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Wrzeciono A, Cieślik B, Kiper P, Szczepańska-Gieracha J, Gajda R. Non-Sleep Deep Rest Relaxation and Virtual Reality Therapy for Psychological Outcomes in Patients with Coronary Artery Disease: A Pilot Randomized Controlled Trial. J Clin Med 2024; 13:7178. [PMID: 39685636 DOI: 10.3390/jcm13237178] [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: 10/24/2024] [Revised: 11/20/2024] [Accepted: 11/26/2024] [Indexed: 12/18/2024] Open
Abstract
Background: While cardiac rehabilitation (CR) primarily focuses on restoring physical strength, preventing relapse, and reducing rehospitalization rates, psychological interventions play a complementary role by supporting mental health, which is crucial for patients' long-term adherence and overall recovery. The effectiveness of psychological interventions in CR is debated, and while technologies like virtual reality (VR) therapy show promise, they have limitations for patients with coronary artery disease (CAD). Therefore, this study examines non-sleep deep rest (NSDR) relaxation, a novel and easily implementable technique, and compares its impact on depression, anxiety, and stress with VR therapy and standard care. Methods: Forty-five CAD patients undergoing CR in ambulatory conditions were divided into three groups: the NSDR group, which received eight sessions of NSDR relaxation as part of their rehabilitation; the VR group, which received eight sessions of VR therapy as part of their rehabilitation; and the control group, which received standard care including Schultz Autogenic Training (SAT). The outcomes were measured using the Hospital Anxiety and Depression Scale (HADS) and the Perception of Stress Questionnaire (PSQ). Results: Both NSDR relaxation and VR therapy were effective in reducing the HADS total score, anxiety levels, the PSQ general score, and emotional tension. No significant differences were observed between the two treatment approaches. However, SAT was found to be insufficient for effectively improving the mental state of cardiac patients. Conclusions: This study suggests that NSDR relaxation is an effective psychotherapeutic intervention in CR. NSDR and VR therapy showed similar benefits, offering promising alternatives to traditional methods. Integrating these techniques could enhance patient outcomes and adherence in CR. Further research is needed to refine these interventions and optimize their clinical application.
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Affiliation(s)
- Adam Wrzeciono
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | | | - Robert Gajda
- Gajda-Med District Hospital, 06-100 Pułtusk, Poland
- Institute of Physical Culture Sciences, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland
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2
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Rich TL, Silva MA, O'Donnell F, Theis-Mahon N, Marth LA, Saylor EP. Exploring maintenance rehabilitation in adults with chronic conditions: a scoping review of the literature. Disabil Rehabil 2024:1-11. [PMID: 39440854 DOI: 10.1080/09638288.2024.2417771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 10/10/2024] [Accepted: 10/12/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVE Individuals with chronic conditions have long-term needs which can be addressed by maintenance rehabilitation. The 2013 Jimmo v Sebelius settlement in the United States (US) clarified the Medicare coverage of maintenance rehabilitation as a skilled service, even when no improvement is expected. A scoping review was conducted to describe maintenance rehabilitation. MATERIALS AND METHODS A systematic search was performed across 9 databases. Maintenance rehabilitation was defined as services (e.g. occupational, physical, or speech language therapies), intended to maintain a person's condition and prevent decline. Studies focused on medical, or non-rehabilitative, interventions (e.g. opioid cessation or chemotherapy) were excluded. Of the 734 abstracts reviewed, 90 met inclusion criteria. Two reviewers extracted data and used descriptive statistics. An exploratory thematic analysis in a convenience sample contextualized the works. RESULTS Most works (90%) were peer-reviewed publications. The works represented 12,638 individuals, with predominant populations being cardiac (4,122 individuals) and pulmonary (2,324 individuals). Physical activity interventions were identified most frequently (87%). Outcome measures primarily focused on activities (49%) or body systems (42%). Thematic analysis suggests maintenance rehabilitation may support domains contributing to quality of life. CONCLUSIONS While evidence exists for maintenance therapy, future research on intervention design will guide implementation by health systems.
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Affiliation(s)
- Tonya L Rich
- Minneapolis VA Health Care System, Rehabilitation and Extended Care Service Line, Minneapolis, Minnesota, USA
- Department of Family Medicine and Community Health, Rehabilitation Science Program, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marcelo A Silva
- Department of Veterans Affairs, Veterans Integrated Services Network 08, Tampa, Florida, USA
| | - Frederica O'Donnell
- Department of Veterans Affairs, Rehabilitation and Prosthetic Services, Washington, DC, USA
| | - Nicole Theis-Mahon
- Health Sciences Library, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lindsay A Marth
- Minneapolis VA Health Care System, Rehabilitation and Extended Care Service Line, Minneapolis, Minnesota, USA
| | - Emily P Saylor
- Department of Veterans Affairs, Veterans Integrated Services Network 04, Pittsburgh, Pennsylvania, USA
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Najafi M, Teimouri-Jervekani Z, Jamalian M, Roohafza H, Paknahad MH, Hadavi MM, Dorostkar N, Sadeghi M. Gender differences in cardiac rehabilitation participation and outcomes: an 18-year retrospective study in Iran. Egypt Heart J 2024; 76:133. [PMID: 39365397 PMCID: PMC11452575 DOI: 10.1186/s43044-024-00565-4] [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: 06/14/2024] [Accepted: 09/20/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) is crucial for addressing cardiovascular diseases globally, with a specific emphasis on gender differences. Despite its demonstrated benefits for women, there's limited acceptance globally, especially in low- and middle-income countries. The program aims to optimize risk factors and improve overall patient well-being. METHODS A cohort study was performed on those who were candidates for CR programs during 2001-2019. Assessments were performed within one week before and one week after the 8-week CR program. Age, sex, smoking status, clinical data, resting systolic and diastolic blood pressure (SBP and DBP, respectively), echocardiography and laboratory data were obtained. Functional capacity was evaluated using the international physical activity questionnaire, and a treadmill exercise test. Anxiety, depression, general quality of life (QoL), and health-related QoL were selected for psychological status. Then statistical analysis was performed on data. RESULT In this study, the number of male patients was 1526 (73.69%). The average age of patients in the female group was higher than that of males (58.66 ± 9.08 vs. 56.18 ± 9.94), according to the crude model results, the changes in emotional, social and physical scores were significant (P-value:0.028, 0.018, 0.030), as well as the differences in Mets and smoking were significant (P-value for both < 0.001) in the adjusted model, the emotional variables and Mets changes were significant in two groups, so that the emotional score in the female group was higher than that of the male group, and the female Mets score was significantly lower than that of the male group. CONCLUSION The CR program can improve cardiovascular outcomes, but the greatest impact was on the quality of life, patient METs and smoking behavers. Also the number of female participants in the CR program was less than the number of males.
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Affiliation(s)
- Marzieh Najafi
- Department of Cardiology, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Teimouri-Jervekani
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Marjan Jamalian
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Paknahad
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mahdi Hadavi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Dorostkar
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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4
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Wray L, Capobianco L, Wells A. Cardiac Rehabilitation practitioners' views on patients' psychological needs: a qualitative study. Front Psychiatry 2024; 15:1434779. [PMID: 39421069 PMCID: PMC11484254 DOI: 10.3389/fpsyt.2024.1434779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 09/09/2024] [Indexed: 10/19/2024] Open
Abstract
Background Psychological difficulties are prevalent in patients undergoing Cardiac Rehabilitation (CR). Recent guidelines recommend that practitioners inquire and address patients' psychological concerns during CR. Therefore, Study One aimed to explore practitioners' understanding of patients' psychological needs, their confidence in supporting those needs, and their views on whether current CR meets patients' needs. Study Two aimed to validate Study Ones' findings among a wider sample of CR practitioners. Methods This study consisted of two interrelated qualitative interviews. Study One utilised qualitative interview data from the PATHWAY trial (REC Reference:15/NW/0163), while Study Two utilised new interview data collected as part of the PATHWAY Beacons study (REC Reference: 22/HRA/2220). In Study One semi-structured interviews with six CR practitioners were analysed using thematic analysis. In Study Two, 11 CR practitioners across England were interviewed using member-checking principles. Transcripts were coded systematically using the codes developed in Study One and, through constant comparative analysis. Results Four main themes were identified: staff's awareness of mental health problems, CR patients' needs, staff's self-efficacy to support patients' psychological needs, and current psychological provision in CR. The main themes and 11 subthemes were transferable to a wider range of CR practitioners, thereby indicating the trustworthiness of the findings. Conclusion Practitioners described that patients experience a range of psychological concerns, including adjustment difficulties, anxiety, and cardiac and noncardiac worries. Most practitioners normalise patient concerns and offer relaxation techniques. However, practitioners have noted that patients often have complex psychological needs, but practitioners' confidence in discussing and supporting psychological concerns varies. Practitioners expressed the need for training to support patients' psychological needs.
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Affiliation(s)
- Laura Wray
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Lora Capobianco
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Adrian Wells
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Research and Innovation, Greater Manchester Mental Health National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
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Myneni P, Bodduluri M, Gadde ST, Nimmagadda R, Manvitha M, Valiveti SC, Sahu S, Younas S. Effectiveness of Cardiac Rehabilitation in Enhancing Clinical Outcomes for Coronary Artery Disease: A Systematic Analysis. Cureus 2024; 16:e69224. [PMID: 39398827 PMCID: PMC11470123 DOI: 10.7759/cureus.69224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2024] [Indexed: 10/15/2024] Open
Abstract
Cardiac rehabilitation (CR) is a structured intervention aimed at improving the clinical outcomes for patients with coronary artery disease (CAD). This systematic review assesses how well different types of CR, such as high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), Nordic walking (NW), and home-based cardiac rehabilitation (HBCR), improve exercise capacity, quality of life, and lower death and illness rates. The objective is to assess the effectiveness of cardiovascular rehabilitation programs in enhancing clinical outcomes for patients diagnosed with CAD. A comprehensive literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model across Google Scholar, EMBASE, PubMed, Medline, and web browsers. Keywords such as "cardiac rehabilitation," "coronary artery disease," "exercise testing," "VO2 peak," and "physical activity" were used in different combinations. Studies were included if they were randomized controlled trials, observational studies, or longitudinal studies published after 2013 in English, with a focus on the impact of CR on CAD. Articles were excluded if they were reviews, meta-analyses, or did not meet the keyword requirements. A total of 375 articles were initially identified with relevant citations. After further screening, 10 studies met the inclusion criteria for analysis. The studies reviewed demonstrated that all forms of CR, including HIIT, MICT, NW, and HBCR, significantly improved exercise capacity and quality of life, and reduced depression severity among CAD patients. Nordic walking showed marked improvements in functional capacity, while HIIT resulted in higher VO2 peak levels compared to moderate-intensity exercise. Home-based CR showed greater adherence rates, especially among older patients and those with strong family support. The results also highlighted the importance of individualized exercise programs to enhance adherence and outcomes. Cardiac rehabilitation is a vital component of secondary prevention in CAD patients, significantly improving clinical outcomes, including exercise capacity, quality of life, and mortality rates. The findings underscore the importance of maintaining and expanding access to CR programs and tailoring interventions to patient needs to optimize long-term health outcomes. Future research should explore the comparative effectiveness of different CR modalities and strategies to increase patient adherence.
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Affiliation(s)
| | | | - Sai T Gadde
- General Medicine, All India Institute of Medical Sciences (AIIMS) Mangalagiri, Mangalagiri, IND
| | - Rithish Nimmagadda
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Male Manvitha
- Internal Medicine, Sri Venkateswara Institute of Medical Sciences (SVIMS) Sri Padmavathi Medical College for Women (SPMCW), Tirupati, IND
| | - Sindhu Chowdary Valiveti
- General Medicine, Sri Venkateswara Institute of Medical Sciences (SVIMS) Sri Padmavathi Medical College for Women (SPMCW), Tirupati, IND
| | - Sweta Sahu
- Internal Medicine, JJM Medical College, Davanagere, IND
| | - Salma Younas
- Pharmacy, Punjab University College of Pharmacy, Lahore, PAK
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6
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Jug B, Sedlar Kobe N, Stojinic D, Lainscak M, Farkas J. Cardiac rehabilitation patient perspectives during COVID-19 pandemic: quantitative and qualitative study. Front Cardiovasc Med 2024; 11:1373684. [PMID: 39139755 PMCID: PMC11319166 DOI: 10.3389/fcvm.2024.1373684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024] Open
Abstract
Background This study aimed to quantitatively assess stress, anxiety and obsessive thinking related to coronavirus disease-19 (COVID-19) and qualitatively appraise perceptions in patients after acute myocardial infarction (AMI) undergoing cardiac rehabilitation (CR) during the COVID-19 pandemic. Methods We used mixed-methods design in patients referred for CR in 2 centres which delivered uninterrupted service during COVID-19 pandemic. Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS), COVID-19 Stress Scale (CSS), Hospital Anxiety and Depression Scale (HADS), and in-person interviews (combination of a priori questions and probing) were used to evaluate patient experience and perceptions with COVID-19 and the healthcare services during pandemic. Results In total, 109 patients (mean age 59 ± 10, 20% women) were included in quantitative part and in 30 of them we conducted the in-person interviews. About a quarter of patients met HADS threshold for anxiety and depression while CAS and OCS results demonstrated extremely low possibility of coronavirus related dysfunctional thinking (3%) and anxiety (2%). The CSS indicated the most prevalent concerns were related to COVID-19 vaccines safety (60%) and fear of getting infected (60%). During interviews, patients perceived the CR as well as health care providers as safe, trustworthy and with enough support to avoid or manage COVID-19 related health risks. Conclusions Overall, patients reported AMI affected their lives more than the COVID-19 pandemic. The COVID-19 related stress and anxiety were relatively low and mostly related to general views of infectious disease. CR was perceived safe and trustworthy in terms of primary disease and COVID-19. Lay summary This mixed-method study included 109 patients with acute myocardial infarction who underwent cardiac rehabilitation during the COVID-19 and focused on their experience and perceptions with COVID-19 and the healthcare services during pandemic.-Patients reported acute myocardial infarction affected their lives more than the COVID-19 pandemic.-The COVID-19 related concerns were mostly related to general views of infectious disease (vaccine safety, fear of getting infected) whilst cardiac rehabilitation was perceived safe and trustworthy environment during COVID-19.
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Affiliation(s)
- Borut Jug
- University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | | | - Mitja Lainscak
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- General Hospital Murska Sobota, Murska Sobota, Slovenia
| | - Jerneja Farkas
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- General Hospital Murska Sobota, Murska Sobota, Slovenia
- National Institute of Public Health, Ljubljana, Slovenia
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7
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Gueçamburu M, Verdy G, Cuadros J, Nocent-Ejnaini C, Macey J, Portel L, Rapin A, Zysman M. Insufficient Pulmonary Rehabilitation Uptake After Severe Exacerbation of COPD: A Multicentre Study in the South West Region of France. Int J Chron Obstruct Pulmon Dis 2024; 19:1579-1589. [PMID: 38983577 PMCID: PMC11232955 DOI: 10.2147/copd.s460991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024] Open
Abstract
Purpose Pulmonary rehabilitation (PR) is a type of multidisciplinary care strongly recommended after severe exacerbation of chronic obstructive pulmonary disease (COPD). Recently, a national French study reported a very low rate of PR uptake (8.6%); however, important clinical data were missing. Here, we aimed to identify the main factors associated with insufficient PR uptake after hospitalisation for COPD exacerbation. Patients and Methods This multicentre retrospective study included patients hospitalised with COPD exacerbation between 1 January 2017 and 31 December 2018, as identified by both coding and a detailed review of medical records. PR was defined as inpatient care in a specialised centre or unit within 90 days of discharge. Multivariate logistic regression was used to identify associations between PR uptake and patient characteristics, such as comorbidities, non-invasive ventilation (NIV), inhaled treatment, and forced expiratory volume in 1 second (FEV1). Results Among the 325 patients admitted for severe COPD exacerbation, 92 (28.3%) underwent PR within 90 days of discharge. In univariate analysis, relative to those who underwent PR, patients without PR had significantly more comorbidities, were less often treated with triple bronchodilator therapy or NIV, and had a higher FEV1. In multivariate analysis, variables independently associated with the lack of PR uptake were the presence of comorbidities (adjusted odds ratio (aOR) = 1.28 [1.10-1.53], p = 0.003) and a higher FEV1 (aOR = 1.04 [1.02-1.06], p < 0.001). There was no significant correlation between PR uptake and departmental PR centre capacity (notably, some departments had no PR facilities). Conclusion These data highlight the lack of PR in the early stages of COPD. Collaboration among all healthcare providers involved in patient management is crucial for improved PR uptake.
