TY - JOUR
T1 - Feasibility of home-based cardiac rehabilitation in frail older patients: a clinical perspective
T2 - a clinical perspective
AU - Terbraak, Michel
AU - Verweij, Lotte
AU - Jepma, Patricia
AU - Buurman, Bianca
AU - Jørstad, Harald
AU - Scholte op Reimer, Wilma
AU - van der Schaaf, Marike
N1 - Publisher Copyright: © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.
PY - 2023
Y1 - 2023
N2 - (a) Background: 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. (b) Objective: To investigate physiotherapists’ (PTs) clinical experience with a guideline-centered, home-based CR protocol for frail older patients. (c) Methods: 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. (d) Results: 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. (e) Conclusion: 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.
AB - (a) Background: 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. (b) Objective: To investigate physiotherapists’ (PTs) clinical experience with a guideline-centered, home-based CR protocol for frail older patients. (c) Methods: 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. (d) Results: 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. (e) Conclusion: 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.
KW - Cardiovascular diseases
KW - cardiac rehabilitation
KW - comorbidity
KW - frail older patients
KW - home-based
UR - http://www.scopus.com/inward/record.url?scp=85123695353&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/09593985.2022.2025549
DO - https://doi.org/10.1080/09593985.2022.2025549
M3 - Article
C2 - 35068322
SN - 0959-3985
VL - 39
SP - 560
EP - 575
JO - Physiotherapy Theory and Practice
JF - Physiotherapy Theory and Practice
IS - 3
ER -