January 1, 2011Open Access

The Effect of a Self Exercise Program in Cardiac Rehabilitation for Patients with Coronary Artery Disease

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery disease (n=91). Intervention: Self exercise program vs. Supervised exercise program. Primary outcome: Changing rate of maximum oxygen consumption (VO2max) (p=<0.05).

Key Result

A self-exercise program improved cardiopulmonary capacity in patients with coronary artery disease, but yielded a significantly lower rate of increase in maximum oxygen consumption (8.6%) compared to a supervised exercise program (21.1%).

Study Design

Type

Cohort (n=91)

Multicenter

PICO

Population

91 patients with coronary artery disease following percutaneous coronary intervention or coronary artery bypass graft surgery, followed for 6 months to compare supervised versus self-exercise cardiac rehabilitation programs.

Intervention / Comparator

Self exercise program vs Supervised exercise program

Primary Outcome

Changing rate of maximum oxygen consumption (VO2max), p=<0.05

Main Result

Absolute Event Rate: 8.6% vs 21.1%

p-value: p=<0.05

Limitations

Not a randomized comparative study, as patients self-selected their participation group.
Patients at high risk of heart attack during exercise were excluded from the self-exercise group.
Differences in the management scores of several risk factors (hypertension, diabetes mellitus, hyperlipidemia, obesity, smoking) were not clearly determined between groups.
Lack of long-term follow-up beyond 6 months.

Abstract

OBJECTIVE: To investigate the effect of self exercise in cardiac rehabilitation on cardiopulmonary exercise capacity for selected patients with coronary artery disease. METHOD: The subjects of this study were patients who received percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery and who participated in a cardiac rehabilitation program. The supervised exercise group participated in 6-8 weeks of aerobic exercise training with telemetry ECG monitoring in hospital. The self exercise group, whose exercise risk was low, was instructed to participiate in self exercise training in a community exercise environment according to the exercise tolerance test (ETT) using a modified Bruce protocol. Both groups underwent ETTs before and 6 months after initiation of the cardiac rehabilitation program. We compared the supervised group with the self exercise groups on exercise capacity. RESULTS: After 6 months, the supervised exercise group showed significant changes in maximum oxygen consumption, maximal heart rate, resting heart rate, and submaximal rate pressure product. The self exercise group also showed significant improvement of maximum oxygen consumption and submaximal rate pressure product. However, the changing rate of maximum oxygen consumption was significantly higher in the supervised exercise group than the self exercise group. CONCLUSION: Both the supervised and self exercise groups showed similar improvement of cardiopulmonary exercise capacity after 6 months' participation in the cardiac rehabilitation program. However, the changing rate of maximum oxygen consumption, maximal heart rate, and resting heart rate were significantly higher in the supervised exercise group than the self exercise group.

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