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  1. Farias-Godoy, Alejandra MD, PhD
  2. Chan, Sammy MD
  3. Claydon, Victoria E. PhD
  4. Ignaszewski, Andrew MD
  5. Mendell, Joanna MPH
  6. Park, Julie E. MMath
  7. Singer, Joel PhD
  8. Lear, Scott A. PhD


Purpose: Cardiac rehabilitation programs (CRPs) remain underutilized partly because of access barriers. We therefore evaluated a CRP with fewer center-based sessions (rCRP) compared with standard CRP (sCRP) with respect to changes in exercise capacity and cardiac risk factors.


Methods: In this randomized controlled noninferiority trial, primary and secondary prevention patients at low and moderate risk were randomized to an sCRP (n = 60) or an rCRP (n = 61). Over 4 months, sCRP and rCRP participants attended 32 and 10 on-site cardiac rehabilitation sessions, respectively. The primary outcome was the difference in the change in exercise capacity from baseline at 4 and 16 months between the groups measured in seconds from a maximal treadmill exercise test. Noninferiority of the rCRP was tested with mixed-effects model analysis with a cut point of 60 seconds for the upper value of the group estimate.


Results: Attendance was higher for the rCRP group (97% +/- 63% vs 71% +/- 22%, P = .002). Over 16 months, exercise test time increased for the sCRP (524 +/- 168 to 604 +/- 172 seconds, P < .01) and the rCRP (565 +/- 183 to 640 +/- 192 seconds, P < .01). The rCRP was not inferior to the sCRP regarding changes in treadmill time (48.47 seconds, P = .454). The rCRP was not inferior to the sCRP regarding metabolic and anthropometric risk factors.


Conclusion: Our findings suggest that, for a selected group of low-/moderate-risk patients, the number of center-based CRP exercise sessions can be decreased while maintaining reduced cardiovascular risk factors.