Referrals should be offered to all patients, and the individual needs of each patient considered
Cardiac rehabilitation has progressed markedly since it was introduced into Australia by the National Heart Foundation in 1961. At that time, the focus was on restoration of a sense of wellbeing and encouraging return to work for survivors of acute myocardial infarction and other cardiac illness. The first cardiac rehabilitation programs in Europe and the United States involved mainly supervised, high-intensity exercise training with electrocardiographic monitoring. As data accumulated that similar benefits could be achieved from low, moderate and high levels of exercise intensity,1,2 an Australian hospital model evolved, based on group light exercise and patient education.3 Recognition that psychosocial factors (rather than heart disease) were the main causes of disability after a myocardial infarction led to greater emphasis on counselling, education and support. This led, in turn, to the development of a multidisciplinary team approach to cardiac rehabilitation, with the aim of focusing on and dealing with the range of factors influencing patients’ quality of life.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1 National Heart Foundation, West Melbourne, VIC.
- 2 Heart Research Centre, Royal Melbourne Hospital, Melbourne, VIC.
- 1. Goble AJ, Hare DL, Macdonald PS, et al. Effect of early programmes of high and low intensity exercise on physical performance after transmural acute myocardial infarction. Br Heart J 1991: 126-131.
- 2. Worcester MC, Hare DL, Oliver RG, et al. Early programmes of high and low intensity exercise and quality of life after acute myocardial infarction. BMJ 1993; 307: 1244-1247.
- 3. Hare DL, Fitzgerald H, Darcy F, et al. Cardiac rehabilitation based on group light exercise and discussion — an Australian hospital model. J Cardiopulm Rehabil 1995; 15: 186-192.
- 4. Seldon WA. Simplifying cardiac rehabilitation. Med J Aust 1986; 144: 395.
- 5. National Heart Foundation of Australia. Directory of Australian cardiac rehabilitation programs. Canberra: National Heart Foundation of Australia, 2001.
- 6. Worcester MC. Cardiac rehabilitation programs in Australian hospitals. Canberra: National Heart Foundation of Australia, 1986.
- 7. Wenger NK, Froelicher ES, Smith LK, et al. Cardiac rehabilitation. Clinical Practice Guideline No. 17. Rockville, Md: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and the National Heart, Lung and Blood Institute, 1995: 1-202. Available at: hstat.nlm.nih.gov/hq/Hquest/db/38/screen/DocTitle/odas/1/s/46665 (accessed Jul 2003).
- 8. Goble AJ, Worcester MC. Best practice guidelines for cardiac rehabilitation and secondary prevention. Victoria: Department of Human Services, 1999. Available at: www.dhs.vic.gov.au/phd/9905015/index.htm (accessed Jul 2003).
- 9. New Zealand Guidelines Group 2002. Best practice evidence-based guideline: cardiac rehabilitation. Available at: www.nzgg.org.nz/library/gl_complete/Cardiac_Rehab/index.cfm (accessed Jul 2003).
- 10. Scott IA, Lindsay KA, Harden HE. Utilisation of outpatient cardiac rehabilitation in Queensland. Med J Aust 2003; 179: 341-345.<eMJA full text>
- 11. Nagle A, Fisher J, Wiggers J, et al. Prevalence of being invited, attending and completing outpatient cardiac rehabilitation. Int J Behav Med 2000; 7(Suppl 1): 44.
- 12. Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare. National Health Priority Areas report: cardiovascular health 1998. Canberra: AIHW, 1999. (AIHW Catalogue No. PHE 9.) Available at: www.health.gov.au/pq/cardio/pubs.htm (accessed Jul 2003).
- 13. Ades PA, Waldmann ML, McCann WJ, Weaver SO. Predictors of cardiac rehabilitation participation in older coronary patients. Arch Intern Med 1992; 152: 1033-1035.