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Alsaleh E, Baniyasin F. Prevalence of physical activity levels and perceived benefits of and barriers to physical activity among Jordanian patients with coronary heart disease: A cross-sectional study. Front Public Health 2023; 10:1041428. [PMID: 36684963 PMCID: PMC9846498 DOI: 10.3389/fpubh.2022.1041428] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background Many studies published in other countries have identified certain perceived benefits of and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease. Objective This study aimed to describe the prevalence of levels of physical activity, the benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity. Methods A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits of and barriers to physical activity and asked to what extent they disagreed or agreed with each. Results Jordanian patients with coronary heart disease perceived various benefits of and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = 0.7). The most substantial barriers to physical activity as perceived by the patients were "feeling anxiety," "not enough time," "lack of interest," "bad weather," and "feeling of being uncomfortable." Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behavior. Conclusion This study demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity and have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.
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Affiliation(s)
- Eman Alsaleh
- School of Nursing, Philadelphia University, Amman, Jordan
| | - Faris Baniyasin
- Department of Physiotherapy, Philadelphia University, Amman, Jordan
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Recognition and Repetition Counting for Local Muscular Endurance Exercises in Exercise-Based Rehabilitation: A Comparative Study Using Artificial Intelligence Models. SENSORS 2020; 20:s20174791. [PMID: 32854288 PMCID: PMC7506764 DOI: 10.3390/s20174791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 11/21/2022]
Abstract
Exercise-based cardiac rehabilitation requires patients to perform a set of certain prescribed exercises a specific number of times. Local muscular endurance exercises are an important part of the rehabilitation program. Automatic exercise recognition and repetition counting, from wearable sensor data, is an important technology to enable patients to perform exercises independently in remote settings, e.g., their own home. In this paper, we first report on a comparison of traditional approaches to exercise recognition and repetition counting (supervised ML and peak detection) with Convolutional Neural Networks (CNNs). We investigated CNN models based on the AlexNet architecture and found that the performance was better than the traditional approaches, for exercise recognition (overall F1-score of 97.18%) and repetition counting (±1 error among 90% observed sets). To the best of our knowledge, our approach of using a single CNN method for both recognition and repetition counting is novel. Also, we make the INSIGHT-LME dataset publicly available to encourage further research.
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Multicenter Study of Temporal Trends in the Achievement of Atherosclerotic Cardiovascular Disease Risk Factor Goals During Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2016; 37:11-21. [PMID: 27798509 DOI: 10.1097/hcr.0000000000000209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Secondary prevention risk factor goals have been established by the American Heart Association/American College of Cardiology, and the American Heart Association has further delineated ideal cardiovascular health metrics. We evaluated risk factor goal achievement during early-outpatient cardiac rehabilitation (CR) and temporal trends in risk factor control. METHODS Patients completed assessments on entry into and exit from CR at 35 centers between 2000 and 2009 and were categorized into 3 cohorts: entire (N = 12 984), 2000-2004 (n = 5468), and 2005-2009 (n = 7516) cohorts. RESULTS Improvements occurred in multiple risk factors during CR. For the entire cohort, the percentages of patients at goal at CR completion ranged from 95.5% for smoking to 21.9% for body mass index (BMI) of <25.0 kg/m. Compared with 2000-2004, the percentage of the 2005-2009 cohort at goal was higher (P < .001) for blood pressure, low-density lipoprotein cholesterol, and physical activity, lower (P = .005) for BMI, and not significantly different (P > .05) for fasting glucose and smoking. At CR completion, of those in the entire, 2000-2004, and 2005-2009 cohorts, 4.4%, 3.9%, and 4.8% (P = .219 vs 2000-2004), respectively, had all biomarkers at the goal for ideal cardiovascular health and, of those with atherosclerotic cardiovascular disease, 70.8%, 71.5%, and 70.3% (P = .165 vs 2000-2004), respectively, were receiving statins. CONCLUSIONS The percentage of patients at goal at CR completion increased for some, but not all, risk factors during 2005-2009 versus 2000-2004. Despite the benefits of CR, risk factor profiles are often suboptimal after CR. There remains room for improvement in risk factor management during CR and a need for continued intervention thereafter.
