Unsupervised rehabilitation: effects of exercise training over the long run.

OBJECTIVE: To assess the safety and efficacy of unsupervised rehabilitation (USR) in the long run in low-risk patients with coronary artery disease.

METHODS: We carried out a retrospective study with 30 patients divided into: group I (GI) - 15 patients from private clinics undergoing unsupervised rehabilitation; group II (GII) - control group, 15 patients from ambulatory clinic basis, paired by age, sex, and clinical findings. GI was stimulated to exercise under indirect supervision (jogging, treadmill, and sports). GII received the usual clinical treatment.

RESULTS: The pre- and postobservation values in GI were, respectively: VO2 peak (mL/kg/min), 24+/-5 and 31+/- 9; VO2 peak/peak HR: 0.18+/-0.05 and 0.28+/-0.13; peak double product (DP peak):26,800+/-7,000 and 29,000 +/- 6,500; % peak HR/predicted HRmax: 89.5+/-9 and 89.3+/-9. The pre- and post- values in GII were: VO2 peak (mL/kg/min), 27+/- 7 and 28+/-5; VO2 peak/peak HR: 0.2+/-0.06 and 0.2+/- 0.05; DP peak: 24,900+/-8,000 and 25,600+/- 8,000, and % peak HR/predicted HRmax: 91.3+/-9 and 91.1+/- 11. The following values were significant: preobservation VO2 peak versus postobservation VO2 peak in GI (p=0.0 063); postobservation VO2 peak in GI versus postobservation VO2 peak in GII (p=0.0045); postobservation VO2 peak/peak HR GI versus postobservation peak VO2/peak HR in GII (p=0.0000). The follow-up periods in GI and GII were, respectively, 41.33+/- 20.19 months and 20.60+/-8.16 months (p<0.05). No difference between the groups was observed in coronary risk factors, therapeutic management, or evolution of ischemia. No cardiovascular events secondary to USR were observed in 620 patient-months.

CONCLUSION: USR was safe and efficient, in low-risk patients with coronary artery disease and provided benefits at the peripheral level.