title: [The effect of spouse participation in cardiac rehabilitation program on patients' compliance and exercise level].
abstract: BACKGROUND
  Exercise-based cardiac rehabilitation programs have proven to be associated with decreased morbidity and mortality after cardiac events. Unfortunately, attendance is often poor, and long term compliance is low. This study examined the effect of the active participation of spouses in the exercise program on the compliance and physical fitness level of their partners.
  
  
  METHODS
  During the years 1998-2001, 24 couples joined our cardiac rehabilitation program. The couples were divided into 2 groups on the basis of their medical status. In Group 1--Rehabilitation program (n = 14); one of the couple had suffered a myocardial infraction or underwent a coronary bypass surgery at least 3 weeks before starting the program. In Group 2--secondary prevention (n = 10); one of the couple had a medical history of cardiac disease. The third Group included the spouse. Each group was compared with a matched control group based on their medical condition. The parameters that were measured were: the number of sessions attended, basic and final physical training level.
  
  
  RESULTS
  In the rehabilitation groups, the participants attended a larger number of sessions (87.3 + 17) compared to control (47.7 + 6) (p < 0.05). There was no difference in the basic training level between the groups (3.5 + 0.2 METS; compared with 3.4 + 0.2 METS) (P = 0.5) and both groups had similarly improved their training level by 0.79 + 0.1 METS compared with 0.6 + 0.1 METS in the control group (p = 0.2). In the secondary preventive groups, the control group attended a larger number of sessions (51 + 13 compared with 31.2 + 6 sessions) (p < 0.02). There was no difference in the basic training level between groups 3.7 + 0.3 METS compared with 4.2 + 0.2 in the control group (p = 0.2). However, at the end of the training period, the control group showed greater improvement in their training level by 0.7 + 0.2 METS compared to 0.3 + 0.1 METS (p < 0.05). The spouses themselves had attended a greater number of sessions (45 + 10 compared with 37 + 6 in the control group) (p = 0.2). There was no difference between those groups in the training level at baseline and at the end of training period.
  
  
  CONCLUSIONS
  Active support during the rehabilitation program may improve the rates of participation but in the secondary prevention program active spouse support may encourage early dropout.
authors.affiliation: Cardiac Preventive Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Greenberg
authors.forename: N
authors.initials: N
authors.lastname: Almaro
authors.forename: G
authors.initials: G
authors.lastname: Keren
authors.forename: D
authors.initials: D
authors.lastname: Sheps
mesh_terms: D000368:Aged; D015444:Exercise; D005260:Female; D006331:Heart Diseases / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D018454:Spouses; D016896:Treatment Outcome