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Am Fam Physician. 1998;57(10):2539

Traditional cardiac rehabilitation programs do not consistently address both the physical and the psychologic well-being of patients. The addition of high-intensity strength training (which has been reported to decrease depression and improve mood in other patients) to traditional cardiac rehabilitation programs may offer an opportunity to improve mood as well as physical function in these patients. Beniamini and associates evaluated the effect of added strength and flexibility training on self-efficacy, mood states and psychologic well-being in cardiac rehabilitation patients.

Thirty-eight patients enrolled in a cardiac rehabilitation program were randomized to undergo either high-intensity strength training or flexibility training in addition to regular aerobic exercise. Patients completed standardized questionnaires to measure self-efficacy, mood states and perception of health status two weeks before and two weeks after the training programs.

Clinical characteristics of both groups were similar at the beginning of the study. Patients in the high-intensity strength training group experienced significant improvements (30 to 100 percent) in self-efficacy scores for areas such as lifting, pushing, climbing, walking and jogging. These patients also had significantly improved mood states and overall perceptions of physical and emotional well-being. Patients in the flexibility group showed no significant changes. In addition, patients in the strength training group showed improvements in physical function, perception of pain, vitality and role emotional-health domains.

The authors conclude that high-intensity strength training is a safe, effective and relatively inexpensive addition to traditional cardiac rehabilitation programs, especially when supervised by a professional exercise specialist or physical therapist. Actual improvements in strength and perceived self-efficacy appeared to be responsible for improvements in mood in patients in the strength training group.

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