Exercise intervention improves quality of life in older adults after myocardial infarction: randomised clinical trial

Abstract

ObjectiveTo establish the benefits of an early, tailored and low-cost exercise intervention in older patients hospitalised for acute coronary syndrome (ACS).MethodsThe study was a multicentre, randomised assessment of an exercise intervention in patients with ACS ≥70 years with reduced physical performance (as defined by the short physical performance battery (SPPB), value 4–9). The exercise intervention included four supervised sessions (1, 2, 3, 4 months after discharge) and home-based exercises. The control group attended a health education programme only. The outcomes were the 6-month and 1-year effects on physical performance, daily activities, anxiety/depression and quality of life. Finally, 1-year occurrence of adverse events was recorded.ResultsOverall, 235 patients with ACS (median age 76 (73–81) years) were randomised 1 month after ACS. Exercise and control groups were well balanced. Exercise intervention improved 6-month and 1-year grip strength and gait speed. Exercise intervention was associated with a better quality of life (as measured by EuroQol-visual analogue scale at 6 months 80 (70–90) vs 70 (50–80) points, p<0.001 and at 1 year 75 (70–87) vs 65 (50–80) points, p<0.001) and with a reduced perception of anxiety and/or depression (6 months: 21% vs 42%, p=0.001; 1 year 32% vs 47%, p=0.03). The occurrence of cardiac death and hospitalisation for cardiac cause was lower in the intervention group (7.5% vs 17%, p=0.04).ConclusionsThe proposed early, tailored, low-cost exercise intervention improves mobility, daily activities, quality of life and outcomes in older patients with ACS. Larger studies are needed to confirm the clinical benefit.Trial registration numberNCT03021044.

Longitudinal evaluation of the effects of illness perceptions and beliefs about cardiac rehabilitation on quality of life of patients with coronary artery disease and their caregivers

“…These appear particularly low for older adults. However, recently Campo et al reported an early, low cost model with very promising results in terms of physical performance after myocardial infarction and quality of life [66,67]. Our findings for caregivers are consistent with Ebbesen et al [68], who identified that caregivers often have poor emotional and physical health-related quality of life.…”

Benefits and harms of exercise therapy in people with multimorbidity: A systematic review and meta-analysis of randomised controlled trials

“…The included studies were conducted across 17 countries, including Europe, ( Edelmann et al, 2011 ; Nolte et al, 2015 ; Pibernik-Okanovic et al, 2015 ; Oerkild et al, 2012 ; Hinrichs et al, 2016 ; Koukouvou et al, 2004 ; Bernocchi et al, 2018a ; Campo et al, 2020 ; Asa et al, 2012 ; Kulcu et al, 2007 ; Rodriguez-Manas et al, 2019 ) USA ( Blumenthal et al, 2012a ; de Groot et al, 2019 ; Gary et al, 2012 , 2010 ; Gary et al, 2004 ; Gretebeck et al, 2019 ; Schneider et al, 2016 ; Blumenthal et al, 2012b ), Australia ( Leung et al, 2013 ), and Asia ( Leung et al, 2019 ; Keihani et al, 2014 ; Abdelbasset et al, 2019 ; Soliman and Abdelbasset, 2019 ). The characteristics of the included studies are reported in Table 1 .…”

“…Aerobic exercise was the most commonly applied type of exercise therapy (n = 11), ( Oerkild et al, 2012 ; Asa et al, 2012 ; Kulcu et al, 2007 ; Blumenthal et al, 2012a ; de Groot et al, 2019 ; Gary et al, 2010 , 2004 ; Blumenthal et al, 2012b ; Keihani et al, 2014 ; Abdelbasset et al, 2019 ; Soliman and Abdelbasset, 2019 ) followed by exercise programmes combining aerobic, strengthening, balance and flexibility exercises (n = 8), ( Edelmann et al, 2011 ; Nolte et al, 2015 ; Pibernik-Okanovic et al, 2015 ; Hinrichs et al, 2016 ; Koukouvou et al, 2004 ; Campo et al, 2020 ; Gary et al, 2012 ; Schneider et al, 2016 ; Bernocchi et al, 2018b ), and Tai Chi (n = 2) ( Leung et al, 2013 , 2019 ), or resistance training alone (n = 2), ( Rodriguez-Manas et al, 2019 ; Gretebeck et al, 2019 ). All the included trials provided total or partial supervision of the exercise sessions.…”

“…Adherence to the exercise therapy sessions varied widely from 51 % to 94 % of the planned exercise sessions. Interventions were delivered individually ( Edelmann et al, 2011 ; Nolte et al, 2015 ; Kulcu et al, 2007 ; Rodriguez-Manas et al, 2019 ; Keihani et al, 2014 ), in group ( Pibernik-Okanovic et al, 2015 ; Koukouvou et al, 2004 ; Asa et al, 2012 ; Blumenthal et al, 2012a ; de Groot et al, 2019 ; Gretebeck et al, 2019 ; Schneider et al, 2016 ; Blumenthal et al, 2012b ; Leung et al, 2013 , 2019 ), or as self-help ( Oerkild et al, 2012 ; Hinrichs et al, 2016 ; Campo et al, 2020 ; Gary et al, 2012 , 2010 , 2004 ; Abdelbasset et al, 2019 ; Soliman and Abdelbasset, 2019 ; Bernocchi et al, 2018b ), (i.e. participants were recommended to exercise by themselves with a structured programme) with or without partial supervision.…”

Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a multistrata non-parametric test

“…Fifth, adherence to the recommended home program was not determined, and thus, a causal relationship between the "dose" of PA and the WS improvement is not possible. However, we recently demonstrated in a randomized controlled trial in older outpatients with CVD that the intervention produced significant increase in habitual PA, associated with improved health outcomes [65][66][67].…”