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García-Bravo S, Cuesta-Gómez A, Campuzano-Ruiz R, López-Navas MJ, Domínguez-Paniagua J, Araújo-Narváez A, Barreñada-Copete E, García-Bravo C, Flórez-García MT, Botas-Rodríguez J, Cano-de-la-Cuerda R. Virtual reality and video games in cardiac rehabilitation programs. A systematic review. Disabil Rehabil 2019; 43:448-457. [PMID: 31258015 DOI: 10.1080/09638288.2019.1631892] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To carry out a systematic review about the information about the application of of virtual reality and videogames in cardiac rehabilitation. METHODS A systematic review was conducted. Jadad scale was applied to evaluate the methodological quality of the articles included and the degree of evidence and the level of recommendation were determined through the Oxford Center for Evidence-Based Medicine. PRISMA guidelines statement for systematic reviews were followed. RESULTS The total number of articles included in the present review was 10, with heterogeneity in the study populations, cardiac rehabilitation phases, technology used and protocols. Most of the studies showed an increase in heart rate, less pain, a greater ability to walk, higher energy levels, an increase in physical activity and improvements of motivation and adherence. The methodological quality of the studies was between acceptable and poor. CONCLUSIONS The use of virtual reality and videogames could be considered as complementary tools of physical training in patients with cardiovascular diseases in the different phases of cardiac rehabilitation. However, it is also necessary to carry out studies with adequate methodological quality to determine the ideal technological systems, target populations and clearly protocols to study their effects in the short, medium and long-term assessments.Implications for rehabilitationThe use of virtual reality and videogames could be considered as complementary tools for physical training in patients with cardiovascular diseases.Interactive virtual reality using exergames may promote heart rate, fatigue perception, physical activity and reduce pain in patients with cardiovascular diseases.Virtual reality and videogames enhance motivation and adherence in cardiac rehabilitation programs.
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Affiliation(s)
- Sara García-Bravo
- International Doctorate School, Rey Juan Carlos University, Madrid, Spain.,Physiocare Physiotherapy Clinic, Madrid, Spain
| | - Alicia Cuesta-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Raquel Campuzano-Ruiz
- Cardiac Rehabilitation Unit, Alcorcón Foundation Universitary Hospital, Alcorcón, Spain
| | | | | | - Aurora Araújo-Narváez
- Cardiac Rehabilitation Unit, Alcorcón Foundation Universitary Hospital, Alcorcón, Spain
| | | | - Cristina García-Bravo
- International Doctorate School, Rey Juan Carlos University, Madrid, Spain.,Physiocare Physiotherapy Clinic, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | | | | | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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Malo S, Aguilar-Palacio I, Feja C, Menditto E, Lallana MJ, Andrade E, Casasnovas JA, Rabanaque MJ. Persistence With Statins in Primary Prevention of Cardiovascular Disease: Findings From a Cohort of Spanish Workers. ACTA ACUST UNITED AC 2017; 71:26-32. [PMID: 28473266 DOI: 10.1016/j.rec.2017.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/21/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to assess patterns of treatment persistence in a cohort of male Spanish workers receiving statin therapy for primary prevention of cardiovascular disease. METHODS This descriptive study was conducted within the framework of the prospective longitudinal Aragon Workers' Health Study (N = 5400). Incident male statin users were identified based on data collected from the regional government's medication consumption information system. Patterns of treatment persistence with statins prescribed for primary cardiovascular disease prevention were assessed and the relevance of potential predictors explored. RESULTS Among the 725 new statin users, less than one third remained persistent during the 1 year of follow-up. About 15% of nonpersistent users discontinued statin therapy after dispensation of the first prescription; of these, 42.1% did not recommence treatment within the following year. Factors reducing the likelihood of treatment discontinuation were older age (HR, 0.55; 95%CI, 0.39-0.77) and cotreatment with antihypertensive drugs (HR, 0.68; 95%CI, 0.56-0.82). No association was observed between treatment persistence and cotreatment with antidiabetic or antithrombotic drugs, baseline low-density lipoprotein levels, or total cholesterol levels. However, persistence was influenced by the type of statin first prescribed. CONCLUSIONS Our analysis of a cohort of healthy male workers revealed poor statin persistence. These findings underscore the need for a better understanding of patterns of statin use, especially in apparently healthy individuals, and for the incorporation of patient behavior into prescribing decisions.
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Affiliation(s)
- Sara Malo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Isabel Aguilar-Palacio
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Cristina Feja
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Enrica Menditto
- Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF), Università degli Studi di Napoli Federico II, Napoli, Italy
| | - María Jesús Lallana
- Servicio Aragonés de Salud, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Elena Andrade
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz y CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José Antonio Casasnovas
- Departamento de Medicina, Psiquiatría y Dermatología, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - María José Rabanaque
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
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