La réadaptation cardiaque: une expérience de 30 ans

Many studies have shown that regular physical activity is an important predictor of good health for normal individuals, coronary patients and patients with heart failure. Benefits of early mobilization after myocardial infarction or following coronary artery surgery are now well documented. It is thus important to make use of facilities that are dedicated to both physical training and correction of vascular risk factors. Rehabilitation programs can be organised either on a stationary or an ambulatory basis. Both are widely available in Switzerland, allowing physicians to make a choice based on indications, contra-indications and the patient’s wishes. Heart failure used to be considered a contra-indication to physical activity. However, it has more recently been shown that rehabilitation is associated with an improved physical aptitude, decreased symptoms and improved quality of life. Rehabilitation, in this case, should be performed in a hospital setting under strict medical supervision. Regular long-term physical activity is essential after a coronary event. It can be done either individually or within a maintenance group. Patients should be encouraged to stay indefinitely in such groups, and we believe that the presence of a physician has several advantages. Our study, performed in an outpatient cardiology office, shows that only a small percentage of coronary patients is included in a maintenance program. In addition, only a minority of patients partakes in regular significant physical activity. Amajor effort to improve matters in this field remains to be done.