CONGRESS ABSTRACT

Purpose: Despite the well-recognized benefits of physical activity (PA) in secondary prevention programs, patients with cardiovascular disease (CVD) are less likely to attend traditional center-based (CB) interventions. The purpose of the study was to investigate the efficacy of a CB and consequent home-based  physical exercise (HBPE) prescription in a low population density area in improving adherence to exercise, implement exercise capacity and clinical outcomes of patients with CVD. Methods: 102 patients (20 females, mean age 66 ± 9 years) were referred after an acute event and attended the program at the UOS of Sports Cardiology and Rehabilitation (ULSS 1 Dolomiti, Feltre) from January 2023 to June 2024. Almost all patients had a form of ischemic cardiomyopathy and 19 had valvular intervention. The CB intervention program consisted of 4 weeks of individual on-site sessions including educational counseling and supervised PE sessions (2-3 sessions/week). At discharge HBPE was prescribed, with indication to keep training in autonomy or in one of the “Palestre della Salute” (PDS) network available in the Veneto Region. All patients were instructed to fill out a weekly exercise diary for at least 6 months. Main outcomes were adherence to HBPE, self-reported levels of PA, variations in physical characteristics and change in the six-minute walking test (6MWT). All variables were assessed at the beginning of the CB program and after 6 months from the end of the supervised intervention. Results: As regards HB intervention, at 6 months 36 patients completed the exercise diary maintaining the prescribed exercise dose. Of those 25 people stably attended a PDS. A significant proportion of patients reported lower-than-prescribed levels of PE or just reported PA and most of patients did not log into a PDS. Moreover, significant changes were observed in mean BMI (from 27.3 to 26.8 kg/m2; p<0.05), waist circumference (from 99.5 to 98.2 cm; p<0.05). Finally, there was a significant increase in median PA levels (from 6.4 to 7.9 MET/h-week; p<0.05), associated with a valuable improvement in the 6MWT (from 490 to 541 m; p<0.0001). Conclusion: This hybrid exercise intervention shows insights into the long term adherence to a physically active lifestyle (including both PE and PA) in patients with CVD in a low population density area. Results may provide valuable insights into the development of more feasible/effective secondary prevention programs.