Effects of rehabilitation in patients with cardiac disease
Prospective, randomised controlled trials were performed to investigate the benefits of cardiac rehabilitation in two selected patient groups. One group comprised patients in the early stage of recovery after an uncomplicated myocardial infarction. The other consisted of patients with stable chronic heart failure, who are usually excluded from exercise programmes. The reliability and validity of a new method of measuring ambulatory activity was determined. The rehabilitation programme for the post myocardial infarction patients lasted six weeks and contained education and exercise components. Three groups were recruited; a control group, a group who only undertook the education sessions and a group who also participated in a training programme. Comparison of changes in psycho-social parameters and physiological function were made between the groups after completing the programme and three months later. The education + exercise group showed significantly greater improvements (p<0.05) in anxiety, ambulatory activity and rehabilitation status compared to the other groups. Indications of predominantly peripheral adaptation to training were observed, but no significant differences in physiological function were found between the three groups. The education only group did not show any significant differences to the control group in any areas. A crossover-design was used in the chronic heart failure study. This comprised a control and exercise period, each lasting two months. Assessments of psycho-social parameters and physiological function were made at monthly intervals. Exercise training produced significant improvements in depression, quality of life and ambulatory activity. Both central and peripheral adaptations to training were observed, with significant benefits in peak cardiac index, oxygen uptake and resting heart rate. Improvements in ventilator efficiency were also noted.