Examination of clinical and psychosocial determinants of exercise capacity change in cardiac rehabilitation

Heart Lung. 2019 Jan;48(1):13-17. doi: 10.1016/j.hrtlng.2018.07.007. Epub 2018 Aug 6.


Purpose: Most cardiac rehabilitation (CR) completers improve in multiple functional and psychosocial domains. However, not all demonstrate uniform improvement in functional indicators such as exercise capacity. This study examined baseline predictors and correlates of change in exercise capacity from CR intake to completion.

Methods: CR participants (n = 488) completed assessment of metabolic equivalents (METs) via treadmill stress test, depressive symptoms, quality of life, and social support at intake and discharge. Associations between demographic, clinical, and psychosocial factors and MET changes was tested with linear regression.

Results: METs increased from intake to discharge (1.91 ± 1.48, p < .001). Younger age (p < .001), lower BMI (p < .001), and lower weight (p < .01) were associated with greater MET change. Greater percentage weight loss (p < .05), and self-reported improvements in physical functioning (p < .001) and bodily pain (p < .01) were concurrently related to MET change.

Conclusions: Older CR attendees and those with higher baseline BMI may benefit from tailored intervention to ensure maximum benefit in exercise capacity.

Keywords: Cardiac rehabilitation; Exercise capacity; Metabolic equivalents.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiac Rehabilitation / methods*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / therapy*
  • Exercise Therapy / methods*
  • Exercise Tolerance / physiology*
  • Female
  • Humans
  • Male
  • Metabolic Equivalent
  • Middle Aged
  • Quality of Life*