PURPOSE: The aim of this study was to assess the effects on exercise performance of supplementing a standard cardiac rehabilitation program with additional exercise programming compared to the standard cardiac rehabilitation program alone in elderly patients after heart surgery. METHODS: In this prospective, randomized controlled trial, 60 patients (32 men and 28 women, mean age 73.1 +/- 4.7 years) completed cardiac rehabilitation (initiated 12.2 +/- 4.9 days postsurgery). Subjects were assigned to either a control group (CG, standard cardiac rehabilitation program (n = 19)), or an intervention group (IG, additional walking (n = 19), or cycle ergometry training (n = 22)). A symptom limited cardiopulmonary exercise test and 6-minute walk test (6MWT) were performed before and after 4 weeks of cardiac rehabilitation. The MacNew questionnaire was used to assess quality of life (QOL). RESULTS: At baseline, no significant differences for peak oxygen uptake (VO2), maximal power output, or the 6MWT were detected between IG and CG. Global QOL was significantly higher in IG. After 4 weeks of cardiac rehabilitation, patients significantly improved in absolute values of the cardiopulmonary exercise test, 6MWT, and QOL scores. Significant differences between groups were found for peak VO2 (IG: 18.2 +/- 3.1 mL/kg/min versus CG: 16.5 +/- 2.2 mL/kg/min, p < 0.05); maximal power output (IG: 72.2 +/- 16 W versus CG: 60.7 +/- 15 W, p < 0.05); 6MWT (IG: 454.8 +/- 76.3 m versus CG: 400.5 +/- 75.5 m, p < 0.05); and QOL global (IG: 6.5 +/- 0.5 versus CG: 6.3 +/- 0.6, p < 0.05). CONCLUSION: The supplementation of additional walking or cycle exercise training to standard cardiac rehabilitation programming compared to standard cardiac rehabilitation alone in elderly patients after heart surgery leads to significantly better exercise tolerance.
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