The Reasons That Cardiac Patients Did Not Participate in and Drop out from the Cardiac Rehabilitation Program

OBJECTIVE: To survey the cause of the cardiacs' low participation rate and poor compliance in cardiac rehabilitation. METHOD: Among those who admitted in the department of cardiology and chest surgery for acute care and then discharged, group 1 included 104 patients who never participated in cardiac rehabilitation, and group 2 included 47 patients who once joined in but discontinued before 7 sessions, and group 3 included 25 patients who continued it more than 18 sessions with good compliance. Questions related to the low participation rate and discontinuity and personality, psychological status, education level were asked. By SPSS, basic discriptive data were calculated. To compare the data among groups, independent t-test and Chi-square test were done. RESULTS: In group 1, the main causes of low participation rate was lack of recognition about it (78 patients, 75%), doubt on effect (48 patients, 46.2%), poor physical condition (38 patients, 36.5%). In group 2, the main cause of discontinuity was lack of time (12 patients, 25.5%), thought of being able to perform at home (11 patients, 23.4%), poor physical condition (7 patients, 14.9%). CONCLUSION: To raise the participation rate and compliance in cardiac rehabilitation, it is very important to make a pitch for cardiac rehabilitation and improve program service for patient's convinience.

Cardiovascular Complications during Cardiac Exercise Program

OBJECTIVE: To investigate the safety of exercise program under medical supervision for cardiac patients in their early phase from cardiac events, and the types and the frequency of possible cardiovascular complications during or after exercise. METHOD: 197 cardiac patients who participated in phase 2 cardiac rehabilitation were selected and they performed aerobic exercise program by individualized exercise prescription under ECG monitoring 3 times a week for 6 weeks. Throughout total 2,429 sessions of exercise, abnormal symptoms, hemodynamic responses and ECG abnormalities were analyzed. RESULTS: Cardiovascular complications ocurred in 25 patients (12.7%). ECG abnormalities in 14 sessions (0.58%) of 13 patients, chest pain during exercise in 17 sessions (0.67%) of 13 patients, abnormal hemodynamic responses in 8 sessions (0.33%) of 8 patients were observed. Cardiac arrest and myocardial infarct didn't happened. 18 patients (72%) experienced these complications during warming-up period, 6 patients (24%) during cool-down period and one patient (4%) during resting period. CONCLUSION: During exercise, there was some possibility of abnormal ECG changes, chest pain, hemodynamic responses but these potentially dangerous situations could be prevented from advancing on real emergency by intense attention and monitoring. Even cardiac patients of acute stage can tolerate adequate amount of exercise load safely under careful clinical supervision.