ABSTRACT


Effects of cardiac rehabilitation program on cardiorespiratory endurance in accordance with the obesity index of middle-aged male with cardiovascular disease


Minhyuk Park
Department of Sports Medicine
Graduate School of Biomedical Science
Korea University
Supervised by Prof. Sangho Kim

Recently, Cardiovascular disease is the one of the three major causes of death, and the acute coronary artery disease is progressively narrow the coronary artery lumen and impair myocardial blood flow. At that point, the plaque buildup in your coronary arteries leads to acute arterial occlusion and will cause death,
In Korea, Because of increasing patients with coronary heart disease, the need for a program that manages the heart was required on 1993 but related research is incomplete and it is still on process. Reduction in cardiorespiratory endurance in accordance with the obesity index decreases the exercise capacity and cause a decrease in the total metabolic activity body. It can repeat the cycle of disease. The Research to find out the cardiopulmonary function changes according to the degree of obesity within the group who has coronary heart disease is still incomplete. So, the further research is needed for prevention of heart disease.
Overweight individual has had lower cardiovascular function than normal and metabolically the overweight individual is also placed at a disadvantage side. Even simple test between the overweight and others show a lot of difference by the simple comparison. Especially the group of cardiovascular disease, the importance in the functional parts of the heart is required. But it is incomplete research for effectiveness of the exercise between overweight individual and non-overweight individual within the group who has cardiovascular disease. Therefore, in the cardiac rehabilitation program also examines various risk factors including obesity in the future so that it is able to provide an effective exercise protocol for the Asian standard.
This study was to compare the results of cardiorespiratory endurance with the results of cardiac rehabilitation program in two groups of age between 45 and 55 mid-age males with cardiovascular disease. The groups are divided by suspected obesity.
The groups under control by Physicians at Cardiac rehabilitation center in K University hospital had a basic screening test first. After 2 weeks, the groups attended cardiac rehabilitation program with Symptom-limited exercise test. The cardiac rehabilitation program is 8 weeks program. The program has 60 minutes cycle and will be provided to groups 3 times per week. The 60 minutes program consists of three exercises? Warm-up for 10 minutes, main exercise for 40 minutes and cool-down for 10 minutes. While they were doing aerobic exercise, we observed the overall cardiac status by using a portable EKG as well as before and after the exercise.
At the warm up status, the group performed 5 minutes light walking and body stretching with 8 to 10 cycles so that the heart rate would be increased as 10 to 12 beats per minute compare to the normal rate. At the main exercise has 2 sessions for 20 minutes each. The intensity of the second main exercise session was determined based on the result of the initial main exercise session considering these factors ? blood pressure, pulse and Borg Scale that is adjusted by the speed and slope with 1METs. For initial intensity of the main exercise, the Target Heart rate is determined by using Karvonen formula. The group performed the exercise starting 40% of intensity to 80% of intensity in the end gradually,
The collected data will be analyzed by SPSS/PC window 18.0 Version. The result was calculated as the mean and standard deviation based on the before and after cardiac rehabilitation program each group. Also, we performed Wilcoxon signed rank test at the difference of the data between the before and after program by using Mann Whitney U-test.

The study results are as follows:

１）The normal group was significantly different from the obesity group in the variation of resting heart rate and the variation of maximum heart rate as a result from the cardiac rehabilitation program(p<0.05).

２）The normal group was significantly different than the obesity group in the variation of systolic blood pressure and the variation of minimum blood pressure as a result from the cardiac rehabilitation program(p<0.05).

３）The normal group was significantly different than the obesity group in the variation of myocardial burden at the maximum level as a result from the cardiac rehabilitation program(p<0.05).

４）The both group were significantly different in the variation of maximal oxygen uptake as a result from the cardiac rehabilitation program(p<0.05).
According to these following findings, the cardiac rehabilitation program for mid aged males between 45 and 55 who had heart disease had a positive impact on cardiovascular endurance. At the Obesity group, the cardiac rehabilitation program has positive impact on maximal oxygen uptake portion. At the normal group the cardiac rehabilitation program has positive impact on resting heart rate, maximum heart rate, maximum systolic blood pressure, minimum blood pressure, myocardial burden at the maximum level, and maximal oxygen intake. So the appropriate adjustment is required in accordance with the obesity index for Asian and various adjustment will be required at the cardiac rehabilitation program.