Improved exercise tolerance and quality of life with cardiac rehabilitation of older patients after myocardial infarction - Results of a randomized, controlled trial

被引:222
作者
Marchionni, N
Fattirolli, F
Fumagalli, S
Oldridge, N
Del Lungo, F
Morosi, L
Burgisser, C
Masotti, G
机构
[1] Univ Florence, Dept Crit Care Med & Surg, Unit Gerontol & Geriatr Med, I-50141 Florence, Italy
[2] Azienda Osped Careggi, Florence, Italy
[3] Indiana Univ, Regenstrief Inst Hlth Care, Sch Allied Hlth Sci, Ctr Aging Res, Indianapolis, IN USA
[4] Indiana Univ, Regenstrief Inst Hlth Care, Sch Med, Ctr Aging Res, Indianapolis, IN USA
[5] Univ Wisconsin, Ctr Urban Populat Hlth, Milwaukee, WI 53201 USA
关键词
aging; coronary disease; exercise; myocardial infarction; quality of life;
D O I
10.1161/01.CIR.0000066322.21016.4A
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Whether cardiac rehabilitation (CR) is effective in patients older than 75 years, who have been excluded from most trials, remains unclear. We enrolled patients 46 to 86 years old in a randomized trial and assessed the effects of 2 months of post-myocardial infarction (MI) CR on total work capacity (TWC, in kilograms per meter) and health-related quality of life (HRQL). Methods and Results - Of 773 screened patients, 270 without cardiac failure, dementia, disability, or contraindications to exercise were randomized to outpatient, hospital-based CR (Hosp-CR), home-based CR (Home-CR), or no CR within 3 predefined age groups (middle-aged, 45 to 65 years; old, 66 to 75 years; and very old, >75 years) of 90 patients each. TWC and HRQL were determined with cycle ergometry and Sickness Impact Profile at baseline, after CR, and 6 and 12 months later. Within each age group, TWC improved with Hosp-CR and Home-CR and was unchanged with no CR. The improvement was similar in middle-aged and old persons but smaller, although still significant, in very old patients. TWC reverted toward baseline by 12 months with Hosp-CR but not with Home-CR. HRQL improved in middle-aged and old CR and control patients but only with CR in very old patients. Complications were similar across treatment and age groups. Costs were lower for Home-CR than for Hosp-CR. Conclusions - Post-MI Hosp-CR and Home-CR are similarly effective in the short term and improve TWC and HRQL in each age group. However, with lower costs and more prolonged positive effects, Home-CR may be the treatment of choice in low-risk older patients.
引用
收藏
页码:2201 / 2206
页数:6
相关论文
共 50 条
[41]   A randomized, controlled trial of fall prevention programs and quality of life in older fallers [J].
Lin, Mau-Roung ;
Wolf, Steven L. ;
Hwang, Hei-Fen ;
Gong, Sheng-You ;
Chen, Chih-Yi .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (04) :499-506
[42]   The factors of quality of life among patients after myocardial infarction in Poland: a cross-sectional study. The quality of life among patients after myocardial infarction [J].
Kolarczyk, Ewelina ;
Kohanova, Dominika ;
Witkowska, Agnieszka ;
Szymiczek, Marek ;
Mlynarska, Agnieszka .
SCIENTIFIC REPORTS, 2024, 14 (01)
[43]   Quality of life in older adults is enhanced by piano practice: Results from a randomized controlled trial [J].
Worschech, Florian ;
Marie, Damien ;
Sinke, Christopher ;
Kliegel, Matthias ;
Juenemann, Kristin ;
Scholz, Daniel S. ;
Krueger, Tillmann H. ;
James, Clara E. ;
Altenmueller, Eckart .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 2025,
[44]   Effects of Exercise Rehabilitation on Blood Pressure of Patients after Myocardial Infarction [J].
Kargarfard, Mehdi ;
Rouzbehani, Reza ;
Basati, Fatema .
INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE, 2010, 1 (02) :124-130
[45]   Multimodal rehabilitation to improve quality of life and fatigue after radiotherapy in esophageal cancer patients: a randomized trial [J].
Chen, Xianyan ;
Zhong, Linjun ;
Wang, Jiao ;
Dai, Tingting ;
Li, Mingxia ;
Luo, Jiao ;
Zhu, Lin ;
Liu, Xinchi ;
Tao, Lin ;
Li, Linjuan ;
Du, Hongyan ;
Ge, Ruyu ;
Tao, Shiqi ;
Yi, Cheng ;
Fu, Yan ;
Gong, Youling .
ONCOLOGIST, 2025, 30 (06)
[46]   Use of Cardiac Rehabilitation in Older Patients With Myocardial Infarction Complicated by Cardiogenic Shock [J].
Essa, Mohammed ;
Decker, Sergio R. R. ;
Liang, Lichen ;
Song, Yang ;
Varghese, Merilyn S. ;
Figueroa, Jose F. ;
Sperling, Laurence ;
Fonarow, Gregg C. ;
Keteyian, Steven J. ;
Thompson, Michael P. ;
Beatty, Alexis ;
Kazi, Dhruv S. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2025, 85 (16) :1614-1617
[47]   Effect of Whey Protein Intake after Resistance Exercise on Skeletal Muscle Mass, Strength, and Quality of Life in Older Adults with Sarcopenia: A Randomized Controlled Trial [J].
Mori, Hiroyasu ;
Tokuda, Yasunobu .
ANNALS OF NUTRITION AND METABOLISM, 2023, 79 :661-661
[48]   The Effectiveness of Case-management Rehabilitation Intervention in Facilitating Return to Work and Maintenance of Employment After Myocardial Infarction: Results of a Randomized Controlled Trial [J].
Zack, Oren ;
Melamed, Samuel ;
Silber, Haim ;
Cinamon, Tali ;
Levy, Doron ;
Moshe, Shlomo .
CLINICAL REHABILITATION, 2022, 36 (06) :753-766
[49]   Quality indicators for cardiac rehabilitation after myocardial infarction in China: a consensus panel and practice test [J].
Zheng, Xianghui ;
Zhang, Maomao ;
Zheng, Yang ;
Zhang, Yongxiang ;
Wang, Junnan ;
Zhang, Ping ;
Yang, Xuwen ;
Li, Shan ;
Ding, Rongjing ;
Siqin, Gaowa ;
Hou, Xinyu ;
Chen, Liangqi ;
Zhang, Min ;
Sun, Yong ;
Wu, Jian ;
Yu, Bo .
BMJ OPEN, 2020, 10 (12)
[50]   Effects of exercise training on exercise capacity and quality of life in patients with a left ventricular assist device: A preliminary randomized controlled trial [J].
Hayes, Kate ;
Leet, Angeline S. ;
Bradley, Scott J. ;
Holland, Anne E. .
JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2012, 31 (07) :729-734