Exercise Training for Cardiac Patients

The relationships of exercise adherence and aerobic fitness to a spectrum of biologic and psychologic benefits were examined in the context of a three-stage model of exercise training: recruitment, participation, and continuation. Ninety-five men consecutively admitted for uncomplicated acute myocardial infarction or for coronary artery bypass graft surgery were screened for exercise training based on their ability to exercise and the distance of their residence from the exercise site, yielding a final sample of 50. Patients were followed up for a period of one year posthospitalization. Fifty percent of the patients attempted training. Exercise adherence declined by 50% after the completion of training and stabilized at that level for the rest of the year. Six variables predicted adherence at two of the three stages of the program throughout the year, while six other variables predicted adherence at only one of the stages. Adherence was positively associated with improvement in mood state as well as with improvement in ischemic and dyspneic symptoms. Neither the extent of participation in exercise training (beyond six weeks of the 12-week program), nor the continuation of exercise activity after training was related significantly to improvement in fitness. Further, improvement in fitness was not significantly associated with improvement in benefits. The pattern of positive relationships between exercise adherence and benefits and null relationships between exercise aerobic fitness and benefits are discussed in terms of a possible psychologic mechanism through which exercise training may exert its positive effects.