scholarly journals Effectiveness of combined eccentric and concentric exercise over traditional cardiac exercise rehabilitation programme in patients with chronic heart failure: protocol for a randomised controlled study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028749 ◽  
Author(s):  
Guillaume Plaquevent-Hostache ◽  
Julianne Touron ◽  
Frédéric Costes ◽  
Hélène Perrault ◽  
Guillaume Clerfond ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ventilatory Threshold ◽  
Intervention Group ◽  
Rehabilitation Programme ◽  
Peak Oxygen Consumption ◽  
Controlled Study ◽  
Control Group ◽  
Concentric Exercise ◽  
The Impact

IntroductionExercise-based rehabilitation is a standard feature of chronic heart failure management. The effectiveness of eccentric exercise could offer new opportunities for better tailoring rehabilitation programme to patients’ limitations. The goal of the study is to contrast the impact of a mixed eccentric and concentric cycling training programme, to that of conventional concentric cycling rehabilitation in patients with chronic heart failure (peak oxygen consumption (VO2Peak) < 15 mL⋅kg-1⋅min-1, ejection fraction <40%).Methods and analysisIt is a prospective, open, controlled and randomised study (2×25 subjects) carried out in a single centre. Subjects will perform five exercise sessions per week per the randomisation outcome, with the intervention group performing eccentric in three of the five weekly sessions while the control group will perform the five sessions of concentric exercise. Cycling intensity will be the same in both groups and fixed to the power associated with the first ventilatory threshold. Self-management education programme, callisthenics sessions and muscle strength trainings will also be carried out as for any heart failure patient normally included in the rehabilitation programme. The primary outcome will be the change in distance covered during the 6 min walk test. Secondary outcomes will include other physical mobility parameters, functional exercise capacities, quality of life and body composition as well as skeletal muscle properties including mitochondrial function parameters.Ethics and disseminationThe study has been approved by the institutional ethics review board (17.079) and the French regulatory authority for research (2017-A00969-44). Adverse events that could occur during the protocol will be reported to the principal investigator. The results will be published in an international peer-reviewed journal.Trial registration numberNCT03716778.

scholarly journals Feasibility and Preliminary Effects of the BESMILE-HF Program on Chronic Heart Failure Patients: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiankun Chen ◽  
Wei Jiang ◽  
Thomas P. Olson ◽  
Cecilia Stålsby Lundborg ◽  
Zehuai Wen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Adverse Events ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Peak Oxygen Consumption ◽  
Control Group

Aims: The Baduanjin Eight-Silken-Movements wIth Self-Efficacy building for Heart Failure (BESMILE-HF) program is a contextually adapted cardiac rehabilitation program. It uses a traditional Chinese exercise, Baduanjin, to solve the unmet demand of exercise-based cardiac rehabilitation programs due to their scarcity and unaffordability in China. This pilot study assesses BESMILE-HF's feasibility and preliminary effects.Methods: Eighteen patients with chronic heart failure were included: 8 in a BESMILE-HF group (age: 67 ± 5 years, EF: 40.4 ± 13.6%) and 10 in a control group (age: 70 ± 13 years, EF: 42.9 ± 12.5%). Both received the usual medications, with the intervention group receiving additionally the BESMILE-HF program for 6 weeks. Feasibility was explored by participants' involvement in the intended intervention. Clinical outcome assessments were conducted at baseline and post-intervention, while adverse events were captured throughout the study period.Results: The BESMILE-HF program was well-received by patients, and adherence to the intervention was good. The intervention group completed all required home exercises and total home-practice time was correlated with baseline self-efficacy (r = 0.831, p = 0.011). Moreover, after 6 weeks, self-efficacy increased in the BESMILE-HF group (p = 0.028) and the change was higher than in the control [mean difference (MD): 3.2; 95% confidence interval (CI) 0.6–5.9, p = 0.004]. For the exercise capacity, the control group demonstrated a significant decline in peak oxygen consumption (p =0.018) whereas, the BESMILE-HF group maintained their exercise capacity (p = 0.063). Although the between-group difference was not statistically significance, there was clear clinical improvement in the BESMILE-HF group (1.5 mL/kg/min, 95% CI, −0.3 to 3.2 vs. minimal clinically important difference of 1 mL/kg/min). Throughout the study period, no adverse events related to the intervention were captured.Conclusions: BESMILE-HF is feasible for patients with chronic heart failure in Chinese settings. A larger sample size and a longer follow-up period is needed to confirm its benefit on clinical outcomes.Clinical Trial Registration:ClinicalTrials.gov: NCT03180320.

