Article

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.

Langue : ANGLAIS

Tiré à part : OUI