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New study suggests doctors worldwide
should emulate Goderich's Healthy Hearts
cardiac rehab program
Darryl Coate
Postmedia Network
A study of patients in a
Goderich cardiac rehabili-
tation program is chal-
lenging how similar pro-
grams worldwide should
run.
Published in "The Cana-
dian Journal of Rural Med-
icine" last spring, the
paper "Rural cardiac reha-
bilitation: a 20 -year suc-
cess story" shows that
patients who participate
long-term in cardiac reha-
bilitation programs are
substantially healthier
than those discharged
after a year and told to
independently exercise.
Before council Sept. 26,
some of the paper's
authors said that their
study of patients in the
Healthy Hearts Rehabilita-
tion Program has world-
wide significance.
"We have shown
through this study that
people who are involved
in cardiac rehab, that are
allowed to stay with the
program and do stay with
the program, their physio-
logical markers of fitness
can be maintained for a
decade or longer," said Dr.
Michael Dawson, one of
three authors of the paper
who spoke to council
Monday night.
The study analyzed 866
stress tests of 85 Healthy
Hearts program patients
over the last 18 years,
finding that those who
have been in the program
for two years were able to
perform a stress test --
which is usually walking
on a treadmill or riding a
stationary bike -- 15 per
cent longer than they did
after their first year in the
program. And over the
next nine years, patients
performed the test 35 per
cent longer than they did
after their first year in the
program.
Most patients in cardiac
rehabilitation programs
complete the program
anywhere between six
weeks and a year and a
half, following which they
are encouraged to exercise
on their own. After exiting
the program the patient
usually exhibits a decline
in health. However, the
paper shows that those
who stay in the program
indefinitely have a marked
improvement in their
health over the long term,
Dawson said.
"Any program, any car-
dio rehab program in the
world which usually dis-
charges people after six
weeks, six months, a year
and a half, they're going to
have to take notice that
that's not the best thing
for their patients, that pro-
grams should be looking
at redesigning to allow
people to participate long
term," Dawson said.
Since most cardiac
rehabilitation programs
discharge patients before
the two-year mark, there
is no data on the long-
term effects of patients
receiving this type of care
over a long period of time,
let alone nearly two dec-
ades, said E. Kent Gillin, a
retired Doctor of Rehabili-
tation Sciences from the
University of Western
Ontario and the primary
researcher on the study.
That is except for those
at Health Hearts, he said.
This study has never
been done before because
"this evidence does not
exist [elsewhere] in the
world," said Dawson.
The second part of the
study was then to under-
stand why patients stay in
the program for an aver-
age of eight years.
"They have you doing
sit-ups and calisthenics
and bikes, and I wouldn't
stay with it," Gillin joked,
but then added that most
people don't stay in theses
programs when given the
option "and that's what
fascinated us."
He said most people
experience the benefits of
exercise, but those bene-
fits aren't usually enough
to keep people returning
to the program. What they
discovered, he said, is that
there's something unique
to the Goderich facility.
"The reason they stayed
with the program has to
do with the amount of
laughter and fun they had
in the program and some-
thing called hedonic well
being," he said.
Chocolate is an exam-
ple. Hedonic well-being is
like chocolate, Gillin
offered; something that
brings pleasure and
quickly dissipates.
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