title: Older adults in cardiac rehabilitation: a new strategy for enhancing physical function.
abstract: OBJECTIVE
  This study contrasted the effect of a group-mediated cognitive-behavioral intervention (GMCB) versus traditional cardiac rehabilitation (CRP) upon changes in objective and self-reported physical function of older adults [mean (SD) age of 64.7 (7.5) yr] after 3 months of exercise therapy.
  
  
  METHODS
  This randomized clinical trial enrolled 147 participants who were eligible for inclusion into cardiac rehabilitation. Baseline to 3-month changes in self-reported and performance related measures of physical function were assessed using a physical functioning questionnaire, a 6-min walk test, and measured MET levels.
  
  
  RESULTS
  Paired t-tests revealed that participants made improvements in all measures across the first 3 months of the study, irrespective of group treatment (P < 0.001). General linear models including effects for baseline levels of physical function, treatment, and gender revealed that lower functioning men in the GMCB treatment made greater improvements than any other subgroup on the two performance outcomes: 6-min walk and measured MET levels (P < 0.01). Gender did not moderate change in self-reported level of physical function (P > 0.05); however, the lower functioning participants in the GMCB intervention experienced greater improvements in self-reported physical function than those in CRP (P < 0.05).
  
  
  CONCLUSIONS
  Exercise therapy is a valuable intervention for improving physical function of older adults with cardiovascular disease (CVD) and those at increased risk for CVD. Baseline level of physical function and gender are important variables to consider when studying the relationship between exercise therapy and improvements in physical function.
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, USA.
authors.forename: W Jack
authors.initials: WJ
authors.lastname: Rejeski
authors.forename: Capri Gabrielle
authors.initials: CG
authors.lastname: Foy
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Brawley
authors.forename: Peter H
authors.initials: PH
authors.lastname: Brubaker
authors.forename: Brian C
authors.initials: BC
authors.lastname: Focht
authors.forename: James L
authors.initials: JL
authors.lastname: Norris
authors.forename: Marci L
authors.initials: ML
authors.lastname: Smith
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000175:diagnosis; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010807:Physical Endurance / Q000502:physiology; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D016896:Treatment Outcome