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European Heart Journal 1999 20(20):1475-1484; doi:10.1053/euhj.1999.1581
Copyright © 1999 by the European Society of Cardiology.
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Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study

A. Ståhlea,b,f1, E. Mattssona, L. Rydénb, A.-L. Undenc and R. Nordlanderb

a Departments of Physical Therapy, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden
b Cardiology, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden
c Research Center for General Health Care, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden

revised February 8, 1999; accepted February 17, 1999

Abstract

Aims Cardiac rehabilitation including exercise training is of proven value in ischaemic heart disease. However, elderly patients frequently are not encouraged to participate in such programmes. This study evaluates the physiological effects and self-reported quality of life after an aerobic outpatient group-training programme in subjects above the age of 65 years.

Methods and Results A consecutive series of 101 patients (males 80%) aged 65–84 (mean 71) years recovering from an acute coronary event were randomized to either a supervised out patient group-training programme (n=50) or to a control group (n=51). The two groups were well balanced as regards clinical characteristics. The compliance in the training group was 87%. Exercise tolerance increased in the trained group from 104 to 122 and 111W after 3 and 12 months respectively. The corresponding values were 102, 105 and 105W among controls. Parameters, such as quality of life, self-estimated level of physical activity, fitness and well-being were graded higher by the trained patients than those who served as controls on the two occasions of follow-up.

Conclusions Aerobic group-training of elderly patients recovering from an acute coronary event beneficially influences physical fitness and several parameters expressing quality of life. Great care has to be taken to preserve the initial effects by continued training.

Key Words: Elderly, acute coronary event, exercise training/capacity, quality of life, randomized controlled trial, cardiac rehabilitation.

f1 Correspondence : Agneta Sthle, PT, MSc, Dept. of Physical Therapy, Karolinska Hospital, SE-171 76 Stockholm, Sweden.

