scholarly journals Readiness of cardiosurgical patients for digital rehabilitation programs

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
S Pomeshkina ◽  
T N Zvereva ◽  
E V Krupyanko ◽  
E E Pomeshkina ◽  
O L Barbarash
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Rehabilitation ◽  
Heart Valves ◽  
Artery Bypass ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Rehabilitation Programs ◽  
Funding Sources ◽  
Home Training

Abstract Introduction To date, the methods of remote rehabilitation using the mobile applications for smartphones are increasingly introduced for a particular category of cardiac patients worldwide. Such programs are of a particular relevance due to a higher accessibility for a patient which is provided by the flexibility of the patients' home training schedule and the possibility of constant communication with a cardiologist and rehabilitation therapist. Purpose To study the readiness of the patients to participate in the remote digital cardiac rehabilitation program. Methods 265 patients (180 (68%) men and 85 (32%) women) undergone a cardiac surgery and staying at the cardiac surgery department were examined. The mean age of the patients was 67±11.9 years. 157 (59%) patients undergone coronary artery bypass grafting (CABG), 73 (34%) patients – heart valves surgery, 13 (5%) patients – simultaneous CABG and heart valves surgery and 5 (2%) – hybrid CABG with carotid endarterectomy. Prior to the discharge from the first inpatient rehabilitation stage (10–12 days after cardiac surgery), all the patients underwent a survey. The survey was conducted using a designed questionnaire including 5 questions, the answers to which determined the patients' awareness of the necessity and the structure of postoperative remote rehabilitation using the digital technologies, as well as the willingness and the possibility to participate in these programs. Results Analyzing the results obtained from the survey it turned out that the majority of patients (258 (97%)) believe that they need cardiac rehabilitation. However, only 86 (32%) patients answered positively to the question about their readiness to participate in remote digital rehabilitation programs. When analyzing the reasons for such a low readiness of patients to participate in remote programs it turned out that 98 (37%) patients didn't have smartphones. 10 (4%) patients despite the presence of a smartphone, refused to participate referring to their inability to use considering themselves incapable of learning it. 71 (27%) patients simply refused claiming that they don't understand the necessity for remote cardiac rehabilitation. Conclusions Thus, only a small number of the patients (32%) are ready to participate in remote digital programs of cardiac rehabilitation. A considerable amount of the patients (37%) can't afford to participate in a remote rehabilitation program only due to the absence of the smartphone and 27% of the patients are not ready to participate in a remote cardiac rehabilitation program not understanding the importance of distance cardiac rehabilitation for them. Funding Acknowledgement Type of funding sources: None.

scholarly journals Readiness of cardiosurgical patients for digital rehabilitation programs

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Pomeshkina ◽  
T N Zvereva ◽  
E V Krupyanko ◽  
E E Pomeshkina ◽  
O L Barbarash
Keyword(s):  
Cardiac Surgery ◽  
Cardiac Rehabilitation ◽  
Heart Valves ◽  
Artery Bypass ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Rehabilitation Programs ◽  
Funding Sources ◽  
Home Training

Abstract Introduction To date, the methods of remote rehabilitation using the mobile applications for smartphones are increasingly introduced for a particular category of cardiac patients worldwide. Such programs are of a particular relevance due to a higher accessibility for a patient which is provided by the flexibility of the patients' home training schedule and the possibility of constant communication with a cardiologist and rehabilitation therapist. Purpose To study the readiness of the patients to participate in the remote digital cardiac rehabilitation program. Methods 265 patients (180 (68%) men and 85 (32%) women) undergone a cardiac surgery and staying at the cardiac surgery department were examined. The mean age of the patients was 67±11.9 years. 157 (59%) patients undergone coronary artery bypass grafting (CABG), 73 (34%) patients – heart valves surgery, 13 (5%) patients – simultaneous CABG and heart valves surgery and 5 (2%) – hybrid CABG with carotid endarterectomy. Prior to the discharge from the first inpatient rehabilitation stage (10–12 days after cardiac surgery), all the patients underwent a survey. The survey was conducted using a designed questionnaire including 5 questions, the answers to which determined the patients' awareness of the necessity and the structure of postoperative remote rehabilitation using the digital technologies, as well as the willingness and the possibility to participate in these programs. Results Analyzing the results obtained from the survey it turned out that the majority of patients (258 (97%)) believe that they need cardiac rehabilitation. However, only 86 (32%) patients answered positively to the question about their readiness to participate in remote digital rehabilitation programs. When analyzing the reasons for such a low readiness of patients to participate in remote programs it turned out that 98 (37%) patients didn't have smartphones. 10 (4%) patients despite the presence of a smartphone, refused to participate referring to their inability to use considering themselves incapable of learning it. 71 (27%) patients simply refused claiming that they don't understand the necessity for remote cardiac rehabilitation. Conclusions Thus, only a small number of the patients (32%) are ready to participate in remote digital programs of cardiac rehabilitation. A considerable amount of the patients (37%) can't afford to participate in a remote rehabilitation program only due to the absence of the smartphone and 27% of the patients are not ready to participate in a remote cardiac rehabilitation program not understanding the importance of distance cardiac rehabilitation for them. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Impact of cardiac rehabilitation on ventricular repolarization indices following coronary artery bypass grafting

