Comparison between two cardiac rehabilitation programs in iceland

Background: Heart patients who undergo phase II cardiac rehabilitation can choose between the following two rehabilitation programs: 1) A four week intensive inpatient rehabilitation at the rehabilitation center Reykjalundur: 2) The Heart and Lung Rehabilitation Center (HL center), an outpatient clinic where patients train three times a week for one hour at a time for 8-10 weeks. The purpose of this study was to compare the longtime outcome of the two rehabilitation programs. Method: Forty nine patients, after myocardial infarct and/or coronary operation (CABG, PTCA), entered the study. They fell into two rehabilitation groups who underwent rehabilitation at Reykjalundur or the HL center. Peak oxygen uptake, blood lactate build up and peak performance were measured by standard cardiopulmonary exrecise test before the phase II heart rehabilitation program immediately after and 13 months later .Thirty three patients concluded the study. Results: Mean peak oxygen uptake before the rehabilitation was 22,8 ml kg^-1 min^-1, after the phase II rehabilitation 26,0 ml kg^-1 min^-1 and thirteen months later 25,3 ml kg^-1 min^-1. Mean peak performance was respectively 153 W, 180 W and 174 W. Mean lactate threshold (4 mmol I'1) was at 126 W, 136 W and 138 W The improvement in these three measurements over the study period was statistically significant whereas we found no statistically significant difference between the two programs. Quality of life was measured by a standardized questionaire before the phase II rehabilitation and thirteen months after conclusion of the phase II rehabilitation. Four out of twelve factors measured where significantly improved at the end of the study. However there was no statistically significant difference beween programs. Conclusions: The results of phase II heart rehabilitation in Iceland is in accord with previous studies (+10-20%) and no significant statistical difference was found between those two rehabilitation programs.