scholarly journals The Effects of Unsupervised Exercise Training on Physical Activity and Physiological Factors after Supervised Cardiac Rehabilitation

2006 ◽  
Vol 9 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Kazuhiro P. Izawa ◽  
Satoshi Watanabe ◽  
Koichiro Oka ◽  
Toru Kobayashi ◽  
Naohiko Osada ◽  
...  
2020 ◽  
Author(s):  
Shannon Wongvibulsin ◽  
Evagelia E Habeos ◽  
Pauline P Huynh ◽  
Helen Xun ◽  
Rongzi Shan ◽  
...  

BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide. Despite strong evidence supporting the benefits of cardiac rehabilitation (CR), over 80% of eligible patients do not participate. Digital health technologies (i.e. the delivery of care through the use of the internet, wearable devices, and mobile applications) have the potential to address the challenges associated with traditional facility-based CR programs but little is known about the comprehensiveness of these interventions to serve as digital approaches to CR. Overall, a systematic evaluation of the current literature on digital interventions for CR is lacking. OBJECTIVE The objective of this systematic literature review is to provide an in-depth analysis of the potential for digital health technologies to address the challenges associated with traditional CR. Through this review, we 1) summarize the current literature on digital interventions for CR, 2) identify the key components of CR that have been successfully addressed through digital interventions, and 3) describe gaps in research that need to be addressed for sustainable and scalable digital CR interventions. METHODS Our search strategy for identifying primary literature pertaining to CR with digital solutions (defined as technology employed to deliver remote care beyond the use of telephone) consisted of querying MEDLINE, Embase, CINAHL, and Cochrane databases for original studies published from January 1990 to October 2018 and consulting with an expert in the field of digital CR. RESULTS Our search returned 31 eligible studies, of which 22 were randomized controlled trials. The CR interventions reviewed primarily targeted physical activity counseling (100%; n=31), baseline assessment (97%; n=30) and exercise training (87%; n=27). The most common modalities used were smartphone/mobile devices (65%; n=20), online portals (58%; n=18), and email-SMS (35%; n=11). Approximately one third of studies addressed the CR core components of nutrition counseling, psychological management, and weight management. In contrast, less than a third of the studies addressed other CR core components including management of lipids, diabetes, smoking cessation, and blood pressure. CONCLUSIONS Digital technologies have the potential to increase access and participation in CR by mitigating the challenges associated with traditional, facility-based CR. However, interventions that have previously been evaluated are primarily focused on physical activity counseling and exercise training without the other core components of CR. Thus, further research is required with more comprehensive CR interventions and long-term follow-up in order to understand the clinical impact of digital interventions. CLINICALTRIAL


Author(s):  
Janusz Kocjan ◽  
Andrzej Knapik

AbstractBackground: Comprehensive cardiac rehabilitation (CR) is a process designed to restore full physical, psychological and social activity and to reduce cardiovascular risk factors. Fear of movement may contribute to the occurrence and intensification of hypokinesia, and consequently affect the effectiveness of therapy. The aim of the study was to determine the level of barriers of physical activity in patients undergoing cardiac rehabilitation. The relationship between selected determinants (age and health selfassessment) and the kinesiophobia level were also examined.Material/Methods: 115 people aged 40-84 years were examined: 50 females (x = 63.46; SD = 11.19) and 65 males (x = 64.65; SD = 10.59) - patients undergoing cardiac rehabilitation at the Upper-Silesian Medical Centre in Katowice. In the present study, the Polish version of questionnaires: Kinesiophobia Causes Scale (KCS) and Short Form Health Survey (SF-36) were used. Questionnaires were supplemented by authors’ short survey.Results: The patients presented an elevated level of kinesiophobia, both in general as well as in individual components. In women, the kinesiophobia level was higher than in men. The psychological domain was a greater barrier of physical activity than the biological one. Strong, negative correlations of psychological and biological domains of kinesiophobia to physical functioning (SF-36) were noted in women. In the case of men, correlations were weaker, but also statistically significant.Conclusions: 1. Sex differentiates patients in their kinesiophobia level 2. Poor self-assessment of health is associated with a greater intensification of kinesiophobia 3. A high level of kinesiophobia may negatively affect cardiac rehabilitation process


2019 ◽  
Author(s):  
Sheeba Nadarajah ◽  
Susan Buchholz ◽  
Kristen Dickins

BACKGROUND Globally, cardiovascular disease is the leading cause of death. Cardiovascular mortality can be decreased by participation in cardiac rehabilitation. Researchers are exploring the use of mHealth technology in cardiac rehabilitation. OBJECTIVE The aim of this systematic review is to examine the effectiveness of randomized controlled trials that use a mHealth intervention as a part of an outpatient and/or home-based cardiac rehabilitation program on improving physical activity and physical fitness outcomes. METHODS For this systematic review, mHealth interventions were limited to text messaging, mobile apps, and use of a mobile phone network for data transmission, used to deliver cardiac rehabilitation program. Using six databases, the search strategy included published English language studies through 2016. Data was extracted independently by two reviewers, and then synthesized. RESULTS The initial search yielded 149 articles, of which 15 articles that represented nine studies met inclusion criteria. Articles were published from 2010 to 2016 and came from two continents. The majority (84%) of participants were male. Generally, the participant mean age was late 50s to early 60s. Text messaging was the most frequently used intervention. The results of the physical activity and physical fitness findings were mixed. Effect sizes for intervention as measured by the 6-minute walk test ranged from 0.46 to 0.58 and peak VO2 ranged from 0.03 to 1.35. CONCLUSIONS Globally, use of mHealth in outpatient and/or home-based cardiac rehabilitation is being studied with greater attention. However, these studies are limited by geography, gender, and age. Therefore, further research in the area of cardiac rehabilitation and mHealth is recommended, especially in developing countries, among women, and older adults.


