Combined Resistive-Aerobic Training in Older Patients With Coronary Artery Disease Early After Myocardial Infarction

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Abstract
Older patients with artery disease have higher rates of disability than younger coronary patients, partly based on lower levels of skeletal muscle strength. We compared the effect of a combined resistive-aerobic training program on muscular strength in older and younger coronary patients early after myocardial infarction. The study population included 45 patients who had recently (4-12 weeks) suffered a myocardial infarction; 19 were age > or = 62 years (mean 68 +/- 3 years) and 25 were < 60 years of age (mean 48 +/- 7 years). Muscle strength was measured by single repetition maximum lifts for leg extension and bench press, before and after the 12-week conditioning program. Body composition was measured in a subset of 16 patients by dual x-ray absorptiometry. At baseline, the older population demonstrated lower strength measures than the younger patients. With conditioning, both groups improved strength similarly with leg-extension and bench press measures increasing by 35% and 14% respectively in the older patients and 39% and 14% in the younger patients (both P < 0.05, NS between groups). Within the older patient group, the men were significantly stronger than the women at baseline yet the women tended to improve their strength measures to a greater degree than the men, increasing leg strength by 66% and bench press by 29% versus 29% and 10% in older men (P < 0.10 between groups). In the overall study population, body composition measures showed a slight decrease in body weight, a decrease in fat mass, and a maintenance of lean body mass and bone mineral content with no difference in response between older and younger patients. Older coronary patients can effectively increase body strength with a combined resistive-aerobic exercise program in the early post-myocardial infarction period.

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