Medically directed at-home rehabilitation soon after clinically uncomplicated acute myocardial infarction: a new model for patient care.
Medically directed at-home rehabilitation was compared with group rehabilitation which began 3 weeks after clinically uncomplicated acute myocardial infarction (AMI) in 127 men, mean age 53 +/- 7 years. Between 3 and 26 weeks after AMI, adherence to individually prescribed exercise was equally high (at least 71%), the increase in functional capacity equally large (1.8 +/- 1.0 METs) and nonfatal reinfarction and dropout rates equally low (both 3% or less) in the 66 men randomized to home training and the 61 men randomized to group training. No training-related complications occurred in either group. The low rate of reinfarction and death (5% and 1%, respectively) in the study as a whole, which included 34 patients with no training and 37 control patients, reflected a stepwise process of clinical evaluation, exercise testing at 3 weeks and frequent telephone surveillance of patients who underwent exercise training. Medically directed at-home rehabilitation has the potential to increase the availability and to decrease the cost of rehabilitating low-risk survivors of AMI.
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D003327:Coronary Disease / Q000209:etiology; D005081:Exercise Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000191:economics / Q000534:rehabilitation* / Q000628:therapy; D010349:Patient Compliance; D005082:Physical Exertion; D055656:Prescriptions; D011897:Random Allocation; D012648:Self Care / Q000379:methods