1. Johnston, M.

Article Content

Background and Aims: The physical consequences of coronary artery disease may significantly limit functional independence of elderly patients. While cardiac rehabilitation exercise programs (CR) have been shown to improve health outcomes such as exercise capacity, morbidity and mortality, little is known about the impact such programs have on daily functional abilities. The purpose of this study was to determine the impact of CR on elderly patients' ability to perform common household tasks.


Methods and Materials: Nineteen post myocardial infarction patients (8 female, 11 male; age 75+/-6.3 years) were studied. Patients were tested prior to entering and again after completion of a CR program (20 combined aerobic + strength training sessions over 8 to 10 weeks; 45 min/day). Physical function was assessed using the Continuous Scale - Physical Function Performance test battery (CS-PFP10) which includes 10 everyday tasks that progress from easy (personal tasks) to moderate (household tasks) to difficult (mobility tasks). The intensity and pace of each task was determined by the patient and quantified by a combination of time, distance or weight moved. Performance on each of the tasks was scored on a 0 - 100 scale and used to calculate a total physical function score (TPF). In addition five domain scores; upper body strength (UBS), upper body flexibility (UBF), lower body strength (LBS), balance and co-ordination (BALCOR) and cardiovascular endurance (END) were calculated from the CS-PFP10.


Results: Post CR the TPF score increased significantly (57+12 vs. 50+/-16; p=0.002). Prior to CR 14 patients scored below the threshold for independent living, as defined by a TPF score<=57 units. Post-CR, only 7 patients scored below the threshold. Significant improvements were also found in four domains including UBS (58+/-18 vs. 50+/-20; p= 0.003), LBS (52+/-13 vs. 45+/-16; p=0.002), BALCOR (59+/-12 vs. 52+/-16; p=0.005) and END (59+/-12 vs. 51+/-15; p=0.002).


Conclusions: A 20 session exercise-based CR program significantly enhanced the physical function of elderly patients, as defined by common household tasks. Furthermore, CR improved upper and lower body muscular strength, balance/coordination and cardiovascular endurance. More importantly 50% of the patients who scored below the threshold for independence prior to CR scored above that threshold post-CR, suggesting that CR may enhance elderly patient's ability to live independently.