide expert recommendations for physiotherapists on how to administer HEBCR to older adults with comorbidities or frailty. Methods: This Delphi study involved a panel of Dutch experts in physiotherapy, exercise physiology, and cardiology. Three Delphi rounds were conducted between December 2020 and February 2022. In the first round panellists provided expertise on applicability and adaptability of existing CR-guidelines. In the second round panellists ranked the importance of statements about HEBCR for older adults. In the third round panellists re-ranked statements when individual scores were outside the semi-interquartile range. Consensus was defined as a semi-interquartile range of ≤ 1.0. Results: Of 20 invited panellists, 11 (55%) participated. Panellists were clinical experts with a median (interquartile range) work experience of 20 (10.5) years. The panel reached a consensus on 89% of statements, identifying key topics such as implementing the patient perspective, assessing comorbidity and frailty barriers to exercise, and focusing on personal goals and preferences. Conclusion: This Delphi study provides recommendations for personalised HEBCR for older, frail patients with cardiovascular disease, which can improve the effectiveness of CR-programs and address the needs of this patient population. Prioritising interventions aimed at enhancing balance, lower extremity strength, and daily activities over interventions targeting exercise capacity may contribute to a more holistic and effective approach, particularly for older adults.
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