title: Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial.
abstract: BACKGROUND
  The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention.
  
  
  METHODS
  After the same inpatient care plan, low-risk patients who experienced an AMI were randomized into 2 groups: (1) a control group (CG) (n = 43) entailing usual care and (2) an intervention group (IG) (n = 45) entailing outpatient (unsupervised) CR primarily centered on a progressive walking program. Initially, all patients underwent a supervised exercise program with early mobilization beginning 12 hours after an AMI. On hospital discharge, all patients were classified according to cardiovascular risk. Quality of life was evaluated by the MacNew Heart Disease HRQL questionnaire 30 days after discharge. Functional capacity was determined by a 6-minute walk test (6MWT) distance on the day of inpatient discharge as well as 30 days afterward.
  
  
  RESULTS
  The HRQL global score was higher in the IG compared with the CG 30 days after discharge (P < 0.001); physical and emotional domain scores were both significantly higher in the IG (P < 0.001). Furthermore, the IG showed a greater 6MWT distance compared with the CG (P < 0.001).
  
  
  CONCLUSIONS
  A CR program based on early progressive exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI.
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors: Thatiana C A
authors: TC
authors: Peixoto
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors: Isis
authors: I
authors: Begot
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors: Douglas W
authors: DW
authors: Bolzan
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors: Lais
authors: L
authors: Machado
authors: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Michel S
authors: MS
authors: Reis
authors: Faculty of Medicine of Ribeirao Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Valeria
authors: V
authors: Papa
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
authors: Antonio C C
authors: AC
authors: Carvalho
authors: Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
authors: Ross
authors: R
authors: Arena
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil. Electronic address: wjgomes.dcir@epm.br.
authors: Walter J
authors: WJ
authors: Gomes
authors: Cardiology Discipline and Cardiovascular Surgery, São Paulo Hospital, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil; Department of Human Motion Sciences, Physical Therapy School, Federal University of São Paulo, Santos/São Paulo, Brazil.
authors: Solange
authors: S
authors: Guizilini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D010045:Outpatients; D010349:Patient Compliance; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking