RETURN TO WORK, SEXUAL-ACTIVITY, AND OTHER ACTIVITIES AFTER ACUTE MYOCARDIAL-INFARCTION

Objectives: (1) To examines the effects of exercise alone and the addi tional benefit of a teaching-counseling program with exercise when com pared with usual medical and nursing care on the rate of return to pre vious activities, and (2) to describe the rates of return to former ac tivities of daily living after an acute myocardial infarction. Design: Prospective randomized clinical trial. Setting: Seven Northwestern ho spitals. Sample: 258 patients, 70 years of age or younger, with the di agnosis of acute myocardial infarction, admitted to coronary care unit s of participating hospitals. Outcome Measures: Return to work, sexual activity, driving, previous maximum level of activity, and activities out of the home. Intervention: Subjects were randomly assigned to con trol group A, which received usual medical and nursing care; group B1, which received usual care plus exercise; or group B2, usual care plus exercise plus teaching-counseling sessions. Home exercise programs we re prescribed for patients in groups B1 and B2. Those in group B2 also participated in the outpatient teaching-counseling program that consi sted of eight group sessions pertaining to risk factor reduction and p sychosocial adjustment to myocardial infarction. All subjects complete d Activity Summary Questionnaires, a 12-item self-report paper and pen cil questionnaire about the week's activity, each week, for 12 consecu tive weeks, and at week 24 after hospital discharge. Results: There we re no significant differences between the three groups. Previously emp loyed patients who returned to work did so by week 24. Patients who re turned to their previous maximum level of activity resumed by week 24. Most patients returned to sexual activity, driving, and activities ou t of the house by week 12. Conclusions: The rates of return to activit ies were not significantly different between the three groups. Most pa tients were active earlier than previously reported. Over 50% of patie nts returned to sexual activity, driving, and outdoor activities by 3 weeks after acute myocardial infarction. These results are useful for health care professionals who counsel patients about expectations in a ctivity resumption.