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. 2022 Nov 1;42(6):449-455.
doi: 10.1097/HCR.0000000000000700. Epub 2022 Jun 23.

Benefits of the First Pritikin Outpatient Intensive Cardiac Rehabilitation Program

Susan B Racette  1 , Lauren K Park, Serene T Rashdi, Kristin Montgomery, Kristin M McKenzie, Elena Deych, Christopher Graham, Nikhil Das, Taylor M Fogarty, Alexandria Van Zandt, Tessa Carson, Dotti Durbin, Jennifer Jonagan, Michael W Rich, Lisa de las Fuentes, Linda R Peterson
Affiliations

Benefits of the First Pritikin Outpatient Intensive Cardiac Rehabilitation Program

Susan B Racette et al. J Cardiopulm Rehabil Prev. .

Abstract

Purpose: Intensive cardiac rehabilitation (ICR) is a comprehensive, medically supervised exercise treatment program covered by Medicare for patients with approved cardiac diagnoses. The aim of this study was to determine the benefits of the first Pritikin outpatient ICR program.

Methods: This retrospective analysis included patients referred to ICR or traditional cardiac rehabilitation (CR) during the first 7 yr (2013-2019) at the first facility to implement Pritikin ICR. Intensive cardiac rehabilitation is composed of 36 education sessions on nutrition, exercise, and a healthy mindset, in addition to 36 monitored exercise sessions that comprise traditional CR. Assessments included anthropometrics (weight, body mass index, and waist circumference), dietary patterns, physical function (6-min walk test, [6MWT] Short Physical Performance Battery [SPPB: balance, 4-m walk, chair rise], handgrip strength), and health-related quality of life (Dartmouth COOP, 36-item Short Form Survey). Baseline and follow-up measures were compared within and between groups.

Results: A total of 1963 patients enrolled (1507 ICR, 456 CR, 66.1 ± 11.4 yr, 68% male, 82% overweight or obese); 1141 completed the program (58%). The ICR patients completed 22 exercise and 18 education sessions in 9.6 wk; CR patients completed 19 exercise sessions in 10.3 wk. ICR resulted in improvements ( P < .001 pre vs post) in all anthropometric measures, dietary patterns, 6MWT distance, all SPPB components, grip strength, and health-related quality of life. The improvements in anthropometrics and dietary patterns were greater in ICR than in CR.

Conclusions: The Pritikin outpatient ICR program promoted improvements in several cardiovascular health indices. Critical next steps are to assess long-term health outcomes after ICR, including cardiac events and mortality.

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Conflict of interest statement

Dr Peterson has stock holdings in Johnson & Johnson, Shockwave Medical, and Medtronic. All other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Changes in body weight and 6-min walk test distance among patients in intensive cardiac rehabilitation (ICR) or traditional cardiac rehabilitation (CR), 2013-2019. Box-and-whisker plots depicting median change (middle line in each box), IQR (whiskers), and outliers (circles above and below the whiskers) for weight (A) and 6-min walk test (B) by body mass index category at baseline.
Figure 2.
Figure 2.
Short Physical Performance Battery (SPPB) results at baseline and after intensive cardiac rehabilitation (ICR) or traditional cardiac rehabilitation (CR), 2013-2019. Bars represent the percentage of patients in each SPPB score category at baseline (top) and follow-up (bottom). Score ranges are 0-12 for the total SPPB and 0-4 for each of the three tests. All scores improved (P < .001) in ICR and CR, with no difference between groups.
Figure 3.
Figure 3.
Rate Your Plate scores at baseline and after intensive cardiac rehabilitation (ICR) or traditional cardiac rehabilitation (CR), 2013-2019. Bars represent the percentage of patients in each score range. A greater proportion of patients were in the highest category at follow-up. Absolute scores increased more in ICR than in CR (P < .0001).
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References

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