There is a great deal of diversity in AAF hospitals regarding the management of the period of convalescence after rheumatic fever. It varies from a prolonged restriction of physical activities to an early participation in special exercise which often may require a great deal of exertion. This difference in attitude regarding physical activity can be explained easily. On the one hand, it has been a medical tradition, based mainly on observation among children, that rest is an essential part of the rheumatic fever regimen not only during the active stage of the disease but also during a long period of time afterward. On the other hand, accumulated experience with rheumatic fever has indicated that this disease affects adults in a lesser degree than children, and therefore the management of the patients in the two instances may not be the same. Moreover, the present attacks on the "abuse of bed rest"
KARPOVICH PV, STARR MP, KIMBRO RW, STOLL CG, WEISS RA. PHYSICAL RECONDITIONING AFTER RHEUMATIC FEVER. JAMA. 1946;130(17):1198–1203. doi:10.1001/jama.1946.02870170004002