2021 ◽  
Vol 29 (2) ◽  
pp. 143-149
Author(s):  
Ömer Taşbulak ◽  
Ahmet Anıl Şahin ◽  
Serkan Kahraman
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Cardiac Rehabilitation ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Rehabilitation Program ◽  
Ventricular Repolarization ◽  
Bypass Grafting ◽  
Cardiac Rehabilitation Program ◽  
Artery Bypass Grafting

Background: The aim of this study was to evaluate the effect of cardiac rehabilitation on electrocardiographic changes in patients undergoing isolated coronary artery bypass grafting. Methods: Between January 2016 and July 2019, a total of 625 patients (485 males, 140 females; mean age: 59.6 years; range, 50.6 to 68.6 years) who underwent isolated coronary artery bypass grafting and survived were retrospectively analyzed. The patients were divided into two groups according to the participation in the cardiac rehabilitation program as follows: the Rehab(+) group (n=363) and the Rehab(-) group (n=262). Electrocardiographic parameters of both groups were compared. Results: There was a significant decrease in the electrocardiographic findings of heart rate (p<0.001), QTc (p<0.001), Tpe duration (p<0.001), Tpe/QT ratio (p<0.001), and Tpe/QTc ratio (p<0.001) in the Rehab(+) group before and after surgery. There was a significant decrease in the Rehab(+) group, compared to the Rehab(-) group, in terms of parameters of QT interval (p=0.001), QTc (p=0.017), Tpe duration (p<0.001), Tpe/QT ratio (p<0.001), and Tpe/QTc ratio (p<0.001). Conclusion: Cardiac rehabilitation program after coronary artery bypass grafting decreases ventricular repolarization indices of electrocardiography. Based on these changes, postoperative cardiac rehabilitation program may reduce the risk of ventricular arrhythmia and sudden cardiac death during follow-up.

Impact of Structured Patient Education and Outpatient Cardiac Rehabilitation Program on the Disability Profile of Conservatively Treated Medically Stable Postmyocardial Infarction Individuals: A Protocol

2021 ◽  
Author(s):  
Varoon Chandramohan Jaiswal ◽  
Lata Parmar ◽  
Snehal Ghodey
Keyword(s):  
Patient Education ◽  
Cardiac Rehabilitation ◽  
Randomised Clinical Trial ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Open Label ◽  
Postmyocardial Infarction ◽  
Rehabilitation Programs ◽  
Enrollment Rates ◽  
The Impact

Introduction: Cardiac rehabilitation and patient education are the two parallel components in the management of coronary heart disease. Although, it is recommended strongly to join an outpatient cardiac rehabilitation program, the enrollment rates are always low. The role of structured patient education in increasing the enrollment in an outpatient cardiac rehabilitation program and its impact on the disability profile of conservatively treated medically stable postmyocardial infarction individuals, after joining and completing the rehabilitation program has not been studied. Aim: To study the impact of structured patient education and outpatient cardiac rehabilitation program on the disability profile of conservatively treated medically stable postmyocardial infarction individuals. Materials and Methods: The study is a mixed method design and will be conducted in two steps. Step 1: It is a qualitative study in which a structured patient education program will be developed based on the framework given by the working Group of Exercise Rehabilitation and Sports (GERS). Step 2: Implementation of the developed program and an outpatient cardiac rehabilitation program in an open-label non randomised clinical trial. Conclusion: The findings of this study will evaluate the need for the development of structured patient education programs for coronary artery disease patients, which may increase the enrollment rates in outpatient cardiac rehabilitation programs and thereby, reducing their disability.

scholarly journals Que Fatores Determinam os Níveis de Atividade Física após Programa de Reabilitação Cardíaca?