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Jones LW, Habel LA, Weltzien E, Castillo A, Gupta D, Kroenke CH, Kwan ML, Quesenberry CP, Scott J, Sternfeld B, Yu A, Kushi LH, Caan BJ. Exercise and Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer. J Clin Oncol 2016; 34:2743-9. [PMID: 27217451 PMCID: PMC5019746 DOI: 10.1200/jco.2015.65.6603] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Cardiovascular disease (CVD) is a leading cause of death among women with nonmetastatic breast cancer. Whether exercise is associated with reductions in CVD risk in patients with breast cancer with an elevated CVD risk phenotype is not known. METHODS Using a prospective design, women (n = 2,973; mean age, 57 years) diagnosed with nonmetastatic breast cancer participating in two registry-based, regional cohort studies, completed a questionnaire that assessed leisure-time recreational physical activity (metabolic equivalent task [MET]-h/wk). The primary end point was the first occurrence of any of the following: new diagnosis of coronary artery disease, heart failure, valve abnormality, arrhythmia, stroke, or CVD death, occurring after study enrollment. RESULTS Median follow-up was 8.6 years (range, 0.2 to 14.8 years). In multivariable analysis, the incidence of cardiovascular events decreased across increasing total MET-h/wk categories (Ptrend < .001). Compared with < 2 MET-h/wk, the adjusted hazard ratio was 0.91 (95% CI, 0.76 to 1.09) for 2 to 10.9 MET-h/wk, 0.79 (95% CI, 0.66 to 0.96) for 11 to 24.5 MET-h/wk, and 0.65 (95% CI, 0.53 to 0.80) for ≥ 24.5 MET-h/wk. Similar trends were observed for the incidence of coronary artery disease and heart failure (P values < .05). Adherence to national exercise guidelines for adult patients with cancer (ie, ≥ 9 MET-h/wk) was associated with an adjusted 23% reduction in the risk of cardiovascular events in comparison with not meeting the guidelines (< 9 MET-h/wk; P < .001). The association with exercise did not differ according to age, CVD risk factors, menopausal status, or anticancer treatment. CONCLUSION Exercise is associated with substantial, graded reductions in the incidence of cardiovascular events in women with nonmetastatic breast cancer.
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Affiliation(s)
- Lee W Jones
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX.
| | - Laurel A Habel
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Erin Weltzien
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Adrienne Castillo
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Dipti Gupta
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Candyce H Kroenke
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Marilyn L Kwan
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Charles P Quesenberry
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Jessica Scott
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Barbara Sternfeld
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Anthony Yu
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Lawrence H Kushi
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
| | - Bette J Caan
- Lee W. Jones, Dipti Gupta, and Anthony Yu, Memorial Sloan Kettering Cancer Center, New York, NY; Laurel A. Habel, Erin Weltzien, Adrienne Castillo, Candyce H. Kroenke, Marilyn L. Kwan, Charles P. Quesenberry Jr, Barbara Sternfeld, Lawrence H. Kushi, and Bette J. Caan, Kaiser Permanente, Oakland, CA; and Jessica Scott, NASA Johnson Space Center, Houston, TX
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Alsaleh E, Windle R, Blake H. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan. BMC Public Health 2016; 16:643. [PMID: 27460675 PMCID: PMC4962414 DOI: 10.1186/s12889-016-3313-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 07/15/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. METHODS Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71) with usual care (n = 85) was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring) and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. RESULTS Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 0.23 (0.87) days/week versus -.06 (0.40); duration: 15.53 (90.15) minutes/week versus -3.67 (22.60) minutes/week; intensity: 31.05 (105.98) Metabolic equivalents (METs) versus 14.68 (90.40) METs). Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 3.15 (2.75) days/week versus 0.37 (1.83) days/week; duration: 150.90 (124.47) minutes/week versus 24.05 (195.93) minutes/week; intensity: 495.12 (413.74) METs versus14.62 (265.06) METs). Effect size was 0.36 for walking frequency, 0.05 for walking duration, 0.32 for walking intensity and 0.29 for total PA intensity. Intervention participants had significantly lower blood pressure, lower body mass index, greater exercise self-efficacy and better health-related quality of life at 6 months compared with controls. CONCLUSIONS Multi-component behavioural intervention increases physical activity, and improves body composition, physiological and psychological outcomes in CHD patients not attending structured rehabilitation programmes. TRIAL REGISTRATION Current Controlled Trials retrospectively registered in 21-03-2012. ISRCTN48570595 .
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Affiliation(s)
- Eman Alsaleh
- School of Nursing, Philadelphia University, Amman, Jordan
| | - Richard Windle
- School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2HA UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham, NG7 2HA UK
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Tsai SW, Lin YW, Wu SK. The effect of cardiac rehabilitation on recovery of heart rate over one minute after exercise in patients with coronary artery bypass graft surgery. Clin Rehabil 2016; 19:843-9. [PMID: 16323383 DOI: 10.1191/0269215505cr915oa] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effects of cardiac rehabilitation on the recovery of heart rate over 1 min after peak exercise of patients who received coronary artery bypass graft (CABG) surgery. Design: Thirty subjects who received CABG surgery were randomly assigned to enter or not enter a cardiac rehabilitation exercise programme (cardiac rehabilitation n=15; control group n=15). Setting: Outpatient cardiac rehabilitation centre in a national medical hospital. Interventions: Patients assigned to the cardiac rehabilitation group received 36 sessions of the exercise programme, three times a week, with the intensity designed to achieve an individual 60-85% peak heart rate in cardiopulmonary exercise test. Patients assigned to the control group did not get further advice about a specific exercise programme. Main outcome measures: Resting heart rate and recovery of heart rate over 1 min after a peak exercise test at discharge and three months later were collected. The heart rates were analysed with computer-recorded electrocardiogram. Results: At follow-up, the 15 patients in the cardiac rehabilitation group had a significantly lower resting heart rate (77.469± 9.49 versus 92.319± 10.18 bpm; p B± 0.001) and a significantly higher recovery of heart rate over 1 min (16.389± 6.32 versus 11.389± 4.81 bpm; p ± 0.03) compared with the control group. There were also significant reductions in resting heart rates (cardiac rehabilitation p ± 0.001; control p=0.05) and improvements in recovery on heart rate over 1 min (cardiac rehabilitation p ± 0.001; control p= 0.001) compared with baseline measurements in both the cardiac rehabilitation and control groups. Conclusion: Cardiac rehabilitation had a positive effect on the improvement of recovery on heart rate over 1 min in patients with coronary artery disease who received CABG surgery.
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Affiliation(s)
- Sen-Wei Tsai
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung and Department of Physical Therapy, HungKuang University, Taichung County, Taiwan
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Wong EML, Zhong XB, Sit JWH, Chair SY, Leung DYP, Leung C, Leung KC. Attitude toward the out-patient cardiac rehabilitation program and facilitators for maintenance of exercise behavior. PSYCHOL HEALTH MED 2015; 21:724-34. [DOI: 10.1080/13548506.2015.1115107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ghannem M, Bulvestre M, Jaunet N, Lepretre PM. [Muscle retraining or aerobic endurance training? What will improve the aerobic capacity of patients with coronary disease in the only 4 weeks?]. Ann Cardiol Angeiol (Paris) 2014; 63:445-50. [PMID: 25450993 DOI: 10.1016/j.ancard.2014.09.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effects of 4 weeks of CT and AT, which training impulse (total external workload and perceived exertion), are similar on power associated at VO2 peak (pVO2 peak) and cardiorespiratory responses of patient with CAD. METHOD Eighteen male with CAD (62 ± 7 years, 175 ± 2 cm, 84 ± 16 kg, fraction of ejection = 0.49 ± 0.16) performed 4 weeks of CT (n = 9) or AT (n = 9). pVO2 peak, maximal and first ventilatory threshold values of oxygen uptake (VO2 peak, VO2-vt) and heart rate (HRmax, HR-vt) were measured before and after training session. Total training impulse (exercise rehabilitation and other paramedical actions) were evaluated and harmonized between AT and CT according to Foster et al. formula (1996) RESULTS: No significant difference were found in training impulse between AT and CT (3650 ± 220 vs 3497 ± 190 U, P = NS). VO2 pic increased after AT (16.9 ± 4.4 vs 18.9 ± 4.9 mL O2/min/kg, P < 0.05) and remained unchanged after CT (17.7 ± 7.8 vs 17.8 ± 7.2, P = NS). Four weeks of training induced significant increase in pVO2 peak, VO2-vt and FC-vt, expressed in absolute or relative value (P < 0,05), without any difference between AT and CT modalities (P = NS). CONCLUSIONS Improving pVO2 pic following an exercise training does not necessarily preclude an improvement in coronary VO2 pic. pVO2 peak was not improved with the same cardiorespiratory adaptations between AT and CT. Thus, there seems important to measure gas exchanges of subject with CAD during the incremental test and identify the respective part of muscular and cardiorespiratory functions in exercise exhaustion.
