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  • Title: Long-term effect of rehabilitation in coronary artery disease patients: randomized clinical trial of the impact of exercise volume.
    Author: Hansen D, Dendale P, Raskin A, Schoonis A, Berger J, Vlassak I, Meeusen R.
    Journal: Clin Rehabil; 2010 Apr; 24(4):319-27. PubMed ID: 20176771.
    Abstract:
    OBJECTIVE: To assess whether exercise volume during phase II rehabilitation affects long-term clinical benefits in patients with coronary artery disease. DESIGN: Prospective randomized clinical trial with long-term follow-up. SETTING: Hospital outpatient clinic. SUBJECTS: Coronary artery disease patients (age 65 +/- 9 years, 82% males) attending a phase II rehabilitation programme were randomized into two groups of exercise volumes: 40- versus 60-minute training sessions. Patients exercised for three days per week for seven weeks, at 65% of baseline oxygen uptake capacity. Next, they were followed up for 18 months. Out of 165 patients with coronary artery disease who completed the exercise intervention, 119 attended the 18-month follow-up assessment. MAIN MEASUREMENTS: Body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, smoking behaviour, habitual physical activity, cardiovascular disease incidence and mortality. RESULTS: In total population, a significant worsening of various cardiovascular disease risk factors was found at 18 months follow-up (P<0.05), and few patients (27% of total group) adhered to the recommended minimal physical activity level. No difference in change of body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and C-reactive protein level, and smoking behaviour was seen between different exercise volumes (P>0.05). In addition, total cardiovascular disease incidence (13% versus 22% in 40- versus 60-minute group, respectively) and habitual physical activity were not different between groups (P>0.05). CONCLUSION: In patients with coronary artery disease following cardiac rehabilitation, the cardiovascular disease risk profile worsened significantly during long-term follow-up. A smaller exercise volume during phase II rehabilitation generated equal long-term clinical benefits compared to a greater exercise volume.
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