Job-simulated phase II cardiac rehabilitation training program: Part A. A comparison with conventional phase II cardiac rehabilitation training program

Abstract

Coronary heart disease (CHD) is the number one killer of people in the World. Besides being the cause of the largest number of deaths in the World, CHD is the main cause of physical disability inflicting the adult human population. The majority of those inflicted are under the age 65. Rehabilitating these individuals, therefore, is the top priority. The cardiac rehabilitation (CR) training program is generally carried out in four phases; phase II, the outpatient rehabilitation, forms the core of the CR training program. Traditionally, the phase II CR training program requires CHD survivors to undergo an aerobic exercise program involving exercises on treadmill, bicycle and arm ergometers, and arm and leg resistance equipment. These exercises are designed to enhance a CHD survivor's aerobic capacity and, in no way, replicate the day-to-day industrial work or prepare him/her for return to work. In fact, the metabolic energy requirements for most industrial jobs are less than 25% of an average person's aerobic capacity. A field study was undertaken to test the hypothesis that a lack of realistic job-simulation during the CR training process may be the reason why the return to work (RTW) rate of the CHD survivors in the United States has not changed in the last 35 yr. A non-aerobic (job-simulated) phase II CR training program was designed to test the significance of this statement. This program included components of non-repetitive and non-endurance activities such as weight lifting and carrying, and flexibility and dexterity activities. The results of the comparison between the conventional and job-simulated phase II CR training programs are reported in this part (part A) of the two-part paper. The results of the field study indicated that, in contrast to conventional phase II CR training program, the job-simulated phase II CR training program was significantly better ( p<0.01) as indicated by CHD survivors returning to work – 100% for the job-simulated program versus 60% for the conventional program. Furthermore, even though aerobic conditioning was not the goal of the job-simulated CR training program, it resulted in a significant post-training enhancement of aerobic capacity ( p<0.05). The gain in aerobic capacity was comparable to that of the conventional CR training program designed to enhance aerobic capacity; differences were insignificant ( p⩾0.10). It is concluded that a phase II CR training program that simulates actual job conditions is far superior to conventional phase II CR training programs as far as the return to work is concerned. Furthermore, the aerobic conditioning advantage of the job-simulated phase II CR training program is the same as that of conventional phase II CR training programs that are intended only to emphasize aerobic conditioning. Relevance to industry Using a job-simulated phase II cardiac rehabilitation training program that significantly enhances return to work chances of coronary heart disease survivors without compromising their aerobic conditioning.