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Bennett E, Devan H, Hale L, Gray E. Evaluation of the quality and self-management related content of websites promoting physical activity engagement after myocardial infarction or cardiac surgery: A scoping review. Heart Lung 2024; 69:94-110. [PMID: 39378531 DOI: 10.1016/j.hrtlng.2024.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 09/26/2024] [Accepted: 09/29/2024] [Indexed: 10/10/2024]
Abstract
INTRODUCTION Uncertainty about safe engagement in activity during early recovery after cardiac events is common. Websites are a potential source of health information, especially for those unable to access follow-up support from health professionals. The variability in online health information quality is concerning as poor web-based information can negatively impact patient health outcomes and the ability to self-manage. OBJECTIVE To evaluate the quality and self-management-related content of websites providing information about physical activity following an MI or cardiac surgery. METHODS Patient-facing websites were searched using three search engines (Google, Bing, and Yahoo). Information about activities of daily living (ADLs), exercise (aerobic and resistance), and safety considerations were explored. Self-management strategies for physical activity were evaluated using a customized 9-item checklist. Website quality was assessed using the 4-item JAMA framework criteria. RESULTS 31 websites were included. Aerobic exercise, ADLs, and safety considerations were the most comprehensively covered topics. Resistance exercise was less frequently and comprehensively covered. The median self-management checklist score was 3/9 (with nine being the highest possible score). Partnering with healthcare professionals, decision-making, action planning, and verbal persuasion were the most common self-management skills addressed by the websites. In contrast, ten or fewer websites modelled mastery experiences, vicarious experiences, reflection, problem-solving, and resource utilization. The median JAMA score for website quality was 2/4 (with four being the highest possible score). CONCLUSIONS The findings highlight quality improvement opportunities for web providers and provide insight for patients and clinicians regarding the highest quality websites that best meet the information and self-management needs following an MI or cardiac surgery.
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Affiliation(s)
- Emily Bennett
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, Otago 9054, New Zealand
| | - Hemakumar Devan
- Rehabilitation Teaching and Research Unit (RTRU), Department of Medicine, University of Otago, Wellington, New Zealand.
| | - Leigh Hale
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, Otago 9054, New Zealand.
| | - Emily Gray
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, Otago 9054, New Zealand.
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Loureiro M, Parola V, Duarte J, Oliveira I, Antunes M, Coutinho G, Martins MM, Novo A. Cardiac Rehabilitation to Inpatient Heart Transplant-HRN4HTx Intervention Protocol. NURSING REPORTS 2024; 14:2084-2094. [PMID: 39311164 PMCID: PMC11417762 DOI: 10.3390/nursrep14030155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 09/26/2024] Open
Abstract
Heart transplantation is the gold-standard treatment for terminal heart failure. Despite being successful, pre- and post-transplant limitations interfere with patients' functional capacity, self-care, and quality of life post-surgery. Rehabilitation is necessary to address these limitations, prevent complications, and promote a safe return home. This study analyzes the safety of a phase 1 cardiac rehabilitation protocol (RN4HTx) in heart transplant patients and its effects on self-care capacity. A quantitative, descriptive study was conducted with 19 heart transplant recipients. The protocol was implemented in collaboration with a rehabilitation professional, who monitored adverse events, hemodynamic variables, self-care capacity (Barthel) pre- and post-transplant, and functional capacity at discharge (6 min walk test). The results showed that 68.42% of recipients were men, with an average age of 50.21 years and 15 days of hospitalization post-transplant. Approximately 73.68% of recipients were transferred from other wards with changes in functional capacity. All patients progressed to the final stage of the program without adverse events. There was a notable improvement in self-care capacity before and after transplantation, with a measure of functional status of 310.035 m (6MWT). The study found that RN4HTx is a feasible cardiac rehabilitation program without adverse events in the immediate postoperative period following heart transplantation, positively impacting functional recovery and therapeutic self-care capacity, thus increasing the safety of returning home. This study was retrospectively registered on Clinical Trials-NCT06552390.
