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Quality of life and return to work 5 years after coronary artery bypass surgery. Long-term results of cardiac rehabilitation
Engblom E, Korpilahti K, Hamalainen H, Ronnemaa T, Puukka P
Journal of Cardiopulmonary Rehabilitation 1997 Jan-Feb;17(1):29-36
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Rehabilitation is an important part of the treatment of patients with ischemic heart disease. Therefore, many patients undergoing coronary artery bypass surgery (CABS) also participate in cardiac rehabilitation programs. This study was conducted to investigate whether rehabilitation influences quality of life and work status after CABS. METHODS: Consecutive patients undergoing elective CABS were randomly assigned to a rehabilitation group (R, N = 119) and a hospital-treatment group (H N = 109). All patients received usual medical care. Group R participated in a rehabilitation program based on exercise and counseling. The follow-up time was 5 years. The measured domains of health-related quality of life were heart symptoms, functional class, exercise capacity, use of medication, depression, the patients' perception of health, and overall life situation. The Nottingham Health Profile as a measure of perceived distress was used. RESULTS: Symptoms, use of medication, exercise capacity, and depression scores did not differ between groups R and H. Five years after the CABS, the patients in group R reported less restriction in physical mobility on the Nottingham Health Profile than patients in group H (p = 0.005), and more patients in group R than in group H perceived their health (p = 0.03) and overall life situation (p = 0.02) as good. The increase in the proportion of subjects working was higher in group R than group H at 3 years after the CABS (p = 0.02), but not at other follow-up times. CONCLUSION: A cardiac rehabilitation program in conjunction with usual medical care after CABS may induce a perception of improved health. The influence on return to work is limited.
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