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  • Study: Listen to the CPGs—Cardiac Rehab Works

    The clinical practice guidelines are right: Ambulatory cardiac rehabilitation (CR) should be routine for patients with cardiovascular events such as myocardial infarction, say authors of a study in the European Heart Journal (abstract only available for free). However, despite evidence of its effectiveness—including a nearly 50% drop all-cause mortality for patient who receive CR—CR “remains significantly underused,” they write.

    Authors compared the long-term outcomes of an early discharge CR program for patients with ST-elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction, planned percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) versus no CR at all. At one hospital, all 839 patients received early CR; at a second, none of the 441 patients received CR, as it was not available. The hospitals were in the same geographic area.

    The CR program included evaluations, cycle-ergometer tests, and echocardiograms for all patients. Patients with STEMI or CABG received 5 weeks of exercise bicycle training followed by 6 weeks of gym training, supervised by a nurse and a physical therapist. The program was tailored to each patient’s needs.

    After a 5-year follow-up period, researchers analyzed the data to account for confounding demographic variables and found:

    • All-cause mortality in the CR group was lower (10%) compared to the non-CR group (19%).
    • Cardiovascular mortality was 2% for the CR group and 7% for the non-CR group.
    • Hospitalization for cardiovascular causes was lower for the CR group (11% for the CR group, 25% for the non-CR group).
    • Combined hospitalization for cardiovascular causes and cardiovascular mortality was 13% for the CR group, compared with 29% for the non-CR group.

    Authors think that the CR method used for their study "can be adopted without the use of expensive resources and can be applied in any ambulatory CR center," thus making it easier for CR to become more widespread.

    And it's that the lack of widespread use of CR that's the problem, they note.

    "Despite these evidences supporting the benefits of CR programs, this service is greatly underutilized, especially by women, elderly, and diabetic patients," authors write. "Referral and participation range is between 30% and 50% in Europe and it is around 25% in [the United States]."

    Past APTA President Ward Named Presiding Officer for Upcoming WCPT Meeting

    Former APTA president R. Scott Ward, PT, PhD, FAPTA, has been appointed by the World Confederation for Physical Therapy (WCPT) to serve as the presiding officer of its 19th General Meeting in Geneva, Switzerland, May 7-9, 2019.

    The General Meeting of the WCPT draws together delegates from over 100 member organizations, representing the primary physical therapy associations in their respective countries around the globe. As the presiding officer, Ward will conduct and coordinate the business of the delegate assembly of the General Meeting.

    Ward brings to this prestigious appointment a wealth of experience and expertise in governance, leadership, scholarship, and international service. He served as APTA’s delegate to the 17th WCPT General Meeting in Amsterdam in 2011 and as alternate delegate to the 18th General Meeting in Singapore in 2015. While president of APTA, Ward represented APTA at all meetings of the North American Caribbean region of WCPT. For more than 8 years he has provided education to physical therapists under the World Health Organization’s curriculum for the provision of manual wheelchairs in less-advantaged countries.

    Ward led APTA as its president from 2006 to 2012, was a member of APTA’s Board of Directors, was president of APTA’s Utah Chapter, and has received numerous awards and recognition for his longstanding service and contributions to physical therapy. He currently is chair of the Department of Physical Therapy and Athletic Training at the University of Utah and is a board member of the American Council of Academic Physical Therapy.

    "Scott stands out as a leader, and his experience in the US and internationally are well suited to WCPT,” said APTA President Sharon Dunn, PT, PhD in an APTA news release. “He has been an asset to APTA, both as a member, former president, and friend. And I am sure his leadership and guidance will be invaluable during WCPT’s General Meeting.”

    APTA is a founding member of WCPT and has participated in all 19 General Meetings. Dunn also will attend as a voting delegate along with 2 nonvoting delegates from APTA.