scholarly journals Controlled Study of the Impact of a Virtual Program to Reduce Stigma Among University Students Toward People With Mental Disorders

2021 ◽  
Vol 12 ◽  
Author(s):  
Matías E. Rodríguez-Rivas ◽  
Adolfo J. Cangas ◽  
Daniela Fuentes-Olavarría
Keyword(s):  
Mental Disorders ◽  
University Students ◽  
Intervention Group ◽  
Project Based Learning ◽  
Controlled Study ◽  
Control Group ◽  
Global Score ◽  
Stigma Reduction ◽  
Before And After ◽  
The Impact

Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p &lt; 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p &lt; 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.

Effect of High Thoracic Sympathetic Nerve Block on Serum Collagen Biomarkers in Patients with Chronic Heart Failure

Cardiology ◽  
2016 ◽  
Vol 136 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Guifang Sun ◽  
Fengqi Liu ◽  
Renhai Qu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Myocardial Fibrosis ◽  
Left Ventricular ◽  
Control Group ◽  
Type I ◽  
Procollagen Type ◽  
Amino Terminal ◽  
Serum Collagen ◽  
The Impact

Objectives: The impact of high thoracic sympathetic block (HTSB) on myocardial fibrosis in chronic heart failure (HF) is unclear. Myocardial collagen synthesis can be assessed by measuring circulating biomarkers. We observed the effect of HTSB on serum collagen biomarkers in HF. Methods: Forty-four patients were randomized to a control and a HTSB group. They received routine medications. Repeated epidural injections were given to the HTSB group for 4 weeks. Echocardiography and measurements of serum carboxy-terminal propeptide of procollagen type I (PICP) and amino-terminal propeptide of procollagen type III (PIIINP) were performed at baseline and 4 weeks later. Results: There were significant reductions in left atrial diameter, left ventricular (LV) diameter and volume, LV weight index (LVWI) and serum PICP and PIIINP levels in the HTSB group (p < 0.05). The changes in LV end-systolic volume and ejection fraction (LVEF) were greater in the HTSB group than in the control group (p < 0.05). In the HTSB group, the decreases in PICP and PIIINP were correlated with the decrease in LVWI (PICP: r = 0.695, p = 0.000; PIIINP: r = 0.642, p = 0.001), and the decrease in PICP was negatively associated with the rise in LVEF (r = -0.813, p = 0.000). Conclusion: HTSB reduces myocardial fibrosis in HF, which may accompany the improvement of LV hypertrophy and dysfunction.

scholarly journals Music intervention affects the quality of life on Alzheimer’s disease: a meta-analysis

2021 ◽  
Author(s):  
Lingyan Zuo ◽  
Fengting Zhu ◽  
Rui Wang ◽  
Hongyan Shuai ◽  
Xin Yu
Keyword(s):  
Meta Analysis ◽  
Intervention Group ◽  
Original Data ◽  
Controlled Study ◽  
Control Group ◽  
Music Intervention ◽  
Significant Difference ◽  
Review Question ◽  
Intervention Modality ◽  
The Impact

Review question / Objective: Inclusion criteria: population: 1) A randomized controlled study on the impact of music intervention on the QOL of patients with AD; 2) The participants in this study is patients with AD; 3) There is no significant difference among age, gender and education background in sorted groups before analysis which make these groups comparable; intervention: 1)Intervention Modality Music-based intervention; comparison: 1) All data were sorted into two groups: the music intervention group and the control group without any music intervention; outcome: 1) The indicators evaluated in the literature included the score of QOL-AD or WHOQOL-BERF scale, at least one of the two scales summarized in selected publications; language: 1) Only articles published in English and Chinese were considered. Exclusion criteria: 1) The participants were not diagnosed with AD; 2) Non-musical intervention;3) Non-RCTs; 4) No specific values for outcome variables; 5) Articles lacking original data; 6) Repeat published reports; 7) Full text could not be obtained.