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Affiliation(s)
- Marina Gueçamburu
- Service des Maladies Respiratoires, CHU Bordeaux, Pessac, 33604, France
- Service de pneumologie, Centre Hospitalier de la Côte Basque, Bayonne, France
- Service de pneumologie, Centre Hospitalier Robert Boulin, Libourne, France
| | - Guillaume Verdy
- Unité d’Informatique et d’Archivistique Médicales, Service d’Information Médicale, CHU Bordeaux, Pessac, 33604, France
| | - Julie Cuadros
- Service des Maladies Respiratoires, CHU Bordeaux, Pessac, 33604, France
| | | | - Julie Macey
- Service des Maladies Respiratoires, CHU Bordeaux, Pessac, 33604, France
| | - Laurent Portel
- Service de pneumologie, Centre Hospitalier Robert Boulin, Libourne, France
| | - Amandine Rapin
- Université de Reims Champagne-Ardenne, VieFra, Reims, F-51100, France
- CHU de Reims, Unité de Médecine Physique et de Réadaptation, Reims, F-51100, France
| | - Maéva Zysman
- Service des Maladies Respiratoires, CHU Bordeaux, Pessac, 33604, France
- Univ-Bordeaux, Centre de Recherche cardio-thoracique de Bordeaux, U1045, CIC 1401, Pessac, F-33604, France
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Quach S. What's Next in MHealth Apps in Rehabilitation: Re-Directing Our Attention to Evaluating Quality. Physiother Can 2024; 76:157-159. [PMID: 38725605 PMCID: PMC11078248 DOI: 10.3138/ptc-2023-76-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Shirley Quach
- From the: School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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9
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Quach S. Que nous réservent les applis de santé mobile en réadaptation – se concentrer sur l’évaluation de la qualité. Physiother Can 2024; 76:160-162. [PMID: 38725591 PMCID: PMC11078243 DOI: 10.3138/ptc-2023-76-2.fr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Shirley Quach
- From the: École des sciences de la réadaptation, Faculté des sciences de la santé, Université McMaster, Hamilton, Ontario, Canada
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10
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Lee S, Yuh C, Shin YB, Lee HJ, Lee YM, Lee J, Cho CH. Effects of a Rice-Farming Simulation Video Game on Nature Relatedness, Nutritional Status, and Psychological State in Urban-Dwelling Adults During the COVID-19 Pandemic: Randomized Waitlist Controlled Trial. J Med Internet Res 2024; 26:e51596. [PMID: 38252464 PMCID: PMC10845032 DOI: 10.2196/51596] [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: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, urban inhabitants faced significant challenges in maintaining connections with nature, adhering to nutritional guidelines, and managing mental well-being. OBJECTIVE Recognizing the urgent need for innovative approaches, this study was designed to explore the potential benefits of a specific digital intervention, the rice-farming simulation game Sakuna: Of Rice and Ruin, for nature relatedness, nutritional behaviors, and psychological well-being. METHODS A total of 66 adults without any prior major psychiatric disorders residing in an urban area were recruited for the study. They were randomly assigned to 2 groups through block randomization: the immediate intervention group (IIG; 34/66, 52%) and the waitlist group (32/66, 48%). Participants in the IIG were instructed to play the game for at least 4 days per week for 3 weeks, with each session lasting from 30 minutes to 3 hours. Assessments were performed at baseline, week 1, and week 3. The Nature Relatedness Scale (NR) and Nutrition Quotient Scale were used to evaluate nature relatedness and nutritional state, respectively. Furthermore, psychological state was assessed using the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), Brief Fear of Negative Evaluation Scale, Social Avoidance and Distress Scale, Toronto Alexithymia Scale, State-Trait Anxiety Inventory, Center for Epidemiologic Studies Depression Scale Revised, and Korean Resilience Quotient. RESULTS This study's results revealed significant time interactions between the IIG and waitlist group for both the total NR score (P=.001) and the score of the self subdomain of NR (P<.001), indicating an impact of the game on nature relatedness. No group×time interactions were found for the total Nutrition Quotient Scale and subdomain scores, although both groups showed increases from baseline. For psychological state, a significant group×time interaction was observed in the total WHOQOL-BREF score (P=.049), suggesting an impact of the game on quality of life. The psychological (P=.01), social (P=.003), and environmental (P=.04) subdomains of the WHOQOL-BREF showed only a significant time effect. Other psychological scales did not display any significant changes (all P>.05). CONCLUSIONS Our findings suggest that the rice-farming game intervention might have positive effects on nature relatedness, nature-friendly dietary behaviors, quality of life, anxiety, depression, interpersonal relationships, and resilience among urban adults during the COVID-19 pandemic. The impact of pronature games in confined urban environments provides valuable evidence of how digital technologies can be used to enhance urban residents' affinity for nature and psychological well-being. This understanding can be extended in the future to other digital platforms, such as metaverses. TRIAL REGISTRATION Clinical Research Information Service (CRIS) KCT0007657; http://tinyurl.com/yck7zxp7.
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Affiliation(s)
- Seulki Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chisung Yuh
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yu-Bin Shin
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Mee Lee
- Department of Medical Education, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jungsil Lee
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Informatics, Korea University College of Medicine, Seoul, Republic of Korea
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11
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Cascino TM, Schopfer DW, Meyer CS, Zhang N, Barnes GD, McLaughlin VV, Jackson EA, Whooley MA. Exercise Rehabilitation is Underutilized Among Veterans With Pulmonary Hypertension. Am J Cardiol 2023; 207:4-6. [PMID: 37717285 DOI: 10.1016/j.amjcard.2023.08.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Thomas M Cascino
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
| | - David W Schopfer
- San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Medicine, University of California, San Francisco, California
| | - Craig S Meyer
- San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Medicine, University of California, San Francisco, California
| | - Ning Zhang
- San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Medicine, University of California, San Francisco, California
| | - Geoffrey D Barnes
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Elizabeth A Jackson
- Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mary A Whooley
- San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Medicine, University of California, San Francisco, California
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12
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McDonagh ST, Dalal H, Moore S, Clark CE, Dean SG, Jolly K, Cowie A, Afzal J, Taylor RS. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2023; 10:CD007130. [PMID: 37888805 PMCID: PMC10604509 DOI: 10.1002/14651858.cd007130.pub5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Cardiovascular disease is the most common cause of death globally. Traditionally, centre-based cardiac rehabilitation programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based and technology-supported cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation, especially during the SARS-CoV-2 pandemic. This is an update of a review previously published in 2009, 2015, and 2017. OBJECTIVES To compare the effect of home-based (which may include digital/telehealth interventions) and supervised centre-based cardiac rehabilitation on mortality and morbidity, exercise-capacity, health-related quality of life, and modifiable cardiac risk factors in patients with heart disease SEARCH METHODS: We updated searches from the previous Cochrane Review by searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) on 16 September 2022. We also searched two clinical trials registers as well as previous systematic reviews and reference lists of included studies. No language restrictions were applied. SELECTION CRITERIA We included randomised controlled trials that compared centre-based cardiac rehabilitation (e.g. hospital, sports/community centre) with home-based programmes (± digital/telehealth platforms) in adults with myocardial infarction, angina, heart failure, or who had undergone revascularisation. DATA COLLECTION AND ANALYSIS Two review authors independently screened all identified references for inclusion based on predefined inclusion criteria. Disagreements were resolved through discussion or by involving a third review author. Two authors independently extracted outcome data and study characteristics and assessed risk of bias. Certainty of evidence was assessed using GRADE. MAIN RESULTS We included three new trials in this update, bringing a total of 24 trials that have randomised a total of 3046 participants undergoing cardiac rehabilitation. A further nine studies were identified and are awaiting classification. Manual searching of trial registers until 16 September 2022 revealed a further 14 clinical trial registrations - these are ongoing. Participants had a history of acute myocardial infarction, revascularisation, or heart failure. Although there was little evidence of high risk of bias, a number of studies provided insufficient detail to enable assessment of potential risk of bias; in particular, details of generation and concealment of random allocation sequencing and blinding of outcome assessment were poorly reported. No evidence of a difference was seen between home- and centre-based cardiac rehabilitation in our primary outcomes up to 12 months of follow-up: total mortality (risk ratio [RR] = 1.19, 95% confidence interval [CI] 0.65 to 2.16; participants = 1647; studies = 12/comparisons = 14; low-certainty evidence) or exercise capacity (standardised mean difference (SMD) = -0.10, 95% CI -0.24 to 0.04; participants = 2343; studies = 24/comparisons = 28; low-certainty evidence). The majority of evidence (N=71 / 77 comparisons of either total or domain scores) showed no significant difference in health-related quality of life up to 24 months follow-up between home- and centre-based cardiac rehabilitation. Trials were generally of short duration, with only three studies reporting outcomes beyond 12 months (exercise capacity: SMD 0.11, 95% CI -0.01 to 0.23; participants = 1074; studies = 3; moderate-certainty evidence). There was a similar level of trial completion (RR 1.03, 95% CI 0.99 to 1.08; participants = 2638; studies = 22/comparisons = 26; low-certainty evidence) between home-based and centre-based participants. The cost per patient of centre- and home-based programmes was similar. AUTHORS' CONCLUSIONS This update supports previous conclusions that home- (± digital/telehealth platforms) and centre-based forms of cardiac rehabilitation formally supported by healthcare staff seem to be similarly effective in improving clinical and health-related quality of life outcomes in patients after myocardial infarction, or revascularisation, or with heart failure. This finding supports the continued expansion of healthcare professional supervised home-based cardiac rehabilitation programmes (± digital/telehealth platforms), especially important in the context of the ongoing global SARS-CoV-2 pandemic that has much limited patients in face-to-face access of hospital and community health services. Where settings are able to provide both supervised centre- and home-based programmes, consideration of the preference of the individual patient would seem appropriate. Although not included in the scope of this review, there is an increasing evidence base supporting the use of hybrid models that combine elements of both centre-based and home-based cardiac rehabilitation delivery. Further data are needed to determine: (1) whether the short-term effects of home/digital-telehealth and centre-based cardiac rehabilitation models of delivery can be confirmed in the longer term; (2) the relative clinical effectiveness and safety of home-based programmes for other heart patients, e.g. post-valve surgery and atrial fibrillation.
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Affiliation(s)
- Sinead Tj McDonagh
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Hasnain Dalal
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Sarah Moore
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Christopher E Clark
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Sarah G Dean
- Department of Health and Community Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Aynsley Cowie
- Cardiac Rehabilitation, University Hospital Crosshouse, NHS Ayrshire and Arran, Kilmarnock, UK
| | | | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
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Rossi LP, Granger BB, Bruckel JT, Crabbe DL, Graven LJ, Newlin KS, Streur MM, Vadiveloo MK, Walton-Moss BJ, Warden BA, Volgman AS, Lydston M. Person-Centered Models for Cardiovascular Care: A Review of the Evidence: A Scientific Statement From the American Heart Association. Circulation 2023; 148:512-542. [PMID: 37427418 DOI: 10.1161/cir.0000000000001141] [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] [Indexed: 07/11/2023]
Abstract
Cardiovascular disease remains the leading cause of death and disability in the United States and globally. Disease burden continues to escalate despite technological advances associated with improved life expectancy and quality of life. As a result, longer life is associated with multiple chronic cardiovascular conditions. Clinical guidelines provide recommendations without considering prevalent scenarios of multimorbidity and health system complexities that affect practical adoption. The diversity of personal preferences, cultures, and lifestyles that make up one's social and environmental context is often overlooked in ongoing care planning for symptom management and health behavior support, hindering adoption and compromising patient outcomes, particularly in groups at high risk. The purpose of this scientific statement was to describe the characteristics and reported outcomes in existing person-centered care delivery models for selected cardiovascular conditions. We conducted a scoping review using Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials through Ovid, and ClinicalTrials.gov from 2010 to 2022. A range of study designs with a defined aim to systematically evaluate care delivery models for selected cardiovascular conditions were included. Models were selected on the basis of their stated use of evidence-based guidelines, clinical decision support tools, systematic evaluation processes, and inclusion of the patient's perspective in defining the plan of care. Findings reflected variation in methodological approach, outcome measures, and care processes used across models. Evidence to support optimal care delivery models remains limited by inconsistencies in approach, variation in reimbursement, and inability of health systems to meet the needs of patients with chronic, complex cardiovascular conditions.
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Wang H, Liu Q, Liu L, Cao J, Liang Q, Zhang X. High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials. Respir Med 2023; 208:107128. [PMID: 36717003 DOI: 10.1016/j.rmed.2023.107128] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Pulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care. METHODS Two investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis. RESULTS A total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14-0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05-0.47), peak work rate (SMD = 0.34, 95%CI: 0.17-0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23-0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06-0.54) and reduced the dyspnea (SMD = -0.27, 95%CI: -0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: -0.01-0.56) and St. George's Respiratory Questionnaire score (SMD = -0.35, 95%CI: -0.73-0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05). CONCLUSIONS HIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.
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Affiliation(s)
- Hongyan Wang
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Qin Liu
- School of Nursing, Chengdu University of TCM, China
| | - Linfeng Liu
- School of Nursing, Sichuan Nursing Vocational College, China
| | - Jun Cao
- School of Nursing, Sichuan Nursing Vocational College, China
| | | | - Xiangeng Zhang
- School of Nursing, Sichuan Nursing Vocational College, China.
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Gao Y, Yue L, Miao Z, Wang F, Wang S, Luan B, Hao W. The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial Revascularization Performed on Multiple Coronary Artery Lesions. Clin Interv Aging 2023; 18:235-248. [PMID: 36843631 PMCID: PMC9948643 DOI: 10.2147/cia.s398732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/10/2023] [Indexed: 02/20/2023] Open
Abstract
Purpose To observe the effect of cardiac rehabilitation (CR) in patients with partial revascularization performed on multiple coronary artery lesions and explore its possible mechanism. Patients and Methods A total of 400 patients with multiple coronary artery lesions were enrolled and randomly divided into a complete revascularization group and a CR group, with 200 cases in each group. Target lesion revascularization was performed radically in the complete revascularization group, while it was partially completed in the CR group, and postoperative CR was performed. All the patients were put under conventional treatment. Left ventricular end diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety and levels of serum nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF) were evaluated and compared between two groups before and after training. Results There was no significant difference in LVEDD, LVEF, 6-MWD, quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two groups before training (p>0.05). 1 year later, compared with the complete revascularization group, the occurrence of major adverse events in the CR group declined (p>0.05); the measurements of LVEDD decreased and LVEF increased (p>0.05), 6-MWD increased significantly (p<0.05), quality-of-life scores were higher (p<0.05), the levels of serum NO, NOS, and SOD increased noticeably, and the levels of serum VEGF decreased significantly in the CR group (p<0.05). There were significant differences within the same group, before and after training (p<0.05). Conclusion Cardiac rehabilitation training, not increase in the incidence of adverse events, is effective and safe after partial revascularization in patients with multiple coronary artery lesions, which has notable clinical advantages in promoting patients' exercise endurance and quality-of-life by improving the nitric oxide synthase system and antioxidant system and reducing the level of VEGF.
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Affiliation(s)
- Yang Gao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Ling Yue
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Zhilin Miao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Fengrong Wang
- Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China
| | - Shuai Wang
- Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China
| | - Bo Luan
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Wenjun Hao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China,Correspondence: Wenjun Hao, Department of Cardiology, The People’s Hospital of Liaoning Province, NO. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email
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Isernia S, Pagliari C, Bianchi LNC, Banfi PI, Rossetto F, Borgnis F, Tavanelli M, Brambilla L, Baglio F. Characteristics, Components, and Efficacy of Telerehabilitation Approaches for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215165. [PMID: 36429887 PMCID: PMC9691096 DOI: 10.3390/ijerph192215165] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is at the top of the list of non-communicable diseases with related rehabilitation needs. Digital medicine may provide continuative integrated intervention, overcoming accessibility and cost barriers. METHODS We systematically searched for randomized controlled trials on telerehabilitation (TR) in people with COPD to profile the adopted TR strategies, focusing on TR models and the main rehabilitation actions: monitoring and assessment, decision, and feedback. Additionally, a meta-analysis was run to test the TR effect on functional capacity, dyspnea, and quality of life compared to no intervention (NI) and conventional intervention (CI). RESULTS Out of the 6041 studies identified, 22 were eligible for the systematic review, and 14 were included in the meta-analyses. Results showed a heterogeneous scenario in terms of the TR features. Furthermore, only a small group of trials presented a comprehensive technological kit. The meta-analysis highlighted a significant effect of TR, especially with the asynchronous model, on all outcomes compared to NI. Moreover, a non-inferiority effect of TR on functional capacity and quality of life, and a superiority effect on dyspnea compared to CI were observed. Finally, the studies suggested a high rate of TR adherence and high safety level. CONCLUSIONS TR is an effective strategy to increase and maintain functional capacity, breath, and quality of life in people with COPD. However, a consensus on the essential elements and features of this approach needs to be defined, and the effect of long-term maintenance merits further investigation.
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Affiliation(s)
- Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
| | - Chiara Pagliari
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Correspondence:
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Xing Z, Qi Y. Development of creativity in physical education teachers using interactive technologies: involvement and collaboration. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:5763-5777. [PMID: 36373051 PMCID: PMC9638470 DOI: 10.1007/s10639-022-11422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/23/2022] [Indexed: 05/24/2023]
Abstract
The popularisation of an active lifestyle and sports is a hot topic today. The countries activate the interest of the population in physical culture introducing creative training activities in sports. The research highlights that it is important to develop creative thinking in physical education teachers. Thus, the main research goal is to analyse the influence of interactive technologies used to develop creativity among physical education teachers. The researchers use tablet computers with a video communication function for the experiment. All training sessions were conducted on the Zoom conferencing platform. The training took 6 months. The proposed training included power training, yoga, dance and gymnastics. At every third lesson, three respondents developed and presented their training programme for the rest of the group. Torrens creative thinking test was used to assess the results. The comparison of the training dynamics in men and women (P-value = 0.019 and 0.003, respectively (p ≤ 0.05)) proves the effectiveness of the proposed training techniques. It means that this technique is effective for sports activities and can be introduced in educational institutions. The scholars recommend using it in schools, universities and other educational institutions.
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Affiliation(s)
- Zhou Xing
- Department of Physical Education, School of Teacher Education, Lishui University, Lishui, China
| | - Yue Qi
- Department of Physical Education, School of Teacher Education, Lishui University, Lishui, China
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Magrì D, Piepoli M, Gallo G, Corrà U, Metra M, Paolillo S, Filardi PP, Maruotti A, Salvioni E, Mapelli M, Vignati C, Senni M, Limongelli G, Lagioia R, Scrutinio D, Emdin M, Passino C, Parati G, Sinagra G, Correale M, Badagliacca R, Sciomer S, Di Lenarda A, Agostoni P. Old and new equations for maximal heart rate prediction in patients with heart failure and reduced ejection fraction on beta-blockers treatment: results from the MECKI score data set. Eur J Prev Cardiol 2022; 29:1680-1688. [PMID: 35578814 DOI: 10.1093/eurjpc/zwac099] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022]
Abstract
AIMS Predicting maximal heart rate (MHR) in heart failure with reduced ejection fraction (HFrEF) still remains a major concern. In such a context, the Keteyian equation is the only one derived in a HFrEF cohort on optimized β-blockers treatment. Therefore, using the Metabolic Exercise combined with Cardiac and Kidney Indexes (MECKI) data set, we looked for a possible MHR equation, for an external validation of Keteyien formula and, contextually, for accuracy of the historical MHR formulas and their relationship with the HR measured at the anaerobic threshold (AT). METHODS AND RESULTS Data from 3487 HFrEF outpatients on optimized β-blockers treatment from the MECKI data set were analyzed. Besides excluding all possible confounders, the new equation was derived by using HR data coming from maximal cardiopulmonary exercise test. The simplified derived equation was [109-(0.5*age) + (0.5*HR rest) + (0.2*LVEF)-(5 if haemoglobin <11 g/dL)]. The R2 and the standard error of the estimate were 0.24 and 17.5 beats min-1 with a mean absolute percentage error (MAPE) = 11.9%. The Keteyian equation had a slightly higher MAPE = 12.3%. Conversely, the Fox and Tanaka equations showed extremely higher MAPE values. The range 75-80% of MHR according to the new and the Keteyian equations was the most accurate in identifying the HR at the AT (MAPEs = 11.3-11.6%). CONCLUSION The derived equation to estimate the MHR in HFrEF patients, by accounting also for the systolic dysfunction degree and anaemia, improved slightly the Keteyian formula. Both formulas might be helpful in identifying the true maximal effort during an exercise test and the intensity domain during a rehabilitation programme.
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Affiliation(s)
- Damiano Magrì
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" Università degli Studi di Roma, Roma, Italy
| | | | - Giovanna Gallo
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" Università degli Studi di Roma, Roma, Italy
| | - Ugo Corrà
- Cardiology Department, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno Institute, Veruno, Italy
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefania Paolillo
- Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli, Italy
| | - Pasquale Perrone Filardi
- Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli, Italy
| | - Antonello Maruotti
- Dipartimento di Giurisprudenza, Economia, Politica e Lingue Moderne-Libera Università Maria Ss Assunta
- Department of Mathematics, University of Bergen, Bergen, Norway
- School of Computing, University of Portsmouth, Portsmouth, UK
| | | | - Massimo Mapelli
- Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milano, Italy
| | - Carlo Vignati
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" Università degli Studi di Roma, Roma, Italy
| | - Michele Senni
- Department of Cardiology, Heart Failure and Heart Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Limongelli
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Napoli, Italy
| | - Rocco Lagioia
- Division of Cardiology, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy
| | - Domenico Scrutinio
- Division of Cardiology, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy
| | - Michele Emdin
- Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy.11 Cardiology Division, Santo Spirito Hospital, Roma, Italy
- Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy
| | - Claudio Passino
- Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy.11 Cardiology Division, Santo Spirito Hospital, Roma, Italy
- Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | | | - Roberto Badagliacca
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, "Sapienza", Rome University, Rome, Italy
| | - Susanna Sciomer
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, "Sapienza", Rome University, Rome, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center, Health Authority n°1 and University of, Trieste, Trieste, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milano, Italy
- Dept. Of Clinical sciences and Community health, Cardiovascular Section, University of Milano, Milano, Italy
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de Freitas Franco G, Souza LA, Monteiro MBB, Gutierres GG, Dos Santos Franco AL, Rodrigues MFSD, Cecatto RB. Comment on "Treatment of diabetic foot ulcers in a frail population with severe co-morbidities using at-home photobiomodulation laser therapy: a double-blind, randomized, sham-controlled pilot clinical study". Lasers Med Sci 2022; 37:3319-3320. [PMID: 35771314 PMCID: PMC9243837 DOI: 10.1007/s10103-022-03595-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Gislene de Freitas Franco
- Health Sciences, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, SP, 01504-001, Liberdade, São Paulo, Brazil
| | - Lincoln Almeida Souza
- School of Medicine, of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | | | - Gabriela Godinho Gutierres
- School of Medicine, of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | | | | | - Rebeca Boltes Cecatto
- Health Sciences, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, SP, 01504-001, Liberdade, São Paulo, Brazil. .,Rehabilitation Service of the, Instituto Do Câncer Do Estado de Sao Paulo School of Medicine of the University of Sao Paulo, Sao Paulo, 01246-903, Brazil.
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Abstract
Cardiac rehabilitation is a complex intervention that seeks to improve the functional capacity, wellbeing and health-related quality of life of patients with heart disease. A substantive evidence base supports cardiac rehabilitation as a clinically effective and cost-effective intervention for patients with acute coronary syndrome or heart failure with reduced ejection fraction and after coronary revascularization. In this Review, we discuss the major contemporary challenges that face cardiac rehabilitation. Despite the strong recommendation in current clinical guidelines for the referral of these patient groups, global access to cardiac rehabilitation remains poor. The COVID-19 pandemic has contributed to a further reduction in access to cardiac rehabilitation. An increasing body of evidence supports home-based and technology-based models of cardiac rehabilitation as alternatives or adjuncts to traditional centre-based programmes, especially in low-income and middle-income countries, in which cardiac rehabilitation services are scarce, and scalable and affordable models are much needed. Future approaches to the delivery of cardiac rehabilitation need to align with the growing multimorbidity of an ageing population and cater to the needs of the increasing numbers of patients with cardiac disease who present with two or more chronic diseases. Future research priorities include strengthening the evidence base for cardiac rehabilitation in other indications, including heart failure with preserved ejection fraction, atrial fibrillation and congenital heart disease and after valve surgery or heart transplantation, and evaluation of the implementation of sustainable and affordable models of delivery that can improve access to cardiac rehabilitation in all income settings.
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Affiliation(s)
- Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health & Well Being, University of Glasgow, Glasgow, UK.
- College of Medicine and Health, University of Exeter, Exeter, UK.
| | - Hasnain M Dalal
- University of Exeter Medical School (Primary Care), Smeall Building, St Luke's Campus, Exeter, UK
| | - Sinéad T J McDonagh
- University of Exeter Medical School (Primary Care), Smeall Building, St Luke's Campus, Exeter, UK
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Morimoto Y, Takahashi T, Sawa R, Saitoh M, Morisawa T, Kagiyama N, Kasai T, Dinesen B, Hollingdal M, Refsgaard J, Daida H. Web Portals for Patients With Chronic Diseases: Scoping Review of the Functional Features and Theoretical Frameworks of Telerehabilitation Platforms. J Med Internet Res 2022; 24:e27759. [PMID: 35084355 PMCID: PMC8832270 DOI: 10.2196/27759] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/08/2021] [Accepted: 12/03/2021] [Indexed: 12/25/2022] Open
Abstract
Background The COVID-19 pandemic has required an increased need for rehabilitation activities applicable to patients with chronic diseases. Telerehabilitation has several advantages, including reducing clinic visits by patients vulnerable to infectious diseases. Digital platforms are often used to assist rehabilitation services for patients in remote settings. Although web portals for medical use have existed for years, the technology in telerehabilitation remains a novel method. Objective This scoping review investigated the functional features and theoretical approaches of web portals developed for telerehabilitation in patients with chronic diseases. Methods PubMed and Web of Science were reviewed to identify articles associated with telerehabilitation. Of the 477 nonduplicate articles reviewed, 35 involving 14 portals were retrieved for the scoping review. The functional features, targeted diseases, and theoretical approaches of these portals were studied. Results The 14 portals targeted patients with chronic obstructive pulmonary disease, cardiovascular, osteoarthritis, multiple sclerosis, cystic fibrosis diseases, and stroke and breast cancer survivors. Monitoring/data tracking and communication functions were the most common, followed by exercise instructions and diary/self-report features. Several theoretical approaches, behavior change techniques, and motivational techniques were found to be utilized. Conclusions The web portals could unify and display multiple types of data and effectively provide various types of information. Asynchronous correspondence was more favorable than synchronous, real-time interactions. Data acquisition often required assistance from other digital tools. Various functions with patient-centered principles, behavior change strategies, and motivational techniques were observed for better support shifting to a healthier lifestyle. These findings suggested that web portals for telerehabilitation not only provided entrance into rehabilitation programs but also reinforced participant-centered treatment, adherence to rehabilitation, and lifestyle changes over time.
