scholarly journals COVID-19 era in long-term cardiac rehabilitation programs: how did physical activity and sedentary time change compared to previous years?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Lemos Pires ◽  
M Borges ◽  
R Pinto ◽  
I Ricardo ◽  
N Cunha ◽  
...  
Keyword(s):  
Physical Activity ◽  
Repeated Measures ◽  
Sedentary Time ◽  
Phase Iii ◽  
Face To Face ◽  
Intention To Treat ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Daily Time

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular rehabilitation (CR) was one of the many areas negatively affected by the COVID-19 pandemic. A high number of cardiovascular disease (CVD) patients had their centre-based program suspended. Physical activity (PA) recommendations for CVD patients are well established and its benefits largely documented. However, few studies have objectively measured the PA of these patients throughout the years and specifically during the COVID-19 pandemic.  Purpose To objectively measure PA and sedentary time (ST) during COVID-19 pandemic in comparison with the previous 2 years in CVD patients who were attending a phase III centre-based CR program.  Methods Before COVID-19, eighty-seven CVD patients (mean age 62.9 ± 9.1, 82.8% male) were attending a face-to-face long-term CR program. Of the 87 patients, 78.2% have been on the program for at least 1 year. Every year, PA and ST were objectively assessed by accelerometery. After the CR centre-based program suspension due to COVID-19, efforts were done to create a CR home-based digital model to maintain the continuum of care and avoid losing the previous acquired benefits. After 7 months of suspension, the face-to-face CR centre was reopened and 57.5% (n = 50) patients returned. We completed the assessment of PA and ST of 37 patients (mean age 64.8 ± 8.1, 89.2% male) and compared it as follows: M1) two assessments before COVID-19; M2) last assessment before COVID-19; M3) 7 months after CR program suspension (last trimester of 2020). Patients wore an ActiGraph accelerometer for 7 consecutive days to assess daily and weekly minutes of light PA, moderate-to-vigorous PA and ST. We used repeated-measures ANOVA and Wilcoxon signed rank as a non-parametric alternative. Results Intention-to-treat analysis showed that in M3 patients decreased their average daily time spent in moderate-to-vigorous PA when compared with M2 (M3: 37.90 ± 3.30 min/day vs M2: 45.01 ± 3.14 min/day, p = 0.035), no changes were found between M1 and M2. Average daily time spent in light PA improved significantly from M1 to M2 (M1: 154.81 ± 7.20 min/day vs M2: 169.17 ± 6.44 min/day, p = 0.042) but did not change from M2 to M3. Despite this, in M3, 81.08% of the patients still met the recommendations for moderate-to-vigorous PA (M1: 89.19% and M2: 91.89%). No changes were found in ST. Conclusion Despite a significant decrease on the amount of moderate-to-vigorous PA during the COVID-19 era, most CVD patients, first in the centre-based CR program and after in the home-based CR program, were able to meet PA recommendations throughout the last years. These findings suggest that CVD patients who attend supervised long-term CR programs might be aware of the importance of reaching PA guidelines. Reducing ST by replacing it by PA of any intensity could be an important and reachable target for long-term CR programs.

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

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.

scholarly journals Impact of the Home Confinement Related to COVID-19 on the Device-Assessed Physical Activity and Sedentary Patterns of Spanish Older Adults

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ángel I. Fernández-García ◽  
Jorge Marin-Puyalto ◽  
Alba Gómez-Cabello ◽  
Ángel Matute-Llorente ◽  
Jorge Subías-Perié ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behaviour ◽  
Repeated Measures ◽  
Sedentary Time ◽  
Exercise Program ◽  
Sedentary Behaviours ◽  
Home Based ◽  
Phase 0 ◽  
Sedentary Bouts

The main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to the COVID-19 pandemic, home confinement, and phase-0 of the deescalation. We also aimed to analyse the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. A total of 18 noninstitutionalized older adults( 78.4 ± 6.0  y.), members of the Spanish cohort of the EXERNET-Elder 3.0 project, participated in the study. They were recommended to perform an exercise prescription based on resistance, balance, and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity, sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. During home quarantine, older adults spent more time in sedentary behaviours ( 71.6 ± 5.3 % ) in comparison with either the situation prior to the pandemic ( 65.5 ± 6.7 % ) or the ending of isolation ( 67.7 ± 7.1 % ) (all p < 0.05 ). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both p < 0.05 ). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the phase-0 of deescalation. According to our results, the home confinement could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period.

Effects Of A Long-term Physical Activity Program On Accelerometry-based Sedentary Time In Older Adults

2015 ◽  
Vol 47 ◽  
pp. 515-516
Author(s):  
Amal A. Wanigatunga ◽  
Walter T. Ambrosius ◽  
Mary M. McDermott ◽  
Abby C. King ◽  
Roger A. Fielding ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Time ◽  
Physical Activity Program ◽  
Activity Program

Modello di riabilitazione cardiologica teleguidata durante pandemia da COVID-19

2020 ◽  
pp. 271-275
Author(s):  
Giovanni Pasanisi ◽  
Biagio Sassone ◽  
Jonathan Myers ◽  
Giorgio Chiaranda ◽  
Andrea Raisi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Physical Activity Intervention ◽  
Rehabilitation Program ◽  
Physical And Mental Health ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Video Tutorials ◽  
Rapid Spread ◽  
Collateral Effects

Background. The COVID-19 pandemic has induced many governments to promote national lockdowns. Despite a period of quarantine is the best option and recommendation to stop the rapid spread of infections, this may have collateral effects on other dimensions of the isolated patients’ physical and mental health. Physical activity is the major component of cardiac rehabilitation programs that have been abruptly discontinued. Aims. To counteract physical inactivity during the COVID-19 outbreak we propose an home cardiac rehabilitation program under telemonitoring guidance, the home-bAsed physiCal acTivity Intervention during cOvid-19 quaraNtine (ACTION) study, testing its feasibility. Methods and results. ACTION is an observational study in cardiac outpatients referred to an exercise-based cardiac rehabilita-tion program. A program consisting of aerobic recommendations combined with a selection of strength and balance exercises is recommended. Video tutorials providing details of the workouts will be sent to patients. Selected patients can be followed during the home-sessions via video connection using current smartphone applications. Conclusions. The ACTION study could provide applicable results for safe and effective exercise therapy in outpatients with car-diovascular disease, while preventing the COVID-19 outbreak from generating adverse health consequences due to acute cessa-tion of physical activity. Findings from the ACTION study can also be useful after the end of COVID-19 outbreak for patients who cannot participate in traditional center- or home-based cardiac rehabilitation programs.

scholarly journals Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness?

2019 ◽  
Vol 27 (4) ◽  
pp. 367-377 ◽  
Author(s):  
Andrea Avila ◽  
Jomme Claes ◽  
Roselien Buys ◽  
May Azzawi ◽  
Luc Vanhees ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Phase Ii ◽  
Home Based ◽  
Artery Disease ◽  
One Year

Background Home-based interventions might facilitate the lifelong uptake of a physically active lifestyle following completion of a supervised phase II exercise-based cardiac rehabilitation. Yet, data on the long-term effectiveness of home-based exercise training on physical activity and exercise capacity are scarce. Objective The purpose of the TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare the long-term effects of a short home-based phase III exercise programme with telemonitoring guidance to a prolonged centre-based phase III programme in coronary artery disease patients. The primary outcome was exercise capacity. Secondary outcomes included physical activity behaviour, cardiovascular risk profile and health-related quality of life. Methods Ninety coronary artery disease patients (80 men) were randomly assigned to 3 months of home-based (30), centre-based (30) or a control group (30) on a 1:1:1 basis after completion of their phase II ambulatory cardiac rehabilitation programme. Outcome measures were assessed at discharge of the phase II programme and after one year. Results Eighty patients (72 (91%) men; mean age 62.6 years) completed the one-year follow-up measurements. Exercise capacity and secondary outcomes were preserved in all three groups ( Ptime > 0.05 for all), irrespective of the intervention ( Pinteraction > 0.05 for all). Eighty-five per cent of patients met the international guidelines for physical activity ( Ptime < 0.05). No interaction effect was found for physical activity. Conclusion Overall, exercise capacity remained stable during one year following phase II cardiac rehabilitation. Our home-based exercise intervention was as effective as centre-based and did not result in higher levels of exercise capacity and physical activity compared to the other two interventions. Trial registration ClinicalTrials.gov NCT02047942. https://clinicaltrials.gov/ct2/show/NCT02047942

scholarly journals Standing Desks in a Grade 4 Classroom over the Full School Year

2019 ◽  
Vol 16 (19) ◽  
pp. 3590 ◽  
Author(s):  
Sharon Parry ◽  
Beatriz IR de Oliveira ◽  
Joanne A. McVeigh ◽  
Joyln Ee ◽  
Angela Jacques ◽  
...  
Keyword(s):  
Physical Activity ◽  
Repeated Measures ◽  
Sedentary Time ◽  
Sitting Time ◽  
Musculoskeletal Discomfort ◽  
Beneficial Effects ◽  
School Aged Children ◽  
School Year ◽  
Significant Difference ◽  
School Day

School-aged children are spending increasingly long periods of time engaged in sedentary activities such as sitting. Recent school-based studies have examined the intervention effects of introducing standing desks into the classroom in the short and medium term. The aim of this repeated-measures crossover design study was to assess the sit-stand behaviour, waking sedentary time and physical activity, and musculoskeletal discomfort at the start and the end of a full school year following the provision of standing desks into a Grade 4 classroom. Accelerometry and musculoskeletal discomfort were measured in both standing and traditional desk conditions at the start and at the end of the school year. At both time points, when students used a standing desk, there was an increase in standing time (17–26 min/school day) and a reduction in sitting time (17–40 min/school day). There was no significant difference in sit-stand behaviour during school hours or sedentary time and physical activity during waking hours between the start and the end of the school year. Students were less likely to report discomfort in the neck and shoulders when using a standing desk and this finding was consistent over the full school year. The beneficial effects of using a standing desk were maintained over the full school year, after the novelty of using a standing desk had worn off.

