scholarly journals CARDIORESPIRATORY RESPONSES TO ISOKINETIC EXERCISE IN PATIENTS WITH CORONARY ARTERY DISEASE

2020 ◽  
Vol 26 (3) ◽  
pp. 201-205
Author(s):  
Aline Ertel Ribeiro ◽  
Suelen Bordin ◽  
Talinara Cristine Marini ◽  
Vivian Carla Florianovicz ◽  
Gilnei Lopes Pimentel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Peak Torque ◽  
Moderate Intensity ◽  
Isokinetic Dynamometer ◽  
Isokinetic Exercise ◽  
Cardiorespiratory Responses ◽  
Rehabilitation Programs ◽  
Artery Disease

ABSTRACT Introduction Exercise training using an isokinetic dynamometer is an alternative for improving muscle strength in patients with coronary artery disease (CAD). Few studies have shown metabolic and cardiorespiratory responses to submaximal isokinetic exercises in patients in cardiac rehabilitation programs. Objective To describe cardiorespiratory responses at two intensities of isokinetic exercise. Additionally, we compared the cardiorespiratory responses of isokinetic exercise with data from the incremental cardiopulmonary exercise test (CPET). Methods Eight individuals with CAD (61.7 ± 6.6 years) performed the following tests: 1) CPET on a treadmill; 2) Peak torque test (five repetitions) and fatigue resistance test (20 repetitions) of knee flexion-extension at angular speeds of 120°/s and 180°/s; 3) Two sets of 20 repetitions were performed at 30–40% (low-intensity, LI) and 50–60% (moderate-intensity, MI) of peak torque at angular speeds of 120°/s and 180°/s, using an isokinetic dynamometer. During the exercises, the individuals were connected to an expired gases analyzer with simultaneous monitoring of the electrocardiogram trace, heart rate (HR), oxygen consumption (VO2), carbon dioxide production, and minute ventilation (VE). The differences (∆) between the peak measurements during exercises and the baseline values were calculated. Results Both LI and MI produced cardiorespiratory responses below the anaerobic threshold (82.8 ± 8.1% of HRmax and 74.4 ± 9.6% of VO2peak) compared to the CPET data ( P < 0.01). MI showed higher ∆ HR (9.8 ± 5.5 vs. 6.3 ± 4.6 bpm; P = 0.01), ∆ rate pressure product (3015 ± 2286 vs. 1957 ± 1932 mmHg·bpm; P = 0.01), and ∆VE (10.2 ± 6.2 vs. 6.9 ± 7 L·min-1; P = 0.03) than LI at the angular velocity of 180°/s. Conclusion These results suggest that this isokinetic exercise protocol may be used as a strategy for cardiac rehabilitation programs in patients with CAD. Level of evidence IV; Case series.

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.

scholarly journals Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease

2020 ◽  
Vol 14 ◽  
pp. 117954682092740
Author(s):  
Alexandra C Murphy ◽  
Georgina Meehan ◽  
Anoop N Koshy ◽  
Phelia Kunniardy ◽  
Omar Farouque ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Systolic Blood Pressure ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Established Coronary Artery Disease ◽  
Rehabilitation Programs ◽  
Artery Disease

Background: Cardiac rehabilitation programs provide a comprehensive framework for the institution of secondary preventive measures. Smartphone technology can provide a platform for the delivery of such programs and is a promising alternative to hospital-based services. However, there is limited evidence to date supporting this approach. Accordingly, we performed a systematic review and meta-analysis examining smartphone-based secondary prevention programs to traditional cardiac rehabilitation in patients with established coronary artery disease to ascertain the feasibility and effectiveness of these interventions. Methods: A systematic search of PubMed, MEDLINE, EMBASE, and the Cochrane Library was conducted. A meta-analysis was performed using a random-effects model with the outcomes of interest being 6-minute walk test (6MWT) distance, systolic blood pressure, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI). Results: A total of 8 studies with 1120 patients across 5 countries were included in the quantitative analysis. Follow-up ranged from 6 weeks to 12 months. Five studies examined all patients post acute coronary syndrome, 2 studies examined only patients undergoing percutaneous coronary intervention, and 1 study examined all patients with a diagnosis of coronary artery disease, independent of intervention. Exercise capacity, as measured by the 6MWT, was significantly greater in the smartphone group (20.10 meters, 95% confidence interval [CI] 7.44-33.97; P < .001; I2 = 45.58). There was no significant difference in BMI reduction, systolic blood pressure, or LDL cholesterol levels between groups ( P value for all > .05). Conclusion: Publicly available smartphone-based cardiac rehabilitation programs are a convenient and easily disseminated intervention which show merit in exercise promotion in patients with established coronary artery disease. Further research is required to establish the clinical significance of recent findings favoring their use.

scholarly journals The role of psychological rehabilitation in complex cardiac rehabilitation of patients with coronary heart disease

2020 ◽  
Vol 40 (4) ◽  
pp. 85-97
Author(s):  
Arseniy A. Velikanov ◽  
Anna A. Stoljarova ◽  
Nadezda E. Kruglova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Integrative Approach ◽  
Common Disease ◽  
Rehabilitation Programs ◽  
Artery Disease ◽  
Anxious Behavior

