The effects of exercise on quality of life before myocardial infarction and during four phase exercise rehabilitation

Abstract

Quality of life may be enhanced after myocardial infarction through participation in exercise rehabilitation. Improvements as a result of exercise participation are seen in physiological function, in psychological state and in the performance of social roles. Changes in physiological function are increased oxygen uptake of skeletal muscle, increased flexibility and increased co-ordination. Changes to psychological state are a reduction in depression and anxiety and improved self esteem and confidence. The performance of social roles is enhanced through psychological and physiological changes and in the sense of achievement generated by attainment of rehabilitation goals. Through the course of exercise rehabilitation from phase one through to phase four, the role of exercise in the components of quality of life changes. Exercise may be used as a tool for the prevention of myocardial infarction. During phase one of rehabilitation, quality of life is reduced by the infarction. Exercise may be used in phase one to restore patient confidence and assist in adjustment to illness. During phases two exercise is used for improvements in physiological function and in psychological adjustment. Phases one and two are marked by the psychological and social considerations of adjustment as well as physiological healing. In phase three, exercise improves quality of life through further improvements in physiological function. Phase three has many physiological gains to be made, whilst in phase four sociological considerations dominate. Adherence to lifelong exercise patterns is a major consideration in phase four since advantageous long term physiological changes, such as enhanced co-lateral circulation can occur. Phase four, the maintenance phase relies on social support of significant others for exercise adherence. Overall the positive effects of exercise rehabilitation after exercise outweigh the risks associated with exercise in this population.