Personal characteristics, health status, physical activity, and quality of life in cardiac rehabilitation participants

Introduction: Cardiac rehabilitation (CR) is an evidence-based program to improve secondary prevention outcomes for patients with cardiovascular disease (CVD). Lower health-related quality of life is a known risk factor for worse CVD outcomes. We examined the effects of a patient-driven appointment-based CR program on health-related quality of life. Methods: We utilized data from the Yale New-Haven Health (YNHH) CR program over a 6-year period (2012-2017). Data was collected on patient demographics, clinical characteristics and socioeconomic status. The Medical Outcome Short-Form General Health Survey (SF-36) was used to measure general health status. We evaluated SF-36 score changes pre and post CR with paired T-tests and conducted logistic regression analysis to examine predictors of improvements in health-related quality of life. Results: Over the 6-year study period, a total of 2,135 patients (27.9% women, mean age 65±12 years) were enrolled in the CR program. Patients demonstrated significant improvements in both the SF-36 physical, mental and health transition components (P<0.001) (Table) . In particular, patients had significant improvement in the social functioning domain (measures limitations patients see in their ability to participate in social activities due to physical/emotional issues), with an increase of 23.3 points out of 100. Physician-reported patient stress and/or depression on intake medical exam were significant negative predictors for improvement in the total SF-36 score (OR 0.23, 95% CI 0.08-0.80, P=0.021), with the effect driven largely by its impact on the physical component of SF-36 (OR 0.27, 95% CI 0.09-0.83, P=0.022). Conclusion: We demonstrated that a novel appointment-based CR program produced improvements in patient-reported health-related quality of life. Appointment-based CR could be a viable alternative for patients who prefer more scheduling flexibility, to optimize health status improvement and CVD outcomes.

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Presenting Health Status in Children Using a Radar Plot

Sports ◽

10.3390/sports8040053 ◽

2020 ◽

Vol 8 (4) ◽

pp. 53 ◽

Cited By ~ 1

Author(s):

Asgeir Mamen ◽

Lars Erik Braaum ◽

Per Morten Fredriksen

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Blood Pressure ◽

Health Status ◽

Vigorous Physical Activity ◽

Density Lipoprotein ◽

Activity Level ◽

Cholesterol Concentration ◽

Lower Systolic Blood Pressure

Background: To try out the feasibility of presenting the health status of children 6 to 12 years old by using radar plots. Methods: With data from the Health Oriented Pedagogical Project (HOPP) we have described the health status for 1340 children aged 6 to 12 years. We collected or calculated: stature, body mass, waist circumference, waist to height ratio, high density lipoprotein (HDL) and total cholesterol concentration, blood pressure, accelerometer assessed physical activity, endurance interval running performance, and quality of life. Pertinent variables were presented through a radar plot for both individual cases and groups. Results: The boys showed better endurance and recorded more moderate to vigorous physical activity than the girls. The activity level dropped from age 6 to age 12 for both sexes. The girls showed a lower systolic blood pressure compared with boys. Self-rated quality of life was high among boys and girls. Conclusions: This cohort showed good health and the radar plot made it easy to visualise health status for groups and individuals.

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P6215Limited functional capacity and physical activity associated with patient withdrawals from cardiac rehabilitation

European Heart Journal ◽

10.1093/eurheartj/ehz746.0820 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Ding ◽

M Gonzalez-Garcia ◽

M Varnfield ◽

A Krumins ◽

Y Martin ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Cardiac Rehabilitation ◽

