Determinants of physical functioning in coronary patients - Response to cardiac rehabilitation

Background: Coronary heart disease is a major cause of disability. There ha s been little study of the effect of cardiac rehabilitation on measures of self-reported physical functioning. Methods: Physical functioning was measured using the Medical Outcomes Study -Short-Form Questionnaire. Determinants of physical function were analyzed in 303 patients with coronary heart disease. Response of physical function to a 3-month exercise rehabilitation program was then determined. Results: At baseline, women had lower physical function scores than men, de spite similar age and diagnostic distribution. Older patients had lower phy sical function than younger patients. Aerobic exercise capacity, leg and ar m strength, and comorbidity and depression scores were all significant pred ictors of baseline physical function (r range, 0.46 to -0.22). Physical fun ction score increased significantly after exercise conditioning, with a mea n (+/- SD) overall score increase from 66 +/- 23 to 80 +/- 20 on a scale of 0 to 100. The best baseline determinant of a favorable physical function i mprovement after rehabilitation was a low baseline physical function score. The best training-related correlate of improved physical function score wa s a decrease in mental depression score. Conclusions: Self-reported physical function in coronary patients is relate d to age, sex, fitness, and mood state. Physical functioning improves after cardiac rehabilitation in all age, sex, and diagnostic groups, but particu larly in patients with low baseline values. These data support the concept that cardiac rehabilitation effectively prevents and treats cardiac disabil ity.