{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T06:42:52Z","timestamp":1770964972219,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Aims: Cardiac rehabilitation (CR) has proven to be effective and beneficial in middle-aged and older patients. However, solid data in large cohorts of elderly individuals are yet to be explored. This retrospective study investigated the general characteristics, outcomes, and the level of response of patients referred to CR over 13 consecutive years. Methods: We reviewed the medical records of patients admitted to Villa Pineta Rehabilitation Hospital for exercise-based CR from 2006 to 2018. The patients\u2019 baseline characteristics and changes following CR in an upper-limb weightlifting test (ULW), 30-s sit-to-stand test (30STS), and the 6-min walking test (6MWT) with associated Borg-related dyspnea (D) and fatigue (F) were collected. We also calculated the number of individuals that reached the minimal clinically relevant change (MCRC) following CR for each outcome. Results: One thousand five hundred and fifty-one patients (70.2 \u00b1 9.7 years, 66% men) with complete datasets were included in the analysis. Coronary artery bypass graft and cardiac valve replacement surgery were the most frequent surgical procedures leading to CR referral (41.1% and 35.8%, respectively). The patients\u2019 age (p = 0.03), number of total comorbidities (p &lt; 0.0001), and post-surgical complications (p = 0.02) significantly increased over time. In contrast, the average absolute changes in ULW, 30STS, and 6MWT with associated D and F, and the proportion of patients that reached their respective MCRC, remained constant over the same period. Conclusion: The patients admitted to exercise-based CR were older and had more comorbidities and complications over time. The outcomes, however, were not influenced in terms of the absolute change or clinically meaningful response.<\/jats:p>","DOI":"10.3390\/ijerph18168871","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T10:24:17Z","timestamp":1629714257000},"page":"8871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Clinical Characteristics and Outcomes of Patients Admitted to Inpatient Cardiac Rehabilitation"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-0336","authenticated-orcid":false,"given":"Stefania","family":"Costi","sequence":"first","affiliation":[{"name":"Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine CHIMOMO, University of Modena and Reggio Emilia, Via del Pozzo n.71, 41124 Modena, Italy"},{"name":"Scientific Directorate, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, Viale Umberto I n.50, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6202-0758","authenticated-orcid":false,"given":"Roberto","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Medicine PhD Program, University of Modena Reggio Emilia, Via del Pozzo n.71, 41124 Modena, Italy"},{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University of Modena and Reggio Emilia, University Hospital of Modena, Via del Pozzo n.71, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Brogneri","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, Via Gaiato n. 127, Pavullo nel Frignano, 41026 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Florini","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, Via Gaiato n. 127, Pavullo nel Frignano, 41026 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-1200","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Tilocca","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, Via Gaiato n. 127, Pavullo nel Frignano, 41026 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Vicentini","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, Viale Amendola n.2, 42123 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Baroncini","sequence":"additional","affiliation":[{"name":"School of Respiratory Medicine, University of Modena Reggio Emilia, Via del Pozzo n.71, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Cerulli","sequence":"additional","affiliation":[{"name":"Respiratory Rehabilitation of Ospedale Villa Pineta-KOS Group, Via Gaiato n. 127, Pavullo nel Frignano, 41026 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1515-5094","authenticated-orcid":false,"given":"Enrico","family":"Clini","sequence":"additional","affiliation":[{"name":"Respiratory Diseases Unit, Department of Medical and Surgical Sciences SMECHIMAI, University of Modena and Reggio Emilia, University Hospital of Modena, Via del Pozzo n.71, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1177\/2047487312449597","article-title":"Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: A policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology","volume":"21","author":"Piepoli","year":"2014","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_2","first-page":"547","article-title":"Linee guida europee 2016 sulla prevenzione delle malattie cardiovascolari nella pratica clinica. Sesta Task Force congiunta della Societ\u00e0 Europea di Cardiologia e di altre Societ\u00e0 sulla Prevenzione delle Malattie Cardiovascolari nella Pratica Clinica (costituita da rappresentanti di 10 societ\u00e0 e da esperti invitati). Redatte con il contributo straordinario dell\u2019Associazione Europea per la Prevenzione e Riabilitazione Cardiovascolare (EACPR) [2016 European guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts. Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation]","volume":"18","author":"Piepoli","year":"2017","journal-title":"G. Ital. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.cjca.2016.03.003","article-title":"Cardiac Rehabilitation in Older Adults","volume":"32","author":"Schopfer","year":"2016","journal-title":"Can. J. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1161\/CIRCULATIONAHA.107.701466","article-title":"Use of Cardiac Rehabilitation by Medicare Beneficiaries After Myocardial Infarction or Coronary Bypass Surgery","volume":"116","author":"Suaya","year":"2007","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Khadanga, S., Savage, P.D., Gaalema, D.E., and Ades, P.A. (2021). Predictors of Cardiac Rehabilitation Participation: OPPORTUNITIES TO INCREASE ENROLLMENT. J. Cardiopulm. Rehabil. Prev.","DOI":"10.1097\/HCR.0000000000000573"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/0269215513502211","article-title":"The cardiac model of rehabilitation for reducing cardiovascular risk factors post transient ischaemic attack and stroke: A randomized controlled trial","volume":"28","author":"Kirk","year":"2014","journal-title":"Clin. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1016\/j.jacc.2018.01.004","article-title":"2018 ACC\/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation: A Report of the American College of Cardiology\/American Heart Association Task Force on Performance Measures","volume":"71","author":"Thomas","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/02701367.1999.10608028","article-title":"A 30-s Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults","volume":"70","author":"Jones","year":"1999","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002). ATS Statement: Guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med., 166, 111\u2013117. Erratum in 2016, 193, 1185.","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2165\/00019053-199915020-00003","article-title":"Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics","volume":"15","author":"Samsa","year":"1999","journal-title":"PharmacoEconomics"},{"key":"ref_12","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates. [2nd ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.rmed.2006.05.007","article-title":"Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease","volume":"101","author":"Ozalevli","year":"2007","journal-title":"Respir. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2519\/jospt.2011.3515","article-title":"A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis","volume":"41","author":"Wright","year":"2011","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1183\/09031936.00150414","article-title":"An official systematic review of the European Respiratory Society\/American Thoracic Society: Measurement properties of field walking tests in chronic respiratory disease","volume":"44","author":"Singh","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1081\/COPD-200050655","article-title":"Minimally Clinically Important Difference for the UCSD Shortness of Breath Questionnaire, Borg Scale, and Visual Analog Scale","volume":"2","author":"Ries","year":"2005","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1513\/AnnalsATS.201512-824OC","article-title":"The Minimal Important Difference in Borg Dyspnea Score in Pulmonary Arterial Hypertension","volume":"13","author":"Khair","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_18","unstructured":"IBM Corp (2017). IBM SPSS Statistics for Windows, Version 25.0, IBM Corp."},{"key":"ref_19","unstructured":"(2021, June 14). GraphPad Prism Version 8.0.0 for Windows, GraphPad Software. Available online: https:\/\/www.graphpad.com."},{"key":"ref_20","unstructured":"The Jamovi Project (2021, June 14). Jamovi. (Version 1.2) [Computer Software]. Available online: https:\/\/www.jamovi.org."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1053\/j.jvca.2019.03.022","article-title":"A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Increasing Mortality","volume":"33","author":"Sartini","year":"2019","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wang, C., von Segesser, L.K., Berdajs, D., and Ferrari, E. (2021). Endovascular treatment of the dissected proximal aortic arch: A systematic review. Interact. Cardiovasc. Thorac. Surg., ivab161.","DOI":"10.1093\/icvts\/ivab161"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Donner, C., Ambrosino, N., and Goldstein, R. (2020). The multimorbidity patient. Pulmonary Rehabilitation, Taylor & Francis Group.","DOI":"10.1201\/9781351015592"},{"key":"ref_24","first-page":"CD010876","article-title":"Exercise-based cardiac rehabilitation for adults after heart valve surgery","volume":"5","author":"Abraham","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/0733464820918134","article-title":"Older Adults\u2019 Experiences of Goals in Health: A Systematic Review and Metasynthesis","volume":"40","author":"Baker","year":"2021","journal-title":"J. Appl. Gerontol."},{"key":"ref_26","first-page":"CD010118","article-title":"Preoperative physical therapy for elective cardiac surgery patients","volume":"11","author":"Hulzebos","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jphys.2014.04.002","article-title":"Preoperative intervention reduces postoperative pulmonary complications but not length of stay in cardiac surgical patients: A systematic review","volume":"60","author":"Snowdon","year":"2014","journal-title":"J. Physiother."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"M\u00f6lken, M.R.-V., Leijten, F., Hoedemakers, M., Tsiachristas, A., Verbeek, N., Karimi, M., Bal, R., De Bont, A., Islam, K., and Askildsen, J.E. (2018). Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analysis (MCDA). BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3367-4"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1183\/13993003.01125-2015","article-title":"Response to pulmonary rehabilitation: Toward personalised programmes?","volume":"46","author":"Ambrosino","year":"2015","journal-title":"Eur. Respir. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/16\/8871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:49:42Z","timestamp":1760165382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/16\/8871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,23]]},"references-count":29,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["ijerph18168871"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18168871","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,23]]}}}