title: [Phase III rehabilitation after heart transplantation].
abstract: BACKGROUND
  Longterm treatment after heart transplantation (HTX) improves survival, although the quality of life and exercise tolerance decreased continuously between one and ten years after transplantation. The role of physical exercise and psychological support in longterm treatment after HTX has not been determined. We analyzed the effects of a one year outpatient rehabilitation program in combination with a home based, computer assisted training program on exercise capacity, coronary risk factors and quality of life.
  
  
  METHODS
  20 heart transplant recipients in an intervention group and 12 patients after HTX in a control group participated in the study (IG (CG); 5.1+/-2.2 (4.5+/-2.3) years after HTX; age: 55+/-7 (54+/-8) years; body mass index: 28.3+/-1.0 (28.7+/-0.9) kg.m(-2)). Before and after the intervention, maximum and constant load exercise capacity, and self-reported quality of life were evaluated. The 12 month intervention period included 10 days of exercise testing as well as medical and psychological support. Furthermore, the IG group performed a computer-assisted and controlled home ergometer training every second day.
  
  
  RESULTS
  After one year with 114+/-18 exercise training sessions, maximum oxygen consumption increased in the IG from 18.8+/-4.2 to 20.1+/-4.2 ml.min(-1).kg(-1) (p<0.05; CG 19.3+/- 4.5 to 18.5+/-2.8 ml.min(- 1).kg(-1); p<0.01 IG vs CG). In the IG, lower back pain, body fat, and blood pressure were all reduced, while the self-reported quality of life, endurance exercise capacity and HDL cholesterol were increased. No significant changes occurred in the control group.
  
  
  CONCLUSIONS
  When initiated years after heart transplantation, longterm rehabilitation reduced coronary risk factors and significantly improved both the subjects' quality of life, as well as a near to normal capacity for physical work.
authors.affiliation: Medizinische Hochschule Hannover, Sportmedizinisches Zentrum (OE 4252), Carl-Neuberg-Str. 1, 30625 Hannover, Germany. tegtbur.uwe@mh-hannover.de
authors.forename: U
authors.initials: U
authors.lastname: Tegtbur
authors.forename: M W
authors.initials: MW
authors.lastname: Busse
authors.forename: K
authors.initials: K
authors.lastname: Jung
authors.forename: A
authors.initials: A
authors.lastname: Markofsky
authors.forename: H
authors.initials: H
authors.lastname: Machold
authors.forename: U
authors.initials: U
authors.lastname: Brinkmeier
authors.forename: H W
authors.initials: HW
authors.lastname: Künsebeck
authors.forename: A
authors.initials: A
authors.lastname: Haverich
authors.forename: K
authors.initials: K
authors.lastname: Pethig
mesh_terms: D000553:Ambulatory Care; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011183:Postoperative Complications / Q000534:rehabilitation; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D013813:Therapy, Computer-Assisted