This investigation was designed to determine the impact of a brief period of cardiac rehabilitation, initiated within 6 weeks of acute myocardial infarction (AMI), on both disease-specific and generic health-related quality of life, exercise tolerance and return to work after AMI. With a stratified, parallel group design, 201 low-risk patients with evidence of depression or anxiety, or both, after AMI, were randomized to either an 8-week program of exercise conditioning and behavioral counseling or to conventional care. Although the differences were small, significantly greater improvement was seen in rehabilitation group patients at 8 weeks in the emotions dimension of a new disease-specific, health-related Quality of Life Questionnaire, in their state of anxiety and in exercise tolerance. All measures of health-related quality of life in both groups improved significantly over the 12-month follow-up period. However, the 95% confidence intervals around differences between groups at the 12-month follow-up effectively excluded sustained, clinically important benefits of rehabilitation in disease-specific (limitations -2.70 to 1.40; emotions -4.86 to 1.10, where negative values favor conventional care and positive values favor rehabilitation) and generic health-related quality of life (time trade-off -0.062 to 0.052; quality of well-being -0.042 to 0.035) or in exercise tolerance (-38.5 to 52.1 kpm/min); also, return to work was similar in the 2 groups (relative risk 0.93; confidence interval 0.71 to 1.64).
With permission from Excerpta Medica Inc.

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