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 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 The Effectiveness of Biological Maturation and Lean Mass in Relation to Muscle Strength Performance in Elite Young Athletes

2020 ◽  
Vol 12 (17) ◽  
pp. 6696 ◽  
Author(s):  
Paulo Francisco de Almeida-Neto ◽  
Dihogo Gama de Matos ◽  
Adam D. G. Baxter-Jones ◽  
Gilmário Ricarte Batista ◽  
Vanessa Carla Monteiro Pinto ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lean Mass ◽  
Lower Limb ◽  
Local Effect ◽  
Strength Development ◽  
Young Athletes ◽  
Cross Sectional ◽  
Strength Performance ◽  
Tennis Players ◽  
Lower Limb Strength

This study aimed to identify the interactional relationships between maturation (biological age (BA)) and lean mass on strength development in young athletes from different sports. Using a cross-sectional study design, a sample of 64 young athletes (rowers, swimmers, jiu-jitsu, volleyball, soccer and tennis players) of both sexes (13.6 ± 1.17 years) were recruited. Body composition was assessed using dual energy bone densitometry with X-ray source (DEXA). Strength of upper limbs (ULS), force hand grip (HG), vertical jump (VJ) and jump against movement (CMJ) were recorded. BA was estimated from anthropometrics. BA relationships were identified with upper limb strength in all athletes, and with the lower limb strength of tennis players, only (p < 0.05). An interaction effect between lean mass and BA was found (η2p = 0.753), as was a local effect within the regression models (ƒ2 ≥ 0.33). Athletes with a higher concentration of lean mass had superior upper and lower limb strength (p < 0.05). Lean mass showed a local effect (ƒ2) greater than that associated with BA. Although maturation is related to strength development, the strength of the relationship is mitigated by the accrual of lean mass. Specifically, the local effect of lean mass on muscle strength is broader than that of maturation, especially for lower limb strength.

scholarly journals Home-Based Cardiac Rehabilitation During COVID-19: A Qualitative Study

2021 ◽  
Author(s):  
Smitha Ganeshan ◽  
Crystal Tse ◽  
Alexis Beatty
Keyword(s):  
Cardiac Rehabilitation ◽  
Organizational Factors ◽  
Structured Interviews ◽  
Ongoing Research ◽  
Staff Members ◽  
Use Of Technology ◽  
Home Based ◽  
Mobile Phone Applications ◽  
Delivery Models

Abstract Background: Cardiac rehabilitation (CR) has been shown to reduce mortality, morbidity, and hospitalizations. Increasingly, digital tools have augmented the ease of delivering programs outside of the traditional rehabilitation center setting. Because of the need for distancing during the COVID-19 pandemic, many cardiac rehabilitation (CR) centers suspended in-person services and pivoted to home-based CR (HBCR). In this study, we qualitatively evaluated implementation of HBCR, which included weekly phone or video visits for individualized exercise plans, nutrition and health education counseling, wellness sessions, and optional mobile phone applications.Methods: Patient participants and staff members (physician, nurses, exercise physiologists, dietician, administrative staff) participated in semi-structured interviews. Two independent reviewers coded interview transcripts for emergent themes and pre-specified themes from the Theory of Planned Behavior, Unified Theory of Acceptance and Use of Technology, and the Consolidated Framework for Implementation Research.Results: A total of 12 patients and 7 staff were interviewed. Narrative descriptions highlighted the isolation, fear, and disruption of life activities during COVID-19. Key facilitators of the HBCR patient experience included strong relationships with staff who served as coaches and sources of accountability and the ability of HBCR to deliver an individually tailored experience within a patient’s home. Important organizational factors for implementation included leadership buy-in, culture of change, and support for staff. Though technology tools facilitated communication and accountability, not all participants embraced technology and some reported challenges with use.Conclusions: Individually tailored HBCR can facilitate access for patients to participate outside of a CR center. Ongoing research is needed to understand the long-term outcomes of flexible delivery models that may include both in-person and remote visits, and the role of technology in these models.

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

Long-term Enrollment in Cardiac Rehabilitation Benefits Cardiorespiratory Fitness and Skeletal Muscle Strength in Men With Cardiovascular Disease

2019 ◽  
Vol 35 (10) ◽  
pp. 1359-1365 ◽  
Author(s):  
Mike Pryzbek ◽  
Maureen MacDonald ◽  
Paul Stratford ◽  
Angelica McQuarrie ◽  
Julie Richardson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Skeletal Muscle ◽  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Cardiorespiratory Fitness ◽  
Skeletal Muscle Strength

Long-term functional outcome after selective posterior rhizotomy

2002 ◽  
Vol 97 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Sandeep Mittal ◽  
Jean-Pierre Farmer ◽  
Borhan Al-Atassi ◽  
Joanne Gibis ◽  
Eileen Kennedy ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Functional Outcome ◽  
Motor Function ◽  
Lower Limb ◽  
Content Type ◽  
Limb Spasticity ◽  
Lower Limb Spasticity ◽  
Selective Posterior Rhizotomy ◽  
Fine Print