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Affiliation(s)
- Yuh Morimoto
- Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Digital Health and Telemedicine Research and Development, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Masakazu Saitoh
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Tomoyuki Morisawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Digital Health and Telemedicine Research and Development, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Digital Health and Telemedicine Research and Development, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Birthe Dinesen
- Laboratory for Welfare Technologies - Telehealth & Telerehabilitation, Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Malene Hollingdal
- Department of Cardiology, Regional Hospital in Viborg, Viborg, Denmark
| | - Jens Refsgaard
- Department of Cardiology, Regional Hospital in Viborg, Viborg, Denmark
| | - Hiroyuki Daida
- Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Digital Health and Telemedicine Research and Development, Faculty of Health Science, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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22
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Gao M, Huang Y, Wang Q, Liu K, Sun G. Effects of High-Intensity Interval Training on Pulmonary Function and Exercise Capacity in Individuals with Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review. Adv Ther 2022; 39:94-116. [PMID: 34792785 DOI: 10.1007/s12325-021-01920-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study aimed to examine the effectiveness of high-intensity interval training (HIIT) on pulmonary function and exercise capacity in individuals with chronic obstructive pulmonary disease (COPD). METHODS Ten databases (PubMed, the Cochrane Library, Web of Science, EMBASE, MEDLINE, CINAHL, CNKI, Wanfang, Weipu, and CBM) were searched for relevant articles published from inception to 30 June 2020. Studies were included if they were randomized controlled trials (RCTs) comparing a HIIT group with usual care or other training groups. Quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, and the overall quality of evidence was assessed using the GRADE approach. The primary outcomes were peak VO2 and FEV1% predicted, and the secondary outcomes were FEV1/FVC, peak VE, peak WR, 6MWD, dyspnea, health-related quality of life, and adverse event. RESULTS Twelve articles (689 patients) were included. HIIT was shown to have a positive effect on exercise capacity (peak WR, 6MWD), pulmonary function (FEV1% pred, peak VE), dyspnea, and quality of life. However, sensitivity analyses for dyspnea were unstable, and the result changed from positive to negative after removing one study (SMD = - 0.13, 95% CI [- 0.44, 0.17], P = 0.40). CONCLUSIONS HIIT could improve pulmonary function, exercise capacity, and quality of life but may not decrease dyspnea in patients with COPD. It can be recommended as a safe and effective exercise modality in rehabilitation programs. Given that the overall results were based on a limited number of studies with significant heterogeneity and some of the results were based on low GRADE rating evidence, more high-quality, larger sample size, multicenter, and long-term follow-up RCTs are needed to confirm the clinical efficacy of HIIT in patients with COPD. PROSPERO REGISTRATION CRD42020165897.
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Affiliation(s)
- Min Gao
- The Nursing School, Nanjing Medical University, Nanjing, China
| | - Yangxi Huang
- The Nursing School, Nanjing Medical University, Nanjing, China
| | - Qianyi Wang
- Jiangyin People's Hospital of Jiangsu Province, Jiangyin, China
| | - Kouying Liu
- The Nursing School, Nanjing Medical University, Nanjing, China
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guozhen Sun
- Cardiology Department of the First Affiliated Hospital of Nanjing Medical University, The Nursing School, Nanjing Medical University, Nanjing, China.
- The Nursing School, Nanjing Medical University, Nanjing, China.
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23
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Zhou G, Wang X. Editorial: Recent Advances of Evidence-Based Neuropsychology. Front Psychol 2021; 12:740450. [PMID: 34456837 PMCID: PMC8385232 DOI: 10.3389/fpsyg.2021.740450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Guangyu Zhou
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Xi Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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24
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Karege G, Zekry D, Allali G, Adler D, Marti C. Gait speed is associated with death or readmission among patients surviving acute hypercapnic respiratory failure. BMJ Open Respir Res 2021; 7:7/1/e000542. [PMID: 32561512 PMCID: PMC7304813 DOI: 10.1136/bmjresp-2019-000542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives Death or hospital readmission are frequent among patients surviving acute hypercapnic respiratory failure (AHRF). Severity scores are not valid to predict death or readmission after AHRF. Gait speed, a simple functional parameter, has been associated with hospital admission and death in the general population. The purpose of this study is to highlight an association between gait speed at hospital discharge and death or readmission among AHRF survivors. Design Secondary analysis of a prospective cohort study. Settings Single Swiss tertiary hospital, pulmonary division. Participants Patients were prospectively recruited to form a cohort of patients surviving AHRF in the intensive care unit between January 2012 and May 2015. Outcome measure Gait speed was derived from a 6 min walking test (6MWT) before hospital discharge. All predictive variables were prospectively collected. Death or hospital readmission were recorded for 6 months. Univariate and multivariate analyses were performed to evaluate the association between predictive variables and death or hospital readmission. Results 71 patients performed a 6MWT. 34/71 (48%) patients died or were readmitted to the hospital during the observation period. Median gait speed was 0.7 (IQR 0.3–1.0) m/s. At 6 months, 66% (25/38) of slow walkers (gait speed <0.7 m/s) and 27% (9/33) of non-slow walkers died or were readmitted to the hospital (p=0.002). In univariate analysis, gait speed was associated with death or readmission (HR 0.41; 95% CI 0.19 to 0.90, p=0.025). In a multivariate model adjusted for age, gender, body mass index, forced expired volume, heart failure and home mechanical ventilation, gait speed remained the only variable associated with death or readmission (multivariate HR: 0.35; 95% CI 0.14 to 0.88, p=0.025). Conclusion This study suggests that a simple functional parameter such as gait speed is associated with death or hospital readmission in patients surviving AHRF. Trial registration number NCT02111876.
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Affiliation(s)
- Gatete Karege
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Geneva University Hospitals, Geneva, Switzerland
| | - Gilles Allali
- Division of Neurology, Geneva University Hospitals, Geneve, Switzerland.,Division of Neurology, Yeshiva University, New York, New York, USA
| | - Dan Adler
- Division of Pulmonary Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Marti
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
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25
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Fettes L, Bone AE, Etkind SN, Ashford S, Higginson IJ, Maddocks M. Disability in Basic Activities of Daily Living Is Associated With Symptom Burden in Older People With Advanced Cancer or Chronic Obstructive Pulmonary Disease: A Secondary Data Analysis. J Pain Symptom Manage 2021; 61:1205-1214. [PMID: 33096219 DOI: 10.1016/j.jpainsymman.2020.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Managing activities of daily living is important to people with advanced cancer or chronic obstructive pulmonary disease (COPD). Understanding disability in activities of daily living may inform service planning. OBJECTIVE To identify the prevalence of disability in activities of daily living, associations and change over time, in older people with advanced cancer or COPD. METHODS Secondary analysis of International Access, Rights and Empowerment (IARE) studies in adults aged ≥65 years with advanced disease in the United Kingdom, Ireland, and United States, using cross-sectional (IARE I & II) and longitudinal (IARE II, 3 timepoints over 6 months) data. Measures included disability in activities of daily living (Barthel Index), symptom severity (Palliative Outcome Scale), and assistive device use (self-reported). Logistic regression was used to identify relationships between disability and age, sex, living alone, diagnosis, and symptom burden; visual graphical analysis explores individual disability trajectories. RESULTS One hundred fifty-nine participants were included (140 cancer, 19 COPD). Sixty-five percent had difficulty climbing stairs, 48% bathing, 39% dressing, and 36% mobilizing. Increased disability was independently associated with increased symptom burden (odds ratio, 1.08 [95% CI:1.02-1.15], P = 0.01) and walking unaided (z = 2.35, P = 0.02), but not with primary diagnosis (z = -0.47, P = 0.64). Disability generally increased over time but with wide interindividual variation. CONCLUSION Disability in activities of daily living in advanced cancer or COPD is common, associated with increased symptom burden, and may be attenuated by use of assistive devices. Individual disability trajectories vary widely, with diverse disability profiles. Services should include rehabilitative interventions, guided by disability in individual activities of daily living.
