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Kanegusuku H, da Silva GO, Braghieri HA, de Carvalho JF, Costa RM, Cucato GG, Wolosker N, Ritti-Dias RM, Correia MA. Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women. EINSTEIN-SAO PAULO 2024; 22:eAO0345. [PMID: 38451689 PMCID: PMC10948092 DOI: 10.31744/einstein_journal/2024ao0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/12/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. METHODS In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. RESULTS At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. CONCLUSION Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease. BACKGROUND ▪ Sitting time increased in 73.9% of women and 84.9% of men at the onset of the pandemic. BACKGROUND ▪ Physical activity was practiced by 23.9% of women and 39.6% of men at the onset of the pandemic. BACKGROUND ▪ The prevalence of both women and men reporting physical mobility difficulties increased at follow-up. BACKGROUND ▪ Hospitalization rates for reasons unrelated to COVID-19 have increased in both women and. BACKGROUND While women experience more consequences related to peripheral artery disease than men, such as worse functional capacity and higher morbidity, there was a similar increase in physical mobility difficulty and frequency of hospitalization for reasons other than COVID-19 one year after the onset of the pandemic.
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Affiliation(s)
- Hélcio Kanegusuku
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | | | - Renan Massena Costa
- Universidade Nove de JulhoSão PauloSPBrazilUniversidade Nove de Julho, São Paulo, SP, Brazil.
| | - Gabriel Grizzo Cucato
- Northumbria UniversityNewcastle upon TyneEnglandNorthumbria University, Newcastle upon Tyne, England.
| | - Nelson Wolosker
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Hospital Israelita Albert EinsteinFaculdade Israelita de Ciências da Saúde Albert EinsteinSão PauloSPBrazilFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | - Marilia Almeida Correia
- Universidade Nove de JulhoSão PauloSPBrazilUniversidade Nove de Julho, São Paulo, SP, Brazil.
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Segheto W, Correia MDA, Kanegusuku H, Wolosker N, Ritti-Dias RM. Functional capacity and excess of body adiposity in patients with peripheral artery disease. JOURNAL OF VASCULAR NURSING 2023; 41:240-244. [PMID: 38072579 DOI: 10.1016/j.jvn.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 09/28/2023] [Accepted: 10/07/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Wellington Segheto
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249 - 2 Subsolo Liberdade São Paulo SP, CEP 01504-001, Brazil.
| | - Marilia de Almeida Correia
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249 - 2 Subsolo Liberdade São Paulo SP, CEP 01504-001, Brazil; Graduated Program in Medicine, Universidade Nove de Julho, Rua Vergueiro, 235/249 - 2º Subsolo Liberdade São Paulo SP, CEP 01504-001, Brazil
| | - Hélcio Kanegusuku
- Hospital Israelita Albert Einstein Av. Albert Einstein, 627/701 - Morumbi, São Paulo SP, CEP 05652-900, Brazil
| | - Nelson Wolosker
- Hospital Israelita Albert Einstein Av. Albert Einstein, 627/701 - Morumbi, São Paulo SP, CEP 05652-900, Brazil
| | - Raphael Mendes Ritti-Dias
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235/249 - 2 Subsolo Liberdade São Paulo SP, CEP 01504-001, Brazil
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Kanegusuku H, Braghieri HA, Carvalho JF, Oliveira MD, Silva GO, Cucato GG, Wolosker N, Correia MA, Ritti-Dias RM. Impact of physical activity on self-reported health parameters in peripheral artery disease in two periods of the COVID-19 pandemic. JOURNAL OF VASCULAR NURSING 2023; 41:109-113. [PMID: 37684087 PMCID: PMC10183624 DOI: 10.1016/j.jvn.2023.05.006] [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: 09/01/2022] [Revised: 03/21/2023] [Accepted: 05/10/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Prolonged social isolation intended to mitigate the spread of Coronavirus 2019 (COVID-19), may potentially affect the physical activity level and health of patients with peripheral artery disease (PAD). OBJECTIVES To analyze the impact of physical activity practice on longitudinal changes in self-reported health parameters during the COVID-19 pandemic in patients with PAD. DESIGN Longitudinal study. SETTING The database of studies developed by our group involving patients with PAD from public hospitals in São Paulo, Brazil. METHODS In this longitudinal study, 99 patients with PAD were evaluated in two periods during the COVID-19 pandemic (i.e., May to August 2020 and May to August 2021). Patients were interviewed by telephone, and information was obtained regarding physical activity practice and self-reported health (i.e., current global, physical, and mental health). Patients were divided into two groups: the physically inactive group (patients who were or became physically inactive, n=76, 51.3% male, 67±10 years old, 8±7 years of disease duration) and the physically active group (patients who started or continued practicing physical activity, n=23, 65.2% male, 71±8years old, 7±6 years of disease). RESULTS The physically inactive group more frequently self-reported their current health as poor (6.6 vs. 17.1%, P=0.045) and were more frequently hospitalized for reasons other than COVID-19 (6.6 vs. 27.6%, P=0.001) between the two periods evaluated during the COVID-19 pandemic. The physically active group self-reported lower declines in walking capacity (13.0 vs. 43.5%, P=0.022) between the two periods evaluated. We did not observe any differences in other parameters in either group between the two periods evaluated (p>0.05). CONCLUSIONS The practice of physical activity during the COVID-19 pandemic can help maintain or mitigate the negative impacts on self-reported global and physical health parameters in patients with PAD.
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O Silva G, Braghieri HA, D Oliveira M, Farah BQ, Kanegusuku H, Cucato GG, A Correia M, Ritti-Dias RM. Objective assessment of functional capacity in patients with peripheral artery disease: a narrative review. Expert Rev Cardiovasc Ther 2023; 21:867-875. [PMID: 37904510 DOI: 10.1080/14779072.2023.2277355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/26/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION Peripheral artery disease (PAD) patients with claudication symptoms exhibit impaired functional capacity, which has been associated with disease severity, worse quality of life and higher risk of cardiovascular events. Different tests have been used to assess functional capacity in PAD patients. Therefore, understanding the characteristics, strengths and limitations of these tests are important to support the choice of tests to be used in clinical practice. AREAS COVERED This review summarizes the main methods to assess functional capacity in PAD patients, discussing their psychometric properties, applications, and limitations. EXPERT OPINION Robust evidence supports the use of treadmill and six-minute walk tests in PAD patients, as their results are associated with clinically meaningful outcomes, adequate psychometric properties and are sensitive to effects of interventions. On the other hand, other functional tests (Shuttle-walk test, outdoor walking capacity test, timed-up and go, four-meter walk test, heel-rise test, short physical performance battery and modified physical performance battery) are related to activities of daily living and do not require sophisticated equipment and can be easily used in clinical practice. However, these other tests still need evidence regarding their clinical relevance, reliability, and ability to detect long-term intervention changes, providing further investigation directions.
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Affiliation(s)
- Gustavo O Silva
- Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | | | - Max D Oliveira
- Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Breno Quintella Farah
- Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Brazil
- Department of Physical Education, Federal Rural University of Pernambuco (UFRPE), Recife, PE, Brazil
| | | | - Gabriel Grizzo Cucato
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Marilia A Correia
- Post-graduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:ijms231810814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Kanegusuku H, Correia MA, Longano P, Ritti-Dias RM, Wolosker N, Cucato GG. Effects of arm-crank exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with peripheral artery disease: Study protocol for a randomized controlled trial. PLoS One 2022; 17:e0267849. [PMID: 35511887 PMCID: PMC9070866 DOI: 10.1371/journal.pone.0267849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Arm-crank exercise training (ACT) is an alternative exercise strategy for patients with symptomatic peripheral artery disease (PAD) due to the attenuation of pain symptoms during the exercise, as well as the benefits to functional capacity. Purpose The aim of this study is to describe the study protocol to analyze the effects of ACT exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with symptomatic PAD. Methods This is a three-armed randomized, prospective, single-blind data collection, single-center, controlled study enrolling 45 patients with symptomatic PAD who will be randomized into 3 intervention groups: walking training (WT), ACT and control group. The WT and ACT will perform 2 sessions/week, 15 to 10 sets of 2 to 5 minutes at values of 13 to 15 on the Borg scale. Before and after 12 weeks of intervention, cardiovascular function (ambulatory blood pressure, office blood pressure, central blood pressure, heart rate variability, arterial stiffness and vascular function), functional capacity (six-minute walk test, 2 minute step test, handgrip test, Walking impairment questionnaire, Walking estimated limitation calculated by history, Baltimore activity scale for intermittent claudication, and short physical performance battery), cognition (executive function and memory), and quality of life (vascular quality of life questionnaire and World Health Organization Quality of Life) will be assessed. Results This is the first trial to evaluate the effects of ACT on regulatory mechanisms of the cardiovascular system in PAD patients. If the results are as expected, they will provide evidence the ability of ACT to promote cardiovascular benefits in the symptomatic PAD population.
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Affiliation(s)
| | | | - Paulo Longano
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
| | | | | | - Gabriel Grizzo Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Ritti-Dias RM, Correia MA, Carvalho JF, Braghieri HA, Wolosker N, Cucato GG, Kanegusuku H. Impact of the COVID-19 pandemic on health lifestyle in patients with peripheral artery disease: A cross-sectional study. JOURNAL OF VASCULAR NURSING 2022; 40:54-58. [PMID: 35287835 PMCID: PMC8743617 DOI: 10.1016/j.jvn.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 08/05/2021] [Accepted: 01/01/2022] [Indexed: 12/24/2022]
Abstract
Background Social isolation has been one of the main strategies to prevent the spread of Coronavirus 2019 (COVID-19). However, the impact of social isolation on the lifestyle of patients with peripheral artery disease (PAD) and claudication symptoms remains unclear. Objectives To analyze the perceptions of patients with PAD of the impact of social isolation provoked by COVID-19 pandemic on health lifestyle. Design Cross-sectional. Setting The database of studies developed by our group involving patients with PAD from public hospitals in São Paulo. Methods In this cross-sectional survey study, 136 patients with PAD (61% men, 68 ± 9 years old, 0.55 ± 0.17 ankle-brachial index, 82.4% with a PAD diagnosis ≥5 years old) were included. Health lifestyle factors were assessed through a telephone interview using a questionnaire containing questions related to: (a) COVID-19 personal care; (b) mental health; (c) health risk habits; (d) eating behavior; (e) lifestyle; (f) physical activity; (g) overall health; and (h) peripheral artery disease health care. Results The majority of patients self-reported spending more time watching TV and sitting during the COVID-19 pandemic and only 28.7% were practicing physical exercise. Anxiety and unhappiness were the most prevalent feelings self-reported among patients and 43.4% reported a decline in walking capacity. Conclusion Most patients with PAD self-reported increased sedentary behavior, lower physical activity level, and worse physical and mental health during the COVID-19 pandemic. Thus, it is necessary to adopt strategies to improve the quality of life of these patients during this period.
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