***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim : To examine the effectiveness of a four-week home-based self-management rehabilitation programme on health-related quality of life , anxiety and depression levels , cardiac risks and unplanned visits to the health services among community-dwelling patients with myocardial infa rct ion . Methods : A r and omised controlled trial with repeated measurements was used . A convenience sample of 128 patients with myocardial infa rct ion was recruited from outpatient cardiology clinics at a tertiary hospital in Singapore . Participants were r and omly assigned to the intervention group or control group . The outcomes were measured using Short Form 12-item Health Survey Version 2 , Myocardial Infa rct ion Dimensional Assessment Scale , and Hospital Anxiety and Depression Scale . The cardiac physiological risk parameters and number of unplanned health service use were also assessed . Data were collected at baseline , and at four weeks and 16 weeks from the baseline . Results : Over the 16 weeks , the two groups reported significant differences in physical activity ( F = 4.23 , p = 0.02 ) , dependency ( F = 5.16 , p = 0.01 ) , concerns over medication ( F = 3.47 , p = 0.04 ) on MIDAS , anxiety level ( F = 3.41 , p = 0.04 ) and body mass index ( F = 3.12 , p = 0.04 ) . A significant difference was also found in unplanned cardiac-related emergency room visits ( χ2 = 6.64 , p = 0.036 ) and medical consultation ( χ2 = 9.67 , p = 0.046 ) at the 16-week study point . Conclusion : The study may provide a useful tool to help health care professionals to meet the cardiac rehabilitative care needs of community-dwelling patients with myocardial infa rct ion in Singapore Background Symptoms of depression and anxiety are common after a myocardial infa rct ion ( MI ) . Internet-based cognitive behavioral therapy ( iCBT ) has shown good results in other patient groups . Objective The aim of this study was to evaluate the effectiveness of an iCBT treatment to reduce self-reported symptoms of depression and anxiety among patients with a recent MI . Methods In total , 3928 patients were screened for eligibility in 25 Swedish hospitals . Of these , 239 patients ( 33.5 % , 80/239 women , mean age 60 years ) with a recent MI and symptoms of depression or anxiety were r and omly allocated to a therapist-guided , 14-week iCBT treatment ( n=117 ) , or treatment as usual ( TAU ; n=122 ) . The iCBT treatment was design ed for post-MI patients . The primary outcome was the total score of the Hospital Anxiety and Depression Scale ( HADS ) 14 weeks post baseline , assessed over the internet . Treatment effect was evaluated according to the intention-to-treat principle , with multiple imputations . For the main analysis , a pooled treatment effect was estimated , controlling for age , sex , and baseline HADS . Results There was a reduction in HADS scores over time in the total study sample ( mean delta=−5.1 , P<.001 ) but no difference between the study groups at follow-up ( beta=−0.47 , 95 % CI −1.95 to 1.00 , P=.53 ) . Treatment adherence was low . A total of 46.2 % ( 54/117 ) of the iCBT group did not complete the introductory module . Conclusions iCBT treatment for an MI population did not result in lower levels of symptoms of depression or anxiety compared with TAU . Low treatment adherence might have influenced the result . Trial Registration Clinical Trials.gov NCT01504191 ; https:// clinical trials.gov/ct2/show/NCT01504191 ( Archived at Webcite at http://www.webcitation.org/6xWWSEQ22 There is substantial evidence of the importance of rehabilitation for patients recovering from acute myocardial infa rct ion in reducing mortality , morbidity , and psychological distress . The aim of this study was to compare a recently established home-based coronary rehabilitation programme in a coronary care unit ( CCU ) with the provision of a selection of information leaflets commonly provided for patients after their myocardial infa rct ion . A comparative study was carried out between two r and omly allocated groups of patients receiving either the Heart Manual rehabilitation programme ( n = 17 ) or general advice and information booklets ( n = 17 ) , with follow-up at 1 , 3 and 6 weeks after discharge for both groups . Question naire measurements included anxiety and depression ( HAD score ) , general practitioner ( GP ) visits , and patients ' perception of their confidence of recovery and progress . The findings show that patients receiving the Heart Manual had significantly higher scores in their confidence of recovery and perception of their progress than the group receiving booklets . The Heart Manual group showed improved levels of anxiety with unchanged scores in depression , while patients receiving the booklets experienced increased depression with little change in their anxiety levels . These results help to provide guidance for health care professionals on a form of rehabilitation which is effective for patients and their families in hospital and within the community BACKGROUND A prospect i ve single-center interventional cohort study was conducted to evaluate the effects of a 5-week comprehensive cardiac rehabilitation program on terms exercise capacity , quality of life , echocardiographic findings and autonomic modulation after first-time myocardial infa rct ion . METHODS We studied 37 consecutive post-myocardial infartion patients ( mean age 66 years ) . All patients began a 5-week cardiac rehabilitation supervised training . The exercise program consisted of 40 minutes of training , three times a week , on a cycle ergometer at 60 - 80 % of the maximal heart rate . At baseline and after training program we analyzed : the distance walked after the Six-Minutes Walking Test ( 6MWT ) ; quality of life ( QoL ) assesed using the Psychological General Well-Being Inventory ( PGWBI ) question naire ; echocardiographic finding and autonomic balance assesed heart rate variability ( HRV ) . RESULTS We observed statistically significant improvement in exercise capacity ( from 423±94 to 496±13 m ; P<0.05 ) . Also we observed statistically significant improvements in the many PGWBI dimensions ; particularly , anxiety + 5.8 % ( from 18.11±5.2 to 19.12±4.4 ) ; depression + 6.0 % ( from 12.00±3.0 to 12.73±2.4 ) ; positive well-being + 6 % ( from 11.55±3.5 to 12.23±4.0 ) ; general health + 10.3 % ( from 9.48±3.5 to 10.46±2.87 ) ; vitality + 6.8 % ( from 12.96±4.2 to 13.85±4.2 ) . Finally , we observed changes in HRV indices after training program : RR ( from 903±169 ms to 952±163 ms ; P<0.05 ) , pNN50 % ( from 4.74±4.89 to 6.23±5.53 ; P<0.05 ) , in time-domain ; LF ( from 274±169 to 362±233 ms2 ; P<0,05 ) ; HF ( from 214±154 to 314±194 ms2 ; P<0.05 ) and LF/HF ( from 1.53±0.54 to 1.24±0.47 ; P<0.05 ) in frequency-domain . CONCLUSIONS The study suggest that a cardiac rehabilitation program in postmyocardial infa rct ion improves exercise capacity , QoL and autonomic modulation Background Many patients experience  anxiety and depression after cardiac bypass surgery . The aim of this study was to examine the effect of cardiac rehabilitation on anxiety and depression in patients undergoing coronary artery bypass grafting in hospitals affiliated to Shiraz University of Medical Sciences in southern Iran . Methods For this r and omized controlled trial , 80 patients who met the inclusion criteria were recruited and r and omly assigned to case and control groups . Anxiety was measured with the Spielberger Anxiety Scale and depression was measured using Beck ’s Depression Inventory at three points in time : on discharge from the hospital , immediately after the intervention , and 2 months after cardiac rehabilitation . After measuring anxiety and depression in both groups upon discharge , the experimental group participated in 8 cardiac rehabilitation sessions over a 4-week period . The control group received only the routine follow-up care . Results There was a statistically significant difference in depression scores between groups at all three time-points ( Mean score from 19.6 to 10 in the intervention group and from 19.5 to 14 in the control group , P = 0.0014 ) . However , no significant difference was seen in anxiety scores between the groups ( Mean score from 37 to 28 in the intervention group and from 38 to 32 in the control group , P = 0.079 ) . Conclusions Cardiac rehabilitation was effective in reducing depression 2 months after surgery in patients undergoing coronary artery bypass grafting . Trial registration I RCT OBJECTIVES This study evaluated the effectiveness of cardiac counseling and rehabilitation programs led by a nurse counselor , compared with normal care on outcomes for myocardial infa rct ion ( MI ) patients and their partners . METHODS A r and omized controlled trial with follow-up to 1 year was conducted