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Affiliation(s)
- M Ghannem
- Unité de cardiologie interventionnelle, centre de prévention et de réadaptation cardiovasculaire Léopold-Bellan d'Ollencourt, hôpital de Gonesse, 38, route de Choisy, 60170 Tracy-le-Mont, France
| | - M Bulvestre
- Centre de prévention et de réadaptation cardiovasculaire Léopold-Bellan d'Ollencourt, 38, route de Choisy, 60170 Tracy-le-Mont, France
| | - N Jaunet
- Unité de cardiologie interventionnelle, centre de prévention et de réadaptation cardiovasculaire Léopold-Bellan d'Ollencourt, hôpital de Gonesse, 38, route de Choisy, 60170 Tracy-le-Mont, France
| | - P M Lepretre
- Laboratoire de recherche « adaptations physiologiques à l'exercice et réadaptation à l'effort », EA-3300, UFR-STAPS, université de Picardie Jules-Verne, allée Paschal-Grousset, 80025 Amiens cedex, France.
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Nalini M, Moradi B, Esmaeilzadeh M, Maleki M. Does the effect of supervised cardiac rehabilitation programs on body fat distribution remained long time? J Cardiovasc Thorac Res 2013; 5:133-8. [PMID: 24404342 PMCID: PMC3883534 DOI: 10.5681/jcvtr.2013.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/05/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION An increased accumulation of fat in the intra-abdominal cavity is highly correlated with adverse coronary risk profiles. Cardiac rehabilitation (CR) produces a host of health benefits related to modifiable cardiovascular risk factors. Further research is needed to define better program for weight loss and risk improvement in coronary patients. The aim of this study was to determine the effect of supervised and unsupervised cardiac rehabilitation program on body composition and body fat distribution in a population with coronary artery disease. METHODS The study investigated 167 patients with coronary artery disease (73% males; mean age = 52.67±9.11 years) before and after a supervised protocol cardiac rehabilitation program, and 12-months later. Target variables included body fat distribution indices (waist and hip circumference and waist to hip ratio), weight and body mass index. RESULTS Weight, waist circumference, waist to hip ratio and body mass index significantly decreased with 2 month supervised program (P<0.001), but hip circumference was not significantly changed. Males improved to a greater extent than the female patients. All of measurements relatively returned to baseline at the end of program (after 12 months). CONCLUSION Supervised cardiac rehabilitation program results in improvements in body composition and body fat distribution. The effects of non-supervised program were minimal and the program needed to be reviewed.
