title: Exercise testing and training in physically disabled men with clinical evidence of coronary artery disease.
abstract: A prospective, randomized, controlled clinical trial in patients with coronary artery disease (CAD) and a concurrent physical disability evaluated the effects of a home exercise training program on cardiovascular function and blood lipids. Eighty-eight men between the ages of 42 and 72 years (mean 62) with documented CAD and a physical disability with functional use of > or = 2 extremities including 1 arm were randomized to either a 6-month home exercise training program using wheelchair ergometry or to a control group that received usual and customary care. Both groups received dietary instructions and were requested to follow a fat-controlled diet. Exercise test variables with echocardiography and blood lipids were measured at baseline and at 6 months. The home exercise training group significantly improved both peak exercise left ventricular ejection fraction (p = 0.007) and fractional shortening (p = 0.01) between baseline to 6 months, whereas the control group showed no significant changes. Exercise training effects of decreased resting heart rate (p = 0.03) and decreased peak rate pressure product (p = 0.03) were also found in the treatment group. No exercise-related cardiac complications occurred. Both groups significantly (p < or = 0.01) increased high-density lipoprotein cholesterol levels. These results indicate that physically disabled men with CAD can safely participate in a home exercise training program which may result in intrinsic cardiac benefits. The metabolic cost of activities of daily living imposed on this disabled population may also have a positive effect on high-density lipoprotein cholesterol levels.
authors.affiliation: Department of Rehabilitation Medicine, School of Medicine, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30322.
authors.forename: B J
authors.initials: BJ
authors.lastname: Fletcher
authors.forename: S B
authors.initials: SB
authors.lastname: Dunbar
authors.forename: J M
authors.initials: JM
authors.lastname: Felner
authors.forename: B E
authors.initials: BE
authors.lastname: Jensen
authors.forename: L
authors.initials: L
authors.lastname: Almon
authors.forename: G
authors.initials: G
authors.lastname: Cotsonis
authors.forename: G F
authors.initials: GF
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000178:diet therapy / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D006233:Persons with Disabilities; D005080:Exercise Test; D005081:Exercise Therapy; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D004041:Dietary Fats; D008055:Lipids