with 100 patients recruited within 72 hours of a first MI and their partners : a Control group received normal care ; an Inpatient group received cardiac rehabilitation from a nurse counselor while in hospital ; and an Extended group received the same cardiac rehabilitation as the Inpatient group , but with additional sessions continuing up to 6 weeks after discharge from hospital . The scales for main outcome measures were 1 ) knowledge of heart disease and treatment ( correct , misconceptions , and uncertainty ) ; 2 ) mood ( Hospital Anxiety and Depression Scale ) ; 3 ) satisfaction ; 4 ) disability ( Functional Limitations Profile ) . RESULTS Inpatient cardiac counseling and rehabilitation result ed in more knowledge , less anxiety , less depression , and greater satisfaction with care in both patients and partners and in less disability in patients , with effects enduring to 1 year . There was some evidence of additional benefit from the Extended program . Both nurse counselors achieved benefits on all outcome variables . CONCLUSIONS This Inpatient cardiac counseling and rehabilitation program result ed in significant and enduring benefits of clinical value . It is likely that it would be acceptable to most post-MI patients , many of whom are not offered or are unable to accept outpatient cardiac rehabilitation Aims The nature of the association of depression and anxiety with risk for  acute myocardial infa rct ion ( AMI ) remains unclear . We aim ed to study the prospect i ve association of single and recurrent self-reported symptoms of anxiety and depression with a risk of AMI in a large Norwegian population based cohort . Methods and results In the second wave of the Nord-Trøndelag Health Study ( HUNT2 , 1995–97 ) baseline data on anxiety and depression symptoms , sociodemographic variables , health status including cardiovascular risk factors and common chronic disorders were registered for 57 953 adult men and women free of cardiovascular disease . The cohort was followed up during a mean ( SD ) 11.4 ( 2.9 ) years for a first AMI from baseline through 2008 . A total of 2111 incident  AMIs  occurred , either identified at hospitals or by the National Cause of Death Registry . The multi-adjusted hazard ratios were 1.31 ( 95 % CI 1.03–1.66 ) for symptoms of depression and 1.25 ( CI 0.99–1.57 ) for anxiety . Two episodes of mixed symptoms of anxiety and depression ( MSAD ) , reported 10 years apart , increased the risk for AMI by 52 % ( 11–108 % ) . After exclusion of the first 5 years of follow-up , the association of depression symptoms with AMI risk was attenuated . Relative risk for AMI with anxiety symptoms and MSAD weakened when participants with chronic disorders were excluded . Conclusion Self-reported symptoms of depression and anxiety , especially if recurrent , were moderately associated with the risk of incident AMI . We had some indications that these associations might partly reflect reverse causation or confounding from common chronic diseases Objective The objective of this secondary analysis was to examine the relationships between a reduction in psychological distress and long-term cardiac and psychological outcomes in post – myocardial infa rct ion patients who participated in a r and omized trial of home-based psychosocial nursing interventions ( the Montreal Heart Attack Readjustment Trial [ M-HART ] ) . Gender differences were considered . Methods We studied  433 patients ( 36.0 % women ) from the M-HART treatment group who received two home visits after achieving a high psychological distress score ( ie , ≥5 ) on the General Health Question naire ( GHQ ) .  Short-term GHQ success was determined by a return to a normal GHQ score ( < 5 ) or a reduction of ≥50 % after the two visits . Patients with short-term successful and unsuccessful GHQ outcomes were compared for mid-term maintenance of success , 1-year death and readmission rates , and 1-year depression and anx 
    Output:
    
Results : We found that exercise‐based CR had a significant effect on decreasing anxiety and depression scores .
Furthermore , exercise‐based CR may alleviate anxiety and depressive symptoms at different time periods .
Conclusions : For patients with MI  , exercise‐based CR has been demonstrated to alleviate anxiety and depressive symptoms .
These findings highlight CR as essential and beneficial for minimizing MI patient anxiety and depression during recovery