Functional Capacity ◽

The Body ◽

Analysis Of Covariance ◽

Exact Test ◽

Related Quality ◽

Age And Sex

Abstract Background Cardiac rehabilitation (CR) assists patients with cardiovascular disease (CVD) in improving physical activity and effectively managing their health conditions. With numerous clinical benefits including reduced risks of mortality (by 25%) and all-cause hospitalizations (by 18% - 25%), CR has been strongly recommended by evidence-based clinical guidelines for secondary prevention of CVD. However, many CR participant withdraw and hence fail to fully benefit from their CR programme. To address this issue, knowledge on risk stratification of patients' characteristics to appropriate CR care pathways is important. Purpose The purpose of this study is to identify clinical baseline characteristics associated with patients who withdraw from a CR programme. Methods We retrospectively analysed patients who participated in the centre-based CR programmes of a research study in Queensland, Australia. The CR programmes provided structured sessions (training and education) once or twice a week for six weeks in community care centres. We compared the patients who withdrew from their CR programme (Group-W) with those who did not withdraw (or simply completion) (Group-C). Withdrawal was defined as discontinuing within the first four weeks of the CR programme. In the comparison, the one-way analysis of variance (ANOVA) and Fisher's exact test were used for analysing age and sex respectively. The analysis of covariance (ANCOVA) with an adjustment for age and sex was used for the body mass index (BMI), six-minute walk test (6WMT), and health-related quality of life (HeartQoL, ESC 2012), comprising physical (HeartQoL-Phy), emotional (HeartQoL-Emo), and global (HeartQoL-Glo) subscales. The study was approved by the Human Research Ethics Committee (Reference: HREC/16/QPAH/636). Results From Dec 2016 to Dec 2017, 600 outpatients with CVD were consented, and enrolled in the study. Seventy participants withdrew. Between the two groups (Group-W vs Group-C), no significant differences were found in age (64±12 years vs 65±10 years; p=0.4221), sex (Female, 31% vs 25%; p=0.2461) and BMI (30.5±6.2 vs 30.1±11.2; p=0.8211). The 6MWT distance was significantly lower in Group-W than Group-C (346±103 m vs 394±92 m; p=0.001). Significantly lower scores of HeartQoL-Phy (1.66±0.86 vs 1.93±0.74; p=0.0072) and HeartQoL-Glo scores (1.80±0.78 vs 2.02±0.67; p=0.0205) were found in Group-W. HeartQoL-Emo scores were lower in Group-W but the difference was not significant (2.19±0.73 vs 2.28±0.72; p=0.4550). Conclusions The levels of functional capacity measured by 6MWT and physical activity related quality of life were found to be significantly lower in withdrawal patients than those who completed their CR programme. The finding indicates that new care strategies, especially for patients with limited functional capacity and physical activity, are needed to improve the adherence and effectiveness of CR intervention in future studies. Acknowledgement/Funding CSIRO and Metro South Health

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Comparison of the effect of 12- and 24-session cardiac rehabilitation on physical, psychosocial and biomedical factors in ischemic heart disease patients

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2019-0023 ◽

2020 ◽

Vol 41 (1) ◽

Author(s):

Masoumeh Sadeghi ◽

Abdullah Izadi ◽

Mohammad Mahdi Hadavi ◽

Mohammad Rafati Fard ◽

Hamidreza Roohafza

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Cardiac Rehabilitation ◽

Ischemic Heart ◽

Life Questionnaire ◽

Short Term ◽

Significant Difference

AbstractBackgroundCardiac rehabilitation (CR) is a key component of effective care for patients with a wide spectrum of cardiac problems. It seems that the short-term provision of these services can facilitate their use and meeting of related needs for patients participating in the CR programs.Materials and methodsIn this interventional study on patients with ischemic heart disease (IHD) referred to the Cardiac Rehabilitation Center of Chamran Hospital, Isfahan, Iran. One-hundred and twelve patients were randomly divided into two groups of 12 and 24 sessions of CR [mean age: 59.2 ± (9.02) and 60.7 ± (9.3) years, respectively] and underwent a CR program. All information was collected in two stages, before the beginning of the program and after completion of 12- and 24-session rehabilitation programs. The data collection tools were demographics questionnaire, the International Physical Activity Questionnaires (IPAQ), McNew Quality of Life Questionnaire, Beck Depression Inventory (BDI), and Zung Self-Rating Anxiety Scale (SAS).ResultsThe results of this study showed that in both groups, total physical activity (PA) and functional capacity increased, and the quality of life (QOL) was statistically improved. Comparison of changes in mean differences at the end of the rehabilitation periods between the two groups, showed that only the weight, body mass index (BMI), waist circumference (WC) and high-density lipoprotein (HDL) in the 24-session group significantly decreased compared to the 12-session group and, but no significant difference in other variables was observed.ConclusionOverall, the findings of this study support the overall benefits of the CR program in both the short and the long term. Therefore it can be suggested that a short-term program can still be a valuable option for reducing the risk in cardiac patients and meeting their service needs.

