Evaluation of cardiac rehabilitation in relation to prognosis.

We designed a rehabilitation program for patients with post-myocardial infarction by modifying the 14-step program of Emory University into a more suitable form for a Japanese. The usefulness of this rehabilitation program was evaluated by comparing the clinical course of our patients with that of the patients in our affiliated institutions, where patients had no systematic rehabilitation therapy. The following results were obtained: 1) Most patients of the rehabilitation-completed group were living a non-restricted life 6 months after discharge. The life style of the rehabilitation group even including the rehabilitation-non-completed group, was far better than that of the non-rehabilitation group. 2) Many patients of the rehabilitation group were working at the same job as before infarction 3 years after discharge, while a substantial number of the patients of the non-rehabilitation group had changed their job or retired within 3 years after discharge. 3) The reason for changing job or retiring was primarily subjective symptoms or objective findings in the rehabilitation-completed group, while it was mostly fear in the non-rehabilitation group. 4) Patients who could not complete our program were mainly old patients of over 70 years of age, patients with extensive anterior infarction and subendocardial infarction and ones with complications such as shock and cardiac failure.