Abstract
Objective
To analyze the interrater agreement among physiotherapists in using 7 risk stratification
(RS) protocols to evaluate participants of cardiac rehabilitation (CR) and the main
factors associated with disagreements that emerged during the RS process.
Design
Cross-sectional observational study.
Setting
Outpatient rehabilitation center.
Participants
Patients (N=72) enrolled in CR with a diagnosis of cardiovascular disease or cardiovascular
risk factors. Mean age was 65.62±12.14 y, and mean body mass index (calculated as
weight in kilograms divided by height in meters squared) was 29.18±4.56.
Interventions
Not applicable.
Main Outcome Measures
The main outcome was to the agreement between 2 physiotherapists in the patients’
RS process, using 7 protocols established in the literature for use in CR: American
Association of Cardiovascular and Pulmonary Rehabilitation, American College of Sports
Medicine, American Heart Association, Sociedade Brasileira de Cardiologia, Sociedad Española de Cardiología, and Société Française de Cardiologie. In addition, the main disagreement factors were assessed.
Results
Interrater agreement was classified as moderate-to-good in the 7 included RS protocols
(kappa index between 0.53-0.76). The most important aspects that led to disagreement
between physiotherapists were reported in 5 categories. The protocol with the greater
agreement index was the American College of Sports Medicine (93.10%; n=67), and the
one with the greater disagreement was the American Association of Cardiovascular and
Pulmonary Rehabilitation (27.80%; n=20).
Conclusions
Moderate-to-good interrater agreement among physiotherapists in using 7 RS protocols
was observed. Major disagreements were the definition of abnormal hemodynamic responses,
rhythm disorders, left ventricular dysfunction, and interpretation of the patient’s
clinical characteristics.
Graphical abstract
Graphical Abstract
Keywords
List of abbreviations:
AACVPR (American Association of Cardiovascular and Pulmonary Rehabilitation), ACSM (American College of Sports Medicine), AHA (American Heart Association), CR (cardiac rehabilitation), RS (risk stratification), SFC (Société Française de Cardiologie)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 05, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
