Efecto de un programa de rehabilitación cardiaca basado en ejercicio sobre la capacidad física, la función cardiaca y la calidad de vida, en pacientes con falla cardiaca

Changes in functional capacity of heart failure patients following a cardiac rehabilitation program

PURPOSE

To evaluate the effectiveness of a cardiac rehabilitation (CR) program on functional capacity in patients with heart failure at a high-complexity hospital in the city of Cali during the period from 2017 to 2023.

METHODS

A retrospective descriptive study that included 127 patients over 18 years of age diagnosed with heart failure, who completed 36 rehabilitation sessions with complete records of the 6-minute walk test (6MWT), anthropometric and physiological measurements at the beginning and end of the program. Categorical variables were summarized as absolute frequencies and percentages. For dependent variables, the Wilcoxon signed-rank test for paired samples was applied. Statistical significance was set at 0.05.

RESULTS

The median age was 65 years. Overall, a significant improvement was observed in the distance covered during the walk test and oxygen consumption with the CR program. In patients under 60 years of age, the distance increased from 479.0 to 598.5 meters, while in the group over 60 years, the distance improved from 419.0 to 523.0 meters.

CONCLUSION

The CR program proved to be effective in improving functional capacity and quality of life in patients. These findings highlight the importance of implementing structured rehabilitation programs for patients with cardiovascular diseases.

Research on heart failure in Colombia 1980-2015: a systematic review

Introducción. La falla cardíaca es una de las enfermedades con mayor prevalencia a nivel mundial. En Colombia no se conoce con certeza el estado de la investigación en torno al tema.Objetivo. Describir las publicaciones originales en falla cardíaca en Colombia.Materiales y métodos. Revisión sistemática. Búsqueda electrónica en Embase, PubMed, LILACS Y SciELO, con términos MeSH: “heart failure”, “colombian”, “Colombia”, “Latin America”, “developing countries”. Búsqueda manual en 58 revistas identificadas en Publindex. Se incluyeron investigaciones originales, publicadas entre 1980 y 2015, que evaluaron población adulta colombiana con falla cardíaca.Resultados. Se identificaron 2 684 artículos: 35 cumplieron criterios de inclusión; 30 (85.7%) fueron publicados a partir del 2009; 30 (85.7%) se realizaron en Bogotá y Medellín; 11 (31.4%) tuvieron n>200; 19 (54.2%) fueron descriptivos y 5 (14.2%) cuasiexperimentales; 9 (25.7%) describieron poblaciones generales; 9 (25.7%) abordaron el tema del autocuidado, 3 (8.8%), la rehabilitación cardíaca, 3 (8.8%), la percepción de enfermedad y 3 (8.8%), los factores pronósticos.Conclusión. El número de investigaciones originales publicadas sobre falla cardíaca es escaso; la mayoría se realizó en los últimos años. El diseño descriptivo fue el más común. Los temas abordados con mayor frecuencia fueron el autocuidado y las descripciones poblacionales.

Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity

The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3–14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice.