Objective
To increase participation in cardiac rehabilitation among outpatients with heart disease in Thailand. Factors contributing to low participation are poorly understood. A scale is needed to identify barriers to participation in cardiac rehabilitation. This study aimed to evaluate the psychometric properties of the newly translated Cardiac Rehabilitation Barriers Scale Thai version to justify its use in the Thai population with cardiovascular diseases.
Methods
Psychometric testing was conducted using a cross-sectional survey of 200 outpatients at a Bangkok hospital eligible for the cardiac rehabilitation program from April 2023 to mid-April 2024. Construct validity was evaluated using principal axis factor analysis and first- and second-order confirmatory factor analysis. Cronbach’s alpha assessed the scale’s internal consistency.
Results
The average age of the total sample was 62.60±12.37 years. Principal axis factoring with Oblimin rotation and Kaiser normalization extracted four components (subscales) that explained 61.8% of the cumulative percentage of variance. These were labeled work and time conflicts, lack of perceived need factors, comorbidities, and logistical barriers. Values for the confirmatory factor analysis goodness of fit indices exceeded recommended minimum thresholds. The internal consistencies for the total scale and the four components were entirely acceptable.
Conclusion
The Cardiac Rehabilitation Barriers Scale Thai version has acceptable psychometric properties for Thai outpatients with cardiovascular diseases. It may be used to identify barriers to participating in cardiac rehabilitation, promote rehabilitation attendance, and improve patient care.

Objective
To investigate the impact of body mass index (BMI) and exercise habits on readmission rates among older patients with heart failure.
Methods
Ninety-seven older patients admitted for heart failure (median age: 81 years; 57.7% male) were included in the study. Patients were categorized into four groups based on the presence or absence of lower BMI and/or the absence of exercise habits. Lower BMI was defined as BMI<20.3 kg/m2 at discharge and exercise habits were defined as engaging in 30 or more minutes of moderate or vigorous exercise at least once a week. The primary outcome was all-cause readmission during the 1-year follow-up period.
Results
The patients were distributed across four groups: lower BMI/non-exerciser (n=24, 24.7%), lower BMI/exerciser (n=22, 22.7%), non-lower BMI/non-exerciser (n=21, 21.6%), and non-lower BMI/exerciser (n=30, 30.9%). Forty-six patients (47.4%) experienced readmission during the 1-year follow-up period. In a cox proportional hazard analysis, non-lower BMI/exerciser remained an independent prognostic factor even after adjusting for confounding factors (non-lower BMI/exerciser vs. lower BMI/non-exerciser: hazard ratio, 0.26; 95% confidence interval, 0.08–0.83; p=0.022).
Conclusion
The coexistence of non-lower BMI and regular exercise habits may reduce readmission during the 1-year in older patients with heart failure. Therefore, it is imperative to conduct appropriate nutritional assessments for patients with lower BMI at discharge. Additionally, promoting and monitoring sustained physical activity after discharge is crucial for older patients with heart failure.

Citations

• Lumbar paraspinal muscle quality and disability in older adults: insights from the SarcoSpine cohort
  Dong Hyun Kim, Yoon-Hee Choi, JooHee Lee, Sang Yoon Lee
  BMC Geriatrics.2026;[Epub]     CrossRef

Objective
To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation.
Methods
The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach’s alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness.
Results
Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants’ sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach’s alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05).
Conclusion
The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.

Citations

• Identification of patient-reported core information needs and associated factors in hospitalized patients with heart failure: A network analysis
  Mei Yang, Yilin Zhang, Wenjie Fang, Wenjie Sun, Ziwei Geng, Xiuzhen Fan
  Heart & Lung.2025; 74: 27.     CrossRef

Objective
To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments.
Methods
The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion.
Results
Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD.
Conclusion
In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.

Citations

• Exploring the experience of community hospital-led home-based cardiac rehabilitation health management in patients with coronary heart disease: a qualitative focus group study
  Lin Wu, Yanyan Song, Ruolan Zhang, Shining Lou, Quanwei Di, Qisong Shi, Lishu Peng, Xian Chang, Ning Liu, Haiming Li, Yan Wang
  Frontiers in Cardiovascular Medicine.2026;[Epub]     CrossRef
• Development of a health literacy-based hypertension self-management education program using sign language for Deaf individuals
  Hee Jung Kim, Gi Won Choi, Yujin Park, Ha Na Jeong, Sun Ju Chang
  BMC Health Services Research.2025;[Epub]     CrossRef

Objective
To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed.
Methods
Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65–74 years) and old-old (≥75 years) female subjects were compared.
Results
Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05).
Conclusion
We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.

Citations

• Impact of digital health management on clinical outcomes during post-PCI outpatient care in patients with acute coronary syndrome: study protocol for a multicentre, randomized controlled trial
  Hang Yu, Wei Zhang, Guoliang Li, Tao Chen, Shaonong Dang, Xiaofeng Ma, XiaoWei Zhang, Xiaofeng Ma, Zhibin Hong, Pengyi He, Xiaohui Xu, Xiuying Chen, Yanyan Geng, Xinjun Lei
  Frontiers in Cardiovascular Medicine.2025;[Epub]     CrossRef
• Fact Sheet on Cardiac Rehabilitation for Cardiovascular Disease in South Korea
  Ki-Hong Kim, Jae-Young Han
  Annals of Rehabilitation Medicine.2023; 47(5): 318.     CrossRef
• Relationship Between Community-Level Distress and Cardiac Rehabilitation Participation, Facility Access, and Clinical Outcomes After Inpatient Coronary Revascularization
  Michael P. Thompson, Hechuan Hou, James W. Stewart, Francis D. Pagani, Robert B. Hawkins, Steven J. Keteyian, Devraj Sukul, Donald S. Likosky
  Circulation: Cardiovascular Quality and Outcomes.2023;[Epub]     CrossRef
• Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study
  Chul Kim, Jidong Sung, Jae-Young Han, Sungju Jee, Jang Woo Lee, Jong Hwa Lee, Won-Seok Kim, Heui Je Bang, Sora Baek, Kyung Lim Joa, Ae Ryoung Kim, So Young Lee, Jihee Kim, Chung Reen Kim, Oh Pum Kwon
  Journal of Korean Medical Science.2022;[Epub]     CrossRef
• Do Patients Maintain Proper Long-Term Cardiopulmonary Fitness Levels After Cardiac Rehabilitation? A Retrospective Study Using Medical Records
  Chul Kim, Hee Eun Choi, Jin Hyuk Jang, Jun Hyeong Song, Byung-Ok Kim
  Annals of Rehabilitation Medicine.2021; 45(2): 150.     CrossRef
• Community-Based Aerobic Exercise Program for Primary Prevention of Cardiovascular Disease in Adults With Visual or Auditory Impairments: A Feasibility Study
  Sora Baek, Yuncheol Ha, Jaemin Mok, Haekyung Lee, Woojoo Song
  Annals of Rehabilitation Medicine.2021; 45(3): 204.     CrossRef
• Short-term community-based exercise programs in low-income older women: Does exercise intensity and modality matters?
  Vanessa Teixeira do Amaral, Bianca Fernandes, Awassi Yuphiwa Ngomane, Isabela Roque Marçal, Gabriel de Souza Zanini, Emmanuel Gomes Ciolac
  Experimental Gerontology.2021; 156: 111591.     CrossRef
• Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea
  Chul Kim, Jidong Sung, Jae-Young Han, Sungju Jee, Jang Woo Lee, Jong Hwa Lee, Won-Seok Kim, Heui Je Bang, Sora Baek, Kyung-Lim Joa, Ae Ryoung Kim, So Young Lee, Jihee Kim, Chung Reen Kim, Oh Pum Kwon
  Journal of Clinical Medicine.2021; 10(21): 5079.     CrossRef