EXERCISE TESTING AND TRAINING IN PHYSICALLY DISABLED MEN WITH CLINICAL-EVIDENCE OF CORONARY-ARTERY DISEASE

A prospective, randomized, controlled clinical trial in patients with coronary artery disease (CAD) and a concurrent physical disability eva luated the effects of a home exercise training program on cardiovascul ar function and blood lipids. Eighty-eight men between the ages of 42 and 72 years (mean 62) with documented CAD and a physical disability w ith functional use of greater-than-or-equal-to 2 extremities including 1 arm were randomized to either a 6-month home exercise training prog ram using wheelchair ergometry or to a control group that received usu al and customary care. Both groups received dietary instructions and w ere requested to follow a fat-controlled diet. Exercise test variables with echocardiography and blood lipids were measured at baseline and at 6 months. The home exercise training group significantly improved b oth peak exercise left ventricular ejection fraction (p = 0.007) and f ractional shortening (p = 0.01) between baseline to 6 months, whereas the control group showed no significant changes. Exercise training eff ects of decreased resting heart rate (p = 0.03) and decreased peak rat e pressure product (p = 0.03) were also found in the treatment group. No exercise-related cardiac complications occurred. Both groups signif icantly (p less-than-or-equal-to 0.01) increased high-density lipoprot ein cholesterol levels. These results indicate that physically disable d men with CAD can safely participate in a home exercise training prog ram which may result in intrinsic cardiac benefits. The metabolic cost of activities of daily living imposed on this disabled population may also have a positive effect on high-density lipoprotein cholesterol l evels.