Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation.
OBJECTIVE
We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients.


METHODS
We studied 557 consecutive patients (51.7 ± 6.9 years; 87.9% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O2 utilization (VO2peak) were analysed using analysis of covariance (ANCOVA) models.


RESULTS
Mean training intensity was 90.7 ± 9.7% of maximum heart rate (81% continuous/19% interval training, 64% additional strength training). A total of 12.2 ± 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100% was achieved (difference end/beginning of CR: 784 ± 623 watts × min). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method.


CONCLUSIONS
CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients.
Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, Germany.
Rona
R
Reibis
Center of Rehabilitation Research, University of Potsdam, Germany.
Annett
A
Salzwedel
Department of Cardiology, Klinik am See, Rüdersdorf, Germany.
Hermann
H
Buhlert
Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Germany.
Karl
K
Wegscheider
Center of Rehabilitation Research, University of Potsdam, Germany.
Sarah
S
Eichler
Center of Rehabilitation Research, University of Potsdam, Germany Department of Cardiology, Klinik am See, Rüdersdorf, Germany heinz.voeller@uni-potsdam.de.
Heinz
H
Völler
D000367:Age Factors; D001642:Bicycling; D015897:Comorbidity; D016208:Databases, Factual; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006304:Health Status; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053580:Muscle Strength; D010101:Oxygen Consumption; D010809:Physical Fitness; D020127:Recovery of Function; D055070:Resistance Training; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
Cardiac rehabilitation; cardiorespiratory fitness; exercise tests; multivariate modelling