Protocol-Guided Phase-1 Cardiac Rehabilitation in Patients with ST-Elevation Myocardial Infarction in A Rural Hospital.

AIMS

Phase-1 Cardiac Rehabilitation (CR) is an important part in the treatment of patients with ST-Elevation Myocardial Infarction (STEMI). Lack of literature in the rural Indian setting led to the design of this study.

SETTING AND DESIGN

Secondary care rural hospital, non-randomized experimental study.

MATERIALS AND METHODS

Fifteen historical controls and 15 prospectively enrolled patients between January 2007 and December 2007. The prospectively enrolled patients received the phase-1, exercise-based, protocol-guided CR. At discharge, the six-minute walk test (6MWT) distance, Borg's Rating of Perceived Exertion (RPE) after the 6MWT, time to return to baseline parameters after the 6MWT, and complications were assessed.

STATISTICAL ANALYSIS USED

Independent t-test and the Mann Whitney test.

RESULTS

Statistically significant (P < 0.01) differences in ratings of perceived exertion (RPE) and time to return to baseline parameters post the 6MWT were seen in the experimental group ((2 vs. 4 and 5.47 vs. 7.93 minutes, respectively). No significant changes in the 6MWT distance between the groups were noticed (470±151.76 m and 379±170.70 m, respectively). No adverse events during the 6MWT and the phase-1 CR were observed.

CONCLUSION

Protocol-guided, phase-1 CR produces a much faster return of heart rate and blood pressure to baseline following the 6MWT, without producing a great rise in the RPE during the 6MWT, which suggests a training benefit among these patients. The 6MWT can be safely administered in this rural population. However, larger studies will be required to validate these results.