Monday, April 18, 2011

Patients should start exercise a week after HEART Attack

Take it easy? Patients should start exercise just a week after heart attack, claim doctors

By Claire Bates
Last updated at 11:42 AM on 15th April 2011

You might expect doctors to advise people who have just had a heart attack to lie back and take it easy for the next few months. But a new study has found it is far better to start exercising a week after the life-changing event.

Researchers at the University of Alberta found early and prolonged exercise is the key to the best health outcomes for stable patients.

The team led by Mark Haykowsky and Alex Clark, reviewed more than 20 years of trials.
A U.S study suggests gentle exercise should start earlier following a heart attack

They found that stable patients who have suffered a cardiac arrest improve their heart performance when starting a light exercise programme just one week after the heart attack, rather than waiting a month or longer to begin rehabilitation.

'While it’s been shown that exercise has a favourable effect on heart function, it’s also important to dispel the idea that what the heart needs is rest,' said Dr Haykowsky.

In the UK, patients are invited to attend a cardiac rehabilitation programme at their local hospital four to eight weeks after leaving hospital.

The study shows that, in fact, the heart will become better with exercise sooner and with continued exercise over a longer period of time.
Patients who begin an exercise program one week after their heart attack were found to have the best heart performance, in the study published in the online journal Trials.

For those who waited to begin their exercise rehabilitation program, the results showed that 'for every week that a patient delayed his or her exercise treatment, he or she would have to train for the equivalent of one month longer to get similar benefits,' said Dr Clark.

Adding: 'Our findings suggest that at least six months of exercise is the most beneficial.'
The authors said that though the concerns were understandable, there was no evidence in the study to suggest that beginning an exercise program earlier that the typical waiting period was harmful.

'In the 70’s, health-care professionals were telling patients not to move for three months after a heart attack. Our findings suggest that stable patients need not wait a month to start exercising in a cardiac-rehabilitation setting,' said Clark.

'Exercise is a wonder drug that hasn’t been bottled,' Dr Haykowsky added.
Ellen Mason, senior cardiac nurse at the British Heart Foundation, told Mail Online: 'Newer treatments mean heart patients often suffer less damage during heart attacks than they used to and so they may benefit from starting formal exercise programmes known as cardiac rehabilitation sooner. But we’d need experts in cardiac rehab in the UK to ensure this is implemented safely.

'It’s very important that anyone who’s just had a heart attack doesn’t take this research as a green light to start exercise unsupervised, definitely speak to your doctor or cardiac rehab nurse first.

'Our real priority should be ensuring all patients get access to cardiac rehabilitation at all. We know it saves lives and is cost effective, yet provision and uptake is still patchy across the UK.'

Professor Bob Lewin, heads the British Heart Foundation Care and Education Research Group at the University of York.
He said: 'This is a very interesting review and confirms what has been advocated for many years, that rehabilitation should begin as soon as possible after a heart attack.
'Unfortunately cardiac rehabilitaiton has never been properly funded and in other areas there may be a waiting list to be able to join a programme.'






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