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Systematic review of preoperative physical activity and its impact on postcardiac surgical outcomes

BMJ Open ◽

10.1136/bmjopen-2016-015712 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015712 ◽

Cited By ~ 13

Author(s):

D Scott Kehler ◽

Andrew N Stammers ◽

Navdeep Tangri ◽

Brett Hiebert ◽

Randy Fransoo ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Systematic Review ◽

Length Of Stay ◽

Adverse Events ◽

Cardiac Rehabilitation ◽

Surgical Outcomes ◽

Physical Activity Behaviour ◽

Activity Behaviour

ObjectivesThe objective of this systematic review was to study the impact of preoperative physical activity levels on adult cardiac surgical patients’ postoperative: (1) major adverse cardiac and cerebrovascular events (MACCEs), (2) adverse events within 30 days, (3) hospital length of stay (HLOS), (4) intensive care unit length of stay (ICU LOS), (5) activities of daily living (ADLs), (6) quality of life, (7) cardiac rehabilitation attendance and (8) physical activity behaviour.MethodsA systematic search of MEDLINE, Embase, AgeLine and Cochrane library for cohort studies was conducted.ResultsEleven studies (n=5733 patients) met the inclusion criteria. Only self-reported physical activity tools were used. Few studies used multivariate analyses to compare active versus inactive patients prior to surgery. When comparing patients who were active versus inactive preoperatively, there were mixed findings for MACCE, 30 day adverse events, HLOS and ICU LOS. Of the studies that adjusted for confounding variables, five studies found a protective, independent association between physical activity and MACCE (n=1), 30-day postoperative events (n=2), HLOS (n=1) and ICU LOS (n=1), but two studies found no protective association for 30-day postoperative events (n=1) and postoperative ADLs (n=1). No studies investigated if activity status before surgery impacted quality of life or cardiac rehabilitation attendance postoperatively. Three studies found that active patients prior to surgery were more likely to be inactive postoperatively.ConclusionDue to the mixed findings, the literature does not presently support that self-reported preoperative physical activity behaviour is associated with postoperative cardiac surgical outcomes. Future studies should objectively measure physical activity, clearly define outcomes and adjust for clinically relevant variables.RegistrationTrial registration numberNCT02219815. PROSPERO number CRD42015023606.

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Verbessert körperliche Aktivität während der Chemotherapie die Lebensqualität von Krebspatienten?

Karger Kompass Onkologie ◽

10.1159/000439416 ◽

2015 ◽

Vol 2 (2) ◽

pp. 96-97

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Health Status ◽

Global Health ◽

Cancer Patients ◽

Körperliche Aktivität ◽

Improve Quality ◽

European Organisation ◽

Metabolisches Äquivalent

Hintergrund: Fortschritte in der Krebstherapie haben zur Verlängerung der Überlebenszeit geführt. Dennoch beeinträchtigen Tumorsymptome und Nebenwirkungen immer noch die körperliche Aktivität und Lebensqualität (LQ). Patienten und Methoden: Wir führten eine anonyme Umfrage unter Krebspatienten durch, die sich zu der Zeit einer Chemotherapie unterzogen. Dabei verwendeten wir standardisierte Fragebögen: den Freiburger Fragebogen zur körperlichen Aktivität und den EORTC-Fragebogen QLQ-C30 (EORTC = European Organisation for Research and Treatment of Cancer). Zwei wichtige Fragen wurden untersucht: Gibt es Unterschiede 1) hinsichtlich der körperlichen Aktivität und LQ von Patienten, die nicht glauben, dass Sport ihre LQ verbessern könnte, und solchen, die dies glauben (Gruppe A vs. B), und 2) hinsichtlich der LQ von Patienten mit einer Gesamtaktivität (GA) von <18 MET-h/Woche (MET = metabolisches Äquivalent) und solchen mit einer GA von ≥18 MET-h/Woche (Gruppe C vs. D)? Ergebnisse: 276 von 400 Fragebögen wurden ausgefüllt. Die Gruppen A und B wurden in Bezug auf die Merkmale zu Studienbeginn ausbalanciert. Gruppe A litt signifikant häufiger unter Müdigkeit und Schmerzen; in Gruppe B waren höhere Werte für den allgemeinen Gesundheitsstatus (global health status; GHS) und die GA zu verzeichnen. Die Gruppen C und D unterschieden sich in Geschlechterverteilung, Alter und Bildungsgrad. Gruppe D wies signifikant höhere GHS-Werte auf; Gruppe C litt stärker unter Müdigkeit, Schmerzen und Appetitlosigkeit. Schlussfolgerung: Körperliche Aktivität korreliert bei Krebspatienten unter einer Chemotherapie mit einer höheren LQ. Übersetzung aus Kripp M, et al: Does physical activity improve quality of life in cancer patients undergoing chemotherapy? Oncol Res Treat 2015;38:230-236 (DOI: 10.1159/000381734)

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