Exercise Prescription for the Myocardial Infarction Patient

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Abstract
The prescription of exercise for the cardiac patient has become increasingly scientific. This article reviews the clinical and physiologic basis for the prescription of exercise in the post-myocardial infarction patient, with specific reference to the patient in a home- or community-based gymnasium program. The importance of warm-up and cool-down is discussed. Guidelines are provided regarding the appropriate intensity, frequency, and duration of training; the methodology underlying the “target heart rate” derivation; and the significance of the ventilatory threshold and perceived exertion in formulating the exercise intensity. Additional topics include the MET method of activity prescription, the merits and limitations of selected isometric and dynamic exercise modalities, training specificity and arm-exercise prescription, environmental factors, and special considerations such as cardiac clinical status and medications. Although exercise guidelines for the post-myocardial infarction patient should be scientifically based, the exercise prescription should be adapted to the patient, rather than the patient to the prescription.

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