scholarly journals Universal Screening and Decolonization for Control of MRSA in Nursing Homes: A Cluster Randomized Controlled Study

2015 ◽  
Vol 36 (4) ◽  
pp. 401-408 ◽  
Author(s):  
Cristina Bellini ◽  
Christiane Petignat ◽  
Eric Masserey ◽  
Christophe Büla ◽  
Bernard Burnand ◽  
...  
Keyword(s):  
Universal Screening ◽  
Controlled Trial ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Standard Precautions ◽  
Carriage Rate ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
The Impact

OBJECTIVEThe risk of carrying methicillin-resistant Staphylococcus aureus (MRSA) is higher among nursing home (NH) residents than in the general population. However, control strategies are not clearly defined in this setting. In this study, we compared the impact of standard precautions either alone (control) or combined with screening of residents and decolonization of carriers (intervention) to control MRSA in NHs.DESIGNCluster randomized controlled trialSETTINGNHs of the state of Vaud, SwitzerlandPARTICIPANTSOf 157 total NHs in Vaud, 104 (67%) participated in the study.INTERVENTIONStandard precautions were enforced in all participating NHs, and residents underwent MRSA screening at baseline and 12 months thereafter. All carriers identified in intervention NHs, either at study entry or among newly admitted residents, underwent topical decolonization combined with environmental disinfection, except in cases of MRSA infection, MRSA bacteriuria, or deep skin ulcers.RESULTSNHs were randomly allocated to a control group (51 NHs, 2,412 residents) or an intervention group (53 NHs, 2,338 residents). Characteristics of NHs and residents were similar in both groups. The mean screening rates were 86% (range, 27%–100%) in control NHs and 87% (20%–100%) in intervention NHs. Prevalence of MRSA carriage averaged 8.9% in both control NHs (range, 0%–43%) and intervention NHs (range, 0%–38%) at baseline, and this rate significantly declined to 6.6% in control NHs and to 5.8% in intervention NHs after 12 months. However, the decline did not differ between groups (P=.66).CONCLUSIONUniversal screening followed by decolonization of carriers did not significantly reduce the prevalence of the MRSA carriage rate at 1 year compared with standard precautions.Infect Control Hosp Epidemiol 2015;00(0): 1–8

scholarly journals Improving surgical patient’s knowledge about safe use of opioids: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Helen R Doherty ◽  
Enoch Lam ◽  
Maria Garstka ◽  
Junior Chuang ◽  
David Tai Wong ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Knowledge Score ◽  
Controlled Study ◽  
Control Group ◽  
Routine Practice ◽  
Opioid Use ◽  
Randomized Controlled ◽  
The Difference ◽  
The Impact