2013 ◽  
Vol 26 (6) ◽  
pp. 689
Author(s):  
Diogo Soares ◽  
Sofia Viamonte ◽  
Sandra Magalhães ◽  
Maria Miguel Ribeiro ◽  
Ana Barreira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Regression Analysis ◽  
Cardiac Rehabilitation ◽  
International Physical Activity Questionnaire ◽  
Linear Regression Analysis ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Physical Activity Questionnaire ◽  
Rehabilitation Programs ◽  
Activity Questionnaire

Introduction: The Cardiac Rehabilitation Programs have gained tremendous importance in the prevention of cardiovascular disease and it’s a challenge to ensure the practice of regular exercise during and after the supervised program. The aim of this study was to determine the factors that influence the physical activity habits at 12 months after the Cardiac Rehabilitation Program.Material and Methods: Prospective study, including 580 patients with ischemic heart disease who were consecutively oriented for Cardiac Rehabilitation Program at Cardiovascular Prevention and Rehabilitation Unit of Centro Hospitalar do Porto, between January 2008 and June 2011. Physical activity levels were measured with International Physical Activity Questionnaire which was calculated at the beginning of the program, 3 and 12 months later. The following variables were chosen and tested as potential determinants of physical activity habits of 12 months after program: age; sex; modifiable risk factors; functional capacity (achieved in treadmill stress test); laboratory analysis (HbA1c, lipid profile, C-Reactive Protein and Brain Natriuretic Peptide). A linear regression analysis was carried to identify the significant determinants and to find the best model adjustment.Results: Advanced age, female gender, functional capacity and low levels of physical activity prior to the Cardiac Rehabilitation Program, as well as a weak evolution of the International Physical Activity Questionnaire during the program were the best univariable predictors of a less favourable evolution of the International Physical Activity Questionnaire during 12 months of follow-up. A multivariable linear regression analysis showed that the best explanatory model included age, gender and evolution of the International Physical Activity Questionnaire during the supervised program (R2 Adj. = 0.318; f = 60.62, p < 0.001).Conclusion: The identification of certain subgroups of patients with lower tendency toward physical activity is beneficial to enable timely and individualized strategies to maximize the therapeutic and preventive potential of the Cardiac Rehabilitation Programs.

scholarly journals The impact of the cardiac rehabilitation program in patients with mid-range heart failure (40-50%) in improving cardio respiratory predictors

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
HR Rodrigues ◽  
V Ferreira ◽  
L Alves ◽  
D Sousa ◽  
J Pinto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Cardiopulmonary Exercise Testing ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
St Segment Elevation ◽  
Funding Sources ◽  
Metabolic Equivalent Of Task ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Universitário Lisboa Central Methods We studied 30 patients (P) with ejection fraction (EF) 40-50%, in a number of 198 P that participated in cardiac rehabilitation program (CRP). Of these P, 24 (80%) male and 6 (20%) female, 20 P were diagnosed myocardial infarction with ST-segment elevation, 2 P myocardial infarction non ST and 8 P with myocardial hypertrophy non ischemic. Of these P 30% were diabetics, 56% hypertension, 70% dyslipidemia, 36% smokers previous to CRP and body mass index 26,3 medium. All P were submitted to previous echocardiogram, cardiopulmonary exercise testing (CET) and a rehabilitation program minimum 4 sessions and maximum 52 sessions. At the end of the total sessions the echocardiogram and CET were repeated. Results Of the 30 P that participated in CRP only 20 completed the program, while the other 10 P dropped out because of social and economic problems. Of the P that completed the CRP, 70% got better on EF, 80% improved VE/VCO2 slope &lt; 33 therefore are classified VC-II in ventilatory classification (VC), 5% VE/VCO2 slope &gt; 40  VC-III classification, and 15% maintained the initial classification.  50% of the P increased at least one level metabolic equivalent of task (MET) from the first CET. Only 3 of the 20 patients came, once, to the hospital after the CRP with heart failure, and one died but did not fulfill the program. Conclusion Patients with mid-range heart failure submitted to a CRP can improve cardiorespiratory predictors, leading to a better quality of life. However, it is important to find solutions to minimize the causes that make patients to give up CRP.

scholarly journals Effect of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmed El Missiri ◽  
Walaa Adel Abdel Halim ◽  
Abdo Saleh Almaweri ◽  
Tarek Rashid Mohamed
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Stable Coronary Artery Disease ◽  
Rehabilitation Program ◽  
Obese Patients ◽  
Cardiac Rehabilitation Program ◽  
Phase 2 ◽  
Rehabilitation Programs ◽  
Artery Disease

