Study of the rehabilitation, prognosis and capacity to resume work of patients with myocardial infarction. Comparison of 4-week and 8-week rehabilitation programs.

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Abstract
The relative benefits of 4- and 8-week rehabilitation programs were compared in inpatients with myocardial infarction. In the 8-week program, complete bed rest was instituted for the initial 3 days, followed by walking around the bed from the 14th day; exercise was gradually increased to target levels such as walking for distances of 500m per time up to a total of 2 to 3 km and climbing up and down several sets of 20 stairs daily. In the 4-week program, complete bed rest was provided for the initial 3 days, and exercise was more rapidly increased for 4 weeks to reach the same exercise level as that of the 8-week program. The duration of hospitalization, and the clinical progress, prognosis and the ability to return to work after discharge of the patients were compared in each program. The percentage of patients who were hospitalized for 40 days or less increased from 0% in the 8-week program to 15.9% in the 4-week program, while the percentage of patients who were hospitalized from 41 to 60 days increased from 13.3 to 37.0%. Shortening of the program did not cause significant differences in the incidence of serious complications such as heart failure, arrhythmia and infarction. The 2-year mortality was 15.9% in the 8-week program and 7.9% in the 4-week program. The state of work after discharge was comparable in both programs. Exercise tolerance, measured by bicycle ergometer, tended to improve remarkably 6 months after infarction. Based on the above results, the 4-week program is considered to be more practical than the 8-week program.

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