Abstract Background Currently, it is not routine practice to provide standardized patient education for safe postoperative opioid use. The objective of our study was to evaluate the impact of an educational pamphlet for surgical patients on knowledge about safe use, proper storage, and disposal of opioids.Methods This multi-center randomized controlled study recruited 100 patients in the pre-operative clinic. Inclusion criteria were English-speaking, ≥ 18 years, able to give informed consent, and not on opioids for chronic pain or within the past 30 days. All patients completed a baseline knowledge questionnaire (maximum score 38) on opioid safety. Patients were randomized to intervention: educational pamphlet, or control: standard care (no pamphlet) group. Questionnaires were repeated immediately post-education in the intervention group, and at 15, and 30 days after surgery in both groups. The primary outcome was change in knowledge score post-education in the intervention compared to control group. Secondary outcomes were immediate post-education, 15, and 30-day score, and answering safe storage, and disposal questions correctly.Results Between groups, the post-education score immediately after the intervention was higher in the intervention vs. control group baseline 34.2 [95% CI 33.1–35.3] vs 28.3 [95% CI 26.6–29.9]; P < 0.0001). In the intervention vs control group, mean scores were higher 31.6 (95% CI 30.5–32.7) vs 29.1 (95% CI 27.9–30.2; P = .002) at 15 days, and 32.4 (95%CI 31.4–33.5) vs 30.5 (95% CI 29.2–31.7; P = .017) at 30 days. Within the intervention group, the mean score immediately post-education (34.2 [95% confidence interval (CI) 33.1–35.3]) was higher than baseline (27.8 [95% CI 26.3–29.3]); P < 0.0001. Within the intervention group, the difference in mean score versus baseline was 3.8 (95% CI 2.1–5.5) at 15 days, and 4.6 (95% CI 2.9–6.3) at 30 days, (P < 0.05 for all timepoints). For safe disposal, a correct answer was given (intervention vs control group) by 100% vs 89.7% at 30 days (P = 0.04).Conclusions Within the intervention group, there was a significant improvement in knowledge on safe opioid use immediately post-education, and retention of knowledge at 15 and 30 days postoperatively. The intervention group had better knowledge scores compared to the baseline control group, and 15 and 30 days after surgery.Trial Registration: This study was registered in clinicaltrials.gov: NCT03959787 on May 22, 2019.

scholarly journals “Brown Bag Clinic”: A Pharmacist-led Approach to Reduce Heart Failure Hospital Readmission

2021 ◽  
Vol 12 (4) ◽  
pp. 11
Author(s):  
Maggie N. Faraj ◽  
Ileana L. Piña ◽  
Candice Garwood
Keyword(s):  
Heart Failure ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Readmissions ◽  
Intervention Group ◽  
The United States ◽  
Control Group ◽  
Post Discharge ◽  
Academic Medical ◽  
The Impact

Objectives: Heart failure (HF) affects approximately 6 million in the United States and despite guideline-directed medical therapy (GDMT), still more than 20% of patients are readmitted within 30 days.1,2 This study evaluated the impact of a “pharmacist-led HF Brown Bag Clinic” (BBC) on HF patient outcomes including readmissions and mortality. Methods: This retrospective study, conducted at an academic medical center, included adult patients 18 to 89 years old with HF presenting to the BBC 7-14 days post HF hospitalization. Those failing to attend the BBC within 30 days of hospital discharge were in the control group. Our electronic medical records were used to capture patients’ baseline characteristics and describe pharmacists’ interventions. Thirty- and ninety-day post-discharge HF readmission and all-cause mortality were evaluated. Results: A total of 32 patients met the inclusion criteria; 15 receiving intervention and 17 controls. A total of 18 HF hospital readmissions occurred, 4 (22%) readmissions in the intervention group and 14 (78%) in the control group (p= 0.06). Hospital readmissions within 30 days and 90 days were greater in the control group compared with the intervention group (18% vs. 7% and 41% vs. 21% respectively). Conclusion: A pharmacist-led post-discharge clinic demonstrated numerically fewer HF hospital readmissions compared with a scheduled but “no show” control group.

scholarly journals The Effect of Teaching Palliative Care on the Self-Efficacy of Elderly Patients with Chronic Heart Failure

2020 ◽  
Vol 12 (3) ◽  
pp. 201-207
Author(s):  
Mahnaz Modanloo ◽  
Ameneh Tazikeh-Lemeski ◽  
Shohreh Kolagari
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
And Control

ABSTRACTObjetive: Determine the effect of teaching palliative care on the self-efficacy of elderly with Chronic Heart Failure. Material and Methods: This single-blind randomized clinical trial was done on patients with Chronic Heart Failure attending to the heart clinics of Golestan University of Medical Sciences in 2018. 48 eligible patients with class-III were selected via convenience sampling. Patients allocated into control and intervention group randomly (n=32). Palliative care training was done for intervention group for six weeks. Data was gathered through the Cardiac Self-Efficacy Scale (CSES) on three time points (before, immediately, and one month after intervention). Data were analyzed in SPSS-18 using independent t-test, chi-squared, Fisher's exact, and repeated-measures ANOVA with corrected Bonferroni post-hoc test. Results: Finding showed that before intervention the mean scores of self-efficacy in intervention and control group was 23.95±8.34 and 24.11±9.41, respectively. Immediate and one month after intervention it was 26.30±8.30 vs. 28.95±8.53 in intervention group and 24.68±9.32 vs. 25.53±10.39 in control group. In intervention group there was no significant difference between the mean scores of before with immediate and one month after intervention. However, there was a significant difference between the two time follow up in both intervention (p<0.0001) and control (p<0.003) groups. Conclusion: Although the education of palliative care has increased the ability to care in elderly, it seems that self-managing in complex conditions is required follow-up over time.

