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Longer cardiac rehab programs necessary, says U of T study

Although three months are often prescribed for cardiac rehabilitation, it takes nine months for patients to reach peak improvement, say researchers from the University of Toronto.

The study, published in the December issue of the Journal of Cardiopulmonary Rehabilitation, found a 52-week rehabilitation program that combined supervised and unsupervised exercise sessions was effective in improving both physical and mental health, with the peak occurring at 38 weeks (nine months).

"To receive the optimal benefits in physical fitness and quality of life, patients should attend cardiac rehabilitation programs which last for at least six, and up to nine months," says Dr. Terence Kavanagh, a professor in U of T's Faculty of Physical Education and Health and the Faculty of Medicine. Increased program length also gives health care professionals a longer period to help patients make heart-healthy lifestyle changes that lower the risk of future cardiac events, such as quitting smoking or switching to a low-fat diet.

In the study, 623 male patients with coronary heart disease were randomized to one of two programs. The first used weekly supervised exercise sessions over 52 weeks, while the second used weekly supervised sessions for 26 weeks followed by one supervised session per month for the remaining 26 weeks. Patients were kept on their drug therapies and had nutritional interventions as well as being prescribed a walking or walk-jog (where appropriate) program.

Dr. Larry Hamm, an adjunct professor in U of T's Faculty of Physical Education and Health and program director of cardiac rehabilitation at National Rehabilitation Hospital, Washington, D.C., says that Ontario and most of Canada already have programs that extend sessions beyond 12 weeks. "They would need very minor modifications to achieve these optimal benefits."

However, American programs typically employ supervised sessions three times a week for 12 weeks, a regime
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