Article

Important goals of cardiac rehabilitation maintenance programs (CMP) are
to increase leisure time physical activity (LTPA) and improve health-related
quality of life (HRQoL).
Elderly patients with cardiac disease and low exercise
capacity are simultaneously the most severely affected and have the most to gain
from exercise-based rehabilitation. Individualized combined exercise (ICE) may be
an effective modality to achieve these goals. We compared six months of ICE to
CMP in their effects on LTPA and HRQoL. METHODS: Sixty patients (70 +/- 9 years,
39% female) with cardiac disease and low exercise capacity (<6 MET) were randomly
allocated to six months of once-weekly ICE or CMP.
The patients in ICE performed
moderate endurance and resistance exercise on machines, based on intensities from
individual peak exercise testing. Patients in CMP performed weekly sessions of
calisthenics, flexibility, coordination and relaxation activities. LTPA and HRQoL
were assessed with accelerometry and questionnaires at baseline and six months.
RESULTS: Sixty patients completed the trial. ICE increased vigorous PA (ICE:
Delta + 12 MET-min/d, CMP: Delta -5 MET-min/d, p = .02)
and steps per day (ICE:
+1586 steps/d, CMP: -838 steps/d, p < .01) compared to CMP after six months. ICE
significantly improved in several components of HRQoL (vitality, emotional
health, social health, positive and negative affect (all p < .05) compared to
CMP. CONCLUSIONS: ICE resulted in significant improvements in physical activity
levels and health related quality of life in moderate to high-risk patients
compared to CMP. Implications for rehabilitation Relatively low volumes and
intensities of exercise may lead to substantial improvements in both physical
activity levels and health-related quality of life Exercise modes in cardiac
rehabilitation maintenance programs should not be limited to calisthenics and
large group-based exercise Supplemental resistance exercise may improve
health-related quality of life and increase physical activity levels in patients
with low exercise capacity Moderate to high-risk elderly patients also benefit
from individualized endurance-resistance exercise.

Langue : ANGLAIS