scholarly journals Effects of a person-centred telephone support on fatigue in people with chronic heart failure: Subgroup analysis of a randomised controlled trial

2019 ◽  
Vol 19 (5) ◽  
pp. 393-400 ◽  
Author(s):  
Sara Wallström ◽  
Lilas Ali ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Andreas Fors
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Usual Care ◽  
Subgroup Analysis ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Telephone Support

Introduction: Fatigue is a prevalent symptom that is associated with various conditions. In patients with chronic heart failure (CHF), fatigue is one of the most commonly reported and distressing symptoms and it is associated with disease progression. Person-centred care (PCC) is a fruitful approach to increase the patient’s ability to handle their illness. Aim: The aim of this study was to evaluate the effects of PCC in the form of structured telephone support on self-reported fatigue in patients with CHF. Method: This study reports a subgroup analysis of a secondary outcome measure from the Care4Ourselves randomised intervention. Patients ( n=77) that were at least 50 years old who had been hospitalized due to worsening CHF received either usual care ( n=38) or usual care and PCC in the form of structured telephone support ( n=39). Participants in the intervention group created a health plan in partnership with a registered nurse. The plan was followed up and evaluated by telephone. Self-reported fatigue was assessed using the Multidimensional Fatigue Inventory 20 (MFI-20) at baseline and at 6 months. Linear regression was used to analyse the change in MFI-20 score between the groups. Results: The intervention group improved significantly from baseline to the 6-month follow-up compared with the control group regarding the ‘reduced motivation’ dimension of the MFI-20 (Δ -1.41 versus 0.38, p=0.046). Conclusion: PCC in the form of structured telephone support shows promise in supporting patients with CHF in their rehabilitation, improve health-related quality of life and reduce adverse events. Trial registration ISRCTN.com ISRCTN55562827

Evaluation of Pharmacist Medication Review Service in an Outpatient Heart Failure Clinic

2019 ◽  
Vol 33 (6) ◽  
pp. 820-826 ◽  
Author(s):  
Lauren Yates ◽  
Megan Valente ◽  
Christina Wadsworth
Keyword(s):  
Heart Failure ◽  
Medication Review ◽  
Intervention Group ◽  
Retrospective Chart Review ◽  
Pharmacist Intervention ◽  
Control Group ◽  
Significant Difference ◽  
Medication Reviews ◽  
Group 2 ◽  
The Impact

Purpose: The purpose of this study was to evaluate the impact of pharmacist medication reviews on drug-related problems (DRPs) in a population with ambulatory heart failure (HF). Methods: The HF pharmacist medication review service incorporated a comprehensive medication review note provided to the cardiologist in a HF clinic. A retrospective chart review was performed on 64 control patients with no previous pharmacist review and 64 intervention patients who had a pharmacist medication review. The primary end point was the number of DRPs identified per patient in the intervention group 2 weeks after pharmacist medication review compared to the number of DRPs identified per patient in the control group. Results: The average DRPs per patient was reduced from 2.80 to 1.95 in intervention group after pharmacist intervention. There was a statistically significant difference between the average DRPs per patient in the control and intervention groups, 2.55 DRPs versus 1.95 DRPs per patient, respectively ( P = .016). Medication adherence (78%), renal dosing (67%), hypertension (58%), and HF DRPs (55%) had the highest acceptance rate. The majority of DRP recommendations in the intervention (87%) and control groups (87%) were high-impact recommendations. Conclusions: Pharmacist medication reviews in an ambulatory HF clinic lead to significantly fewer DRPs.

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