Comparison of supervised and unsupervised exercise training after coronary bypass surgery.

Functional capacity and cardiovascular responses to serial graded treadmill testing ( GXT ) were compared in 180 patients who performed prescribed unsupervised exercise and 24 patients who were referred for supervised exercise after coronary artery bypass surgery (CABS). The groups were men similar in age range, number of bypass grafts, preoperative left ventricular impairment and number of days hospitalized. All patients received similar predischarge exercise monitoring and began a progressive home walking or cycling program. Initial GXT (T1) was performed 44 +/- 9 days postoperatively. Both groups were instructed to continue prescribed exercise at 75 to 85% maximal heart rate (HR) for 30 to 40 minutes 3 days (supervised) or 5 days ( unsupervised ) per week. The second GXT (T2) was performed 115 +/- 27 days after CABS. In each group there were significant (p less than 0.01) increases in exercise capacity and HR from T1 to T2. However, there were no significant differences in maximal exercise capacity and HR between groups at T1 or T2. Improvement in functional capacity was not influenced by therapeutic beta blockade. These findings indicate that prescribed unsupervised exercise can be performed safely and results in similar functional improvements compared with supervised exercise after uncomplicated CABS.