Babi Muralidar, (2020) Effect of Aerobic Interval Training (AIT) in improving functional capacity and LV remodelling in post-MI Patients: A Randomized Controlled Trial. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: Exercise-based cardiac rehabilitation aims to improve cardiac reserve and overall functional capacity in patients treated for acute coronary syndrome (ACS). Cardiac rehabilitation has been suggested to reverse pathological remodelling and improve LV stroke volume and Cardiac output. Over and above a primary Percutaneous Coronary Intervention (PCI) and drugs for post-Acute Myocardial Infarction (AMI) cardiac recovery, an exercise-based cardiac rehabilitation program has shown to improve mortality and morbidity in western studies. However, there is scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on Reverse LV remodelling in post-MI Patients, in Indian setting. OBJECTIVES: To measure the effect of Aerobic Interval Training in improving functional capacity and LV remodelling in post-MI Patients who are medically stable at discharge. METHODOLOGY: All adult participants who were less than 65 years, hospitalized for treatment of an acute coronary syndrome (ACS), once medically stable on optimal medical therapy and fit for discharge, were recruited for exercise-based cardiac rehabilitation program after obtaining written consent. Participants were initially stratified based on the LV ejection fraction (EF < 40%) into two groups and then randomized into intervention group and controls. Intervention group received a 12-week supervised AIT in addition to the standard post-AMI care whereas the controls received the standard post-AMI care as per the current institutional practice. Both the intervention group and the controls were assessed at baseline and at 3 months for (1) Functional capacity, as measured by the following variables - METS (Metabolic Equivalents), Heart rate recovery at 1 min (HRR) and 6min Walk Distance (6MWD) (2) Cardiac function, as measured by ECHO parameters and (3) Cardiometabolic profile, as assessed with the following variables - blood pressure, blood sugar, lipid profile, body mass index (BMI) and waist-hip ratio (WHR). RESULTS: 119 patients were randomized into 65 to receive AIT and 54 to receive the usual care. With a 53.8% drop-out in the AIT group, 30 completed the protocol while 42 among the control group completed the study. The exercise duration, METs achieved and 6-minute walk distance improved significantly in the AIT group. The treadmill based Duke prognostic score also improved significantly in this group. The reduction in body weight and BMI was also significant among patients who underwent AIT. LV function (LVEF & LVGLS) showed significant improvement among intervention group with good compliance as compared to controls. However, the metabolic profile of patients did not show any significant difference between the two groups. CONCLUSION: In post-MI patients who are medically stable on optimal medical therapy, aerobic interval training (AIT) leads to significant improvement in functional capacity and contributes to reverse LV remodelling, thus improving the cardiac prognosis.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201729052 |
| Uncontrolled Keywords: | Aerobic Interval Training (AIT), functional capacity, LV remodelling, post-MI Patients, Randomized Controlled Trial. |
| Subjects: | MEDICAL > Physical Medicine and Rehabilitation |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 18:13 |
| Last Modified: | 04 Feb 2021 18:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13852 |
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