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El-Malahi O, Mohajeri D, Mincu R, Bäuerle A, Rothenaicher K, Knuschke R, Rammos C, Rassaf T, Lortz J. Beneficial impacts of physical activity on heart rate variability: A systematic review and meta-analysis. PLoS One 2024; 19:e0299793. [PMID: 38578755 PMCID: PMC10997132 DOI: 10.1371/journal.pone.0299793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/16/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV. METHODS Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed. RESULTS Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p < 0.01) concerning CHF. CONCLUSION We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.
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Affiliation(s)
- Ouahiba El-Malahi
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Darya Mohajeri
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Raluca Mincu
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Korbinian Rothenaicher
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Ramtin Knuschke
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
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Scheer A, Shah A, Ito Ramos de Oliveira B, Moreno-Suarez I, Jacques A, Green D, Maiorana A. Twelve weeks of water-based circuit training exercise improves fitness, body fat and leg strength in people with stable coronary heart disease: a randomised trial. J Physiother 2021; 67:284-290. [PMID: 34518147 DOI: 10.1016/j.jphys.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
QUESTION In people with stable coronary heart disease, what are the effects of water-based circuit training exercise on aerobic capacity, strength and body composition? How do these effects compare with those of gym-based exercise? DESIGN Parallel group, randomised controlled trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS Fifty-two participants with stable coronary heart disease. INTERVENTIONS Twelve weeks of: three 1-hour sessions per week of moderate-intensity water-based circuit training exercise with alternating aerobic and resistance stations (WEX); three 1-hour sessions per week of moderate-intensity gym-based circuit training exercise (GEX); or continuing usual activities (control). OUTCOME MEASURES Aerobic capacity (VO2peak), upper and lower limb one repetition maximum strength (biceps curl, latissimus dorsi pulldown, hamstring curl and leg press), anthropometry (weight, body mass index and girth) and dual energy x-ray absorptiometry. RESULTS Forty-five participants completed the study (WEX n = 15, GEX n = 18, control n = 12). Both training groups significantly improved VO2peak compared with control: WEX by 2.5 ml/kg/min (95% CI 0.6 to 4.4) and GEX by 2.3 ml/kg/min (95% CI 0.6 to 4.0). WEX and GEX improved hamstring strength compared with control: WEX by 6.3 kg (95% CI 1.2 to 11.3) and GEX by 7.6 kg (95% CI 2.9 to 12.2). Compared with control, GEX increased leg press strength by 15.5 kg (95% CI 5.7 to 25.3), whereas the effect of WEX was less clear (MD 7.1 kg, 95% CI -3.5 to 17.7). Only GEX improved latissimus dorsi pulldown strength. Compared with control, total body fat was reduced with WEX (-1.1 kg, 95% CI -2.3 to 0.0) and GEX (-1.2 kg, 95% CI -2.3 to -0.1). There were negligible between-group differences in weight or waist circumference. CONCLUSION WEX was well tolerated and improved aerobic capacity, leg strength and body fat to a similar degree as GEX in people with coronary heart disease. These findings suggest that WEX is an effective exercise training alternative to GEX for people with coronary heart disease. TRIAL REGISTRATION ANZCTR12616000102471.
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Affiliation(s)
- Anna Scheer
- School of Allied Health, Curtin University, Perth, Australia
| | - Amit Shah
- Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia
| | | | - Ignacio Moreno-Suarez
- School of Allied Health, Curtin University, Perth, Australia; The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Hong Kong
| | - Angela Jacques
- School of Allied Health, Curtin University, Perth, Australia
| | - Daniel Green
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Andrew Maiorana
- School of Allied Health, Curtin University, Perth, Australia; Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia; Allied Health Department, Fiona Stanley Hospital, Perth, Australia.
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Modification of the Forms of Self-Determined Regulation and Quality of Life after a Cardiac Rehabilitation Programme: Tennis-Based vs. Bicycle Ergometer-Based. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179207. [PMID: 34501797 PMCID: PMC8430765 DOI: 10.3390/ijerph18179207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
Background: The objective is to analyse and compare the effects of an adapted tennis cardiac rehabilitation programme and a classical bicycle ergometer-based programme on the type of motivation towards sports practice and quality of life in patients classified as low risk after suffering acute coronary syndrome. Methods: The Behavioural Regulation in Exercise Questionnaire (BREQ-2) and Velasco’s Qualityof Life Test were applied. The sample comprised 110 individuals (age = 55.05 ± 9.27) divided into two experimental groups (tennis and bicycle ergometer) and a control group. Results: The intra-group analysis showed a significant increase between pre- and post-test results in intrinsic regulation in the tennis group and in the control group. In identified regulation, the bicycle ergometer group presented significant differences from the control group. On the other hand, in the external regulation variable, only the tennis group showed significant differences, which decreased. Significant improvements in all quality-of-life factors when comparing the pre-test period with the post-test period were only found in the experimental groups. As per the inter-group analysis, significant differences were observed in favour of the tennis group with respect to the control group in the variables of health, social relations and leisure, and work time as well as in favour of the bicycle ergometer group compared with the control group in the variables of health, sleep and rest, future projects and mobility. No significant differences were found in any of the variables between the tennis group and the bicycle ergometer group. Conclusion: It is relevant to enhance the practice of physical exercise in infarcted patients classified as low risk as it improves the forms of more self-determined regulation towards sporting practice and their quality of life.
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Ribeiro BC, Poça JJGD, Rocha AMC, Cunha CNSD, Cunha KDC, Falcão LFM, Torres DDC, Rocha LSDO, Rocha RSB. Different physiotherapy protocols after coronary artery bypass graft surgery: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 26:e1882. [PMID: 33103326 DOI: 10.1002/pri.1882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/30/2020] [Accepted: 10/12/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to investigate the influence of different physiotherapy protocols on heart rate variability (HRV) and hospital length of stay in older adults undergoing coronary artery bypass graft (CABG). METHODS Randomized controlled trial with allocation and researcher blinding and intention-to-treat analysis. Forty-eight patients undergoing CABG were randomly assigned to a control group (CG), early mobilization group (EMG), or virtual reality group (VRG). CG performed respiratory physiotherapy and metabolic exercises, the EMG performed cycle ergometer exercises and ambulation, and the VRG performed the same activities as the EMG, with the addition of two Nintendo Wii games during 3 postoperative days. The variables of heart rate variability on preoperative and fourth postoperative day, and time of discharge of hospital was analyzed. RESULTS The VRG presented a shorter hospital length of stay (p = 0.03). The CG showed a decline in HRV from the preoperative period to fourth postoperative day on square root of the mean of the squared differences between successive RR intervals (33.18 ± 9.89-9.74 ± 6.88, p < 0.05), standard deviation of all RR intervals (25.48 ± 7.50-15.23 ± 11.27, p < 0.05), and dispersion of points perpendicular to identity line (28.26 ± 21.6-2.73 ± 1.31, p < 0.05). The EMG and VRG presented a higher cardiac autonomic modulation compared to the CG (p < 0.05), with improved parasympathetic activity. CONCLUSIONS Different protocols of physiotherapy intervention affected autonomic modulation of the heart rate and hospital length of stay in patients undergoing CABG.
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Comparative Effects of High-Intensity Interval Training vs Moderate-Intensity Continuous Training in Phase III of a Tennis-Based Cardiac Rehabilitation Program: A Pilot Randomized Controlled Trial. SUSTAINABILITY 2020. [DOI: 10.3390/su12104134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to investigate the effects of two tennis-based cardiac rehabilitation programs using two protocols: high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) in the body composition, physical fitness, heart rate variability, and health-related quality of life. It was performed as a single-blinded randomized controlled trial of 21 people with acute coronary syndrome. The 12-week cardiac rehabilitation program consisted of three sessions per week of 60 min with the main part consisting of 10 sets of 15 s with 15 s of active recovery at 85%–90% of their maximum heart rate or 40 min at 70%–85% of their maximum heart rate in the HIIT and the MICT groups, respectively. Results show that both cardiac rehabilitation programs improved the agility and the mental components of the health-related quality of life (p-value < 0.05). The HIIT protocol also showed a significant improvement in the flexibility of upper and lower limbs (p-value < 0.05). Moreover, significant group × time interaction was found in the handgrip strength in favor of the HIIT group (p-value = 0.035). Nevertheless, no significant effects on cardiorespiratory fitness or heart rate variability were found. Importantly, no adverse event was detected, so HIIT appears to be a safe and effective alternative for the rehabilitation of patients with acute coronary syndrome.
