Cardiac rehabilitation after myocardial infarction: A review to understand barriers to participation and potential solutions

B. J. Witt, R. J. Thomas, V. L. Roger

Research output: Contribution to journalReview article

40 Scopus citations


As survival after myocardial infarction (MI) improves, secondary prevention is becoming increasingly important. Cardiac rehabilitation (CR) is one modality for delivery of secondary prevention, whose ultimate goal is to help patients receive appropriate preventive therapies that will help them optimize health and reduce the risk of future cardiac diseases. However, participation rates in CR are less than optimal: in the United States, only 29.5% of MI survivors participated, in Japan 21% of those with acute MI, and in Australia 29% of those eligible were referred, and only 1/3 of those referred actually attended CR; moreover, there does not appear to be a trend towards increasing participation over time. After reviewing the components of CR and the benefits of participation, this paper will focus on the barriers to participation in CR: from a theoretical framework to consider barriers at patient, provider, health system, and societal levels. We then explore the possible solutions to overcome them and finally propose recommendation for future research.

Original languageEnglish (US)
Pages (from-to)27-34
Number of pages8
JournalEuropa Medicophysica
Issue number1
StatePublished - Mar 1 2005



  • Cardiac rehabilitation
  • Exercise
  • Myocardial infarction

ASJC Scopus subject areas

  • Rehabilitation

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