References

  1. Wenger NK. Guidelines for exercise training of elderly patients with coronary artery disease. South Med J. 1994;87:S66–S69[Web of Science][Medline]
  2. Williams MA, Maresh CM, Esterbrooks DJ, Harbrecht JJ, Sketch MH. Early exercise training in patients older than age 65 years compared with that in younger patients after acute myocardial infarction or coronary bypass grafting. Am J Cardiol. 1985;55:263–266[CrossRef][Web of Science][Medline]
  3. Lavie CJ, Milani RV, Littman AB. Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly. J Am Coll Cardiol. 1993;22:678–683[Abstract]
  4. Hellman EA, Williams MA. Outpatient cardiac rehabilitation in elderly patients. Heart & Lung. 1994;23:506–513[Web of Science][Medline]
  5. Opasich C, Cobelli F, Assandri J. Is old age a contraindication to cardiac rehabilitation after acute myocardial infarction. Eur Heart J. 1984;5:105–107
  6. Marchionni N, Fattirolli F, Valoti P. Improved exercise tolerance by cardiac rehabilitation after myocardial infarction in the elderly: results from a preliminary, controlled study. Aging Clin Exp Res. 1994;6:175–180
  7. Ades PA, Waldman ML, Gillespie C. A controlled trial of exercise training in older coronary patients. J Gerontol A Biol Sci Med Sci. 1995;50:M7–11[Abstract]
  8. Yusuf S, Cairns JA, Camm JA, Fallen EL, Gersh BJ. Evidenced Based Cardiology. London: BMJ Books; 1998.
  9. Ebbesen LS, Guyatt GH, McCartney N, Oldridge NB. Measuring quality of life in cardiac spouses. J Clin Epidemiol. 1990;43:482–487
  10. Thompson DR, Meadows KA, Lewin RJP. Measuring quality of life in patients with coronary heart disease. Eur Heart J. 1998;19:693–695[Web of Science][Medline]
  11. Sthle A, Nordlander R, Rydén L, Mattsson E. Effects of organized group aerobic training in elderly patients discharged after an acute coronary syndrome. A randomized controlled study. Scand J Rehab Med. 1999;31:101–107[CrossRef][Web of Science][Medline]
  12. ström H, Jonsson B. Design of exercise tests, with special reference to heart patients. Br Heart J. 1976;38:795–800
  13. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehab Med. 1970;2:92–98[Medline]
  14. Borg G. A category scale with ratio properties for intermodal and interindividual comparisons. Geissler HG, Petzolds P. Psychophysical judgement and the process of perception. Berlin: VEB Verlag der Wissenschaften; 1982.
  15. Linde-Edelstam C, Nordlander R, Unden A, Orth-Gomer K, Ryden L. Quality-of-life in patients treated with atrioventricular synchronous pacing compared to rate modulated ventricular pacing: a long-term double-blind, crossover study. Pacing Clin Electrophysiol. 1992;15:1467–1476[CrossRef][Medline]
  16. Olsson M, Janfjell H, Orth-Gomer K, Unden A, Rosenqvist M. Quality of life in octogenarians after valve replacement due to aortic stenosis. A prospective comparison with younger patients. Eur Heart J. 1996;17:583–589[Abstract/Free Full Text]
  17. Unden A, Schenck-Gustavsson K, Axelsson P, Karlsson I, Orth-Gomer K, Ydrefors A. Positive effects of increased nurse support for male patients after acute myocardial infarction. Qual Life Res. 1993;2:121–127[CrossRef][Web of Science][Medline]
  18. Tibblin G, Tibblin B, Peciva S, Kullman S, Svärdsudd K. The Goteborg quality of life instrument—an assessment of well-being and symptoms among men born in 1913 and 1923 Methods and validity. Scand J Prim Health Care. 1990;:33–38
  19. Gadler F. Atrioventricular synchronous pacing in hypertrophic obstructive cardiomyopathy. Stockholm: Karolinska Institute; 1997.
  20. Frändin K, Grimby G. Assessment of physical activity, fitness and performance in 76-years-olds. Scand J Med Sci Sports. 1994;4:41–46
  21. Bland M. An introduction to medical statistics. Oxford: Oxford University Press; 1995.
  22. Ades PA, Grunvald MH. Cardiopulmonary exercise testing before and after conditioning in older coronary patients. Am Heart J. 1990;120:585–589[CrossRef][Web of Science][Medline]
  23. Arnman K, Rydén L. Comparison of Metoprolol and Verapamil in the treatment of angina pectoris. Am J Cardiol. 1982;49:821–827[CrossRef][Web of Science][Medline]
  24. Nyberg G, Carlsens P, Lindström E. The effect of isosorbide-5-mononitrate (5-ISMN) Durules on exercise tolerance in patients with exertional angina pectoris. A placebo controlled study. Eur Heart J. 1986;7:835–842[Abstract/Free Full Text]
  25. Nyberg G, Holmberg B. Haemodynamic, anti-anginal and anti-ischemic effects of sublingual nitroglycerin: Dose-response, duration and time of onset of action. Eur J Clin Pharmacol. 1988;34:561–567[CrossRef][Web of Science][Medline]
  26. Nordlander R, Walter M. Once- versus twice-daily administration of controlled-release isorbide-5-mononitrate 60mg in the treatment of stable angina pectoris. A randomized, double-blind, cross-over study. Eur Heart J. 1994;15:108–113[Abstract/Free Full Text]
  27. strand P-O, Rodahl K. Textbook of Work Physiology. Singapore: McGraw-Hill Co; 1986.
  28. Goble AJ, Hare DL, Macdonald PS, Oliver RG, Reid MA, Worcester MC. Effect of early programmes of high and low intensity exercise on physical performance after transmural acute myocardial infarction. Br Heart J. 1991;65:126–131[Abstract/Free Full Text]
  29. Worcester MC, Hare DL, Oliver RG, Reid MA, Goble AJ. Early programmes of high and low intensity exercise and quality of life after acute myocardial infarction. BMJ. 1993;307:1244–1247[Abstract/Free Full Text]
  30. Holmbäck AM, Säwe U, Fagher B. Training after myocardial infarction: Lack of long-term effects on physical capacity and psychological variables. Arch Phys Med Rehabil. 1994;75:551–554[Web of Science][Medline]
  31. Ehsani AA, Biello DR, Schultz J, Sobel BE, Holoszy JO. Improvement of left ventricular contractile function by exercise training in patients with coronary artery disease. Circulation. 1986;74:350–358[Abstract/Free Full Text]
  32. Hedbäck B, Perk J. 5-year results of a comprehensive rehabilitation programme after myocardial infarction. Eur Heart J. 1987;8:234–242[Abstract/Free Full Text]
  33. Carlsson R, Lindberg G, Westin L, Israelsson B. Influence of coronary nursing management follow up on lifestyle after acute myocardial infarction. Heart. 1997;77:256–259[Abstract/Free Full Text]
  34. Young A, Dinan S. Fitness for older people. BMJ. 1994;309:331–334[Free Full Text]
  35. Fletcher GF, Balady G, Blair SN. Statement on exercise: Benefits and recommendations for physical activity programs for all Americans. Circulation. 1996;94:857–862[Free Full Text]

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