Effects of Phase I and Phase II Cardiac Rehabilitation on Health-Related Quality of Life in Patients of Acute Myocardial Infarction

Q: What is the clinical evidence from this study?

Study design: RCT. Population: First-time ST-elevation acute myocardial infarction (STEMI) (n=70). Intervention: Structured Phase I (inpatient) and Phase II (6-week supervised outpatient) exercise-based cardiac rehabilitation (EBCR) vs. Conventional cardiology care alone. Primary outcome: Total health-related quality of life (HeartQoL) score at 6 weeks (MD 7.28, 95% CI 5.57–9.00, p=<0.001).

Q: What does this research mean for the field?

Structured Phase I and II exercise-based cardiac rehabilitation significantly improves health-related quality of life across physical and emotional domains in post-AMI patients compared to conventional care. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Devjanee Das; Md Shawkat Hossain; Anisul Awal; Abu Sayem Mohammad Omar Faroque; Md Abirul Islam; Mohammad Arman; Shohag Chakrabarty; Mohammad Zahidur Rahman Mazumder

doi:10.3329/jcomcta.v30i2.94548

November 3, 2026Journal of Comilla Medical College Teachers AssociationOpen Access

Effects of Phase I and Phase II Cardiac Rehabilitation on Health-Related Quality of Life in Patients of Acute Myocardial Infarction

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Key result

Structured Phase I and II cardiac rehabilitation significantly improved total HeartQoL scores at 6 weeks compared to conventional care in post-AMI patients (MD 7.28, 95% CI 5.57–9.00; p<0.001).

Why the study?

Exercise-based cardiac rehabilitation is a critical component of recovery after AMI, yet its impact on health-related quality of life in resource-limited settings remained understudied.

Does structured Phase I and Phase II exercise-based cardiac rehabilitation improve health-related quality of life at 6 weeks in patients with first-time ST-elevation myocardial infarction compared to conventional care alone?

Study Design

Type

RCT (n=70)

Blinding

Open-label

Randomization

Simple lottery randomization (odd identifiers to intervention, even to control)

Multicenter

No

Structured PICO

Does structured Phase I and Phase II exercise-based cardiac rehabilitation improve health-related quality of life at 6 weeks in patients with first-time ST-elevation myocardial infarction compared to conventional care alone?

P

Population

70 hemodynamically stable adults aged 18-70 years (64 analyzed) with first-time STEMI in Bangladesh, followed for 6 weeks.

I

Intervention

Conventional cardiology care plus structured Phase I and Phase II exercise-based cardiac rehabilitation (EBCR). Phase I (in-hospital) began after ≥48 hours of stabilization and continued throughout hospitalization (~7 days), delivered three times daily (5–20 minutes) including range-of-motion exercises, progressive mobilization, sitting/standing/walking, diaphragmatic breathing, and incentive spirometry. Phase II (outpatient) began post-discharge and continued for 6 weeks (three supervised sessions/week, 45–60 minutes each), comprising warm-up, aerobic exercise (treadmill walking, stationary cycling, and upper-limb ergometry), and cool-down, supplemented by stretching and light resistance exercises.

C

Comparator

Conventional cardiology care (pharmacotherapy, dietary/activity advice, routine follow-up) without structured exercise-based cardiac rehabilitation.

O

Outcome

Health-related quality of life (HRQoL) assessed at 6 weeks post-intervention using the validated 14-item HeartQoL questionnaire (total score, physical domain score, and emotional domain score).patient reported

Main Result

Mean Difference: 7.28 (95% CI 5.57–9)

Absolute Event Rate: 32.06% vs 24.78%

p-value: p=<0.001

Structured Phase I and II exercise-based cardiac rehabilitation significantly improves short-term physical and emotional health-related quality of life in first-time STEMI patients within a resource-limited tertiary hospital setting in Bangladesh.

Limitations

Single-center study in a public tertiary-level healthcare facility limiting generalizability
Small sample size and short 6-week follow-up duration
Baseline health-related quality of life (HRQoL) was not assessed, limiting within-group comparisons over time
Outcome assessors were not blinded to group allocation, introducing potential assessment bias
Conducted in a single public tertiary-level healthcare facility, which may limit generalizability
Relatively small sample size and short follow-up duration restrict the ability to assess long-term outcomes and sustainability
Outcome assessors were not blinded to group allocation, introducing potential for assessment bias

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Supports incorporating structured phase I-II cardiac rehabilitation to improve early HRQoL post-STEMI; extends evidence to resource-limited settings.

Abstract

Background: Exercise-based cardiac rehabilitation (EBCR) is a critical component of recovery post-Acute Myocardial Infarction (AMI), yet its impact on health-related quality of life (HRQoL) in resource-limited settings remains understudied. Objectives: This study aimed to evaluate the effects of structured phase I (in-hospital) and phase II (supervised-outdoor based) EBCR on HRQoL among first-time AMI patients admitted to a tertiary healthcare facility in Chattogram, Bangladesh. Methods: A randomized controlled trial was conducted at Chittagong Medical College Hospital, Bangladesh, from May 2024 to April 2025. Seventy patients with first-time STEMI were randomized to cardiac rehabilitation (n=35) or conventional care (n=35). The intervention included supervised inpatient and six-week outpatient exercise rehabilitation. HRQoL was assessed at baseline and 6 weeks using the HeartQoL questionnaire. Data were analyzed using SPSS 28.0; p<0.05 was considered significant. Ethical approval and informed consent were obtained. Results: After 6 weeks, the experimental group demonstrated significantly greater improvement in HRQoL compared to the control group [mean HeartQoL score difference: 7.28 (95% confidence interval (CI): 5.57–9.00); p<0.05]. Sub domain analysis revealed marked improvements in physical [23.25 ± 2.55 and 17.47 ± 2.68 in the experimental and control group, respectively, with a mean difference (MD) of 5.78 (95% CI: 4.47–7.09)] and emotional dimensions [8.88 ± 1.45 and 7.25 ± 1.59, in the experimental and control group, respectively, with a MD of 1.63 (95% CI: 0.87 - 2.39)] of HRQoL in the experimental group. Conclusion: Structured phase I and II EBCR significantly enhances HRQoL in post-AMI patients within a resource-constrained tertiary care setting. These findings advocate for integrating EBCR into standard cardiac care protocols in similar contexts to optimize patient recovery and quality of life. J Com Med Col Teachers’ Asso July 2026; 30(2): 112-118

Discussion

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Cite This Study

Das et al. (2026) conducted an RCT in First-time ST-elevation acute myocardial infarction (STEMI) (n=70). Structured Phase I (inpatient) and Phase II (6-week supervised outpatient) exercise-based cardiac rehabilitation (EBCR) vs. Conventional cardiology care alone was evaluated on Total health-related quality of life (HeartQoL) score at 6 weeks (MD 7.28, 95% CI 5.57–9.00, p=<0.001). Structured Phase I and II cardiac rehabilitation significantly improved total HeartQoL scores at 6 weeks compared to conventional care in post-AMI patients (MD 7.28, 95% CI 5.57–9.00; p<0.001).

synapsesocial.com/papers/6aebc8ba3e63ca1b6c315e92 https://doi.org/10.3329/jcomcta.v30i2.94548

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Effects of Phase I and Phase II Cardiac Rehabilitation on Health-Related Quality of Life in Patients of Acute Myocardial Infarction

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Effects of Phase I and Phase II Cardiac Rehabilitation on Health-Related Quality of Life in Patients of Acute Myocardial Infarction

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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