The impact of early rehabilitation program on exercise tolerance in post-myocardial infarction patients: a 5-week intervention study

BACKGROUND: Cardiovascular diseases remain the leading cause of death worldwide, with cardiac rehabilitation playing a key role in recovery after myocardial infarction. This study aimed to assess the impact of an early 5-week cardiac rehabilitation program (24 training sessions; 5 sessions/week), implemented approximately 17 days after myocardial infarction, on improving exercise tolerance. METHODS: The study included 188 patients (133 men, 55 women, mean age 61.36 years) with first ST-segment elevation myocardial infarction after successful revascularization. The rehabilitation program consisted of general conditioning exercises, endurance training, and resistance training. Assessment was performed before and after rehabilitation using electrocardiographic exercise testing, 6-minute walk test, and hemodynamic measurements. RESULTS: After the 5-week program, significant improvements were observed in maximum heart rate (113.89 ± 14.90 to 121.27 ± 15.91 beats/min, p = 0.0001), physical capacity expressed in metabolic equivalent of task (METs) (6.28 ± 1.98 to 8.50 ± 2.64, p = 0.0001), double product reserve (DPr) (18,063.48 ± 6,531.58 to 19,115.82 ± 4,021.28, p = 0.0001), and distance in 6-minute walk test (483.46 ± 105.15 to 535.53 ± 98.47 m, p = 0.0001). A significant decrease in peak diastolic blood pressure (80.03 ± 7.32 to 78.56 ± 7.44 mmHg, p = 0.04) and perceived exertion on the Borg scale (14.06 ± 1.90 to 13.05 ± 0.92, p = 0.0001) was also noted. CONCLUSIONS: Early, intensive cardiac rehabilitation leads to significant improvement in exercise tolerance after just 5 weeks, as demonstrated by changes in key cardiovascular parameters. Implementing intensive, short-term rehabilitation programs during the critical period of cardiac remodeling may provide an effective alternative to longer programs, particularly in healthcare systems with limited resources.