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Affiliation(s)
- Maria Loureiro
- Instituto Ciências Biomédicas Abel Salazar, Cintesis-NursID, Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal
| | - Vítor Parola
- Nursing School of Coimbra (ESEnfC), The Health Sciences Research Unit-Nursing (UICISA:E), Centre for Evidence-Based Practice—A Joanna Briggs Institute Centre of Excellence, 3004-011 Coimbra, Portugal;
| | - João Duarte
- Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal;
| | - Isabel Oliveira
- Nursing School of Coimbra (ESEnfC), The Health Sciences Research Unit-Nursing (UICISA:E), 3004-011 Coimbra, Portugal;
| | - Margarida Antunes
- Unidade Local de Saúde de Coimbra, Núcleo de Investigação em Enfermagem do CHUC, 3000-602 Coimbra, Portugal;
| | - Gonçalo Coutinho
- Faculdade de Medicina de Coimbra, Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal;
| | | | - André Novo
- Instituto Politécnico de Bragança-Escola Superior de Saúde, LiveWell—Research Center for Active Living and Wellbeing, 5300-121 Bragança, Portugal;
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Wiens K, Hayden KA, Park L, Colwell S, Coltman C, King-Shier KM. Post-sternotomy movement strategies in adults: a scoping review. Eur J Cardiovasc Nurs 2024; 23:435-440. [PMID: 38167748 DOI: 10.1093/eurjcn/zvad109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 01/05/2024]
Abstract
AIMS Post-sternotomy movement strategies for adults should be an evidence-informed approach and support a safe, independent return to daily activity. Recent new movement strategies have emerged. The aim of this scoping review was to identify and summarize the available evidence for post-sternotomy movement strategies in adults. METHODS AND RESULTS The electronic databases searched included MEDLINE, Embase, Sport Discus, CINAHL, Academic Search Complete, the Cochrane Library, Scopus, and PEDro. The search did not have a date limit. After 2405 duplicates were removed, 2978 records were screened, and 12 were included; an additional 2 studies were identified through reference searching for a total of 14 included studies. A data extraction table was used, and the findings are summarized in a tabular and narrative form. Three post-sternotomy movement strategies were identified in the literature: sternal precautions (SP), modified SP, and Keep Your Move in the Tube (KYMITT™). The authors suggested that the practice of SP was based on expert opinion and not founded in evidence. However, the evidence from the identified articles suggested that new movement strategies are safe and allow patients to choose an increased level of activity that promotes improved functional status and confidence. CONCLUSION More prospective cohort studies and multi-centred randomized control trials are needed; however, the current evidence suggests that modified SP and KYMITT™ are as safe as SP and can promote a patient-centred approach. REGISTRATION University of Calgary's Digital Repository PRISM http://hdl.handle.net/1880/115439.
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Affiliation(s)
- Karen Wiens
- Faculty of Nursing, University of Calgary, 2500 University Dr NW, Calgary, AB, CanadaT2N 1N4
- Foothills Medical Center, Alberta Health Services, 1403 29 St NW, Calgary, AB, CanadaT2N 2T9
- Libin Cardiovascular Institute of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, CanadaT2N 4N1
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, 2500 University Dr NW, Calgary, AB, CanadaT2N 1N4
| | - Lauren Park
- Foothills Medical Center, Alberta Health Services, 1403 29 St NW, Calgary, AB, CanadaT2N 2T9
- Libin Cardiovascular Institute of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, CanadaT2N 4N1
| | - Susan Colwell
- Foothills Medical Center, Alberta Health Services, 1403 29 St NW, Calgary, AB, CanadaT2N 2T9
- Libin Cardiovascular Institute of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, CanadaT2N 4N1
| | - Christopher Coltman
- Foothills Medical Center, Alberta Health Services, 1403 29 St NW, Calgary, AB, CanadaT2N 2T9
- Libin Cardiovascular Institute of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, CanadaT2N 4N1
| | - Kathryn M King-Shier
- Faculty of Nursing, University of Calgary, 2500 University Dr NW, Calgary, AB, CanadaT2N 1N4
- Libin Cardiovascular Institute of Alberta, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, CanadaT2N 4N1
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, CanadaT2N 1N4
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Hathorn B, Adams J. Return of a flight attendant to full duty following myocardial infarction and subsequent coronary artery bypass grafting through a high-intensity occupation-specific cardiovascular rehabilitation program. Proc AMIA Symp 2023; 37:165-168. [PMID: 38173993 PMCID: PMC10761117 DOI: 10.1080/08998280.2023.2259762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/10/2023] [Indexed: 01/05/2024] Open
Abstract
Flight attendants play a vital role in the safety and security of air passengers during emergencies. A 61-year-old flight attendant who endured myocardial infarction and coronary artery bypass graft surgery wanted to return to full duty. To meet airline requirements, he chose to participate in our occupation-specific, high-intensity performance training program. This patient returned to full duty as a flight attendant upon completion of this specialized cardiac rehabilitation program.
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Affiliation(s)
- Brandon Hathorn
- Cardiac Rehabilitation Department, Baylor Hamilton Heart and Vascular Hospital, Dallas, Texas, USA
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
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Md Ali NA, El-Ansary D, Abdul Rahman MR, Ahmad S, Royse C, Huat CT, Muhammad Nor MA, Dillon J, Royse A, Haron H, Ismail MI, Abdul Manaf MR, Katijjahbe MA. E arly S u p ervised I ncremental R es istance T raining ( ESpIRiT) following cardiac surgery via a median sternotomy: a study protocol of a multicentre randomised controlled trial. BMJ Open 2023; 13:e067914. [PMID: 37451709 PMCID: PMC10351238 DOI: 10.1136/bmjopen-2022-067914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/21/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION There is no consistency in current practice pertaining to the prescription and progression of upper limb resistance exercise following cardiac surgery via median sternotomy. The aim of this study is to investigate whether less restrictive sternal precautions with the addition of early-supervised resistance training exercise improves upper limb function and facilitates recovery following median sternotomy. METHODS AND ANALYSIS This is double-blind randomised controlled trial, with parallel group, concealed allocation, blinding of patients and assessors, and intention-to-treat analysis. 240 adult participants who had median sternotomy from eight hospitals in Malaysia will be recruited. Sample size calculations were based on the unsupported upper limb test. All participants will be randomised to receive either standard or early supervised incremental resistance training. The primary outcomes are upper limb function and pain. The secondary outcomes will be functional capacity, multidomain recovery (physical and psychological), length of hospital stay, incidence of respiratory complications and quality of life. Descriptive statistics will be used to summarise data. Data will be analysed using the intention-to-treat principle. The primary hypothesis will be examined by evaluating the change from baseline to the 4-week postoperative time point in the intervention arm compared with the usual care arm. For all tests to be conducted, a p value of <0.05 (two tailed) will be considered statistically significant, and CIs will be reported. The trial is currently recruiting participants. ETHICS AND DISSEMINATION The study was approved by a central ethical committee as well as the local Research Ethics Boards of the participating sites (UKM:JEP-2019-654; Ministry of Health: NMMR-50763; National Heart Centre: IJNREC/501/2021). Approval to start was given prior to the recruitment of participants commencing at any sites. Process evaluation findings will be published in peer-reviewed journals and presented at relevant academic conferences. TRIAL REGISTRATION NUMBER International Standard Randomised Controlled Trials Number (ISRCTN17842822).
