Long-Term Enrollment in Cardiac Rehabilitation Benefits of Cardiorespiratory Fitness and Skeletal Muscle Strength in Females with Cardiovascular Disease

Smoking is an important risk factor for cardiovascular disease and all-cause mortality. Cardiac rehabilitation (CR) is effective for reducing the risk of recurrent cardiac events through improving cardiorespiratory fitness (CRF). Little is known about the influence of smoking on CRF throughout long-term CR. The purpose of this analysis was to compare CRF trajectories among individuals with positive and negative smoking history enrolled in long-term CR. Participants had a positive smoking history if they currently smoke or formerly smoked (Smoke+, n=55, mean age=64.9 ± 9.0 years) and had a negative history if they never smoked (Smoke–, n=34, mean age=61.4 ± 9.0 years). CRF (VO2peak) was measured at baseline and annually thereafter for 6 years. The Smoke+ group had lower CRF compared to the Smoke– group over enrollment (β=-3.29 (SE=1.40), 95% CI -6.04, -0.54, p=0.02), but there was no interaction of smoking history and enrollment (β=0.35 (SE=0.21), 95% CI -0.06, 0.77, p=0.10). Moreover, trajectories were not influenced by pack-years (β=0.01 (SE=0.01), 95% CI -0.01, 0.04, p=0.23) or time smoke-free (β=-0.002 (SE=0.01), 95% CI -0.02, 0.02, p=0.80). Although the trajectories of CRF do not appear to be affected by smoking behaviour, individuals without a history of smoking maintained higher CRF throughout enrollment. Novelty bullets: • The benefits of long-term exercise-based cardiac rehabilitation on cardiorespiratory fitness are similar between those who have smoked and those who have never smoked. • Neither the number of pack-years nor the length of time spent smoke-free influence cardiorespiratory fitness trajectories following long-term cardiac rehabilitation.

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PRELIMINARY ANALYSIS OF THE EFFECTS OF STATINS ON FUNCTIONAL PERFORMANCE AND SKELETAL MUSCLE STRENGTH DURING CARDIAC REHABILITATION

Cardiopulmonary Physical Therapy Journal ◽

10.1097/01823246-201223040-00012 ◽

2012 ◽

Vol 23 (4) ◽

pp. 29-30

Author(s):

L Healey ◽

D E Forman ◽

L P Cahalin

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Cardiac Rehabilitation ◽

Preliminary Analysis ◽

Functional Performance ◽

Skeletal Muscle Strength

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Effect of long-term treatment with corticosteroids on skeletal muscle strength, functional exercise capacity and health status in patients with interstitial lung disease

Respirology ◽

10.1111/resp.12807 ◽

2016 ◽

Vol 21 (6) ◽

pp. 1088-1093 ◽

Cited By ~ 16

Author(s):

Masatoshi Hanada ◽

Noriho Sakamoto ◽

Yuji Ishimatsu ◽

Tomoyuki Kakugawa ◽

Yasushi Obase ◽

...

Keyword(s):

Skeletal Muscle ◽

Health Status ◽

Interstitial Lung Disease ◽

Muscle Strength ◽

Term Treatment ◽

Long Term Treatment ◽

Functional Exercise ◽

Functional Exercise Capacity ◽

Skeletal Muscle Strength

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COVID-19 era in long-term cardiac rehabilitation programs: how was muscle strenght and lean mass affected in cardiovascular patients?

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.362 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Borges ◽

M Lemos Pires ◽

R Pinto ◽

G De Sa ◽

I Ricardo ◽

...

Keyword(s):

Muscle Strength ◽

Cardiac Rehabilitation ◽

Lean Mass ◽

Lower Limb ◽

Lower Limbs ◽

Phase Iii ◽

Face To Face ◽

Home Based ◽

Lower Limb Strength

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.

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