Cardiac rehabilitation: evaluation of a long-term programme of physical training for out-patients.

A community-based long-term cardiac rehabilitation programme (LTP) has been designed for patients who had completed a two-year hospital-based physical training programme after myocardial infarction (MI) and wished to continue with community-based group training sessions. Since the start of LTP 20% of all patients in a consecutive MI population less than 65 yrs have participated. The programme operates on a low-cost base. Its feasibility is supported by a high attendance rate and by the absence of adverse effects during more than 2,000 patient training hours. In order to evaluate LTP 20 participating MI patients were compared with 20 matched control patients, who had completed the hospital-based training, but did not participate in LTP. The main reason for participation was the need for continued group support and social contact (15/20). Reasons for not participating were preference to exercise at home (10/20), long distance (6/20) and working hours (4/20). When compared with the data of the hospital-based programme one year post MI, both groups showed 4 years (average) post MI a slight but significant increase of systolic blood pressure of 12 vs. 18 mmHg. Work performance levels had been maintained (132 vs. 136 W). No patients had started smoking and there were no differences between the groups as to leisure time activities. It is concluded that a long-term training programme can be provided safely and at low cost for those MI patients who need continued support in order to maintain the effectiveness of the hospital-based cardiac rehabilitation.