{
  "abstract": "Purpose The primary aim of this study was to describe physical fitness in a large real-world cohort of patients entering exercise-based cardiac rehabilitation (EBCR) after first-time myocardial infarction (MI). The secondary aim was to compare the results with clinical reference values.Methods This registry-based cohort study used data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) post-MI registry between 2016 and 2019. Patients with first-time MI who underwent physiotherapist-led assessments of physical fitness at EBCR entry were included. Exercise capacity was evaluated by a symptom-limited cycle ergometer test and muscular endurance by a unilateral heel-rise test. Results were compared with age-stratified and sex-stratified clinical reference values. Reference values for exercise capacity were based on the Swedish Kalmar dataset, the national standard reference in Sweden since 2014, and reference values for heel-rise performance were based on a Swedish normative dataset of healthy adults.Results A total of 15 105 patients (mean age 62.5±9.1 years, 78.4% men) were included. Exercise capacity (Watt max from the exercise test) was higher in men than women across age groups, and muscular endurance declined with age, with a steeper age-related decline in women’s heel rise performance. The mean exercise capacity of the study population corresponded to 64.7±27.4% of predicted values in men and 68.4±18.9% in women. Muscular endurance averaged 78.4%±51.0% of reference values in men and 61.7%±43.2% in women.Conclusion At EBCR entry after a first-time MI, both exercise capacity and muscular endurance were substantially below age-specific and sex-specific reference values. These results underscore the importance of systematic baseline assessments and tailored rehabilitation interventions targeting both exercise capacity and muscular endurance.",
  "authors": [
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Physiotherapy Department, Region Västernorrland, Sundsvall, Sweden"
      ],
      "name": "Kajsa Hedin"
    },
    {
      "affiliations": [
        "Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden",
        "Clinical Department of Clinical Physiology, Region Östergötland, Linköping, Sweden"
      ],
      "name": "Anna Carlén"
    },
    {
      "affiliations": [
        "Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Nermin Hadziosmaniovic"
    },
    {
      "affiliations": [
        "Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Emil Hagström"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences, Danderyd hospital, Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Tomas Jernberg"
    },
    {
      "affiliations": [
        "Department of Cardiology, Skåne University Hospital, Malmö, Sweden",
        "Faculty of Medicine, Lund University, Malmö, Sweden"
      ],
      "name": "Margret Leosdottir"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden"
      ],
      "name": "Annica Ravn-Fischer"
    },
    {
      "affiliations": [
        "Department of Community Health and Rehabilitation, Umeå University, Umeå, Sweden"
      ],
      "name": "Camilla Sandberg"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University West, Trollhättan, Sweden",
        "Department of Research and Development, Region Västra Götaland, NU-Hospital Group, Trollhättan, Sweden",
        "Department of Orthopedics, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Kristina Åhlund"
    },
    {
      "affiliations": [
        "Department of Women's and Children’s Health, Physiotherapy, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Charlotte Urell"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Västra Götaland County, Sweden"
      ],
      "name": "Maria Bäck"
    }
  ],
  "title": "Physical fitness after myocardial infarction compared with clinical reference values: a SWEDEHEART registry study",
  "uid": "a11303b7-d6d4-54af-aae0-a620908f5ea7"
}