The recent "position paper" of the American College of Physicians1 and the associated review of the efficacy of cardiac rehabilitation services2 provide an excellent summary of selected studies and discussions concerning cardiac rehabilitation. The features and outcomes of clinical trials of exercise training, undertaken predominantly during the last decade, were compared as a basis for providing guidelines for the use of rehabilitative services. However, we were concerned that some pivotal questions were not addressed and that some contemporary issues were not highlighted; thus, a less-than-complete overview of current cardiac rehabilitative practices has been provided for primary care physicians caring for coronary patients and for third-party insurers funding their care.
WHAT ARE APPROPRIATE GOALS OF EXERCISE REHABILITATION FOLLOWING MYOCARDIAL INFARCTION OR MYOCARDIAL REVASCULARIZATION? WHY CAN EXERCISE TRAINING AS AN ISOLATED INTERVENTION NOT BE CONSIDERED SYNONYMOUS WITH CORONARY REHABILITATION?
Most physicians recommend, and most coronary patients undertake, exercise rehabilitation with