Early-Phase Exercise-Based Comprehensive Cardiac Rehabilitation Program after Myocardial Infarction: A Randomized Controlled Trial.

BACKGROUND

Myocardial infarction (MI) remains a leading cause of mortality and morbidity worldwide. Cardiac rehabilitation (CR) is an evidence-based intervention that improves cardiovascular outcomes; however, the optimal timing and contents of CR remain unclear.

OBJECTIVES

This study aimed to investigate the effects of an early-phase, exercise-based supervised comprehensive CR program on functional exercise capacity, grip strength, fatigue, sleep quality, and health-related quality of life (HRQOL) in patients with MI.

METHODS

A randomized controlled trial was conducted involving 32 medically stable MI patients allocated to either an intervention or control group. The intervention group received a two-phase supervised CR program initiated within the first week post-MI, including inpatient and outpatient aerobic, calisthenic, and strengthening exercises for eight weeks. The control group received usual care. Primary and secondary outcomes included the 6-minute walk distance (6MWD), 30-second sit-to-stand test (30-sec STS), grip strength, fatigue (functional assessment of chronic illness therapy [FACIT]-fatigue), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and HRQOL (12-Item Short-Form Questionnaire and MacNew Heart Disease Health-Related Quality of Life Questionnaire).

RESULTS

Compared to the control group, the intervention group showed significant improvements in 6MWD (mean difference [MD] = 97.3 m, p < 0.001), 30-sec STS (MD = 3.1 repetitions, p = 0.001), grip strength (MD = 5.7 kg, p = 0.04), FACIT-Fatigue score (MD = 8.8 points, p < 0.001), PSQI score (MD = -2.7 points, p < 0.001), and HRQOL subdomains (p < 0.05). No adverse events were reported.

CONCLUSIONS

Early-phase supervised CR significantly enhanced physical capacity, fatigue, sleep quality, and HRQOL in this cohort of MI patients. Early initiation of structured CR should be considered in clinical practice to promote faster recovery and improve long-term outcomes following MI.