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Affiliation(s)
- Nur Ayub Md Ali
- Cardiothoracic Unit, Surgery Department, Faculty of Medicine, UKM, Cheras, Kuala Lumpur, Malaysia
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
| | - Doa El-Ansary
- School of Biomedical and Health Sciences, RMIT, Victoria, Melbourne, Australia
- Department of Physiotherapy, Hospital Canselor Tunku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Ramzisham Abdul Rahman
- Cardiothoracic Unit, Surgery Department, Faculty of Medicine, UKM, Cheras, Kuala Lumpur, Malaysia
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
| | - Suriah Ahmad
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
- Department of Physiotherapy, Hospital Canselor Tunku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Colin Royse
- Department of Surgery, The University of Melbourne, Victoria, Melbourne, Australia
- Cardiothoracic Surgery, Royal Melbourne Hospital, Victoria, Melbourne, Australia
- Australian Director, Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA
| | - Chong Tze Huat
- Department of Surgery, Hospital Serdang, Cheras, Selangor, Malaysia
| | | | - Jeswant Dillon
- Department of Cardiothoracic and Vascular Surgery, National Institute Heart Centre, Kuala Lumpur, Malaysia
| | - Alistair Royse
- Department of Surgery, The University of Melbourne, Victoria, Melbourne, Australia
- Cardiothoracic Surgery, Royal Melbourne Hospital, Victoria, Melbourne, Australia
| | - Hairulfaizi Haron
- Cardiothoracic Unit, Surgery Department, Faculty of Medicine, UKM, Cheras, Kuala Lumpur, Malaysia
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
| | - Muhamad Ishamudin Ismail
- Cardiothoracic Unit, Surgery Department, Faculty of Medicine, UKM, Cheras, Kuala Lumpur, Malaysia
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Md Ali Katijjahbe
- Heart and Lung Centre, Hospital Canselor Tuanku Muhriz, UKM, Cheras, Kuala Lumpur, Malaysia
- Department of Physiotherapy, Hospital Canselor Tunku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Lyapina IN, Shaleva VA, Teplova YE, Pomeshkina SA, Barbarash OL. Effect of early postoperative rehabilitation with aerobic exercise on functional status and cardiac remodeling in patients after heart valve surgery. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2023. [DOI: 10.15829/1728-8800-2023-3381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Aim. To develop a program for early physical rehabilitation of inpatients after heart valve surgery and to evaluate its effectiveness and safety.Material and methods. The study included 80 patients with valvular heart disease (VHD) after elective on pump valve surgery. Patients in the control group (n=47) underwent standard cardiac rehabilitation after surgery; patients of the main group (n=33) additionally, starting from the 8th day after the intervention, had 14-day treadmill training with the program selection, taking into account the results of cycle ergometry spirometry (CES). A week after the operation and at the end of the training course (median, 24 days after the operation), cardiac remodeling and functional status was assessed according to echocardiography and CE, respectively.Results. For 7 days after surgery, patients of both groups were comparable. During physical training in the main group, there were no lifethreatening cardiac arrhythmias, episodes of ischemia, desaturation, as well as intracardiac hemodynamics deterioration. With a 14-day training, CES showed a significant increase in exercise tolerance (ET) in the main group from a median of 50 to 75 W (p=0,002), peak oxygen uptake (VO2peak) from 11,7 to 13,4 ml/kg/min (p=0,001). For 24 days after surgery in the control group, there was a trend towards improvement in ET and VO2peak, but without significant changes (p=0,09/p=0,08).Conclusion. Early inhospital rehabilitation, including physical training of moderate intensity with an individual treadmill speed and incline angle, starting from day 8 after surgery, showed effectiveness and safety in the form of an increase in ET and VO2peak, while not worsening hemodynamic parameters.
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Affiliation(s)
- I. N. Lyapina
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - V. A. Shaleva
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - Yu. E. Teplova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - S. A. Pomeshkina
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - O. L. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
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Move in the Tube Sternal Precautions: A Retrospective Analysis of a Single Inpatient Rehabilitation Facility. Cardiopulm Phys Ther J 2022. [DOI: 10.1097/cpt.0000000000000194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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