Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 14, Number 5, October 2023, pages 351-359

Influence of Daily Aerobic Exercise Duration on Phase 2 Cardiac Rehabilitation at a Rehabilitation Hospital and Health-Related Quality of Life After Discharge

**Table 1.** Baseline Characteristics of the Study Patients
Characteristics	n = 40
Results are expressed as mean ± SD or n (%) as indicated. NYHA class: New York Heart Association functional classification; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; E/e’: early diastolic transmitral flow velocity to early diastolic mitral annular tissue velocity ratio; eGFR: estimated glomerular filtration rate; CRP: C-reactive protein; BNP: brain natriuretic peptide; CR: cardiac rehabilitation; EQ-5D-5L: EuroQol five-dimension five-level.
Basic data
Age (years)	77.8 ± 10.4
Male, n (%)	15 (37.5)
Body mass index (kg/m²)	20.9 ± 3.2
Barthel index before hospitalization	93.6 ± 12.4
Kihon checklist before hospitalization	8.8 ± 5.7
Living alone, n (%)	11 (27.5)
Principal disease, n (%)
Heart failure	5 (12.5)
Ischemic heart disease	6 (15.0)
Cardiovascular surgery	12 (30.0)
Aortic surgery	10 (25.0)
Combined surgery (cardiovascular and aortic surgery)	7 (17.5)
Charlson comorbidity index after transfer	3.2 ± 2.2
NYHA class after transfer, n (%)
Class 1	0 (0)
Class 2	10 (25.0)
Class 3	28 (70.0)
Class 4	2 (5.0)
Echocardiographic after transfer
LVEF, %	53.4 ± 13.7
LAD, mm	38.2 ± 7.1
E/e’	14.0 ± 9.0
Laboratory data after transfer
Hemoglobin, g/dL	11.1 ± 1.3
Albumin, g/mL	3.3 ± 0.4
Creatinine, mg/dL	0.94 ± 0.42
eGFR, mL/min/1.73 m²	55.9 ± 17.1
CRP, mg/dL	1.65 ± 2.24
BNP, pg/mL	259.2 ± 235.4
Hospitalization process
Total CR time, min/day	131.2 ± 17.1
Aerobic exercise time, min/day	19.2 ± 19.0
Length of hospital stay, days	57.4 ± 28.0
Home discharge, n (%)	38 (95.0)
Temporary transfer to an acute care hospital, n (%)	6 (15.0)
Length of hospital stay before transfer, days	33.3 ± 20.9
After discharge from rehabilitation hospital
EQ-5D-5L	0.696 ± 0.235

Table 1. Baseline Characteristics of the Study Patients

Characteristics

n = 40

Results are expressed as mean ± SD or n (%) as indicated. NYHA class: New York Heart Association functional classification; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; E/e’: early diastolic transmitral flow velocity to early diastolic mitral annular tissue velocity ratio; eGFR: estimated glomerular filtration rate; CRP: C-reactive protein; BNP: brain natriuretic peptide; CR: cardiac rehabilitation; EQ-5D-5L: EuroQol five-dimension five-level.

Basic data

Age (years)

77.8 ± 10.4

Male, n (%)

15 (37.5)

Body mass index (kg/m²)

20.9 ± 3.2

Barthel index before hospitalization

93.6 ± 12.4

Kihon checklist before hospitalization

8.8 ± 5.7

Living alone, n (%)

11 (27.5)

Principal disease, n (%)

Heart failure

5 (12.5)

Ischemic heart disease

6 (15.0)

Cardiovascular surgery

12 (30.0)

Aortic surgery

10 (25.0)

Combined surgery (cardiovascular and aortic surgery)

7 (17.5)

Charlson comorbidity index after transfer

3.2 ± 2.2

NYHA class after transfer, n (%)

Class 1

0 (0)

Class 2

10 (25.0)

Class 3

28 (70.0)

Class 4

2 (5.0)

Echocardiographic after transfer

LVEF, %

53.4 ± 13.7

LAD, mm

38.2 ± 7.1

E/e’

14.0 ± 9.0

Laboratory data after transfer

Hemoglobin, g/dL

11.1 ± 1.3

Albumin, g/mL

3.3 ± 0.4

Creatinine, mg/dL

0.94 ± 0.42

eGFR, mL/min/1.73 m²

55.9 ± 17.1

CRP, mg/dL

1.65 ± 2.24

BNP, pg/mL

259.2 ± 235.4

Hospitalization process

Total CR time, min/day

131.2 ± 17.1

Aerobic exercise time, min/day

19.2 ± 19.0

Length of hospital stay, days

57.4 ± 28.0

Home discharge, n (%)

