Cardiac rehabilitation without exercise tests for post-myocardial infarction and post-bypass surgery patients.
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.
McConnell
T R
TR
Geisinger Medical Center, Penn State Geisinger Health System, Danville 17822-2150, USA.
Klinger
T A
TA
Gardner
J K
JK
Laubach
C A
CA
Herman
C E
CE
Hauck
C A
CA
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