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Directly Measured Physical Function in Cardiac Rehabilitation

Rengo, Jason L. MSc; Savage, Patrick D. MSc; Shaw, Joan C. RN; Ades, Philip A. MD

Journal of Cardiopulmonary Rehabilitation & Prevention: May 2017 - Volume 37 - Issue 3 - p 175–181
doi: 10.1097/HCR.0000000000000231
Cardiac Rehabilitation

PURPOSE: The Short Physical Performance Battery (SPPB) is a strong predictor for risk of physical disability in older adults. Roughly half of individuals participating in phase II cardiac rehabilitation (CR) are 65 years or older, many presenting with low aerobic capacities and may be at increased risk for physical disability.

METHODS: The cohort consisted of 196 consecutive patients (136 men), aged 65 years or older, entering CR who were prospectively evaluated by the SPPB. Data were also obtained for age, self-reported physical function (Medical Outcomes Study Short Form-36 questionnaire), and peak aerobic capacity. Measures were repeated upon completion of CR for those individuals who completed the program.

RESULTS: The average age of patients was 74 ± 0.5 years. At baseline, total SPPB score was 9.7 ± 0.2 (out of 12). Followup data were obtained on 133 (68%) patients, with a mean improvement of 0.8 ± 0.1 (P < .0001), which was not clinically significant (≥1 point). Focusing on patients with a low baseline SPPB score, 72 subjects scored ≤9 (7.1 ± 0.2), with 45 completing exit measures. Improvements were found in gait speed (0.5 ± 0.1, P < .0001), chair-stand (1.0 ± 0.1, P < .0001), and total SPPB (1.6 ± 0.3, P < .0001) in this more disabled group. Measures of

O2peak were significantly reduced in the low SPPB group (13.5 ± 0.4 vs 17.5 ± 0.4 mL/kg/min, P < .0001). Measured

O2peak (R2 = 26%, P < .0001) and self-reported physical function score (R2 = 5%, P = .02) were the only multivariate predictors of baseline SPPB.

CONCLUSION: For patients who enter CR with low SPPB scores (37%), significant improvements in physical function were noted, largely explained by improved walking speed and leg strength (chair-stand).

The Short Physical Performance Battery is a strong predictor for risk of physical disability in older adults. For older patients who enter cardiac rehabilitation with diminished physical function (37%), significant improvement is noted in walking speed and leg strength (chair-stand) following completion of an exercise program.

Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington (Messrs Rengo and Savage, Ms Shaw, and Dr Ades); and University of Vermont College of Medicine, Burlington (Dr Ades).

Correspondence: Philip A. Ades, MD, Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, 62 Tilley Dr, South Burlington, VT 05403 (philip.ades@uvmhealth.org).

The authors report no conflicts of interest.

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