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Affiliation(s)
- Mehdi Nalini
- Department of Prevention and Cardiac Rehabilatation, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahieh Moradi
- Echocardiography Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Esmaeilzadeh
- Echocardiography Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Maleki
- Echocardiography Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Magalhães S, Miguel Ribeiro M, Barreira A, Fernandes P, Torres S, Lopes Gomes J, Viamonte S. Long-term effects of a cardiac rehabilitation program in the control of cardiovascular risk factors. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Magalhães S, Viamonte S, Miguel Ribeiro M, Barreira A, Fernandes P, Torres S, Lopes Gomes J. Efeitos a longo prazo de um programa de reabilitação cardíaca no controlo dos fatores de risco cardiovasculares. Rev Port Cardiol 2013; 32:191-9. [DOI: 10.1016/j.repc.2012.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/16/2012] [Accepted: 08/02/2012] [Indexed: 12/01/2022] Open
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Effect of exercise-based cardiac rehabilitation on multiple atherosclerotic risk factors in patients taking antidepressant medication. Am J Cardiol 2013. [PMID: 23178050 DOI: 10.1016/j.amjcard.2012.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antidepressants might increase compliance with cardiovascular disease risk reduction interventions. However, antidepressants have been linked to deleterious metabolic effects. In the present multicenter study, we sought to determine whether patients who take antidepressants derive the expected benefits from cardiac rehabilitation in terms of improvements in multiple atherosclerotic risk factors. A cohort of 26,957 patients who had completed a baseline assessment before participating in an exercise-based cardiac rehabilitation program constituted the study population. The patients were stratified into 3 cohorts (i.e., nondepressed, depressed unmedicated, and depressed medicated) at baseline according to a self-reported history of depression and the current use of antidepressants. Risk factors were assessed at baseline and after ∼12 weeks of program participation. A self-reported history of depression was present at baseline in 5,172 patients (19.2%). Of these patients, 2,147 (41.5%) were taking antidepressants. Patients in the nondepressed cohort (49.4% completion) were more likely (p <0.001) to complete the exit assessment than patients in the depressed unmedicated (44.5% completion) or depressed medicated (43.5% completion) cohorts. Patients in all 3 cohorts who completed the exit assessment showed significant improvement in multiple risk factors. Moreover, the magnitude of improvement in blood pressure, serum lipids and lipoproteins, fasting glucose, weight, and body mass index was similar (p >0.05) in patients taking antidepressants and those who were not. In conclusion, our study is the first to show that antidepressants do not offset the average magnitude of improvement in multiple atherosclerotic risk factors that occurs with completion of a cardiac rehabilitation program.
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The Prevalence of Impaired Glucose Metabolism in Patients Referred to Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2013; 33:42-6. [DOI: 10.1097/hcr.0b013e31827415b2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kligfield P. Exercise Training for Refractory Angina: Why Does It Work. Cardiology 2012; 122:167-9. [DOI: 10.1159/000341243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 06/19/2012] [Indexed: 11/19/2022]
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Patient education and quality of home-based rehabilitation in patients older than 60 years after acute myocardial infarction. J Cardiopulm Rehabil Prev 2011; 31:249-53. [PMID: 21623216 DOI: 10.1097/hcr.0b013e31821c1391] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Because only one-third of eligible patients participate in formal cardiac rehabilitation, home-based programs constitute a suitable alternative. We examined effectiveness of a minimal educational intervention on patient fitness and activity levels through the use of simple motivational tools including verbal encouragement and the provision of a booklet containing exercise guidelines and exercise diary. METHODS We enrolled 186 patients (age, 60 – 78 years; mean age, 69 years; 140 men) who were admitted to the outpatient clinic of Warsaw Institute of Cardiology in 2007-2009 after acute myocardial infarction. Of these, 61.3% had coronary angioplasty with stenting and 30.7% had coronary artery bypass. Patients were randomly assigned into an intervention group receiving minimal educational intervention or control. At baseline and 3 months, assessment was made of cardiopulmonary fitness and autonomic tone with exercise testing. Leisure-time physical activity and atherosclerosis risk factors were assessed at baseline and after 3 and 12 months. RESULTS At baseline, exercise test results and leisure-time activity levels were not significantly different between groups. After 3 months, we noted statistically significant differences in exercise test responses between the intervention group versus control: peak workload 57.3 ± 2.3 versus 47.2 ± 2.2 kJ (P < .04) and heart rate recovery 26.5 3.3 versus 23.7 4.2 bpm (P < .001). Leisure-time activity was greater in the intervention group than in control, 3.9 versus 2.3 h/wk (P < .001). Improvement in atherosclerosis risk factors during the course of the study was similar between groups. CONCLUSION Minimal educational intervention is an effective and safe form of promoting physical activity in older patients after myocardial infarction.
