INFLUENCE OF INITIAL FITNESS ON THE RESPONSE TO CARDIAC REHABILITATION
Bibliographic record
Abstract
The aerobic training response of healthy young adults is apparently related to the intensity of effort, expressed as a percentage of maximal oxygen intake. We thus asked whether the training responses of cardiac patients would show a similar pattern. PURPOSE: To test whether patients admitted to a community-based out-patient cardiac rehabilitation program show a larger aerobic training response if their initial cycle ergometer symptom-limited peak oxygen intake is low. METHODS: Our population comprised a large and unselected group of 7958 male patients admitted to a 12-month community-based out-patient program of progressive aerobic exercise (mainly walking/jogging, 5 times/wk; exercise sessions physician-supervised once/wk for 6 months, once/month for the remaining six months). We excluded individuals where the initial peak oxygen intake was unusually low (< 15 ml/[kg.min], 1025 patients, 13% of sample). The remaining 6933 individuals (4132 with myocardial infarction, 1728 with coronary arterial bypass graft, and 1073 with myocardial ischemia) were stratified into four categories of initial aerobic fitness (peak VO2 15–18, 18–21, 21–24 and > 24 ml/[kg.min]; n = 1527, 2021, 1683, and 1702, respectively). Measurements of peak VO2 were repeated after 12 months of rehabilitation. RESULTS: Apparent increases of peak VO2 were inversely related to initial aerobic fitness: Increase in peak VO2 = 7.5 −0.23[peak VO2] (p < 0.001). Estimated gains ranged from an average of 3.3 ml/[kg.min] in those initially 15–18 ml/[kg.min] to only 1.5 ml/[kg.min] in those initially > 24 ml/[kg.min]. Gains were unrelated to spontaneous recovery, differences in diagnosis or medication. Reversion to the mean was an important contributing factor, and the relative intensity of effort also tended to be higher for less fit individuals. CONCLUSIONS: As in healthy adults, the apparent training response is inversely related to initial fitness. Part of this phenomenon reflects reversion to the mean. Nevertheless patients with a low peak VO2 that limits their daily activities have a good prospect of regaining and/or sustaining functional independence through participation in a progressive aerobic training program of adequate duration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".