Abstract Background Obesity is associated with significant cardiovascular morbidity and mortality effects. Cardiac rehabilitation programs cause a significant reduction in cardiovascular mortality and a reduction in all cardiovascular risk factors. Up to 80% of patients referred to cardiac rehabilitation programs are either overweight or obese. This study aimed to compare the effects of a phase 2 cardiac rehabilitation program on obese and non-obese patients with stable coronary artery disease following total revascularization by coronary angioplasty. Results This was a prospective study including 120 patients with stable coronary artery disease. Patients were enrolled in a 12-week phase 2 cardiac rehabilitation program. Patients were classified into two groups based on their body mass index (BMI): those with a BMI < 30 kg/m2 were considered non-obese (n = 58) while those with a BMI ≥ 30 kg/m2 were considered obese (n = 62). At baseline, BMI and blood pressure (BP) were recorded; fasting blood sugar, triglyceride levels, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were assessed; and echocardiography was used to measure left ventricular ejection fraction (LVEF). These were re-assessed after completion of the program. At baseline, there were more females in the obese group 20 (32.25%) vs 6 (10.13%) (p = 0.04), more hypertensives (p = 0.023), and less smokers 32 (51%) vs 46 (79%) (p = 0.025). Obese patients achieved fewer metabolic equivalent of tasks (METs) 7.97 ± 2.4 vs 9.74 ± 2.47 (p = 0.007) and had higher LDL-C levels 121.63 ± 36.52 mg/dl vs 95.73 ± 31.51 mg/dl (p = 0.005). At the end of the program, obese patients showed more reduction in BMI − 1.78 ± 1.46 kg/m2 vs − 0. 60 ± 0.70 kg/m2 (p < 0.001) and systolic and diastolic BP (p = 0.016 and 0.038, respectively). LDL-C level was more reduced in the obese group − 25.76 ± 14.19 mg/dl vs − 17.37 ± 13.28 mg/dl (p = 0.022). Non-obese patients had more increase in LVEF (p = 0.024). There was no difference between obese and non-obese patients in the magnitude of increase in METs achieved (p = 0.21). Conclusion Cardiac rehabilitation programs lead to an improvement in cardiovascular disease risk factors with more reduction in BMI, BP, and LDL-C levels in obese patients compared to non-obese ones. LVEF was more increased in non-obese individuals. Exercise capacity in the form of METs achieved was equally improved in both groups.

Heart-Type Fatty Acid-Binding Protein (H-FABP) in Patients with Coronary Artery Bypass Graft Surgery Undergoing Cardiac Rehabilitation Program

2017 ◽  
Vol 68 (7) ◽  
pp. 1485-1489
Author(s):  
Razan Al Namat ◽  
Viviana Aursulesei ◽  
Maura Gabriela Felea ◽  
Irina Iuliana Costache ◽  
Antoniu Petris ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Fatty Acid ◽  
Cardiac Rehabilitation ◽  
Fatty Acid Binding Protein ◽  
Rehabilitation Program ◽  
Mean Value ◽  
Cardiac Rehabilitation Program ◽  
Fatty Acid Binding ◽  
Acid Binding Protein ◽  
The Mean

Heart-type Fatty Acid-Binding Protein (H-FABP), compared with classical biomarkers, proved to have high sensitivity for myocardial damage size in patients undergoing cardiac surgery. High H-FABP levels are strongly associated in case of death, post-operatively acute kidney injury and atrial fibrillation. Cardiac rehabilitation is an instrument of medical management in cardiovascular diseases; beyond prevention, it can improve heart and muscle functioning in patients that were undergoing CABG, and cardiac and vascular adaptation. Over a 2-year period, 110 subjects were randomized and comprehensively evaluated. The mean age of the patients under study was 65.70 � 9.91 years old. For the H-FABP, the mean value in the Phase I was 67.40 � 9.81 ng/mL, while the mean value in Phase III was 4.80 � 2.30 ng/mL. The difference registered between the plasma H-FABP value in the first 24 h after cardiac surgery and the value in 6 months after the onset of cardiac rehabilitation program was important and statistically significant, as p [ 0.05. Fibrinogen showed significant phase-to-phase reductions of plasmatic values. Lipid profile values showed a statistically significant decrease. The renal filtration function evaluated by plasma creatinine showed statistically significant improvement and, in terms of absolute values, creatinine level was reduced in a range between 0.2-0.4 mg/dL. Also, it was recorded a significantly lower level of blood urea. The reduction of plasma H-FABP values were registered between the first phase (the first 24 h) after cardiac surgery and the third phase of the cardiac rehabilitation program. H-FABP protein had a higher sensitivity and specificity when compared to other enzymes of myocardial cytolysis.

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