[Strength training in patients after myocardial infarct]

The objective of the work was to evaluate the suitability and safety of resistance training in patients after myocardial infarction (IM), in older patients and to assess the suitable time for including resistance exercise into the rehabilitation programme. The group comprises a total of 74 patients after IM aged 27-76 years (57 +/- 9). The group included 65 men and 9 women. The authors divided the whole group into two sub-groups by age. The first group is formed by patients under 65 years and the second one by those aged > 65 years. The authors included resistance training from the third week of the rehabilitation programme. During the resistance exercise none of the patients suffered from impaired rhythm or stenocardia. The total muscular strength during the initial tests was in the first group (< 65 years) 105 +/- 26 kg and 93 +/- 26 kg in the group of older patients. At the end of the rehabilitation programme in both groups a statistically significant increase of the total strength was recorded. In the first group it was 120 +/- 20 kg and in the older patients 108 +/- 23 kg, i.e. an increase by 14 and 16%. The mean value of the ejection fraction (EF) was at the onset of rehabilitation 58 +/- 7% and did not differ substantially in the two groups. The mean EF value at the end of rehabilitation was 59 +/- 9% in the first group and 58 +/- 10% in the second group (n.s.). The body weight expressed as the body mass index was initially significantly lower in the older patients (25.5 +/- 2.6 kg/m2 vs. 27.4 +/- 3.3 kg/m2, p < 0.01). During the rehabilitation programme in both groups a slight but statistically significant decline of body weight was recorded. In the first group (< 65 years) to 27.0 +/- 3.2 kg/m2 and in the group of older patients to 25.2 +/- 2.4 kg/m2 (p < 0.01). It can be concluded that the application of resistance exercise as a supplement of classical aerobic training is a suitable, beneficial and safe extension of the regabilitation programme. The use of resistance exercise is suitable even in older patients, it is well tolerated and is not associated with cardiovascular complications. Resistance exercise can be applied already after two weeks of the aerobic programme.