INJURIES IN OUTPATIENT CARDIAC REHABILITA TION

Background: In Israel in 1956 Gottheiner introduced outpatient rehabil itation programs in patients who had survived a myocardial infarction. In Germany one decade later these WHO phase III activities were estab lished as well. At present any patient with cardiovascular disease is included unless suffering from acute illnesses or presenting with symp toms at rest. Gymnastics, stretching and the ''historic'' volleyball a re completed by jogging, soccer, basketball and anaerobic exercise. Th us, a notable trauma rate would be expected especially in the elderly and those who are on anticoagulation. Methods: A retrospective analysi s evaluated questionnaires of 903 patients in 116 outpatient coronary care groups covering congruent to 270,000 patient exercise hours. Resu lts: 101 of 123 injuries (congruent to 1/2 200 patient exercise hours) occurred during games the majority of which having been distorsions ( 53.7%), hematomas, or bruises (15.4%). Severe traumas included bone fr actures (11.4%) and ruptured muscles, tendons, or ligaments (12.2%). O ne patient lost the sight of one eye due to a broken spectacle frame. Patients who had felt exercise as too exhausting (p < 0.001) or compla ined of cardiovascular symptoms (p < 0.01) showed a significantly elev ated traumarate. Conclusions: Thus, in outpatient cardiac rehabilitati on the trauma rate is within the range of healthy sports men. To preve nt injuries sports should be limited to the patient's level of activit y. Improved skills in techniques and strategies as well as unbreakable glasses are recommended.