Comprehensive evaluation of the out patient rehabilitation in subjects myocardial infarction in a long term follow up
Folia Medica Cracoviensia 28(3-4): 227-256
ISSN/ISBN: 0015-5616 Accession: 007148196
The effect of 5-year supervised physical training on certain indices of the functional state of the cardiovascular system, plasma lipids, blood coagulation system, patients' psychological state and their return to professional work in comparison with non-supervised and control groups was studied in 202 men after first acute myocardial infarction. After randomized selection supervised training group consisted of 86 subjects (42.5%), non supervised group of 56 (27.7%) and control group of 60 patients (29.7%). It was found that supervised interval physical training significantly decreased reinfarction rate and sudden death rate. These patients significantly less frequently developed rhythm disturbances, anginal pain and changes in the ST-T segment of the ECG, or were rehospitalized. Interval training improved significantly the state of the cardiovascular system defined by slower heart rate at the same workload, stabilization of the arterial blood pressure, an increase in physical work capacity and coronary sufficiency with their peak after 6 months. The improvement in left ventricular performance was defined by shortening of left ventricular ejection time index (LVETI) and a reduction in the PEP/LVET ratio. In trained subjects a decrease in certain lipid fractions being an atherosclerosis risk factor was found with a simultaneous increase in fractions preventing its development. Changes, however equivocal, were also seen in the blood coagulation system. The supervised rehabilitation significantly reduced also the level of anxiety about the health state. In supervised group after one year of rehabilitation 23.2% more after 5 years 25.4% more patients resumed work than in control group. The achievement of such benefical changes is determined by a regular long-term rehabilitation. This points to the role and need of the organized form of physical training for patients with myocardial infarction.