Author(s):  
Giulia Foccardi ◽  
Marco Vecchiato ◽  
Daniel Neunhaeuserer ◽  
Michele Mezzaro ◽  
Giulia Quinto ◽  
...  

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients’ adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects’ ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ −77.5 (95% CI 104.9, −50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients’ Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Kourek ◽  
E Karatzanos ◽  
D Delis ◽  
M Alshamari ◽  
V Linardatou ◽  
...  

Abstract Background Chronic heart failure (CHF) remains a leading cause of morbidity and mortality and it is characterized by vascular endothelial dysfunction. During the last decades, endothelial progenitor cells (EPCs) are being used as an index of the endothelium restoration potential, therefore reflecting the vascular endothelial function. Exercise training has been shown to stimulate the mobilization of EPCs at rest in CHF patients. However, the effect of exercise training on the acute respond of EPCs after maximum exercise in CHF patients remains unknown. Purpose The purpose of the study was to assess the effect of a cardiac rehabilitation (CR) program on the acute respond of EPCs after maximum exercise in patients with CHF. Methods Forty-four consecutive patients (35 males) with stable CHF [mean±SD, Age (years): 56±10, BMI (kg/m2): 28.7±5.2, EF (%): 33±8, Peak VO2 (ml/kg/min): 18.4±4.4, Peak work rate (watts): 101±39] enrolled a 36-session CR program based on high-intensity interval exercise training. All patients underwent an initial symptom limited maximal cardiopulmonary exercise testing (CPET) on an ergometer before the CR program and a final maximal CPET after the CR program. Venous blood was drawn before and after each CPET. Five circulating endothelial populations were identified and quantified by flow cytometry; CD34+/CD45-/CD133+, CD34+/CD45-/CD133+/VEGFR2, CD34+/CD133+/VEGFR2, CD34+/CD45-/CD133- and CD34+/CD45-/CD133-/VEGFR2. EPCs values are expressed as cells/million enucleated cells in medians (25th-75th percentiles). Results The acute mobilization of EPCs after the final CPET was higher than after the initial CPET in 4 out of 5 circulating endothelial populations. Most specifically, difference of the acute mobilization of CD34+/CD45-/CD133+ cells [initial CPET: 25 (15–46) vs final CPET: 49 (26–71), p=0.002], CD34+/CD45-/CD133+/VEGFR2 cells [initial CPET: 3 (2–5) vs final CPET: 8 (5–12), p&lt;0.001], CD34+/CD45-/CD133- cells [initial CPET: 129 (52–338) vs final CPET: 250 (129–518), p=0.03] and CD34+/CD45-/CD133-/VEGFR2 cells [initial CPET: 2 (1–4) vs final CPET: 6 (3–9), p&lt;0.001] increased after the final CPET. The acute mobilization of CD34+/CD133+/VEGFR2 cells [initial CPET: 3 (−1–7) vs final CPET: 5 (0–15), p=0.441] did not differ between the 2 CPETS. Conclusion A 36-session cardiac rehabilitation program increases the acute respond of endothelial progenitor cells after maximum cardiopulmonary exercise training in patients with chronic heart failure, therefore indicating the beneficial effect of exercise training on the vascular endothelial function. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): Co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning” in the context of the project


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
NPD Cunha ◽  
I Aguiar-Ricardo ◽  
T Rodrigues ◽  
P Silverio Antonio ◽  
S Couto Pereira ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction A number of randomized controlled trials have examined the effect of exercise training on left ventricle (LV) remodeling in individuals with cardiovascular disease. However, the results of these trials have been inconclusive.  Purpose Evaluation of the impact of a cardiac rehabilitation program (CRP) on left ventricle remodelling evaluated by echocardiogram.  Methods Observational single centre study including consecutive patients, undergoing structured CRP since June 2016 until February 2020. Phase II CRP included 3 months of exercise training, aerobic and strength exercise, individually prescribed, 3 times a week, 60 minutes sessions. All patients were submitted to a clinical evaluation, echocardiogram, and cardiopulmonary exercise test before and after the CRP. Results 205 patients (62.6 ± 11 years, 83.4% men, 82.3% ischemic disease) were included in a phase II CRP. Most patients had ischemic disease (82.3%) and 23.5% of patients had left ventricular ejection fraction (LVEF) &lt;40%. Of the cardiovascular risk factors, hypertension was the most prevalent (76%), followed by dyslipidaemia (67.4%), active smoking (45.9%) and diabetes (26.9%).  After the CRP, there was a significant improvement of LVEF (from 48.3 ± 13 to 52 ± 11.6 %, p = 0.001) and a significant reduction of LV volumes (LV end-diastolic volume, LVEDV , decreased from 140 ± 81 to 121 ± 57, p = 0.002; LV end-systolic volume , LVESV , reduced from 80 ± 75 to 64 ± 48, p = 0.004). Considering only the patients with LVEF &lt; 40% (n = 38), the improvement was even greater: LVEF increased from 30 ± 8 to 39 ± 13 (p = 0.002); LVEDV reduced from 206 ± 107 to 159 ± 81 (p = 0.001) and LVESV reduced from 142 ± 99 to 101 ± 66 (p = 0.002). 63.6%(n = 14) of these patients improved at least 10% of LVEF and only 1 of them had a cardiac resynchronization therapy device.  Conclusions A phase II CR program was associated with significant improvements in left ventricular reverse remodelling irrespective of baseline EF classification. Those with reduced baseline EF derived an even greater improvement, highlighting the great importance of CR in this subgroup of patients.


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