Exercise training, cardiac rehabilitation and return to work in patients with coronary artery disease.

Few studies have analysed the influence of exercise training or cardiac rehabilitation on return to work in patients with coronary artery disease. In a consecutive series of 41 men less than 60 years of age admitted for acute myocardial infarction, 19 participated in a comprehensive rehabilitation programme focused on physical training, and 22 received standard care. The baseline clinical and social variables of the two groups were comparable except for left ventricular ejection fraction which was significantly lower in the intervention group. Work resumption was not significantly different between the two groups (9/19, 47% in the intervention group vs 17/22, 77% in the control group); after three years, 42% and 73%, respectively, were still employed. These results are in keeping with that of most controlled studies of cardiac rehabilitation after myocardial infarction or coronary artery surgery, which fail to demonstrate a significant improvement in work resumption. Psychosocial factors are probably more important determinants of work resumption than is exercise training.