Abstract
The benefits of early ambulation and predischarge exercise testing for stable patients after acute myocardial infarction have been well documented. Early exercise testing can help stratify patients into risk categories; these can guide recommendations for further diagnostic testing for medical or surgical interventions, as well as suggest appropriate activity levels after hospital discharge. The scope of cardiac patients currently considered eligible for exercise rehabilitation is far greater than in the past. Exercise training can improve functional capacity, predominantly mediated by peripheral adaptations; guidelines must be developed for the exercise training and surveillance of severely ill and elderly coronary patients. Education in coronary risk reduction and counseling to limit psychosocial complications of coronary disease and encourage return to work when appropriate can improve the coronary patient's functional status and clinical outcome. Further research is needed to determine the rehabilitative needs of more severely impaired, medically complex patient subgroups and the most cost-effective means of delivering rehabilitative services.
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