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Affiliation(s)
- Lucy Fettes
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK.
| | - Anna E Bone
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK
| | - Simon N Etkind
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK
| | - Stephen Ashford
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK; Regional Hyper-acute Rehabilitation Unit, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK; Centre for Nursing Midwifery and Allied health Research and the National Hospital for Neurology and Neurosurgery, University College London Hospitals, Holborn, London, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Denmark Hill, London, UK
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26
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van Zyl C, Badenhorst M, Hanekom S, Heine M. Unravelling 'low-resource settings': a systematic scoping review with qualitative content analysis. BMJ Glob Health 2021; 6:e005190. [PMID: 34083239 PMCID: PMC8183220 DOI: 10.1136/bmjgh-2021-005190] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as 'low-to-middle-income countries' or 'developing countries', are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings. METHODS A systematic scoping review was undertaken to start unravelling the term 'low-resource setting'. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to 'low-resource setting' and 'rehabilitation'. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used. RESULTS A total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term 'low-resource setting'. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices. CONCLUSION The emerging themes may assist with (1) the groundwork needed to unravel 'low-resource settings' in health-related research, (2) moving away from assumptive umbrella terms like 'low-to-middle-income countries' or 'low/middle-income countries' and (3) promoting effective knowledge transfer between settings.
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Affiliation(s)
- Chanel van Zyl
- Division of Physiotherapy, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Marelise Badenhorst
- Institute of Sport and Exercise Medicine, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Martin Heine
- Institute of Sport and Exercise Medicine, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
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27
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Li X, Xia WY, Jiang F, Liu DY, Lei SQ, Xia ZY, Wu QP. Review of the risk factors for SARS-CoV-2 transmission. World J Clin Cases 2021; 9:1499-1512. [PMID: 33728294 PMCID: PMC7942044 DOI: 10.12998/wjcc.v9.i7.1499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/22/2020] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which has lasted for nearly a year, has made people deeply aware of the strong transmissibility and pathogenicity of SARS-CoV-2 since its outbreak in December 2019. By December 2020, SARS-CoV-2 had infected over 65 million people globally, resulting in more than 1 million deaths. At present, the exact animal origin of SARS-CoV-2 remains unclear and antiviral vaccines are now undergoing clinical trials. Although the social order of human life is gradually returning to normal, new confirmed cases continue to appear worldwide, and the majority of cases are sporadic due to environmental factors and lax self-protective consciousness. This article provides the latest understanding of the epidemiology and risk factors of nosocomial and community transmission of SARS-CoV-2, as well as strategies to diminish the risk of transmission. We believe that our review will help the public correctly understand and cope with SARS-CoV-2.
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Affiliation(s)
- Xia Li
- Department of Anaesthesiology, Institute of Anaesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Wei-Yi Xia
- Poznan University of Medical Science, Poznan 60-781, Poland
| | - Fang Jiang
- Department of Anesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Dan-Yong Liu
- Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Shao-Qing Lei
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Zheng-Yuan Xia
- Department of Anesthesiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Qing-Ping Wu
- Department of Anaesthesiology, Institute of Anaesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
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28
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De Smet S, Van Craenenbroeck AH. Exercise training in patients after kidney transplantation. Clin Kidney J 2021; 14:ii15-ii24. [PMID: 33981416 PMCID: PMC8101622 DOI: 10.1093/ckj/sfab022] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/11/2021] [Indexed: 02/07/2023] Open
Abstract
Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Next to the risk of allograft failure, major obstacles for disease-free survival after kidney transplantation include a higher incidence of cancer, infection and cardiovascular events. Risk factors for adverse clinical outcomes include pre-existent comorbidities, the introduction of an immunodeficient status and (lack of) lifestyle changes after transplantation. Indeed, physical inactivity and poor physical fitness are important targets to address in order to improve clinical outcomes after kidney transplantation. This review summarizes the current evidence on exercise training after kidney transplantation, derived from randomized controlled trials. As much as possible, results are discussed in the perspective of the Standardized Outcomes in Nephrology-Transplantation core outcomes, which were recently described as critically important outcome domains for trials in kidney transplant recipients.
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Affiliation(s)
- Stefan De Smet
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Amaryllis H Van Craenenbroeck
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
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29
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Higginson IJ, Reilly CC, Maddocks M. Breathlessness. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Cascino TM, Ashur C, Richardson CR, Jackson EA, McLaughlin VV. Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States. Pulm Circ 2020; 10:2045894020974926. [PMID: 33343883 PMCID: PMC7731716 DOI: 10.1177/2045894020974926] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/30/2020] [Indexed: 11/23/2022] Open
Abstract
Exercise rehabilitation is underutilized in patients with pulmonary arterial hypertension despite improving exercise capacity and quality of life. We sought to understand the association between (1) patient characteristics and (2) patient-perceived barriers and referral to exercise rehabilitation. We performed a cross-sectional survey of patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension attending an International PAH meeting. Predictors of referral considered included gender, body mass index, subjective socioeconomic status, insurance type, age, and World Health Organization functional class and perceived barriers assessed using the Cardiac Rehabilitation Barriers Scale. Among 65 participants, those in the lowest subjective socioeconomic status tertile had reduced odds of referral compared to the highest tertile participants (odds ratio 0.22, 95% confidence interval: 0.05–0.98, p = 0.047). Several patient-perceived barriers were associated with reduced odds of referral. For every 1-unit increase in a reported barrier on a five-point Likert scale, odds of referral were reduced by 85% for my doctor did not feel it was necessary; 85% for prefer to take care of my health alone, not in a group; 78% many people with heart and lung problems don’t go, and they are fine; and 78% for I didn’t know about exercise therapy. The lack of perceived need subscale and overall barriers score were associated with a 92% and 77% reduced odds of referral, respectively. These data suggest the need to explore interventions to promote referral among low socioeconomic status patients and address perceived need for the therapy.
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Affiliation(s)
- Thomas M Cascino
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Carmel Ashur
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Elizabeth A Jackson
- Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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31
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Hui D, Maddocks M, Johnson MJ, Ekström M, Simon ST, Ogliari AC, Booth S, Ripamonti C. Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines †. ESMO Open 2020; 5:e001038. [PMID: 33303485 PMCID: PMC7733213 DOI: 10.1136/esmoopen-2020-001038] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 12/22/2022] Open
Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, London, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden
| | - Steffen T Simon
- Department of Palliative Medicine and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Anna C Ogliari
- Pulmonary Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Booth
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, London, UK; Cambridge Breathlessness Intervention Service, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - CarlaI Ripamonti
- Oncology-Supportive Care in Cancer Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milan, Italy
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32
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Xie L, Liu Z, Hao S, Wu Q, Sun L, Luo H, Yu R, Li X, Wu X, Li S. Assessment of knowledge, attitude, and practice towards pulmonary rehabilitation among COPD patients: A multicenter and cross-sectional survey in China. Respir Med 2020; 174:106198. [PMID: 33120194 DOI: 10.1016/j.rmed.2020.106198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/03/2020] [Accepted: 10/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) has been recognized to be an evidence-based treatment recommended for chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate COPD patients' knowledge, attitudes and practices towards PR in China. METHODS 1138 COPD patients from 13 hospitals were enrolled in this cross-sectional study. A questionnaire designed based on an official statement was completed by the participants. Effects of PR in patients were investigated. RESULTS Mean score of the knowledge portion was only 7.76, while 46.22% of the participants believed they needed PR. Attendance rate was 24.69%. Financial conditions and hospitalization were contributing factors for scores, attendance rate, and belief in demands for PR therapy. Severe pulmonary function impairment indicated more demands for PR (OR = 0.18) and higher uptake rate (OR = 0.30). There was a weak correlation between smoking status (rho = -0.060), diagnosis year (rho = 0.094), frequency of exacerbations (rho = 0.059) and grades. High CAT score is a facilitator for attitudes towards PR (OR = 0.022). 93.24% of patients claimed that their exercise tolerance improved with PR therapy. The improvements were positively associated with needs (rho = 0.20), family support (rho = 0.22), grades (rho = 0.18), and monthly income of the family (rho = 0.14), but negatively correlated with age (rho = -0.16), exacerbations (rho = -0.15), and CAT score (rho = -0.13). CONCLUSIONS This study suggested poor perception, disbelief in the need for PR, and limited uptake of PR among COPD patients in China, and revealed the significant factors involved. The findings of this study may assist health professionals in developing targeted strategies to promote PR and improve access and uptake of PR.
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Affiliation(s)
- Liang Xie
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zilong Liu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shengyu Hao
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qinhan Wu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lidan Sun
- Department of Respiratory Medicine, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, China
| | - Huixiu Luo
- Department of Respiratory Medicine, Shanggao People's Hospital, Yichun, Jiangxi, China
| | - Ronghuan Yu
- Department of Respiratory Medicine, Xuhui District Central Hospital, Shanghai, China
| | - Xia Li
- Department of Respiratory and Critical Care, Third People's Hospital of Dalian, Dalian, China
| | - Xiaodan Wu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Clinical Centre for Sleep Breathing Disorders and Snoring, Zhongshan Hospital, Fudan University, Shanghai, China.
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Taylor-Piliae RE, Finley BA. Tai Chi exercise for psychological well-being among adults with cardiovascular disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2020; 19:580-591. [DOI: 10.1177/1474515120926068] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background:
Regular exercise is beneficial for adults with cardiovascular disease to improve psychological well-being. Tai Chi is a mind–body exercise thought to promote psychological well-being.
