title: Cardiac rehabilitation without exercise tests for post-myocardial infarction and post-bypass surgery patients.
abstract: OBJECTIVE
  To compare the progress of patients who were exercise tested before or during cardiac rehabilitation versus those patients who were not tested.
  
  
  METHODS
  Eighty-eight (88) post-myocardial infarction patients and 141 post-bypass surgery patients had a symptom-limited exercise test before or during 12 weeks of cardiac rehabilitation. Another 125 post-myocardial infarction and 146 post-surgery patients were not tested.
  
  
  RESULTS
  Caloric expenditure during class increased for the entire group (P < 0.001) from week 1 to week 12. Body weight decreased for the entire group as a result of cardiac rehabilitation (P < 0.001). Tricep skinfolds decreased for the entire group (P < 0.001) while subscapular skinfolds did not change (P = 0.28). The percent change from week 1 to week 12 for both groups was similar for all variables. No problems occurred during cardiac rehabilitation that required emergency medical management.
  
  
  CONCLUSIONS
  Patients completing a 12-week cardiac rehabilitation program can be safely progressed in terms of their exercise capacity without an entry exercise test. This is desirable in a managed-care setting for reducing costs while maintaining effective patient care. Such factors as staff training and experience, institutional philosophy, patient referral patterns, and facility location must be considered before adopting a no-test policy.
authors.affiliation: Geisinger Medical Center, Penn State Geisinger Health System, Danville 17822-2150, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: McConnell
authors.forename: T A
authors.initials: TA
authors.lastname: Klinger
authors.forename: J K
authors.initials: JK
authors.lastname: Gardner
authors.forename: C A
authors.initials: CA
authors.lastname: Laubach
authors.forename: C E
authors.initials: CE
authors.lastname: Herman
authors.forename: C A
authors.initials: CA
authors.lastname: Hauck
mesh_terms: D001823:Body Composition; D001026:Coronary Artery Bypass; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors