title: Cardiac Rehabilitation in Very Old Adults: Effect of Baseline Functional Capacity on Treatment Effectiveness.
abstract: To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event.
  
  
  
  Observational.
  
  
  
  In-hospital CR unit.
  
  
  
  Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4).
  
  
  
  Peak oxygen consumption (VO2 peak, power) during a symptom-limited cardiopulmonary stress test, distance walked in a 6-minute walk test (6MWT, resistance), and peak torque (strength) using an isokinetic dynamometer, were assessed at baseline and at discharge from a 4-week supervised training program.
  
  
  
  Indexes of physical performance improved from baseline to discharge (VO2 peak, 10.9%; 6MWT, 11.0%; peak torque, 11.5%). Baseline performance was independently associated with changes in all three indexes, with higher baseline values predicting less improvement (VO2 peak: OR=0.86, 95% confidence interval (CI)=0.77-0.97; 6MWT: OR= 0.99, 95% CI=0.99-1.00; peak torque: OR=0.96, 95% CI=0.94-0.98).
  
  
  
  An exercise-based CR program was associated with improvement in all domains of physical performance even in older adults after an acute coronary event or cardiac surgical intervention, particularly in those with poorer baseline performance.
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Samuele
authors.initials: S
authors.lastname: Baldasseroni
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pratesi
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Francini
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Pallante
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Barucci
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orso
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Costanza
authors.initials: C
authors.lastname: Burgisser
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattirolli
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation / Q000379:methods*; D015897:Comorbidity; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D053581:Muscle Strength Dynamometer; D017063:Outcome Assessment, Health Care; D010100:Oxygen / Q000097:blood*
chemical_list: D010100:Oxygen
keywords: cardiac rehabilitation; cardiovascular diseases; elderly; functional capacity