***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: [ Purpose ] While recent studies have reported that cardiac rehabilitation is an effective treatment , there have been few studies of its effects in rehabilitation for acute coronary syndrome ( ACS ) . Therefore , the purpose of this study was to identify the effects of a home-based exercise training using a wireless electrocardiogram ( ECG ) monitoring device on ACS patients . [ Subjects ] Fifty ACS patients were r and omly divided into a experimental group of 25 patients and a control group of 25 patients . [ Methods ] The experimental group received education on the training before discharge from hospital and started home-based exercise training two weeks after discharge from hospital . The control group received conventional treatments . The left ventricular function was measured in both groups before the intervention at and 12 weeks , at the end of the intervention . [ Results ] Both the experimental group and the control group showed significant improvements in the left ventricular ejection fraction and number of regional wall motion abnormalities . In the comparison of the two groups , the experimental group showed a significantly greater decline in regional wall motion abnormalities than the control group . [ Conclusion ] Home-based exercise training implemented with a wireless monitoring device was effective at improving the left ventricular function of ACS patients Wu S-K , Lin Y-W , Chen C-L , Tsai S-W : Cardiac rehabilitation vs. home exercise after coronary artery bypass graft surgery : a comparison of heart rate recovery . Am J Phys Med Rehabil 2006;85:711–717 . Objective : The autonomic dysfunction is known to adversely affect clinical outcome in patients with cardiovascular disease , and exercise training has been shown to modify the sympathovagal control of heart rate . The purpose s of this study were to investigate the effect of cardiac rehabilitation on heart rate recovery in patients who received coronary artery bypass grafting ( CABG )  and compare the effect with that of a home-based exercise program . Design : Fifty-four male patients having undergone CABG were r and omly assigned to a cardiac rehabilitation exercise program ( n = 18 ) , a home-based exercise program ( n = 18 ) , and a control group ( n = 18 ) for 12 wks to evaluate the differences in heart rate recovery among groups . Results : Patients in the cardiac rehabilitation group had significant increases in heart rate recovery ( 19.1 ± 6.2 vs. 14.0 ± 5.4 beats/min , P = 0.022 ) compared with those in the control group . There were no significant differences in heart rate recovery between cardiac rehabilitation and home-based exercise groups ( 16.2 ± 4.8 beats/min ) or between home-based exercise and control groups . All three groups had significantly improved heart rate recovery compared with their baseline data ( P < 0.001 , < 0.001 , and 0.007 ) . Conclusion : Our results point out that a cardiac rehabilitation exercise program has a positive effect on heart rate recovery in patients having undergone CABG and is consistent with the autonomic improvement . Although the home-based exercise group did not reveal statistical significance s over those in the control group , it had comparable efficacy to that demonstrated in the cardiac rehabilitation group Background —Whether cardiac rehabilitation ( CR ) is effective in patients older than 75 years , who have been excluded from most trials , remains unclear . We enrolled patients 46 to 86 years old in a r and omized trial and assessed the effects of 2 months of post-myocardial infa rct ion ( MI ) CR  on total work capacity ( TWC , in kilograms per meter ) and health-related quality of life ( HRQL ) . Methods and Results —Of 773 screened patients , 270 without cardiac failure , dementia , disability , or contraindications to exercise were r and omized to outpatient , hospital-based CR ( Hosp-CR ) , home-based CR ( Home-CR ) , or no CR within 3 predefined age groups ( middle-aged , 45 to 65 years ; old , 66 to 75 years ; and very old , > 75 years ) of 90 patients each .  TWC and HRQL were determined with cycle ergometry and Sickness Impact Profile at baseline , after CR , and 6 and 12 months later . Within each age group , TWC improved with Hosp-CR and Home-CR and was unchanged with no CR . The improvement was similar in middle-aged and old persons but smaller , although still significant , in very old patients . TWC reverted toward baseline by 12 months with Hosp-CR but not with Home-CR .  HRQL improved in middle-aged and old CR and control patients but only with CR in very old patients . Complications were similar across treatment and age groups . Costs were lower for Home-CR than for Hosp-CR . Conclusions —Post-MI Hosp-CR and Home-CR are similarly effective in the short term and improve TWC and HRQL in each age group . However , with lower costs and more prolonged positive effects , Home-CR may be the treatment of choice in low-risk older patients Aim To determine the effectiveness and cost-effectiveness of a mobile phone intervention to improve exercise capacity and physical activity behaviour in people with ischaemic heart disease ( IHD ) . Methods and results In this single-blind , parallel , two-arm , r and omized controlled trial adults ( n = 171 ) with IHD were r and omized to receive a mobile phone delivered intervention  ( HEART ; n = 85 ) plus usual care , or usual care alone ( n = 86 ) . Adult participants aged 18 years or more , with a diagnosis of IHD , were clinical ly stable as out patients , able to perform exercise , able to underst and and write English , and had access to the Internet . The HEART ( Heart Exercise And Remote Technologies ) intervention involved a personalized , automated package of text messages and a secure website with video messages aim ed at increasing exercise behaviour , delivered over 24 weeks . All participants were able to access usual community-based cardiac rehabilitation , which involves encouragement of physical activity and an offer to join a local cardiac support club . All outcomes were assessed at baseline and 24 weeks and included peak oxygen uptake ( PVO2 ; primary outcome ) , self-reported physical activity , health-related quality of life , self-efficacy and motivation ( secondary outcomes ) . Results showed no differences in PVO2 between the two groups ( difference −0.21 ml kg−1 min−1 , 95 % CI : −1.1 , 0.7 ; p = 0.65 ) at 24 weeks . However significant treatment effects were observed for selected secondary outcomes , including leisure time physical activity ( difference 110.2 min/week , 95 % CI : −0.8 , 221.3 ; p = 0.05 ) and walking ( difference 151.4 min/week , 95 % CI : 27.6 , 275.2 ; p = 0.02 ) . There were also significant improvements in self-efficacy to be active ( difference 6.2 % , 95 % CI : 0.2 , 12.2 ; p = 0.04 ) and the general health domain of the SF36 ( difference 2.1 , 95 % CI : 0.1 , 4.1 ; p = 0.03 ) at 24 weeks . The HEART programme was considered likely to be cost-effective for leisure time activity and walking . Conclusions A mobile phone intervention was not effective at increasing exercise capacity over and above usual care . The intervention was effective and probably cost-effective for increasing physical activity and may have the potential to augment existing cardiac rehabilitation services BACKGROUND Heart failure , a condition predominantly affecting the elderly , represents an ever-increasing clinical and financial burden for the NHS . Cardiac rehabilitation , a service that incorporates patient education , exercise training and lifestyle modification , requires further evaluation in heart failure management . AIM The aim of this study was to determine whether a cardiac rehabilitation programme improved on the outcomes of an outpatient heart failure clinic ( st and ard care ) for patients , over 60 years of age , with chronic heart failure . METHODS Two hundred patients ( 60 - 89 years , 66 % male ) with New York Heart Association ( NYHA ) II or III heart failure confirmed by echocardiography were r and omised . Both st and ard care and experimental groups attended clinic with a cardiologist and specialist nurse every 8 weeks . Interventions included exercise prescription , education , dietetics , occupational therapy and psychosocial counselling . The main outcome measures were functional status ( NYHA , 6-min walk ) , health-related quality of life ( MLHF and EuroQol ) and hospital admissions . RESULTS There were significant improvements in MLHF and EuroQol scores , NYHA classification and 6-min walking distance ( meters ) at 24 weeks between the groups ( p<0.001 ) . The experimental group had fewer admissions ( 11 vs. 33 , p<0.01 ) and spent fewer days in hospital ( 41 vs. 187 , p<0.001 ) . CONCLUSIONS Cardiac rehabilitation , already widely established in the UK , offers an effective model of care for older patients with heart failure OBJECTIVE To evaluate the effectiveness of a home-based cardiac rehabilitation ( CR ) program on post-coronary arteries bypass graft patients . METHODS This is a r and omized study conducted in King Fahd Armed Forces Hospital , Jeddah , Kingdom of Saudi Arabia between June 2008 and January 2010 . Forty-nine participants were r and omized to either a control group ( st and ard hospital treatment , n=21 ) or an intervention group ( home-based CR , n=28 ) . Data were collected before hospital discharge ( baseline test ) and repeated 6 months after hospital discharge ( follow-up test ) . RESULTS There were no significant differences between the groups in the body mass index , hemodynamics , serum fasting lipid profile , and Quality of Life question naire ( QoL ) ( p>0.05 ) , with differences in physical function and Hospital Anxiety and Depression Scales ( HADS ) ( p<0.05 ) at the baseline test . At the follow-up test , the intervention group showed greater improvement in health-related QoL and risk factors compared to the control group , with significant differences in fasting blood glucose , triglycerides , high density lipoprotein cholesterol , physical function , and both QoL and HADS question naires ( p<0.05 ) . The intervention group also demonstrated significant improvements in QoL , HADS , body mass index , heart rate , high density lipoprotein cholesterol and physical function ( p<0.05 ) , while significant differences were observed in the control group in heart rate , QoL and physical function ( p<0.05 ) . CONCLUSION The home-based CR program improves health-related QoL and risk factor profiles for patients following coronary arteries bypass graft to greater extent than the st and ard hospital care BACKGROUND Cardiac rehabilitation ( CR ) is associated with significantly lower mortality and improved psychosocial well-being . However , women are less likely to participate than men . This trial tested whether participation in women-only CR results in better health behaviours and psychosocial outcomes than do other models . METHODS  Cardiac Rehabilitation  for her Heart Event Recovery ( CR4HER ) was a single-blind r and omized trial with 3 parallel arms . Low-risk cardiac patients were recruited from 6 sites in Ontario . Consenting participants completed surveys assessing health behaviours ( physical activity , diet , medication adherence , smoking ) and psychosocial well-being ( social support , quality of life , depressive symptoms ) and wore pedometers for 7 days . After intake assessment , eligible participants were r and omized to mixed-sex , women-only , or home-based CR .  Participants were mailed follow-up surveys and pedometers 6 months later . RESULTS One hundred sixty-nine patients were r and omized , and 116 ( 68.6 % ) were retained .  Self-reported physical activity increased among women in mixed-sex and women-only CR groups ( per protocol and as treated , P < 0.05 ) . Diet improved among women in women-only CR groups ( as treated , P < 0.05 ) . Quality of life improved among women in mixed-sex ( per protocol and as treated , P < 0.05 ) and women-only CR groups ( per protocol , P < 0.05 ; as treated , P < 0.01 ) . After testing , women in the mixed-sex CR group had higher anxiety symptoms than did those in the women-only group ( per protocol , P = 0.017 ) , and those in the mixed-sex CR group had higher depressive symptoms than did those in the women-only group ( as treated , P = 0.001 ) . Analyses adjusted for confounding variables revealed no significant differences in any outcome by model . Post hoc equivalency tests were computed on a per- protocol basis , and all outcomes were equivalent by model . CONCLUSIONS Behavioural and psychosocial outcomes were largely equivalent regardless of model ; however , women-only programs may confer an advantage for anxiety and depressive symptoms The aim of this study is to consider the cost-effectiveness of a nurse-led , home-based intervention ( HBI ) in cardiac patients with private health insurance compared to usual post-discharge care . A within trial analysis of the Young @ Heart multicentre , r and omized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care . For the micro-simulation model , future costs , from the perspective of the funder , and effects are estimated over a twenty-year time horizon . An Incremental Cost-Effectiveness Ratio , along with Incremental Net Monetary Benefit , is evaluated using a willingness to pay threshold of $ 50,000 per quality adjusted life year . Sub-group analyses are conducted for men and women across three age groups separately .  Costs and benefits that arise in the future are discounted at five percent per annum . Overall , home based intervention for secondary prevention in 
    Output:
    
This up date supports previous conclusions that home- and centre-based forms of cardiac rehabilitation seem to be similarly effective in improving clinical and health-related quality of life outcomes in patients after myocardial infa rct ion or revascularisation , or with heart failure .