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Effect of Exercise-Based Cardiac Rehabilitation Following Coronary Artery Bypass Surgery on Ventricular Repolarization Indices. J Cardiopulm Rehabil Prev 2011; 31:239-44. [DOI: 10.1097/hcr.0b013e318211e3c0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Jünger C, Rauch B, Schneider S, Liebhart N, Rauch G, Senges J, Bestehorn K. Effect of early short-term cardiac rehabilitation after acute ST-elevation and non-ST-elevation myocardial infarction on 1-year mortality. Curr Med Res Opin 2010; 26:803-11. [PMID: 20121656 DOI: 10.1185/03007991003604216] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim was to evaluate the effect of short-term cardiac rehabilitation (CR) on clinical events during a 1-year follow-up after acute myocardial infarction. METHODS From the observational, prospective Acute COronary Syndromes (ACOS) registry, 4547 consecutive patients after ST-elevation (STEMI: n = 2432) or non-ST-elevation myocardial infarction (NSTEMI: n = 2115), recruited between June 2000 and December 2002, were characterised and evaluated for clinical outcomes during a 1-year follow-up. From the STEMI group 67.8% and from the NSTEMI group 52.3% participated in cardiac rehabilitation (CR+). RESULTS Age > 70 years and previous myocardial infarction were independent predictors not to attend CR in STEMI and NSTEMI patients, whereas early revascularisation (<48 hours after hospital admission) was associated with increased likelihood to undergo CR. Multivariable analysis adjusting for propensity score shows that CR+ was independently associated with a significant reduction of all-cause mortality (STEMI: OR 0.41, 95% CI 0.28-0.60; NSTEMI: OR 0.53, 95% CI 0.38-0.76) and major adverse cardiac and cerebrovascular events (MACCE; STEMI: OR 0.66, 95% CI 0.49-0.89; NSTEMI: OR 0.73, 95% CI 0.55-0.98) during a 1-year follow-up. CONCLUSION The study shows an independent and strong association of CR+ with markedly reduced total mortality and MACCE during a 1-year follow-up after STEMI or NSTEMI. The limitation of the study is that it is not a prospective randomised trial. Furthermore, unequal distribution of risk factors relevant for long-term prognosis had to be corrected by multivariable analysis adjusting for propensity score.
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Affiliation(s)
- Claus Jünger
- Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen, Germany
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Physical activity habits of cardiac patients participating in an early outpatient rehabilitation program. J Cardiopulm Rehabil Prev 2010; 29:299-303. [PMID: 19935142 DOI: 10.1097/hcr.0b013e3181b4ca61] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The primary purpose of the study was to assess whether physical activity (PA) habits change following 4 to 6 weeks of an early outpatient cardiac rehabilitation (CR) program. A secondary purpose was to determine whether the PA habits differ on days attending CR versus not attending CR. METHODS Fourteen men and 8 women completed the study (age = 65.6 +/- 13.2 years, body mass index = 29.1 +/- 4.6 kg/m). Subjects wore an accelerometer during the entry and exit weeks of CR participation. Steps per day, activity counts per observation minute, percentage time spent inactive, light-intensity PA minutes per day, and moderate-intensity PA minutes per day were compared both at entry and exit from CR and on days attending CR and not attending CR. RESULTS From entry to exit of the early outpatient CR, patients increased total PA behavior (194.4 +/- 2 to 217.8 +/- 15.3 activity counts per observation minute) and time spent in moderate-intensity PA (13.9 +/- 2.3 to 18.7 +/- 2.5 min/d). Patients were more active, both in total activity (224.0 +/- 15.6 activity counts per observation minute vs 188.2 +/- 14.5 activity counts per observation minute) and in moderate intensity (19.7 +/- 3.3 min/d vs 12.8 +/- 2.0 min/d), on days they attended CR than on days they did not attend CR. CONCLUSIONS These data support the value of early outpatient CR programs for increasing patient PA levels, particularly moderate-intensity PA on days during which patients attended CR. Because PA targets for coronary risk reduction are not being achieved when patients exit CR, referral to a maintenance CR program and support for performing PA on days they do not attend CR become essential.
