Phase II intensive monitored cardiac rehabilitation for coronary artery disease and coronary risk factors--a six-session protocol.

To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal MET level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or myocardial infarction. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs.