Preventive use of exercise rehabilitation after myocardial infarction

Randomized controlled clinical trials of exercise after myocardial infarction, although difficult to compare, have not shown a reduction in mortality or morbidity. However, physiological and psychological improvements occur that enable patients to improve their quality of life. The effectiveness of exercise programmes is impaired by poor patient compliance. Some characteristics of poor compliers may be identified, but it is safer to assume all participants are potential non-compliers, and to apply compliance-improving strategies within exercise programmes. The authors' experience has indicated that a number of strategies may be followed at little cost. These include a spouse support programme, a written agreement to participate, self-control techniques including self-monitored exercise testing, and group discussion periods.