Object. Selective posterior rhizotomy (SPR) is a well-recognized treatment for children with spastic cerebral palsy (CP). Few investigators have used quantitative outcome measures to assess the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term functional outcome of children who had undergone selective dorsal rhizotomy accompanied by intraoperative electrophysiological monitoring. Methods. The study population was composed of children with spastic CP who underwent SPR and were evaluated by a multidisciplinary team preoperatively, and at 6 months and 1 year postoperatively. Quantitative standardized assessments of lower-limb spasticity, passive range of motion, muscle strength, and ambulatory function were obtained. Of the 93 patients who met the entry criteria for the study, 71 completed the 3-year and 50 completed the 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in spasticity, range of motion, and functional muscle strength at 1 year after SPR. The preoperative, 1-, 3-, and 5-year values for the global score of the Gross Motor Function Measure were 64.6, 70.8, 80, and 85.6, respectively. The greatest improvement occurred in the dimensions reflecting lower-extremity motor function, where the mean change was 10.1% at 1 year, 19.9% at 3 years, and 34.4% at the 5-year follow-up review in comparison with the baseline value. This was associated with a lasting improvement in alignment and postural stability during developmental positions, as well as increased ability to perform difficult transitional movements. Conclusions. The results of this study support the presence of significant improvements in lower-limb functional motor outcome 1 year after SPR, and the improvements persist at 3 and 5 years. The authors conclude that SPR in conjunction with intraoperative stimulation is valuable for permanently alleviating lower-limb spasticity while augmenting motor function.

EFFECT OF CYCLE ERGOMETER USING AN MR ROTARY BRAKE ON LOWER LIMB EXERCISE

2013 ◽  
Vol 13 (06) ◽  
pp. 1340017
Author(s):  
CHANG HO YU ◽  
MI YU ◽  
KYUNG KIM ◽  
TAE KYU KWON
Keyword(s):  
Visual Feedback ◽  
Lower Limb ◽  
Cycle Ergometer ◽  
Lower Limbs ◽  
Mechanical Resistance ◽  
Term Condition ◽  
Low Intensity ◽  
Feedback Mode ◽  
Cycle System

In this study, a new cycle ergometer system using a magneto-rheological (MR) rotary brake was developed to improve muscular strength and reduce asymmetric pedaling characteristics for the rehabilitation of hemiplegia patients. For evaluation of this cycle ergometer, the characteristics of lower limb muscles were analyzed according to three factor of cycle system with MR rotary brake: (1) the electrical current of MR rotary brake, (2) the intensity and duration of cycling, (3) the application of visual feedback. The results showed that muscle activity was significantly different for various levels of current applied to the MR rotary brake. A higher current was associated with a higher integrated electromyography (IEMG) of the lower limb muscle. In low-intensity and long-term condition, IEMG of RF, TA, VL and VAS increased in the late stage of exercise (compared to the early stage), however, decreased in high-intensity and short term condition. The asymmetry of pedaling between the dominant and non-dominant leg was 19.63% in the non-visual feedback mode and 1.97% in the visual feedback mode. Therefore, our new cycle system using an MR brake with real time control of mechanical resistance can be used to enhance muscle strength in patients with hemiplegia and elderly people. Increased muscular activity of the lower limbs in patients with hemiplegia and the elderly is expected with low-intensity training over a long-term period.

scholarly journals Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study

2014 ◽  
Vol 41 (1) ◽  
pp. 125-132 ◽  
Author(s):  
Alberto Carvalho ◽  
Paulo Mourão ◽  
Eduardo Abade
Keyword(s):  
Body Composition ◽  
Strength Training ◽  
Body Fat ◽  
Lower Limb ◽  
Vertical Jump ◽  
Fat Content ◽  
Lower Limbs ◽  
Strength Development ◽  
Lower Limb Strength ◽  
Body Fat Content

AbstractThe purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90°s-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

scholarly journals The effect of inspiratory muscle training on the quality of life, immune response, inspiratory and lower limb muscle strength of older adults: a randomized controlled trial

2019 ◽  
Vol 22 (6) ◽  
Author(s):  
Adriano Florencio Vilaça ◽  
Bárbara Cristina de Souza Pedrosa ◽  
Thamara Cunha Nascimento Amaral ◽  
Maria do Amparo Andrade ◽  
Célia Maria Machado Barbosa de Castro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Muscle Strength ◽  
Lower Limb ◽  
Inspiratory Muscle ◽  
Limb Muscle ◽  
Muscle Training ◽  
Sf 36 ◽  
Lower Limb Strength

Abstract Objective: To evaluate the impact of inspiratory muscle training (IMT) on the quality of life, immune response, inspiratory and lower limb muscle strength of older adults. Method: A randomized clinical trial was conducted with 30 institutionalized older adults. They were allocated into two groups: the IMT group (n=15), which underwent IMT with PowerBreathe Classic, using a load of 60% of maximal inspiratory pressure (MIP). This was performed using a 30 repetition protocol, three times a week, for six weeks. The second group was the control group (n=15) which did not perform any type of therapeutic intervention. In both groups, MIP, lower limb strength by sit-up test, quality of life by the SF-36 questionnaire and C-reactive protein (CRP) were evaluated. Results: The results demonstrated the homogeneity between the groups regarding the demographic and clinical variables. The IMT group showed an increase in the variation of MIP (9.20±7.36 cmH2O) compared to the control (0.93±8.79 cmH2O). Improvement was also observed in the sitting and standing test (p<0.05) (Tukey Test) in the difference between the values before and after the IMT. In terms of quality of life, two of the eight SF-36 domains were influenced by the IMT, namely: functional capacity and limitations due to physical factors. There were no changes in CRP in either group. Conclusion: IMT improved the inspiratory muscle strength, lower limb strength and quality of life of institutionalized older adults. These findings reinforce the contribution of this therapy to reducing the deleterious effects of aging.

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