Protocol-guided phase-1 cardiac rehabilitation in patients with ST-elevation myocardial infarction in a rural hospital

ABSTRACT

Phase-1 Cardia Rehabilitation [CR] is an important part in the treatment of patients with ST-Elevation Myocardial Infarction [STEMI]. Lac of literature in the rural Indian setting led to the design of this study. Secondary care rural hospital, non-randomized experimental study. Fifteen historical controls and 15 prospectively enrolled patients between January 2007 and December 2007. The prospectively enrolled patients received the phase-1, exercise-based, protocol-guided CR. At discharge, the six-minute walk test [6MWT] distance, Borg's Rating of Perceived Exertion [RPE] after the 6MWT, time to return to baseline parameters after the 6MWT, and complications were assessed. Independent t-test and the Mann Whitney test. Statistically significant [P< 0.01] differences in rating of perceived exertion [RPE] and time to return to baseline parameters post the 6MWT were seen in the experimental group [2 vs. 4 and 5.47 vs. 7.93 minutes, respectively]. No significant changes in the 6MWT distance between the groups were noticed [470+151.76 m and 379 +170.70 m, respectively]. No adverse events during the 6MWT and the phase-1 CR were observed. Protocol-guided, phase-1 CR produces a much faster return of heart rate and blood pressure to baseline following the 6MWT, without producing a great rise in the RPE during the 6MWT, which suggests a training benefit among these patients. The 6MWT can be safely administered in this rural population. However, larger studies will be required to validate these results: