Document Detail

Failure to improve cardiopulmonary fitness in cardiac rehabilitation.
MedLine Citation:
PMID:  19935140     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A primary goal of cardiac rehabilitation (CR) exercise is to increase cardiopulmonary fitness. The aim of this study was to identify characteristics of CR participants who fail to improve peak oxygen uptake (peakV(O(2))). METHODS: The study cohort included 385 consecutive patients with directly measured peakV(O(2)) prior to and upon completion of CR. Patients were classified as a "nonimprover" if exit peakV(O(2)) was less than or equal to entry peakV(O(2)). RESULTS: Eighty-one (21%) patients failed to improve peakV(O(2)). Baseline characteristics predicting nonimprovement included the following: lower handgrip strength, lower peak exercise respiratory exchange ratio, a nonsurgical diagnosis, female status, and more medical comorbidities. The number of sessions attended and exercise duration were similar between groups. Nonimprovers, however, exercised at lower exercise intensity despite a similar rating of perceived exertion. By multivariate analysis, independent positive correlates of percentage change in peakV(O(2)) included exercise training intensity and baseline handgrip strength. Negative correlates included baseline peakV(O(2)), comorbidity score, self-reported physical function, and a diagnosis of diabetes (cumulative total r = 0.51, adjusted R = 0.26, P < .0001). CONCLUSIONS: Twenty-one percent of CR participants failed to improve peakV(O(2)) primarily due to exercise training performed at lower relative intensity despite a similar rating of perceived exertion. For patients with baseline characteristics associated with nonimprovement, alternative training protocols should be considered.
Patrick D Savage; MaryEllen Antkowiak; Philip A Ades
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiopulmonary rehabilitation and prevention     Volume:  29     ISSN:  1932-751X     ISO Abbreviation:  J Cardiopulm Rehabil Prev     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101291247     Medline TA:  J Cardiopulm Rehabil Prev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  284-91; quiz 292-3     Citation Subset:  IM    
Cardiac Rehabilitation and Prevention, Division of Cardiology, University of Vermont College of Medicine and Fletcher Allen Health Care, Burlington, VT 05401, USA.
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MeSH Terms
Aged, 80 and over
Exercise Therapy / methods*
Follow-Up Studies
Heart Diseases / complications,  physiopathology,  rehabilitation*
Middle Aged
Oxygen Consumption / physiology*
Pulmonary Disease, Chronic Obstructive / complications,  physiopathology,  rehabilitation*
Pulmonary Gas Exchange / physiology*
Retrospective Studies
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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