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Park SY, Wong A, Son WM, Pekas EJ. Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease. J Appl Physiol (1985) 2020; 128:565-575. [PMID: 32027542 DOI: 10.1152/japplphysiol.00744.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with poor vascular function, walking impairment, and reduced quality of life. Land-based exercise therapy (LBET) is frequently recommended to improve walking and reduce symptoms. Recently, evidence has suggested that heated-water exercise therapy (HWET) is an effective intervention for PAD. However, the efficacy of LBET versus HWET in PAD patients had not been elucidated. Therefore, we sought to compare effects of LBET with HWET on cardiovascular function, exercise tolerance, physical function, and body composition in PAD patients. PAD patients (n = 53) were recruited and randomly assigned to a LBET group (n = 25) or HWET group (n = 28). The LBET group performed treadmill walking, whereas the HWET group performed walking in heated water for 12 wk. Leg (legPWV) and brachial-to-ankle arterial stiffness (baPWV), blood pressure (BP), ankle-brachial index (ABI), 6-min walking distance (6MWD), claudication onset time (COT), physical function, and body composition were assessed before and after 12 wk. There were significant group-by-time interactions (P < 0.05) for legPWV, BP, 6MWD, COT, body composition, and resting metabolic rate (RMR). Both groups significantly reduced (P < 0.05) legPWV, BP, and body fat percentage, and HWET measures were significantly lower than LBET measures. Both groups significantly increased 6MWD, COT, and RMR, and HWET group measures were significantly greater than LBET measures. A time effect was noted for baPWV reduction in both groups (P < 0.05). These results suggest that both LBET and HWET improve cardiovascular function, exercise tolerance, and body composition, and HWET showed considerably greater improvements compared with LBET in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that although land-based exercise therapy is effective for reducing arterial stiffness and blood pressure in patients with peripheral artery disease (PAD), heated-water exercise therapy demonstrates greater benefits on vascular function. The greater improvements in muscular strength, time to onset of claudication, and exercise tolerance after heated-water exercise therapy may have clinical implications for improving quality of life in patients with PAD. The heated-water exercise therapy intervention demonstrated relatively higher exercise training adherence (∼88%) compared with the land-based exercise intervention (∼81%).
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Affiliation(s)
- Song-Young Park
- School of Health and Kinesiology, University of Nebraska-Omaha, Omaha, Nebraska
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, Virginia
| | - Won-Mok Son
- School of Health and Kinesiology, University of Nebraska-Omaha, Omaha, Nebraska
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska-Omaha, Omaha, Nebraska
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Göz M, Sert C, Hazar A, Aydın MS, Kankılıç N. Bioelectrical Impedance Analysis for Monitoring Fluid and Body Cell Mass Changes in Patients Undergoing Cardiopulmonary Bypass. Braz J Cardiovasc Surg 2020; 35:16-21. [PMID: 32270955 PMCID: PMC7089741 DOI: 10.21470/1678-9741-2019-0152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate preoperative and postoperative body fluid distribution with a bioelectrical impedance analyzer in patients undergoing cardiopulmonary bypass. METHODS Fifteen adult patients undergoing cardiopulmonary bypass were included in this study. Total body fluid changes, basal metabolism rates, body fat masses, lean body masses, and total cell masses were recorded. The patients' values were measured before anesthesia, after anesthesia, after sternotomy, at the 5th, 30th, and 60th minutes of cardiopulmonary bypass, and on the 1st, 3rd, and 5th postoperative days. All values were compared with preoperative values. RESULTS Total body fluid changed significantly after cardiopulmonary bypass (P<0.01). Metabolic velocity significantly changed compared to preoperative measurements (P<0.05). Fat mass and lean body mass also changed significantly. Body mass index and phase angle did not change significantly (P>0.05). CONCLUSION Changes in body fluids during and after cardiopulmonary bypass are inevitable. The increase in total body weight shows that this fluid load shifts to the extracellular space during bypass and the fluid load in this area passes into the intravascular area in the early postoperative period. This may cause edema and dysfunction in the major organs. Therefore, the fluid balance should be adjusted very carefully, especially during the bypass phase and the early postoperative period.
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Affiliation(s)
- Mustafa Göz
- Harran University Medical School Department of Cardiovascular Surgery Şanliurfa Turkey Department of Cardiovascular Surgery, Medical School of Harran University, Şanliurfa, Turkey
| | - Cemil Sert
- Harran University Medical School Department of Biophysics Şanliurfa Turkey Department of Biophysics, Medical School of Harran University, Şanliurfa, Turkey
| | - Abdussamet Hazar
- Malatya Education and Research Hospital Department of Cardiovascular Surgery Malatya Turkey Department of Cardiovascular Surgery, Malatya Education and Research Hospital, Malatya, Turkey
| | - Mehmet Salih Aydın
- Harran University Medical School Department of Cardiovascular Surgery Şanliurfa Turkey Department of Cardiovascular Surgery, Medical School of Harran University, Şanliurfa, Turkey
| | - Nazim Kankılıç
- Harran University Medical School Department of Cardiovascular Surgery Şanliurfa Turkey Department of Cardiovascular Surgery, Medical School of Harran University, Şanliurfa, Turkey
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Cugusi L, Manca A, Bassareo PP, Crisafulli A, Deriu F, Mercuro G. Supervised aquatic-based exercise for men with coronary artery disease: a meta-analysis of randomised controlled trials. Eur J Prev Cardiol 2019; 27:2387-2392. [PMID: 31640423 DOI: 10.1177/2047487319878109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Lucia Cugusi
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Italy
| | - Pier Paolo Bassareo
- University College of Dublin, Mater Misericordiae University Hospital, Republic of Ireland
| | - Antonio Crisafulli
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
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