[Outcome of a four-week ambulatory cardiac rehabilitation (phase II) on cardiovascular risk factors, physical fitness and occupational reintegration in patients after myocardial infarct, dilatation treatment and heart operation].
From October 1994 to July 1996, 128 patients (30 women, 98 men) participated in an outpatient cardiac rehabilitation program (phase II). Our objectives were to demonstrate risk-factor modification and increased workload capacity resulting directly from the rehabilitation in terms of primary results and long-term effects 6 and 12 months (n = 118, Figure 1) respectively 1.5 and 2 years (n = 87) after termination of the program (Tables 9 to 12). We observed how many of the patients were able to be occupationally reintegrated after completion of phase-II rehabilitation. Workload capacity significantly increased from 1.2 W/kg upon entry to 1.5 W/kg (p < or = 0.05) upon completion of 4 weeks cardiac rehabilitation. Workload capacity remained consistently high at 6 months and 1 year (1.5 W/kg) and at 1.5 and 2 years (1.7 W/kg). Total cholesterol decreased significantly from 247 to 201 mg/dl (p < or = 0.05) during the 4-week program. Significant cholesterol (p < or = 0.01) reductions persisted at 6 months (216 mg/dl) and 1 year (215 mg/dl). After 1.5 and 2 years, the total cholesterol was less than 14% and 17% below the mean of cholesterol at the beginning of the program. Similarly, LDL cholesterol was 185 mg/dl before entering the program, 146 mg/dl after 4 weeks, 151 mg/dl after 6 months and 149 mg/dl after 1 year. Triglyceride levels showed a significant reduction (p < or = 0.01) with levels 189 mg/dl before entering the program, 148 mg/dl after 4 weeks, 151 mg/dl after 6 months and 154 mg/dl after 1 year. LDL cholesterol and triglyceride levels did not significantly increase after 1.5 and 2 years. The HDL cholesterol increased slightly as a long-term effect (from 51 mg/dl before entering the program to 55, 56 and 54 mg/dl after 1, 1.5 and 2 years, respectively). Seventy-three percent of the patients questioned (n = 73) found the program very good, 27% said it was good and no patient was dissatisfied. Fifty-one (81%) of the 63 patients who were actively employed before becoming ill and later entering our program were immediately able to be reintegrated into their previous occupation. In several cases reintegration took 7 weeks. Seven (11%) patients applied for pension, 5 (8%) patients remained unemployed on sick-leave.
Gysan
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DB
Ambulantes kardiologisches Rehabilitationszentrum, Köln. gysan.heinzler@t-online.de
Heinzler
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Schmidt
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D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000534:rehabilitation*; D003631:Day Care, Medical; D005080:Exercise Test; D005260:Female; D005858:Germany; D006801:Humans; D006937:Hypercholesterolemia / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D009204:Myocardial Revascularization / Q000534:rehabilitation*; D010348:Patient Care Team; D010809:Physical Fitness; D012050:Rehabilitation, Vocational; D012307:Risk Factors; D016896:Treatment Outcome
Auswirkungen einer vierwöchigen ambulanten kardialen Rehabilitationsmassnahme (Phase II) auf kardiovaskuläre Risikofaktoren, körperliche Belastbarkeit und berufliche Reintegration bei Patienten nach Myokardinfarkt, Dilatationsbehandlung und Herzoperation.