title: [Effects of a phase II cardiac rehabilitation program performed on an outpatient basis].
abstract: OBJECTIVE
  In Germany, phase II cardiac rehabilitation has always been carried out on an inpatient basis. Meanwhile, the governmental health authorities are demanding more flexible solutions for cardiac rehabilitation. The objective of this study is to examine the effects of phase II cardiac rehabilitation performed on an outpatient basis (OCR) in a larger patient cohort. These are the first results of patients before and directly after the OCR performed at six different rehabilitation centers.
  
  
  METHODS
  The study group consisted of 479 men and 74 women, 56.1 +/- 11.5 years. Cardiovascular indications for the OCR were myocardial infarction in 219 cases, coronary artery disease (CAD) in 92, in 84 cases with invasive procedures, coronary artery bypass graft in 185, cardiac valve surgery in 26, and other cardiac diseases in 29. 70% of the patients were worker, 25% without professional training. Staying with the family (42%) and aversion to stationary programs (61%)were the main reasons for the choice of OCR. Without OCR,27.4% would have refused any rehabilitation program.
  
  
  RESULTS
  Maximal physical performance increased from 97.8 + - 31.4 to 120.4 +/- 37.3 W (p < 0.001). LDL cholesterol was reduced from 145.9 +/- 42.7 to 117.5 +/- 34.7 mg% (p < 0.001), triglycerides from 203.3 +/- 136.0 to 161.9 +/- 91.6 mg% (p < ).010), HDL cholesterol increased from 39.8 + 11.2 to 41.0 +/- 11.3 mg% (p = 0.003). The use of lipid-lowering therapy in CAD patients increased from 63.1% to 80.7%. A reduction in body mass index from 27.1 +/- 3.6 to 26.9 +/- 3.5 kg/m2 (p = 0.010) was demonstrated. The number of active smokers decreased from 53.8% to 25.6%.
  
  
  CONCLUSIONS
  The results obtained are interesting with respect to the patients' social status. With 70% general laborers, our cohort is in contrast to previously published OCR data. On the whole, these results demonstrate that rehabilitative measures can also be implemented on an outpatient basis, without a decrease in the quality of treatment. This also applies to patients who represent lower socioeconomic levels. The results should motivate to work harder and more sufficiently on the development of more flexible cardiac rehabilitation programs.
authors.affiliation: Institut für Kreislaufforschung und Sportmedizin, Deutsche Sporthochschule, Cologne, Germany. bjarnason@dshs-koeln.de
authors.forename: Birna
authors.initials: B
authors.lastname: Bjarnason-Wehrens
authors.forename: Lothar
authors.initials: L
authors.lastname: Benesch
authors.forename: Karl Otto
authors.initials: KO
authors.lastname: Bischoff
authors.forename: Brigitte
authors.initials: B
authors.lastname: Buran-Kilian
authors.forename: Detlef
authors.initials: D
authors.lastname: Gysan
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hollenstein
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mayer-Berger
authors.forename: Mike
authors.initials: M
authors.lastname: McCabe
authors.forename: Rolf
authors.initials: R
authors.lastname: Wilkniss
authors.forename: Gregor
authors.initials: G
authors.lastname: Sauer
mesh_terms: D000368:Aged; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000534:rehabilitation; D005260:Female; D005858:Germany; D006331:Heart Diseases / Q000534:rehabilitation*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation; D010045:Outpatients; D010809:Physical Fitness; D012047:Rehabilitation Centers; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides