Patient Education and Quality of Home-Based Rehabilitation in Patients Older Than 60 Years After Acute Myocardial Infarction

Abstract

Because only one-third of eligible patients participate in formal cardiac rehabilitation, home-based programs constitute a suitable alternative. We examined effectiveness of a minimal educational intervention on patient fitness and activity levels through the use of simple motivational tools including verbal encouragement and the provision of a booklet containing exercise guidelines and exercise diary. We enrolled 186 patients (age, 60 – 78 years; mean age, 69 years; 140 men) who were admitted to the outpatient clinic of Warsaw Institute of Cardiology in 2007-2009 after acute myocardial infarction. Of these, 61.3% had coronary angioplasty with stenting and 30.7% had coronary artery bypass. Patients were randomly assigned into an intervention group receiving minimal educational intervention or control. At baseline and 3 months, assessment was made of cardiopulmonary fitness and autonomic tone with exercise testing. Leisure-time physical activity and atherosclerosis risk factors were assessed at baseline and after 3 and 12 months. At baseline, exercise test results and leisure-time activity levels were not significantly different between groups. After 3 months, we noted statistically significant differences in exercise test responses between the intervention group versus control: peak workload 57.3 ± 2.3 versus 47.2 ± 2.2 kJ (P < .04) and heart rate recovery 26.5 3.3 versus 23.7 4.2 bpm (P < .001). Leisure-time activity was greater in the intervention group than in control, 3.9 versus 2.3 h/wk (P < .001). Improvement in atherosclerosis risk factors during the course of the study was similar between groups. Minimal educational intervention is an effective and safe form of promoting physical activity in older patients after myocardial infarction.