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Randomized Controlled Trial
. 2023 Sep 1;103(9):pzad055.
doi: 10.1093/ptj/pzad055.

Effects of a Dedicated Cardiac Rehabilitation Program for Patients With Obesity on Body Weight, Physical Activity, Sedentary Behavior, and Physical Fitness: The OPTICARE XL Randomized Controlled Trial

Iris den Uijl  1 , Rita J G van den Berg-Emons  1 , Madoka Sunamura  2 , Mattie J Lenzen  3 , Henk J Stam  1 , Eric Boersma  3 , Nicole C C W Tenbült-van Limpt  4 , Hareld M C Kemps  4   5 , Marcel L Geleijnse  3 , Nienke Ter Hoeve  1   2
Affiliations
Randomized Controlled Trial

Effects of a Dedicated Cardiac Rehabilitation Program for Patients With Obesity on Body Weight, Physical Activity, Sedentary Behavior, and Physical Fitness: The OPTICARE XL Randomized Controlled Trial

Iris den Uijl et al. Phys Ther. .

Abstract

Objective: Previously published results of the OPTICARE XL open label randomized controlled trial showed no added value of OPTICARE XL CR, a dedicated cardiac rehabilitation (CR) program for patients with obesity, with respect to health-related quality of life (primary outcome). This clinical trial studied the effects of OPTICARE XL CR on several secondary outcomes, which included body weight, physical activity, sedentary behavior, and physical fitness.

Methods: Patients with coronary artery disease or atrial fibrillation and body mass index ≥ 30 were randomized to OPTICARE XL CR (n = 102) or standard CR (n = 99). OPTICARE XL CR was a 1-year group intervention, specifically designed for patients with obesity that included aerobic and strength exercise, behavioral coaching, and an aftercare program. Standard CR consisted of a 6- to 12-week group aerobic exercise program, supplemented with cardiovascular lifestyle education. Study end points included body weight, physical activity, sedentary behavior (accelerometer), and physical fitness (6-Minute Walk Test and handgrip strength), which were evaluated 6 months after the end of CR (primary endpoint) and 3 months after the start of CR.

Results: Six months after completion of either program, improvements in body weight, physical activity, sedentary behavior, and physical fitness were similar between the groups. Three months after CR start, patients randomized to OPTICARE XL CR showed greater weight loss (mean change = -3.6 vs -1.8 kg) and a larger improvement in physical activity (+880 vs +481 steps per day) than patients randomized to standard CR.

Conclusion: Patients allocated to OPTICARE XL CR lost significantly more body weight and showed promising results with respect to physical activity 3 months after the start of CR; however, these short-term results were not expanded or sustained in the longer term.

Impact: Patients with obesity do not benefit from standard CR programs. The new OPTICARE XL CR program showed its effects in the short term on weight loss and physical activity, and, therefore, redesign of the aftercare phase is recommended.

Keywords: Body Weight; Cardiac Rehabilitation; Obesity; Physical Activity; Physical Fitness; Sedentary Behavior.

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Figures

Figure 1
Figure 1
Patients were randomized in 1 of 2 groups. Within each group, 4 measurements were performed within 18 months. Part I of the OPTICARE XL CR program lasted 3 months, part II lasted the following 9 months. Standard CR lasted for 3 months. CR = cardiac rehabilitation; M = month.
Figure 2
Figure 2
List of topics addressed in the Healthy Weight Module of the OPTICARE XL CR program.
Figure 3
Figure 3
Included patients were randomized into 1 of 2 groups: OPTICARE XL CR (n = 102) or standard CR (n = 99). Six months post-CR (primary study endpoint), 26 patients in the OPTICARE XL CR group, and 12 patients in the standard CR group were lost to follow-up. Reasons for lost to follow-up were motivational problems, not answering calls or e-mails, and lack of time.
See this image and copyright information in PMC

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