Protocol-Guided Phase-1 Cardiac Rehabilitation in Patients with ST-Elevation Myocardial Infarction in A Rural Hospital

AIMS: Phase-1 Cardiac Rehabilitation (CR) is an important part in the treatment of patients with ST-Elevation Myocardial Infarction (STEMI). Lack of literature in the rural Indian setting led to the design of this study. SETTING AND DESIGN: Secondary care rural hospital, non-randomized experimental study. MATERIALS AND METHODS: 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. STATISTICAL ANALYSIS USED: Independent t-test and the Mann Whitney test. RESULTS: Statistically significant (P < 0.01) differences in ratings 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. CONCLUSION: 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.