Adaptation to Low-Intensity Exercise on a Cycle Ergometer by Patients With Acute Myocardial Infarction Undergoing Phase I Cardiac Rehabilitation

Abstract

BackgroundThe adaptation of patients with acute myocardial infarction (AMI) to a phase I rehabilitation program has not been widely assessed. Methods and Results Forty-two male patients (62±8 years) with AMI were classified as exercise tolerant (group A, n=25) or excessive response (systolic blood pressure (SBP) increase >30 mmHg during exercise; group B, n=17). Hemodynamic parameters during exercise using a cycle-ergometer were monitored for the first 3 days. The power of low-and high-frequency components (LF: 0.05-0.2 Hz; HF: 0.2-1 Hz) was analyzed by heart rate variability. Anxiety status was assessed using the Spielberger's State-Trait Anxiety Inventory. Patients in group B were significantly older, had lower cardiac function and a longer hospitalization than group A (p<0.05, respectively). The excessive elevation of SBP on Day 1 decreased and became <30 mmHg on Day 3 in group B. The decreases in HF during exercise on Days 1 and 3 were significantly smaller in group B than in group A (p<0.05 and p<0.05, respectively). The LF/HF ratio on Day 1 was significantly higher in group B than in group A (p<0.05). In group B, the anxiety score before exercise was significantly higher than that at the time of discharge (p<0.05), whereas there was no change in group A. Conclusion Factors influencing a significant elevation of blood pressure during phase I rehabilitation are age, physical deconditioning, imbalance of autonomic nervous activity and anxiety. (Circ J 2004; 68: 938 -945)

Heart rate autonomic responses during deep breathing and walking in hospitalised patients with chronic heart failure

“…The results of the present study demonstrate that a physiotherapy session composed of early postural change, orthostatism, deep breathing and walking is feasible and safe during hospitalisation in patients diagnosed with decompensated CHF [24]. In addition, despite the absence of HRV changes during postural changes and reduced HRV during walking and recovery compared with matched controls, deep breathing exercises and walking positively influenced HRV in these patients.…”

Analysis of heart rate variability at rest and during aerobic exercise: a study in healthy people and cardiac patients

“…It reports a HR increase in patients with AMI during an aerobic exercise on a cycle ergometer; on the basis of a reduction in HF component during exercise,33 the authors conclude that it is due to a decrease of the parasympathetic activity.…”

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

“…3,5 Psychological and educational interventions have additional effects and can lead to changes in risk factors, in the patient's life style, and social and psychological function- ing. 1,2,7,[33][34][35][36][37][38] Many published studies have shown an increase in health-related QOL in patients with CHD who undergo CR. 1,3,[5][6][7][8][9][10][11]22,[39][40][41] More profound changes have been observed in patients who participate in comprehensive CR programs based on physical activity as well as psychological and educational approaches, compared with patients who have only physical training.…”