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Exercise training soon after myocardial infarction
de Busk RF, Houston N, Haskell W, Fry G, Parker M
The American Journal of Cardiology 1979 Dec;44(7):1223-1229
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; 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*

To assess the cardiovascular effects of exercise training soon after clinically uncomplicated myocardial infarction, 70 men (mean age 54 years) underwent gymnasium training (N = 28), home training (N = 12) or no training (N = 30) 3 to 11 weeks after the acute event. During this 8 week interval functional capacity increased significantly (p < 0.001) in all three groups: gymnasium training, 66 percent; home training, 41%; and no training, 34 percent. Peak functional capacity at 11 weeks was 11.0 +/- 1.6, 10.3 +/- 1.4 and 9.4 +/- 1.8 (mean +/- standard deviation) multiples of resting energy expenditure (METS) in the three groups- values approximating those of sedentary men of similar age without coronary heart disease. Functional capacity increased more in the gymnasium training group than in the no training group, but this difference was statistically significant only in patients without exercise-induced ischemic S-T segment depression or angina pectoris (p < 0.01). Another "training effect" -- diminished heart rate response to submaximal work -- was also observed in all three groups. It is concluded that (1) symptom-limited treadmill exercise testing performed soon after clinically uncomplicated myocardial infarction is feasible and safe and provides useful guidelines for physical reconditioning. (2) Patients who demonstrate nonischemic responses to treadmill exercise testing soon after infarction may safely undergo unsupervised exercise training at home. (3) Formal exercise training may not be required to restore functional capacity to nearly normal values soon after clinically uncomplicated myocardial infarction.
With permission from Excerpta Medica Inc.

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