Background. Coronary artery disease (CHD) remains the most common disease and a common cause of death worldwide. In this regard, much attention is paid to preventive measures in relation to coronary heart disease. Providing high-quality and timely psychological rehabilitation as part of secondary prevention programs has the potential to improve the prognosis of patients with coronary disease. Therefore, it is urgent to improve the measures of psychological rehabilitation. Objective: review and analysis of data from modern foreign and domestic studies on the psychological rehabilitation of patients with coronary heart disease (within the framework of complex cardiac rehabilitation). Results. Despite the obvious, recognized by experts, benefits of rehabilitation programs, there is a problem of insufficient active participation of patients with coronary heart disease in such programs. Research is needed to identify factors and develop methods that improve patient motivation to participate in and complete rehabilitation activities. The main targets of psychological rehabilitation of patients with coronary heart disease include the correction of such psychological characteristics as: hostility, emotional tension, manifestations of depressive and anxious behavior, maladaptive personality traits. The importance of dealing with anxiety and depression is emphasized. According to scientific literature, the most effective and appropriate methods of psycho-correction in the system of psychological rehabilitation of patients with coronary heart disease are cognitive-behavioral methods, as well as the use of an integrative approach. It is important to develop and implement general organizational standards for psychological rehabilitation of patients with coronary artery disease, as well as the inclusion of positions of medical psychologists in the staffing of cardiological medical institutions. Conclusions. Despite the use of modern methods of treatment and rehabilitation, the mortality rate from CHD remains high. Therefore, it is necessary to continue research aimed at optimizing treatment and rehabilitation measures with the expansion of the set of psychological rehabilitation.

scholarly journals Brief Vigorous Stair Climbing Effectively Improves Cardiorespiratory Fitness in Patients With Coronary Artery Disease: A Randomized Trial

2021 ◽  
Vol 3 ◽  
Author(s):  
Emily C. Dunford ◽  
Sydney E. Valentino ◽  
Jonathan Dubberley ◽  
Sara Y. Oikawa ◽  
Chris McGlory ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Stair Climbing ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Unsupervised Training ◽  
Artery Disease ◽  
High Intensity Interval ◽  
Rehabilitation Exercise

Background: Cardiac rehabilitation exercise reduces the risk of secondary cardiovascular disease. Interval training is a time-efficient alternative to traditional cardiac rehabilitation exercise and stair climbing is an accessible means. We aimed to assess the effectiveness of a high-intensity interval stair climbing intervention on improving cardiorespiratory fitness (V˙O2peak) compared to standard cardiac rehabilitation care.Methods: Twenty participants with coronary artery disease (61 ± 7 years, 18 males, two females) were randomly assigned to either traditional moderate-intensity exercise (TRAD) or high-intensity interval stair climbing (STAIR). V˙O2peak was assessed at baseline, following 4 weeks of six supervised exercise sessions and after 8 weeks of ~24 unsupervised exercise sessions. TRAD involved a minimum of 30 min at 60–80%HRpeak, and STAIR consisted of three bouts of six flights of 12 stairs at a self-selected vigorous intensity (~90 s/bout) separated by recovery periods of walking (~90 s). This study was registered as a clinical trial at clinicaltrials.gov (NCT03235674).Results: Two participants could not complete the trial due to the time commitment of the testing visits, leaving n = 9 in each group who completed the interventions without any adverse events. V˙O2peak increased after supervised and unsupervised training in comparison to baseline for both TRAD [baseline: 22.9 ± 2.5, 4 weeks (supervised): 25.3 ± 4.4, and 12 weeks (unsupervised): 26.5 ± 4.8 mL/kg/min] and STAIR [baseline: 21.4 ± 4.5, 4 weeks (supervised): 23.4 ± 5.6, and 12 weeks (unsupervised): 25 ± 6.2 mL/kg/min; p (time) = 0.03]. During the first 4 weeks of training (supervised) the STAIR vs. TRAD group had a higher %HRpeak (101 ± 1 vs. 89 ± 1%; p ≤ 0.001), across a shorter total exercise time (7.1 ± 0.1 vs. 36.7 ± 1.1 min; p = 0.009). During the subsequent 8 weeks of unsupervised training, %HRpeak was not different (87 ± 8 vs. 96 ± 8%; p = 0.055, mean ± SD) between groups, however, the STAIR group continued to exercise for less time per session (10.0 ± 3.2 vs. 24.2 ± 17.0 min; p = 0.036).Conclusions: Both brief, vigorous stair climbing, and traditional moderate-intensity exercise are effective in increasing V˙O2peak, in cardiac rehabilitation exercise programmes.

scholarly journals The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease

2021 ◽  
Vol 18 (3) ◽  
pp. 147916412110201
Author(s):  
Katarzyna Szmigielska ◽  
Anna Jegier
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Interval Training ◽  
Patients With Diabetes ◽  
Artery Disease

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes. Method: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. Results: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. Conclusions: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.

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