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Pérez IP, Zapata MÁ, Cervantes CE, Jarabo RM, Grande C, Plaza R, Garcia S, Rodriguez ML, Crespo S, Perea J. Cardiac Rehabilitation Programs Improve Metabolic Parameters in Patients With the Metabolic Syndrome and Coronary Heart Disease. J Clin Hypertens (Greenwich) 2010; 12:374-9. [DOI: 10.1111/j.1751-7176.2009.00259.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A comprehensive cardiac rehabilitation program in post-CABG patients: a rationale and critical pathway. Crit Pathw Cardiol 2009; 2:20-33. [PMID: 18340315 DOI: 10.1097/01.hpc.0000057391.93352.aa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nagelkirk PR, Franklin BA, Coughlin AM, Hassouna HI, Fink GD, Pivarnik JM, Womack CJ. Discordant Hemodynamic and Fibrinolytic Adaptations Following a 6-Week Cardiac Rehabilitation Program. ACTA ACUST UNITED AC 2007; 10:196-203. [DOI: 10.1111/j.1520-037x.2007.06425.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zimmerman L, Barnason S. Use of a Telehealth Device to Deliver a Symptom Management Intervention to Cardiac Surgical Patients. J Cardiovasc Nurs 2007; 22:32-7. [PMID: 17224695 DOI: 10.1097/00005082-200701000-00005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A variety of approaches can provide cardiac patients with needed follow-up care. However, with the explosion of telehealth capabilities, clinicians are more ready to explore other methods to integrate the use of telehealth devices into the delivery of effective nursing interventions. This article summarizes the development of a symptom management intervention for coronary artery bypass graft patients using the Health Buddy to deliver a nursing intervention in the early recovery period after hospital discharge. Considerations used to design the symptom management intervention and selection of this telehealth modality are discussed. This overview can help clinicians and researchers gain perspective on how to evaluate telehealth modalities to aid in the delivery of interventions for cardiac and other clinical populations.
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Affiliation(s)
- Lani Zimmerman
- College of Nursing, University of Nebraska Medical Center, 1230 "O" Street, STE 131, PO Box 880220, Lincoln, NE 68588-0220, USA.
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Wu SK, Lin YW, Chen CL, Tsai SW. Cardiac Rehabilitation vs. Home Exercise After Coronary Artery Bypass Graft Surgery. Am J Phys Med Rehabil 2006; 85:711-7. [PMID: 16924183 DOI: 10.1097/01.phm.0000228597.64057.66] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The autonomic dysfunction is known to adversely affect clinical outcome in patients with cardiovascular disease, and exercise training has been shown to modify the sympathovagal control of heart rate. The purposes of this study were to investigate the effect of cardiac rehabilitation on heart rate recovery in patients who received coronary artery bypass grafting (CABG) and compare the effect with that of a home-based exercise program. DESIGN Fifty-four male patients having undergone CABG were randomly assigned to a cardiac rehabilitation exercise program (n = 18), a home-based exercise program (n = 18), and a control group (n = 18) for 12 wks to evaluate the differences in heart rate recovery among groups. RESULTS Patients in the cardiac rehabilitation group had significant increases in heart rate recovery (19.1 +/- 6.2 vs. 14.0 +/- 5.4 beats/min, P = 0.022) compared with those in the control group. There were no significant differences in heart rate recovery between cardiac rehabilitation and home-based exercise groups (16.2 +/- 4.8 beats/min) or between home-based exercise and control groups. All three groups had significantly improved heart rate recovery compared with their baseline data (P < 0.001, < 0.001, and 0.007). CONCLUSION Our results point out that a cardiac rehabilitation exercise program has a positive effect on heart rate recovery in patients having undergone CABG and is consistent with the autonomic improvement. Although the home-based exercise group did not reveal statistical significances over those in the control group, it had comparable efficacy to that demonstrated in the cardiac rehabilitation group.
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Affiliation(s)
- Shyi-Kuen Wu
- Department of Physical Therapy, HungKuang University, Taichung County, Taiwan
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Masson CR, Dias-da-Costa JS, Olinto MTA, Meneghel S, Costa CCD, Bairros F, Hallal PC. Prevalência de sedentarismo nas mulheres adultas da cidade de São Leopoldo, Rio Grande do Sul, Brasil. CAD SAUDE PUBLICA 2005; 21:1685-95. [PMID: 16410852 DOI: 10.1590/s0102-311x2005000600015] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo desta pesquisa foi identificar a prevalência de sedentarismo e fatores associados em mulheres adultas (20-60 anos) de São Leopoldo, Rio Grande do Sul, Brasil. Foi realizado um estudo transversal de base populacional em quarenta setores censitários da cidade. Sedentarismo foi definido como nenhuma atividade física no lazer ou apenas uma vez por semana, de intensidade leve. Dentre as 1.026 mulheres entrevistadas, 380 (37,0%; IC95%: 34,0-40,0) foram classificadas como sedentárias. Além destas, 609 (59,3%) relataram praticar atividades físicas moderadas ou vigorosas no lazer menos de três vezes por semana. Na análise bruta o sedentarismo foi mais comum entre mulheres não-brancas, com maior número de filhos, de menor escolaridade, de menor renda e obesas. Na análise ajustada apenas o efeito do índice de massa corporal manteve-se estatisticamente significativo. A implementação de políticas municipais, estaduais e nacionais com ênfase em aconselhamento e melhorias ambientais é necessária para reversão da alta prevalência de sedentarismo observada na comunidade.
