Walking Speed in Patients With First Acute Myocardial Infarction Who Participated in a Supervised Cardiac Rehabilitation Program After Coronary Intervention

Abstract

This study aimed to evaluate the degree of reduction in walking speed in patients with acute myocardial infarction (AMI) compared to age-matched community-dwelling people and identify factors associated with walking speed. The subjects were 210 middle-aged and 188 elderly patients with a first AMI (AMI group) and 198 age-matched community-dwelling people with no medical events (non-AMI group). We measured maximum walking speed in all subjects and collected clinical data, including that related to motor function, at the end of a supervised cardiac rehabilitation program in the AMI group. Data were analyzed based on age and sex. Walking speed in men and women in the middle-aged AMI subgroup decreased to 77.9% and 75.7% relative to that of the non-AMI subgroup matched by sex, respectively; walking speed in men and women in the elderly AMI subgroup decreased to 78.7% and 74.2% relative to that of the non-AMI subgroup matched by sex, respectively. Moreover, 6.4% of men and 23.8% of women in the middle-aged AMI subgroup, and 28.8% of men and 43.5% of women in the elderly AMI subgroup, had a slower walking speed compared to their respective non-AMI groups, which may contribute to an increased risk for cardiovascular mortality. Stepwise multiple regression analysis for motor function revealed that only leg strength in the middle-aged AMI subgroup, and both leg strength and standing balance in the elderly AMI subgroup, were associated with walking speed, regardless of sex after adjusting for clinical characteristics. These results suggest that evaluation and management of walking speed are necessary in implementing effective disease management for patients with first AMI.