scholarly journals Sustained Long-Term Effectiveness of an Energy Management Training Course on Employee Vitality and Purpose in Life

2019 ◽  
Vol 34 (2) ◽  
pp. 177-188 ◽  
Author(s):  
Sai Krupa Das ◽  
Shawn T. Mason ◽  
Taylor A. Vail ◽  
Caroline M. Blanchard ◽  
Meghan K. Chin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Repeated Measures ◽  
Short Form ◽  
Depression Scale ◽  
Purpose In Life ◽  
Well Being ◽  
Sf 36

Purpose: Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting. Design: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months. Setting: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8). Participants: One hundred sixty-three employees with a mean age of 47 (11) years (57% female). Intervention: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL). Measures: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months. Analysis: General linear models with repeated measures for mean values at baseline and follow-up. Results: At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL ( P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months ( P < .05 for all measures). Conclusions: An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.

Physical Activity Across the Cancer Journey: Experiences and Recommendations From People Living With and Beyond Cancer

2019 ◽  
Vol 100 (3) ◽  
pp. 575-585
Author(s):  
Mairéad Cantwell ◽  
Deirdre Walsh ◽  
Bróna Furlong ◽  
Lisa Loughney ◽  
Noel McCaffrey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sense Of Self ◽  
Exercise Program ◽  
Well Being ◽  
Home Exercise ◽  
Program Success ◽  
Rehabilitation Programs ◽  
Cancer Support ◽  
And Control

Abstract Background The majority of individuals living with and beyond cancer are not sufficiently active to achieve health benefits. Objective The aim of this study was to explore individuals’ experiences of physical activity (PA) behavior across the cancer journey and to ask individuals living with and beyond cancer to identify strategies to support habitual PA. Design An exploratory, descriptive, qualitative design was used. Methods Purposive sampling methods were used to recruit individuals living with and beyond cancer who had been referred to, and/or participated in, a community-based exercise program or were attending a cancer support center. The focus group discussions were audio recorded, transcribed verbatim, and analyzed using a thematic analysis approach. Results Seven focus groups were conducted with 41 participants. Many individuals reported that regular PA provided a vehicle for recovery that created a sense of “self-power,” defined as taking ownership and control of one’s health to increase well-being. Barriers to PA participation included environmental-, patient-, and treatment-related challenges. Recommendations to support long-term adherence to PA included completion of fitness assessments at regular intervals and provision of a home exercise program. Limitations The benefits and barriers to PA participation for individuals diagnosed with cancers that were not represented may not have been identified. The strategies recommended to support habitual PA may be salient only to individuals whose cancer diagnoses were represented. Conclusions Exercise is seen as a vehicle for recovery from cancer but long-term adherence for individuals is complex. The findings from this study can inform the development of exercise oncology rehabilitation programs and could support a greater likelihood of program success, thereby optimizing the health, well-being, and quality of life of survivors of cancer.

A phase III study of the impact of a physical activity program on disease-free survival in patients with high-risk stage II or stage III colon cancer: A randomized controlled trial (NCIC CTG CO.21).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. TPS3647-TPS3647
Author(s):  
Christopher M. Booth ◽  
Kerry S. Courneya ◽  
Janette L. Vardy ◽  
Derek J. Jonker ◽  
Sharlene Gill ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colon Cancer ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Free Survival ◽  
Face To Face ◽  
Randomized Controlled ◽  
Disease Free

TPS3647 Background: Observational data indicate that physical activity (PA) is strongly associated with colon-cancer specific survival. NCIC CTG CO.21 (CHALLENGE) is designed to determine the effects of a structured PA intervention on disease-control outcomes for survivors of high-risk stage II or III colon cancer who have completed adjuvant chemotherapy within the previous 2-6 months. Methods: Phase III randomized controlled trial. Target sample size of 962 patients is powered to detect a Hazard Ratio of 0.75 for disease-free survival (DFS). Trial participants will be stratified by centre, disease stage, body mass index, and performance status, and will be randomly assigned to a structured, individualized PA intervention or to general health education materials. The PA intervention will consist of a behavioural support program and supervised PA sessions delivered over a 3-year period, beginning with regular face-to-face sessions and tapering to less frequent face-to-face or telephone sessions. The goal of the PA program is to increase weekly PA by 10 MET hours/week. The PA program is delivered by physical activity consultants trained in exercise physiology and behavior change. Outcomes: The primary endpoint is DFS. Important secondary endpoints include multiple patient-reported outcomes (including those that address fatigue), objective physical functioning, biologic correlative markers (including assessment of the insulin pathway), and an economic analysis. Current Enrollment: The study is open at 19 centers in Canada and 20 centers in Australia. Accrual as of February 4, 2013 includes 212 registered and 184 randomized patients. Summary: Cancer survivors and cancer care professionals are interested in the potential role of PA to improve multiple disease-related outcomes, but a randomized controlled trial is needed to provide compelling evidence to justify changes in health care policies and practice. Clinical trial information: NCT00819208.

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