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Affiliation(s)
- Carmen Rosane Masson
- Programa de Pós-graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brasil
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Maroto Montero JM, Artigao Ramírez R, Morales Durán MD, de Pablo Zarzosa C, Abraira V. Rehabilitación cardíaca en pacientes con infarto de miocardio. Resultados tras 10 años de seguimiento. Rev Esp Cardiol 2005. [DOI: 10.1157/13079912] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Heart disease in men is declining steadily, but it remains the number one killer of men in the United States. CLRD, influenza/pneumonia, and lung cancer are three more causes of top 10 mortalities in men. Epidemiological and clinical studies conclude that CVD is largely preventable through lifestyle modification. CHD, COPD, occupational lung disease, and lung cancer are all preventable by primary prevention (ie, no cigarette smoking). All men should be counseled about the grave significance of heart and lung disease as a cause of illness and death, the importance of primary prevention, and the great variability in symptom presentation. Nurses are in the ideal position to educate patients, families, and colleagues about heart and lung disease.
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Affiliation(s)
- Jane S Kaufman
- Texas Christian University, Harris School of Nursing and School of Nurse Anesthesia, TCU Box 298620, Fort Worth, TX 76129, USA.
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de Jong Z, Munneke M, Zwinderman AH, Kroon HM, Jansen A, Ronday KH, van Schaardenburg D, Dijkmans BAC, Van den Ende CHM, Breedveld FC, Vliet Vlieland TPM, Hazes JMW. Is a long-term high-intensity exercise program effective and safe in patients with rheumatoid arthritis? Results of a randomized controlled trial. ARTHRITIS AND RHEUMATISM 2003; 48:2415-24. [PMID: 13130460 DOI: 10.1002/art.11216] [Citation(s) in RCA: 209] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE There are insufficient data on the effects of long-term intensive exercise in patients with rheumatoid arthritis (RA). We undertook this randomized, controlled, multicenter trial to compare the effectiveness and safety of a 2-year intensive exercise program (Rheumatoid Arthritis Patients In Training [RAPIT]) with those of physical therapy (termed usual care [UC]). METHODS Three hundred nine RA patients were assigned to either the RAPIT program or UC. The primary end points were functional ability (assessed by the McMaster Toronto Arthritis [MACTAR] Patient Preference Disability Questionnaire and the Health Assessment Questionnaire [HAQ]) and the effects on radiographic progression in large joints. Secondary end points concerned emotional status and disease activity. RESULTS After 2 years, participants in the RAPIT program showed greater improvement in functional ability than participants in UC. The mean difference in change of the MACTAR Questionnaire score was 2.6 (95% confidence interval [95% CI] 0.1, 5.2) over the first year and 3.1 (95% CI 0.7, 5.5) over the second year. After 2 years, the mean difference in change of the HAQ score was -0.09 (95% CI -0.18, -0.01). The median radiographic damage of the large joints did not increase in either group. In both groups, participants with considerable baseline damage showed slightly more progression in damage, and this was more obvious in the RAPIT group. The RAPIT program proved to be effective in improving emotional status. No detrimental effects on disease activity were found. CONCLUSION A long-term high-intensity exercise program is more effective than UC in improving functional ability of RA patients. Intensive exercise does not increase radiographic damage of the large joints, except possibly in patients with considerable baseline damage of the large joints.
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Affiliation(s)
- Zuzana de Jong
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
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Franklin BA, Berra K. The case for cardiac rehabilitation after coronary revascularization: achieving realistic outcome assessments. JOURNAL OF CARDIOPULMONARY REHABILITATION 2002; 22:418-20. [PMID: 12464829 DOI: 10.1097/00008483-200211000-00006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Barry A Franklin
- Department of Medicine, Division of Cardiology, William Beaumont Hospital, Royal Oak, Mich, USA.
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