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Heart. 1999 April; 81(4): 359–366. | PMCID: PMC1729018 |
Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme L Dugmore, R Tipson, M Phillips, E Flint, N Stentiford, M Bone, and W Littler Action Heart, Cardiac Rehabilitation Centre, Wellesley House, 117 Wellington Road, Dudley, West Midlands DY1 1UB, UK. OBJECTIVE—To examine and evaluate improvements in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status in postmyocardial infarction patients during and after a comprehensive 12 month exercise rehabilitation programme. SUBJECTS—The sample population comprised 124 patients with a clinical diagnosis of myocardial infarction (122 men and two women). INTERVENTIONS—62 patients were randomly allocated to a regular weekly aerobic training programme, three times a week for 12 months, and compared with 62 matched controls who did not receive any formal exercise training. A five year follow up questionnaire/interview was subsequently conducted on this population to determine selected vocational/lifestyle changes. RESULTS—Significant improvements in cardiorespiratory fitness (p < 0.01-0.001), psychological profiles (p < 0.05-0.001), and quality of life scores (p < 0.001) were recorded in the treatment population when compared with their matched controls. Although there were no significant differences in mortality, a larger percentage of the regular exercisers resumed full time employment and they returned to work earlier than the controls. Controls took lighter jobs, lost more time from work, and suffered more non-fatal reinfarctions (p < 0.05-0.01). CONCLUSIONS—Regularly supervised and prolonged aerobic exercise training improves cardiorespiratory fitness, psychological status, and quality of life. The trained population also had a reduction in morbidity following myocardial infarction, and significant improvement in vocational status over a five year follow up period.
Keywords: myocardial infarction; exercise training; fitness; quality of life The Full Text of this article is available as a PDF (140K). These references are in PubMed. This may not be the complete list of references from this article. - Carson P, Phillips R, Lloyd M, Tucker H, Neophytou M, Buch NJ, Gelson A, Lawton A, Simpson T. Exercise after myocardial infarction: a controlled trial. J R Coll Physicians Lond. 1982 Jul;16(3):147–151. [PubMed]
- Bethell HJ, Mullee MA. A controlled trial of community based coronary rehabilitation. Br Heart J. 1990 Dec;64(6):370–375. [PubMed]
- Lipkin DP. Is cardiac rehabilitation necessary? Br Heart J. 1991 May;65(5):237–238. [PubMed]
- Horgan J, Bethell H, Carson P, Davidson C, Julian D, Mayou RA, Nagle R. Working party report on cardiac rehabilitation. Br Heart J. 1992 May;67(5):412–418. [PubMed]
- DeBusk RF, Blomqvist CG, Kouchoukos NT, Luepker RV, Miller HS, Moss AJ, Pollock ML, Reeves TJ, Selvester RH, Stason WB, et al. Identification and treatment of low-risk patients after acute myocardial infarction and coronary-artery bypass graft surgery. N Engl J Med. 1986 Jan 16;314(3):161–166. [PubMed]
- Théroux P, Waters DD, Halphen C, Debaisieux JC, Mizgala HF. Prognostic value of exercise testing soon after myocardial infarction. N Engl J Med. 1979 Aug 16;301(7):341–345. [PubMed]
- Bigger JT, Jr, Dresdale FJ, Heissenbuttel RH, Weld FM, Wit AL. Ventricular arrhythmias in ischemic heart disease: mechanism, prevalence, significance, and management. Prog Cardiovasc Dis. 1977 Jan–Feb;19(4):255–300. [PubMed]
- DeBusk RF, Haskell W. Symptom-limited vs heart-rate-limited exercise testing soon after myocardial infarction. Circulation. 1980 Apr;61(4):738–743. [PubMed]
- Ruberman W, Weinblatt E, Goldberg JD, Frank CW, Shapiro S. Ventricular premature beats and mortality after myocardial infarction. N Engl J Med. 1977 Oct 6;297(14):750–757. [PubMed]
- Kavanagh T, Shephard RJ, Tuck JA. Depression after myocardial infarction. Can Med Assoc J. 1975 Jul 12;113(1):23–27. [PubMed]
- Ehsani AA, Heath GW, Hagberg JM, Sobel BE, Holloszy JO. Effects of 12 months of intense exercise training on ischemic ST-segment depression in patients with coronary artery disease. Circulation. 1981 Dec;64(6):1116–1124. [PubMed]
- Coats AJ, Adamopoulos S, Meyer TE, Conway J, Sleight P. Effects of physical training in chronic heart failure. Lancet. 1990 Jan 13;335(8681):63–66. [PubMed]
- Kavanagh T. Distance running and cardiac rehabilitation: physiologic and psychosocial considerations. Clin Sports Med. 1984 Apr;3(2):513–526. [PubMed]
- Kavanagh T, Shephard RJ, Tuck JA, Qureshi S. Depression following myocardial infarction: the effects of distance running. Ann N Y Acad Sci. 1977;301:1029–1038. [PubMed]
- Langosch W. Psychological effects of training in coronary patients: a critical review of the literature. Eur Heart J. 1988 Nov;9 Suppl NaN:37–42. [PubMed]
- Morgan WP, Roberts JA, Brand FR, Feinerman AD. Psychological effect of chronic physical activity. Med Sci Sports. 1970 Winter;2(4):213–217. [PubMed]
- Danchin N. Work capacity after myocardial revascularization: factors related to work resumption. Eur Heart J. 1988 Nov;9 Suppl NaN:44–47. [PubMed]
- Levin LA, Perk J, Hedbäck B. Cardiac rehabilitation--a cost analysis. J Intern Med. 1991 Nov;230(5):427–434. [PubMed]
- Denolin H, Feruglio GA, Gobbato F, Maisano G. Guidelines for return to work after myocardial infarction and/or revascularisation. Eur Heart J. 1988 Nov;9 Suppl NaN:130–131. [PubMed]
- Watson PA, Mayberry JF, Calcraft B, Colbourne G. Employment after myocardial infarction amongst previously healthy men. J R Soc Med. 1986 Jun;79(6):329–330. [PubMed]
- Lamm G, Denolin H, Dorossiev D, Pisa Z. Rehabilitation and secondary prevention of patients after acute myocardial infarction. WHO collaborative study. Adv Cardiol. 1982;31:107–111. [PubMed]
- Rechnitzer PA, Cunningham DA, Andrew GM, Buck CW, Jones NL, Kavanagh T, Oldridge NB, Parker JO, Shephard RJ, Sutton JR, Donner AP. Relation of exercise to the recurrence rate of myocardial infarction in men. Ontario Exercise-Heart Collaborative Study. Am J Cardiol. 1983 Jan 1;51(1):65–69. [PubMed]
- Oldridge NB, Guyatt GH, Fischer ME, Rimm AA. Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA. 1988 Aug 19;260(7):945–950. [PubMed]
- O'Connor GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS, Jr, Hennekens CH. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation. 1989 Aug;80(2):234–244. [PubMed]
- Hedbäck B, Perk J. 5-year results of a comprehensive rehabilitation programme after myocardial infarction. Eur Heart J. 1987 Mar;8(3):234–242. [PubMed]
- Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993 Apr 15;118(8):622–629. [PubMed]
- Thompson DR, Bowman GS, Kitson AL, de Bono DP, Hopkins A. Cardiac rehabilitation in the United Kingdom: guidelines and audit standards. National Institute for Nursing, the British Cardiac Society and the Royal College of Physicians of London. Heart. 1996 Jan;75(1):89–93. [PubMed]
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