title: Early and late rehabilitation and physical training in elderly patients after cardiac surgery.
abstract: OBJECTIVE
  Few randomized trials have enrolled patients who have undergone cardiac surgery, and even fewer have included patients aged 75 yrs or more. Furthermore, the optimal timing of cardiac rehabilitation for postsurgical patients has not yet been codified. The aim of this study was to verify whether rehabilitation outcomes are also favorable in postsurgical patients aged 75 yrs or more and whether an early rehabilitation program is as effective and safe as a late one.
  
  
  METHODS
  Three hundred patients who underwent cardiac surgery, 27.7% of whom were at least 75 yrs old, were randomly assigned to a rehabilitation program starting within the second week after operation or within the fourth week. All events occurring during the rehabilitation program or in the following year were recorded.
  
  
  RESULTS
  During the rehabilitation program, new-onset atrial fibrillation was significantly more frequent in the early rehabilitation group, independent of age class, and anemia was significantly more frequent in older patients, independent of rehabilitation timing. At the end of the rehabilitation program, more than 90% of patients showed significant increases in walking distance, and during the follow-up, no significant difference was found with regard to mortality, nonfatal events, functional ability, or control of cardiovascular risk factors, independent of rehabilitation timing and age class.
  
  
  CONCLUSIONS
  This study provides evidence that in selected patients who have undergone cardiac surgery, rehabilitation outcomes are also favorable in patients aged 75 yrs or more, and an early rehabilitation program is as effective and safe as a traditionally late one.
authors: Cardiac Rehabilitation Unit, Don Gnocchi Foundation, Florence, Italy.
authors: Claudio
authors: C
authors: Macchi
authors: Francesco
authors: F
authors: Fattirolli
authors: Raffaele Molino
authors: RM
authors: Lova
authors: Andrea A
authors: AA
authors: Conti
authors: Maria Luisa Eliana
authors: ML
authors: Luisi
authors: Rosanna
authors: R
authors: Intini
authors: Renato
authors: R
authors: Zipoli
authors: Costanza
authors: C
authors: Burgisser
authors: Lorenzo
authors: L
authors: Guarducci
authors: Giulio
authors: G
authors: Masotti
authors: Gian Franco
authors: GF
authors: Gensini
mesh_terms: D000367:Age Factors; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D004434:Early Ambulation / Q000009:adverse effects; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology