[Favorable effects of breathing and relaxation instructions in heart rehabilitation: a randomized 5-year follow-up study][Article in Dutch]

OBJECTIVE: To determine the effect of breathing and relaxation instruction of patients after a myocardial infarction on the occurrence of cardiac events during 5 years. DESIGN: Prospective randomised. SETTING: Kennemer Gasthuis, Haarlem, the Netherlands. METHOD: In the period 1981-1983, 156 myocardial infarction patients were randomly assigned to either rehabilitation plus relaxation therapy (six weekly sessions of breathing and relaxation instruction) (n = 76) or cardiac rehabilitation alone (n = 80). The occurrence of cardiac events and the amount of medical consumption on the two treatments was compared during 5 years. RESULTS: At five-year follow-up, 12 cardiac deaths had occurred, 5 in the relaxation group and 7 in the control group, reinfarction was observed in 10 and 12 patients, and cardiac surgery was performed in 2 and 11, respectively. In total 15 (20%) and 26 patients (33%), respectively, had at least one of these events (odds ratio (OR) for the relaxation group: 0.51; 95% confidence interval (CI): 0.25-1.06). Medical consumption (counted as cardiac events and cardiac hospitalisations) was 30 patients (39%) experiencing 52 cardiac events in the relaxation group, for which the patients were hospitalized for a total of 476 days, and 38 patients (48%) experiencing 78 cardiac events in the control group (OR: 0.72; 95% CI: 0.38-1.36) with a total of 719 hospitalisation days; the total number of hospitalisations was reduced by 31% by relaxation instruction. CONCLUSION: In the long run, the disease course after myocardial infarction is probably influenced favourably by adding relaxation instruction to cardiac rehabilitation. The extra costs are compensated for by a decrease in hospitalisation for cardiac problems.