A comparison of traditional and modified cardiac rehabilitation protocols on compliance to exercise, patient self-efficacy, cardiovascular outcomes, and program cost

everal problems have been identified with the traditional protocol (TP) for cardiac rehabilitation (CR) including low participation rates, poor facilitation of exercise beyond 3 months, and most recently, a decrease in insurance reimbursement. Additionally, even though continuous electrocardiogram monitoring (CECGM) is not required during exercise in low and moderate risk patients, it is commonly used despite the cost and the possibility its use may negatively impact patient self-efficacy (SE) towards independent exercise. To address these concerns, a reduced cost modified protocol (MP) designed to promote SE toward independent off-site exercise was developed. The study objectives were to compare the effectiveness of the MP to a TP and to evaluate differences in program cost over 6 months. Outcomes included exercise behavior, program participation, SE toward exercise, and cardiovascular (CV) health measures. Eighty low to moderate risk CR patients were randomized to a TP (n = 42) or a MP (n = 38). The first month patients followed identical regimens and included 3 CECGM exercise sessions/wk with encouragement to achieve a total of...