Feasibility of Aerobic Interval Training in Nonambulant Persons after Stroke

ABSTRACT Background: Modifiable cardiovascular risk factors are prevalent and poorly managed in people after stroke. Aerobic exercise is effective in reducing many modifiable cardiovascular risk factors after stroke but is challenging and under-researched in nonambulant persons. This pilot study aimed to investigate the feasibility of aerobic interval training in nonambulant persons after stroke. Methods: Aerobic exercise was performed on an upright or semi-recumbent cycle ergometer. Participants were prescribed 4 × 4-min intervals of exercise at 85% maximum age-predicted heart rate (APHRmax) with a 3-min active recovery at 70%APHRmax per 30-min session, 3 times per week for 10 weeks. Heart rate, rating of perceived exertion, workload, cadence, and duration of exercise achieved were recorded for each interval. Results: Nine participants (mean ± SD; age 62 ± 12 y; 5 males) unable to walk without assistance after stroke (2.9 ± 3.9 y) were recruited. There were no adverse events reported, but there was one dropout (due to bronchitis). Attendance for the remaining participants was 93 ± 6%. The mean training %APHRmax was 72 ± 14% for the higher intensity interval and 57 ± 21% for the recovery interval. The mean increase in training workload between weeks 1 and 10 was 11.2 ± 11.6 W (27 ± 28%) for the higher intensity interval and 4.0 ± 7.7W (17 ± 33%) for the recovery interval. The mean increase in VO2peak was 2.3 ± 2.9 mL·kg−1·min−1 (18 ± 22%) over the 10-week intervention. Conclusion: Aerobic interval training at a moderate-vigorous intensity on an upright or recumbent cycle ergometer is feasible for nonambulant persons after stroke. Aerobic interval training should be further investigated to determine its potential to improve cardiorespiratory fitness after stroke and risk factors for recurrent stroke.

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Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents

Clinical Science ◽

10.1042/cs20080249 ◽

2009 ◽

Vol 116 (4) ◽

pp. 317-326 ◽

Cited By ~ 167

Author(s):

Arnt E. Tjønna ◽

Tomas O. Stølen ◽

Anja Bye ◽

Marte Volden ◽

Stig A. Slørdahl ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Interval Training ◽

Maximal Heart Rate ◽

Absolute Change ◽

Obese Adolescents ◽

Aerobic Interval Training ◽

Overweight Adolescents

The aim of the present study was to compare the effects of a multidisciplinary approach (MTG) and aerobic interval training (AIT) on cardiovascular risk factors in overweight adolescents. A total of 62 overweight and obese adolescents from Trøndelag County in Norway, referred to medical treatment at St Olav's Hospital, Trondheim, Norway, were invited to participate. Of these, 54 adolescents (age, 14.0±0.3 years) were randomized to either AIT (4×4 min intervals at 90% of maximal heart rate, each interval separated by 3 min at 70%, twice a week for 3 months) or to MTG (exercise, dietary and psychological advice, twice a month for 12 months). Follow-up testing occurred at 3 and 12 months. V̇O2max (maximal oxygen uptake) increased more after AIT compared with MTG, both at 3 months (11 compared with 0%; P<0.01) and 12 months (12 compared with −1%; P<0.01). AIT enhanced endothelial function compared with MTG at both 3 months (absolute change, 5.1 compared with 3.9%; P<0.01) and 12 months (absolute change, 6.3 compared with 1.0%; P<0.01). AIT was favourable compared with MTG in reducing BMI (body mass index), percentage of fat, MAP (mean arterial blood pressure) and increasing peak oxygen pulse. In addition, AIT induced a more favourable regulation of blood glucose and insulin compared with MTG. In conclusion, the novel findings of the present proof-of-concept study was that 3 months of twice weekly high-intensity exercise sessions reduced several known cardiovascular risk factors in obese adolescents more than that observed after a multitreatment strategy, which was initiated as hospital treatment. Follow-up at 12 months confirmed that AIT improved or maintained these risk factors to a better degree than MTG.

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Corrigendum to “Estimation of maximal oxygen consumption and heart rate recovery using the Tecumseh sub-maximal step test and their relationship to cardiovascular risk factors” [Artery Research 18 (June 2017) 29–35]

Artery Research ◽

10.1016/j.artres.2018.07.003 ◽

2018 ◽

Vol 23 (C) ◽

pp. 44

Author(s):

Alun D. Hughes ◽

Nish Chaturvedi

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Oxygen Consumption ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Heart Rate Recovery ◽

Maximal Oxygen Consumption ◽

Step Test

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Increased afternoon step count increases heart rate variability in patients with cardiovascular risk factors

Journal of Clinical Nursing ◽

10.1111/jocn.16018 ◽

2021 ◽

Author(s):

Natsuki Nakayama ◽

Masahiko Miyachi ◽

Koji Tamakoshi ◽

Shuji Morikawa ◽

Koji Negi ◽

...

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Heart Rate Variability ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Step Count

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Abstract P037: School Lunch is Associated with Increased Cardiovascular Risk Among Middle-school Children

Circulation ◽

10.1161/circ.133.suppl_1.p037 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Rosa S de Visser ◽

Rachel Sylvester ◽

Qingmei Jiang ◽

Eva Kline-Rogers ◽

Jean DuRussel-Weston ◽

...

Keyword(s):

Risk Factors ◽

Middle School ◽

Heart Rate ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Low Income ◽

School Lunch ◽

School Lunches ◽

Healthy Behaviors ◽

Physiologic Parameters

Introduction: Millions of children consume school lunches daily. Children from low-income families are eligible for free or reduced-price school meals. While studies show improvement in the nutritional quality of school lunches, the effect of school lunch or lunch brought from home on cardiovascular risk factors among children is unknown. Hypothesis: We hypothesized that frequently consuming school lunch is associated with increased cardiovascular risk factors when compared with lunch brought from home. Methods: All 15,742 sixth graders enrolled in Project Healthy Schools, a school-based wellness intervention, were included in this cross-sectional study (2004-2015). We examined 10,169 behavioral surveys and 1,845 physiological screenings. We compared self-reported diet, physical activity (PA), sedentary behaviors and physiologic parameters (height, weight, blood pressure (BP) and heart rate) in 2 groups, children who reported eating school lunch daily and those who eat home-prepared lunch daily. The groups were further stratified by socioeconomic status (SES); low SES (<$35,000) or high SES (>$50,000) based on the median household income of the school region. Students in the middle SES range ($35,000-$50,000) were excluded from analysis (n=4230). Results: School lunch students were associated with less healthy behaviors (PA, diet [fruit/vegetable servings, meat and sugary beverage intake], and sedentary activities) and physiologic measures (percent of overweight/obesity, systolic BP and recovery heart rate) compared with students bringing lunch from home in low and high SES groups (Table 1). Conclusions: In this large cohort of children, we observed frequent school lunch consumption, even after adjustment for SES, was associated with less healthy behaviors and physiologic parameters. Further research is warranted to determine whether healthier school lunches would improve cardiovascular health characteristics and health behaviors in middle-school students.

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Cardiovascular Risk Factors and Sympatho-vagal Balance: Importance of Time-domain Heart Rate Variability

Journal of Clinical & Experimental Cardiology ◽

10.4172/2155-9880.1000289 ◽

2014 ◽

Vol 05 (02) ◽

Author(s):

Colonna A Bozzini S

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Heart Rate Variability ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Time Domain

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The significant gap between international standards and stroke management practices at Queen Elizabeth Central Hospital (Malawi): An audit report

Malawi Medical Journal ◽

10.4314/mmj.v31i4.6 ◽

2019 ◽

Vol 31 (4) ◽

pp. 249-255 ◽

Cited By ~ 1

Author(s):

Yohane Gadama

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Acute Stroke ◽

Cardiovascular Risk Factors ◽

Management Practices ◽

Vital Signs ◽

Central Hospital ◽

Stroke Management ◽

The Mean ◽

Queen Elizabeth Central Hospital

BackgroundThe Queen Elizabeth Central Hospital (QECH) is preparing to set up the first stroke unit in Blantyre, Malawi. We conducted this audit to assess current stroke management practices and outcomes at QECH and identify priority areas for intervention.MethodsFrom April to June 2018, we prospectively enrolled patients with acute stroke and collected data on clinical presentation, cardiovascular risk factors, investigations and interventions, in-hospital outcomes, and follow-up plans after discharge. The American Heart Association/American Stroke Association (AHA/ASA) guidelines were used as the standard of care for comparison.ResultsFifty patients with acute stroke were enrolled (46% women, 54% men). The mean age was 63.1 years (95% CI: 59.7–66.6). The diagnosis of stroke was based on the World Health Organization criteria. The diagnosis was made within 24 hours of admission in 19 patients (38%). Acute revascularisation therapy was not available. Forty-eight patients (96%) had their vital signs checked at baseline and <10% had their vital signs checked more than three times within the first 24 hours. Essential blood tests including random blood sugar (RBS), full blood count (FBC), urea/creatinine, and lipid profiles were performed in 72%, 68%, 48%, and 4%, respectively. An electrocardiogram was performed on 34 patients (68%). Blood pressure on admission was >140/90 mmHg in 34 patients (68%), including 4 with values >220/120 mmHg. Nine patients had an RBS >10 mmol/L and four received insulin. Prophylaxis for deep venous thrombosis was offered to 12 patients (24%). Aspiration pneumonia was reported in 16 patients (32%) and was the most common hospital complication. The mean duration of hospitalisation was 10.4 days (95% CI: 5.6–15.2), and case fatality was 18%. The modified Rankin scale at discharge was ≤2 in 32% of patients. Only four patients (8%) were transferred to a rehabilitation centre. At the time of discharge, only 32% of patients received education on stroke.ConclusionAcute stroke care is less than optimal in this setting. Simple interventions such as reducing the delay in making a stroke diagnosis, early swallow assessments, and closer monitoring of vital signs could make a significant difference in stroke outcome. Furthermore, treating cardiovascular risk factors and setting up health education programmes to improve secondary prevention represent key priorities.

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High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

Advances in Rheumatology ◽

10.1186/s42358-019-0089-1 ◽

2019 ◽

Vol 59 (1) ◽

Cited By ~ 4

Author(s):

Maria Fernanda Brandão de Resende Guimarães ◽

Carlos Ewerton Maia Rodrigues ◽

Kirla Wagner Poti Gomes ◽

Carla Jorge Machado ◽

Claiton Viegas Brenol ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Laboratory Data ◽

Premature Cardiovascular Disease ◽

Prevalence Of Obesity ◽

The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

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