Rehabilitation post cardiovascular (CV) events with appropriate physical activity can stimulate significant changes in pulmonary, respiratory, skeletal muscle and CV systems (Lavie et al, 2015). Although the wide range of benefits have been shown, surveys in many countries have shown a less than 50% participation rate in rehabilitation (Bethell 2001; Blackburn 2000; Bunker 1999). Many factors reported poor adherence is the major reason. In order to achieve a better outcome, practitioners need to address not only the physical problems, but also issues with psychosocial perspectives. The International Classification of Functioning, Disability and Health (ICF) model further highlights the major influence of personal and environmental factors on the impact of “health”. Therefore, we have prepared a series of blogs that will analyse not only the physical, but also the environmental and personal factors that contribute towards the inadequate adherence to exercise rehabilitation. The barriers we have focused on include access, self efficacy, cost of time/money, social support, motivation, health literacy, and physical function.
Within each blog, we have also proposed solutions to the barriers in rehabilitation/exercise adherence, with our final blog promoting a brand new tool that could be incorporated into research and clinical practice in an attempt to improve compliance to rehabilitation. The Health LEADS model was introduced by the Australian Health Ministers’ Advisory Council and is utilised widely among health professionals today. It consists of 5 parts, which are leads self, engage others, achieve outcomes, drive innovations and shaping systems. It defines five important areas as key factors that must be adopted by leaders in order to implement a successful and sustainable change in the healthcare sector. This leadership theory will therefore be discussed and applied throughout the blogs in an attempt to reach out to and empower all stakeholders; inclusive of patients, healthcare professionals and government bodies, in an attempt to collaboratively and innovatively lead a meaningful change to this current issue that is low exercise compliance, that exists within the physiotherapy profession.
– AD, BH, JH, RJ
Bethell, H. J., Turner, S. C., Evans, J. A., & Rose, L. (2001). Cardiac rehabilitation in the United Kingdom: How complete is the provision?. Journal of Cardiopulmonary Rehabilitation and Prevention, 21(2), 111-115.
Blackburn, G. G., Foody, J. M., Sprecher, D. L., Park, E., Apperson-Hansen, C., & Pashkow, F. J. (2000). Cardiac rehabilitation participation patterns in a large, tertiary care center: evidence for selection bias. Journal of Cardiopulmonary Rehabilitation and Prevention, 20(3), 189-195.
Bunker, S., McBurney, H., Cox, H., & Jelinek, M. (1999). Identifying participation rates at outpatient cardiac rehabilitation programs in Victoria, Australia. Journal of Cardiopulmonary Rehabilitation and Prevention, 19(6), 334-338.
Lavie, C. J., Arena, R., Swift, D. L., Johannsen, N. M., Sui, X., Lee, D., …& Blair, S. N. (2015). Exercise and the Cardiovascular System: Clinical Science and Cardiovascular Outcomes. Circulation Respiratory, 117(2): 207–219