Intensive early in-hospital physiotherapy after myocardial infarction increased mean 6-minute walk test distance by 20 meters (446.4 vs 426.23 m) compared to standard care at discharge.
RCT (n=172)
1:1
No
Does an intensive early physiotherapy program improve functional capacity at discharge in adults hospitalized after myocardial infarction treated with primary PCI?
Intensive early in-hospital physiotherapy after primary PCI for MI provides a modest improvement in functional capacity at discharge.
Mean Difference: 20
Absolute Event Rate: 446.4% vs 426.23%
Abstract Introduction Exercise-based cardiac rehabilitation (CR) has consistently demonstrated significant benefits for physical fitness. However, most CR programs are typically initiated several weeks after hospital discharge, leaving the immediate post-myocardial infarction period largely unaddressed. Initiating structured physiotherapy during this period may prevent physical deconditioning. Purpose The aim of this study was to investigate the effect of intensive physiotherapy treatment in the acute phase after myocardial infarction on the submaximal functional capacity of MI patients. Methods In this single-center RCT, 172 adults hospitalized after MI treated with primary percutaneous coronary intervention (PCI) were randomized 1:1 to either an intensive physiotherapy program (daily supervised mobilization, education, graded activity based on the evidence-based physiotherapy approach Myocardial Infarction Therapy Model, see Figure 1) or control (standard medical care + information flyer). Outcomes were assessed at discharge and included functional capacity (6-minute walk test, 6MWT), vital parameters (heart rate, blood pressure, respiratory rate, oxygen saturation) and self-assessment using Borg Scale. Figure1 * Day 1 is PCI Day **6 MWT = 6-minute walk test *** Average duration of stay 5.21 days ±1.2 Results The average number of therapy days in the intervention group was 3.6±1.4. In the 6-minute walk test (6MWT), the intervention group achieved a mean walking distance of 446.4 meters (SD 78.4), which was on average 20 metres (4.51%) more than the walking distance in the control group (426.23, SD 111.8). Literature values enabled the comparative interpretation of the submaximal functional capacity test results. Similar or even better results were found (see Figure 2), when comparing the 6 MWT results of this study from the day of discharge with previously published data for patients with MI from related studies. Figure 2. There were no significant differences between the interventional and control group regarding vital sign values or Borg scale scores. Conclusions Intensive early in-hospital physiotherapy leads to a modest but relevant increase in functional capacity during the acute post-MI phase. Implementing structured early mobilization protocols may enhance recovery and provide meaningful benefits during the initial days after PCI.Figure 1 Figure 2
Balla et al. (Wed,) conducted a rct in Myocardial infarction (n=172). Intensive physiotherapy program vs. Standard medical care plus information flyer was evaluated on Functional capacity assessed by 6-minute walk test (6MWT) at discharge (MD 20). Intensive early in-hospital physiotherapy after myocardial infarction increased mean 6-minute walk test distance by 20 meters (446.4 vs 426.23 m) compared to standard care at discharge.