38 (95.0)

Temporary transfer to an acute care hospital, n (%)

6 (15.0)

Length of hospital stay before transfer, days

33.3 ± 20.9

After discharge from rehabilitation hospital

EQ-5D-5L

0.696 ± 0.235

**Table 2.** Changes in ADL, Physical Function, Cognitive Function, and Exercise Tolerance After Rehabilitation
	Before	After	P value
All results are expressed as mean ± SD. ADLs: activities of daily living; FIM: functional independence measure; SPPB: short physical performance battery; MMSE: mini-mental state examination; 6MD: 6-minute walking distance.
FIM, points	73.6 ± 15.8	112.6 ± 16.5	< 0.001
FIM-motor, points	48.4 ± 12.4	80.6 ± 13.6	< 0.001
FIM-cognitive, points	25.2 ± 6.4	32.0 ± 4.3	< 0.001
SPPB, points	8.2 ± 3.9	9.9 ± 3.5	< 0.001
Gait speed, m/s	0.82 ± 0.33	0.98 ± 0.37	< 0.001
Hand grip strength, kg	16.5 ± 7.1	17.1 ± 7.1	0.023
Knee extension strength, %BW	30.7 ± 14.8	39.5 ± 21.0	< 0.001
MMSE, points	25.1 ± 3.6	26.4 ± 2.6	< 0.001
6MD, m	205.1 ± 135.7	282.3 ± 152.3	< 0.001

Table 2. Changes in ADL, Physical Function, Cognitive Function, and Exercise Tolerance After Rehabilitation

Before

After

P value

All results are expressed as mean ± SD. ADLs: activities of daily living; FIM: functional independence measure; SPPB: short physical performance battery; MMSE: mini-mental state examination; 6MD: 6-minute walking distance.

FIM, points

73.6 ± 15.8

112.6 ± 16.5

< 0.001

FIM-motor, points

48.4 ± 12.4

80.6 ± 13.6

< 0.001

FIM-cognitive, points

25.2 ± 6.4

32.0 ± 4.3

< 0.001

SPPB, points

8.2 ± 3.9

9.9 ± 3.5

< 0.001

Gait speed, m/s

0.82 ± 0.33

0.98 ± 0.37

< 0.001

Hand grip strength, kg

16.5 ± 7.1

17.1 ± 7.1

0.023

Knee extension strength, %BW

30.7 ± 14.8

39.5 ± 21.0

< 0.001

MMSE, points

25.1 ± 3.6

26.4 ± 2.6

< 0.001

6MD, m

205.1 ± 135.7

282.3 ± 152.3

< 0.001

**Table 3.** Multiple Regression Analysis of Factoring Influencing EQ-5D-5L at 6 Months Post-Discharge
Model	Unstandardized coefficients B	Standardized coefficients beta	t-value	P-value	VIF
BI: Barthel index; NYHA class: New York Heart Association functional classification; CCI: Charlson comorbidity index; VIF: variance inflation factor.
1
Constant	-0.537		-1.513	0.139
Age, years	0.002	0.067	0.557	0.581	1.167
BI before hospitalization, points	0.011	0.592	4.413	< 0.001	1.448
Daily aerobic exercise duration, min/day	0.003	0.274	2.116	0.041	1.345
2
Constant	0.854		3.782	< 0.001
NYHA class	-0.091	-0.201	-1.259	0.216	1.377
CCI	-0.002	-0.021	-0.143	0.887	1.176
Daily aerobic exercise duration, min/day	0.005	0.443	2.725	0.010	1.429

Table 3. Multiple Regression Analysis of Factoring Influencing EQ-5D-5L at 6 Months Post-Discharge

Model

Unstandardized coefficients B

Standardized coefficients beta

t-value

P-value

VIF

BI: Barthel index; NYHA class: New York Heart Association functional classification; CCI: Charlson comorbidity index; VIF: variance inflation factor.

Constant

-0.537

-1.513

0.139

Age, years

0.002

0.067

0.557

0.581

1.167

BI before hospitalization, points

0.011

0.592

4.413

< 0.001

1.448

Daily aerobic exercise duration, min/day

0.003

0.274

2.116

0.041

1.345

Constant

0.854

3.782

< 0.001

NYHA class

-0.091

-0.201

-1.259

0.216

1.377

CCI

-0.002

-0.021

-0.143

0.887

1.176

Daily aerobic exercise duration, min/day

0.005

0.443

2.725

0.010

1.429