Aim:
Examine the efficacy of Tai Chi in improving psychological well-being among persons with cardiovascular disease.
Methods:
An electronic literature search of 10 databases (AMED, CINAHL, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted. Clinical trials that examined one or more aspect of psychological well-being, incorporated a Tai Chi intervention among cardiovascular disease participants, and were published in English or German languages were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc.) was used to calculate the effect sizes (i.e. Hedges’ g) and the 95% confidence intervals using random effects models.
Results:
A total of 15 studies met the inclusion criteria, enrolling 1853 participants (mean age = 66 years old, 44% women). Outcomes included: quality of life (QOL), stress, anxiety, depression, and psychological distress. When Tai Chi was compared with controls, significantly better general QOL (Hedges’ g 0.96; p=0.02, I2=94.99%), mental health QOL (Hedges’ g=0.20; p=0.01, I2=15.93) and physical health QOL (Hedges’ g=0.40; p=0.00, I2=0%); with less depression (Hedges’ g=0.69; p=0.00, I2=86.64%) and psychological distress (Hedges’ g=0.58; p=0.00, I2=0%) were found.
Conclusions:
Few Tai Chi studies have been conducted during the past decade examining psychological well-being among older adults with cardiovascular disease. Further research is needed with more rigorous study designs, adequate Tai Chi exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Chi.
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Affiliation(s)
| | - Brooke A Finley
- College of Nursing, University of Arizona, Tucson, USA
- The Meadows Behavioral Health, Wickenburg, USA
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34
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Consensus document on the diagnosis and treatment of chronic bronchial infection in chronic obstructive pulmonary disease. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.arbr.2020.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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de la Rosa Carrillo D, López-Campos JL, Alcázar Navarrete B, Calle Rubio M, Cantón Moreno R, García-Rivero JL, Máiz Carro L, Olveira Fuster C, Martínez-García MÁ. Consensus Document on the Diagnosis and Treatment of Chronic Bronchial Infection in Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2020; 56:651-664. [PMID: 32540279 DOI: 10.1016/j.arbres.2020.04.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/22/2020] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
Although the chronic presence of microorganisms in the airways of patients with stable chronic obstructive pulmonary disease (COPD) confers a poor outcome, no recommendations have been established in disease management guidelines on how to diagnose and treat these cases. In order to guide professionals, the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has prepared a document which aims to answer questions on the clinical management of COPD patients in whom microorganisms are occasionally or habitually isolated. Since the available scientific evidence is too heterogeneous to use in the creation of a clinical practice guideline, we have drawn up a document based on existing scientific literature and clinical experience, addressing the definition of different clinical situations and their diagnosis and management. The text was drawn up by consensus and approved by a large group of respiratory medicine experts with extensive clinical and scientific experience in the field, and has been endorsed by the SEPAR Scientific Committee.
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Affiliation(s)
| | - José Luís López-Campos
- Servicio de Neumología, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Bernardino Alcázar Navarrete
- Servicio de Neumología, Hospital Regional Universitario de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, España
| | - Myriam Calle Rubio
- Servicio de Neumología, Hospital de Alta Resolución de Loja, Loja, Granada, España
| | - Rafael Cantón Moreno
- Servicio de Neumología, Unidad de Infección Bronquial Crónica, Fibrosis Quística y Bronquiectasias, Hospital Universitario Ramón y Cajal, Madrid, España
| | - Juan Luis García-Rivero
- Servicio de Neumología, Hospital Clínico San Carlos. Departamento de Medicina, Facultad de Medicina, UCM, Madrid, España
| | - Luís Máiz Carro
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
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Razumov AN, Ponomarenko GN, Badtieva VA. [Medical rehabilitation of patients with pneumonia associated with the new COVID-19 coronavirus infection]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2020; 97:5-13. [PMID: 32592564 DOI: 10.17116/kurort2020970315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Effective medical rehabilitation of patients with pneumonia caused by the new SARS-CoV-2 coronavirus is critical for the recovery and optimization of emergency and specialty care outcomes. In this regard, it is relevant to develop a scientifically based medical rehabilitation program for patients with the coronavirus infectious disease COVID-19, whose composition and structure includes methods and tools that have proven effectiveness. AIM To develop evidence-based approaches to medical rehabilitation for patients with pneumonia associated with the new COVID-19 coronavirus infection. RESULTS The clinical effects and suggested mechanisms of action of rehabilitation technologies in patients with pneumonia, including those associated with the new COVID-19 coronavirus infection, are considered in Detail. The most studied of the physical methods that have a proven effect are physical exercises, breathing exercises, the complex effect of factors of resort therapy, hydrotherapy, which affect the main clinical manifestations of the underlying disease, astheno-neurotic syndrome and increasing immunity. Clinical recommendations for medical rehabilitation are proposed and its promising methods are considered. CONCLUSION Regular generalization and analysis of high-quality randomized controlled clinical trials to evaluate various physical methods of treatment of patients with pneumonia associated with the new COVID-19 coronavirus infection is Necessary, which serve as a basis for the development of future valid clinical recommendations. Timely and adequate specialized medical rehabilitation care is critical to maintaining the health, reducing disability and mortality of patients with pneumonia associated with the new COVID-19 coronavirus infection.
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Affiliation(s)
- A N Razumov
- Sechenov First Moscow state medical University, Ministry of health of Russia, Moscow, Russia.,Moscow scientific and practical center for medical rehabilitation, rehabilitation and sports medicine, Moscow, Russia
| | - G N Ponomarenko
- Federal research center for rehabilitation of disabled people named after G.A. Albrecht, Ministry of labor of Russia, St. Petersburg, Russia.,St. Petersburg state medical University named after I. I. Mechnikov, Ministry of health of the Russian Federation, St. Petersburg, Russia
| | - V A Badtieva
- Sechenov First Moscow state medical University, Ministry of health of Russia, Moscow, Russia.,Moscow scientific and practical center for medical rehabilitation, rehabilitation and sports medicine, Moscow, Russia
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Jesus TS, Landry MD, Hoenig H, Zeng Y, Kamalakannan S, Britto RR, Pogosova N, Sokolova O, Grimmer K, Louw QA. Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4139. [PMID: 32531949 PMCID: PMC7312462 DOI: 10.3390/ijerph17114139] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/06/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
Abstract
Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r2 = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources.
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Affiliation(s)
- Tiago S. Jesus
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Michel D. Landry
- School of Medicine, Duke University, Durham, NC 27710, USA;
- Duke Global Health Institute (DGHI), Duke University, Durham, NC 27710, USA
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC 27705, USA;
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
| | - Yi Zeng
- Center for Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University, Durham, NC 27710, USA;
- National School of Development and Raissun Institute for Advanced Studies, Peking University, Beijing 100871, China
| | - Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health, Hyderabad 500 033, (IIPH-H), India;
| | - Raquel R. Britto
- Rehabilitation Science Post Graduation Programs of Universidade Federal de Minas Gerais and Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, Brazil;
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow 524901, Russian Federation; (N.P.); (O.S.)
| | - Olga Sokolova
- National Medical Research Center of Cardiology, Moscow 524901, Russian Federation; (N.P.); (O.S.)
| | - Karen Grimmer
- Department of Health and Rehabilitation Sciences, Physiotherapy Division, Stellenbosch University, Stellenbosch 7505, South Africa; (K.G.); (Q.A.L.)
| | - Quinette A. Louw
- Department of Health and Rehabilitation Sciences, Physiotherapy Division, Stellenbosch University, Stellenbosch 7505, South Africa; (K.G.); (Q.A.L.)
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Xing Y, Yang SD, Wang MM, Feng YS, Dong F, Zhang F. The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly. Front Physiol 2020; 11:270. [PMID: 32390856 PMCID: PMC7194188 DOI: 10.3389/fphys.2020.00270] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/09/2020] [Indexed: 12/11/2022] Open
Abstract
Worldwide, elderly people have a higher prevalence of myocardial infarction (MI), which is associated with body function aging and a sedentary lifestyle. In addition to medication, exercise training is a well-established supplementary method to prevent and treat cardiovascular diseases (CVDs). Substantial evidence has shown the value of different intensity exercise programs in the prevention and treatment of MI, and exercise rehabilitation programs are also applicable to elderly patients with MI. Although exercise rehabilitation programs could significantly improve function, quality of life (QoL), and lower mortality and morbidity for people with MI, such programs are underused because their mechanisms are not accurately elucidated. To promote the application of exercise therapy for MI, this review summarizes the benefits and mechanisms of exercise rehabilitation for post-MI patients and provides rationalized proposals for outpatient cardiac rehabilitation.
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Affiliation(s)
- Ying Xing
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Si-Dong Yang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, Australia
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Man-Man Wang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ya-Shuo Feng
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fang Dong
- Department of Clinical Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Feng Zhang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Orthopedic Biomechanics Key Laboratory, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Feng Zhang,
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