The new Phase 1 cardiac rehabilitation protocol in 37 post-AMI patients showed no adverse events across 68 supervised sessions, confirming its safety.
Is a new Phase 1 cardiac rehabilitation protocol safe in clinically stable post-acute myocardial infarction patients during acute hospitalization?
A new Phase 1 cardiac rehabilitation protocol involving supervised aerobic and strength exercises appears safe and reproducible for clinically stable post-AMI patients during acute hospitalization.
Absolute Event Rate: 0% vs 0%
Abstract Background Phase 1 cardiac rehabilitation after acute myocardial infarction (AMI) is understudied, with inconsistent protocols and challenges in exercise prescription that may compromise patient safety and rehabilitation continuity. Objective To evaluate the safety of a new cardiac rehabilitation protocol by identifying the occurrence of potential adverse events in AMI patients during the most acute phase of hospitalization (Phase 1). Methods This single-center retrospective study analyzed training session data collected at least 24 hours after treating the primary lesions that led to AMI during patients’ stays in a semi-intensive cardiology unit. Patients were admitted to a rehabilitation room (Picture 1) once they demonstrated clinical stability, sufficient strength (MRC scale 48), and adequate mobility (Perme scale 17) to perform aerobic (stationary bike or treadmill) and strength exercises. All exercises were supervised and monitored with a 5-lead electrocardiogram. Exercise intensity was set at 55-60% of the maximum heart rate (220 – age) or 20 bpm above baseline, maintaining a Borg scale rating of 11-13. The Talk Test was also used, with exercise interrupted if patients exhibited broken speech. Statistical comparisons between groups were performed using T-Student and Mann-Whitney tests (after normality testing), and adverse event differences were assessed with Fisher’s Exact Test and Confidence Intervals. Results Data from 68 exercise sessions of 37 AMI patients were analyzed, divided into ST-segment elevation myocardial infarction (STEMI, n=19) and non-ST-segment elevation myocardial infarction (NSTEMI, n=18). Table 1 shows the data regarding the characteristics of the participants, as well as the time to rehabilitation initiation and the median number of sessions each patient underwent, in addition to data on cardiac response to exertion, reported fatigue level, training duration, load used, and distance covered. There were no differences between groups for any evaluated variable. The treadmill was used in 97.3% of the training sessions, and in only 2.7% of the sessions, patients trained under vasoactive drugs (dobutamine) during the exercise, all in the STEMI group. No adverse events or complications were observed in any of the exercise sessions. Conclusion Analysis of training sessions for the new Phase 1 cardiac rehabilitation protocol in post-AMI patients revealed no adverse events or complications, confirming its safety and reproducibility.Picture 1 Table 1
Colucci et al. (Sat,) reported a other. The new Phase 1 cardiac rehabilitation protocol in 37 post-AMI patients showed no adverse events across 68 supervised sessions, confirming its safety.
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