Fast-track versus traditional cardiac rehabilitation: clinical outcomes and the use of the 6-minute walk test.

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Part A: Australian Cardiac rehabilitation phase II programs are traditionally conducted over 6 to 8 weeks combining education and exercise sessions. Exercise training is considered to require between six and eight weeks. Increasing exercise and achieving life style changes with long term adherence are the main aims of cardiac rehabilitation. Programs with reduced contact hours would allow greater accessibility to patients and suit patients returning quickly to their life roles, however, it is unclear if these provide similar benefits to traditional programs involving 2-3 sessions a week. The current study aims to compare outcomes and costs in the same community setting between two six week programs with a) 1 exercise session a week and one education day or b) 2 exercise and 2 education sessions per week. Hypothesis: Outcomes will be statistically similar for participants in either the fast track or traditional program. Part B: The aims of exercise testing in cardiac rehabilitation are to provide an outcome measure for the exercise component of the program and to provide information on exercise safety and exercise capacity of the participant. The six minute walk test is a ‘functional’ exercise test which is commonly implemented utilising two to three repeated tests to obtain maximal walking distance for an individual. This is time consuming and the benefit of multiple testing in this setting is unclear. The timed up and go test is commonly used in the aged care setting. The aims of this study are to determine in the cardiac population if a) repeated 6MWT at assessment /reassessment is mandatory for outcome measurement or exercise prescription and b) the Timed up and go test could provide an equally effective outcome measure as the 6MWT.Hypothesis: 1. The 6MWT and TUGT similarly demonstrate improvements in exercise capacity in the cardiac rehabilitation population 2. The difference between the first 6MWT and the second 6MWT at a given point in time i.e. at commencement, at discharge and at 6 months is consistent and hence only one test is required for outcome measurement purposes. 3. The difference between the second TUGT and the third TUGT at commencement, at discharge and at 6 months is consistent and hence only two tests are required for outcome measurement purposes. 4. The TUGT can be used to prescribe exercise level in the cardiac rehabilitation population.

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