Significance of sequential cardiac rehabilitation program through inter-hospital cooperation between acute care and rehabilitation hospitals in elderly patients after cardiac surgery in Japan.
Tomoyuki Morisawa: Department of Physical Therapy, Hyogo University Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan. morisawa@huhs.ac.jp.
Katsuhiro Ueno: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Yuko Fukuda: Department of Cardiovascular Medicine, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Naoto Kanazawa: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Hiroshi Kawaguchi: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Rikito Zaiki: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Hiroaki Fuzisaki: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Haruka Yoshioka: Department of Rehabilitation, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Maki Sasaki: Department of Cardiovascular Medicine, Nishi-Kinen Port-Island Rehabilitation Hospital, Kobe, Japan.
Kentaro Iwata: Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan.
Tadaaki Koyama: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Takeshi Kitai: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
Yutaka Furukawa: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
Tetsuya Takahashi: Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan.
This study is to evaluate the impact of cooperation between acute care hospital and rehabilitation hospital on physical function, exercise tolerance, activities of daily living (ADL), health-related quality of life (HR-QOL), and psychological function in heart disease patients undergoing cardiac rehabilitation. Among patients undergoing concurrent medical treatment and cardiac rehabilitation starting early in acute care hospitalization, we selected 30 patients who required continued cardiac rehabilitation in rehabilitation hospitals as subjects. At the time of admission and discharge from the rehabilitation hospital, we measured and compared physical function [grip strength, knee extension strength, and the short physical performance battery (SPPB)], ADL ability using the Functional Independence Measure (FIM), exercise tolerance [six-minute walking distance (6MD)], and psychological functions such as the MOS 36-Item Short-Form Health Survey (SF-36). The average age of the subjects was 76.8 years and 60% were women. In 70% of cases, musculoskeletal causes were the reasons for continued cardiac rehabilitation in a rehabilitation hospital. In evaluations before and after hospitalization, significant improvements were observed in knee extension strength and the results of the SPPB (p < 0.01), FIM, and 6MD (p < 0.01). In SF-36, significant improvements were observed in physical function, role functioning, vitality, and emotional functioning (p < 0.05, p < 0.01). With intensive cardiac rehabilitation in rehabilitation hospitals, physical function, ADL, exercise tolerance, and HR-QOL improved significantly. As the severity and prevalence of heart disease are expected to increase in association with multiple disabilities and aging, the importance of cooperation between acute care hospitals and rehabilitation hospitals will increase; therefore, cardiac rehabilitation should be the basis for such cooperation.
