Exercise training has been shown to reverse the decline in muscle strength and aerobic power that occurs in older patients with coronary artery disease (CAD). A small increase in the peak aerobic power was associated with a 10 percent reduction in cardiac mortality in older women with CAD. Older women with CAD have peak aerobic power and muscle strength lower than age-matched healthy sedentary or active women, and a lower level than is required to maintain activities of daily living. Previous cardiac rehabilitation studies have excluded older women with CAD, but this population probably has the most to gain from exercise programs. Hung and colleagues measured the impact of an aerobic training program with or without strength training in older women with CAD.
The trial included 18 women 60 to 80 years of age who were referred to a rehabilitation program after a recent myocardial infarction. The rehabilitation program was eight weeks long with three sessions per week. Study participants were randomly assigned to receive aerobic training or combined aerobic training with upper- and lower-extremity strength training. The study participants were assessed before the start and at the end of the rehabilitation program. The assessment included an incremental exercise test, a six-minute walk test, and upper- and lower-extremity maximal strength tests. A health-related quality of life survey was performed after the rehabilitation program using the MacNew heart disease health-related quality of life instrument, which measures the physical, emotional, social, and global domains of well-being.
The aerobic training group and the combined aerobic and strength training group had significant increases in peak aerobic power, distance walked in six minutes, and lower extremity strength. Both groups also had improved emotional and global quality of life scores. Study participants who received combined aerobic and strength training also had improved upper-extremity strength and physical and social quality of life scores, whereas those in the aerobic training group had no changes in these variables.
The authors concluded that older women with CAD should receive aerobic and strength training to improve their overall fitness and quality of life.