Effectiveness of exercise training on improving exercise capacity in patients undergoing cardiac rehabilitation

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Effectiveness of exercise training on improving exercise capacity in patients undergoing cardiac rehabilitation

 

Author: Ho, Yuk-lai Ester
Title: Effectiveness of exercise training on improving exercise capacity in patients undergoing cardiac rehabilitation
Degree: M.Sc.
Year: 2000
Subject: Hong Kong Polytechnic University -- Dissertations
Heart -- Diseases -- Patients -- Rehabilitation
Heart -- Diseases -- Exercise therapy
Exercise therapy
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: iv, 65 leaves ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1658997
URI: http://theses.lib.polyu.edu.hk/handle/200/4177
Abstract: The aims of this study were to evaluate the effectiveness of exercise training on improving exercise capacity in patients undergoing a cardiac rehabilitation program (CRP); and to identify factors associated with the change of exercise capacity. Ninety-two subjects (74 male, 18 female) aged 41 to 85 with ischemic heart disease; myocardial infarction and heart failure were assigned either to the CRP group or the control group. The CRP group received an 8-week of exercise-based cardiac rehabilitation program, while the control group received the conventional care. Subjects' exercise capacity was assessed both by an Exercise Stress Test (GXT) and a Six-minute Walking Test (6MWT) before and after the program. Change of exercise capacity between the CRP and the control groups was compared to evaluate the effectiveness of the exercise training program. After then, its correlation with demographic and clinical data were assessed to identify factors potentially affecting the training response. It was found that the exercise capacity improved both in the CRP group (before Vs after: 4.79+-2.93 Vs 5.99+-2.90METs; p= 0.000) and the control group (before Vs after: 4.61+-2.34 Vs 5.03+-2.84METs; p=0.000), with a greater improvement found in the CRP group (CRP Vs control: 44.97+-62.84 Vs 12.93+-45.14%; p=0.019). Change of exercise capacity, when assessed by GXT, was positively correlated with CRP group (r=0.249; p=0.019), beta-blocker (r=0.236; p=0.027), exercise intensity (r=0.292; p=0.006), and the total exercise duration (r=0.281; p=0.008); and negatively correlated with the initial METs level (r=-0.435; p=0.000), HF (r=-0.210; p=0.049), and data from the initial GXT, namely, the absolute maximum heart rate (r=-0.308; p=0.004) and in percentage of age-predicted maximum (r=-0.270; p=0.011), chronotropic response (r=-0.303; p=0.004) and the maximum rate pressure product (r=-0.311; p=0.007). When assessed by 6MWT, change of exercise capacity was correlated positively with heart failure (r=0.285; p=0.007); and negatively with the initial METs level (r=-0.212; p=0.047), initial distance walked from 6MWT (r=-0.560; p=0.000), and chronotropic response (r=-0.237; p=0.027). Change of exercise capacity was not correlated with age, gender, body mass index, body weight, ischemic heart disease, myocardial infarction, surgical revascularization, angiotensin converting enzyme inhibitor, positive stress test, ejection fraction, time lag from cardiac events to exercise program, nor home exercise habit when assessed by Pearson correlation coefficients. However, after adjusted for the inter-correlation between variables by multiple regression, change of exercise capacity, as assessed by GXT, was only correlated negatively with the initial METs level (r=-0.423; p=0.003), age (r=-0.304; p=0.038), and positive stress test (r=-0.296; p=0.004). When assessed by 6MWT, exercise capacity was correlated positively with heart failure (r=0.263; p=0.043) and the absolute MHR achieved form GXT (r=0.337; p=0.008); and negatively with the initial distance walked from 6MWT (r=-0.614; p=0.000) and the MHR achieved in percentage of the age-predicted maximum (r=-0.411; p=0.001). Demographic and clinical variables selected in this study were accounted for 50% and 56% of the total variability of the change of the exercise capacity, in terms of METs as assessed by GXT and walking scores as assessed by 6MWT respectively. In conclusion, exercise training is effective on improving exercise capacity in patients undergoing cardiac rehabilitation program. A lot of demographic and clinical data were correlated with the change of exercise capacity, which potentially are the factors affecting the training response.

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