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Zulianello dos Santos R, Scheafer Korbes A, Batista Bonin CD, Marques Vieira A, Karsten M, Benetti M, Oh P, Ghisi GLDM. Preliminary Effects of a Structured Educational Program in Cardiac Patients at Different Stages of Enrollment in Cardiovascular Rehabilitation. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:365-376. [PMID: 38817096 PMCID: PMC11143761 DOI: 10.1177/0272684x221080119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
This quasi-experimental study investigated the preliminary effects of a structured education intervention in a pooled sample of cardiovascular rehabilitation (CR) patients in Brazil. Recently enrolled (RE) and long-term enrolled (LTE) patients attended 12 weekly education sessions in addition to three weekly exercise sessions. Patients completed surveys assessing disease-related knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was assessed by the 6-minutes walking test. All outcomes were assessed at pre-,post-CR, and 6-months follow-up. Bonferroni correction was applied. In total, 69 (69.7%) patients completed all three assessments. There were significant improvements in knowledge pre-to post-test in both subgroups (p < 0.001), and in functional capacity (p ≤ 0.001) and food intake (p ≤ 0.001) pre-to post-test in the RE subgroup. Post-test knowledge was correlated to physical activity, functional capacity and health literacy. This preliminary study suggests the importance of structured education for CR patients. A larger study using a randomized controlled design is needed to determine efficacy.
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Affiliation(s)
| | - Andrea Scheafer Korbes
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Christiani D. Batista Bonin
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Ariany Marques Vieira
- Montreal Behavioural Medicine Centre, Hôpital Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Marlus Karsten
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Magnus Benetti
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Paul Oh
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Milani JGPO, Milani M, Machado FVC, Wilhelm M, Marcin T, D'Ascenzi F, Cavigli L, Keytsman C, Falter M, Bonnechere B, Meesen R, Braga F, Cipriano GFB, Cornelissen V, Verboven K, Junior GC, Hansen D. Accurate Prediction Equations for Ventilatory Thresholds in Cardiometabolic Disease When Gas Exchange Analysis is Unavailable: Development and Validation. Eur J Prev Cardiol 2024:zwae149. [PMID: 38636093 DOI: 10.1093/eurjpc/zwae149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/08/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
AIMS To develop and validate equations predicting heart rate (HR) at the first and second ventilatory thresholds (VTs) and an optimized range-adjusted prescription for patients with cardiometabolic disease (CMD). To compare their performance against guideline-based exercise intensity domains. METHODS Cross-sectional study involving 2,868 CMD patients from nine countries. HR predictive equations for first and second VTs (VT1, VT2) were developed using multivariate linear regression with 975 cycle-ergometer cardiopulmonary exercise tests (CPET). 'Adjusted' percentages of peak HR (%HRpeak) and HR reserve (%HRR) were derived from this group. External validation with 1,893 CPET (cycle-ergometer or treadmill) assessed accuracy, agreement, and reliability against guideline-based %HRpeak and %HRR prescriptions using mean absolute percentage error (MAPE), Bland-Altman analyses, intraclass correlation coefficients (ICC). RESULTS HR predictive equations (R²: 0.77 VT1, 0.88 VT2) and adjusted %HRR (VT1: 42%, VT2: 77%) were developed. External validation demonstrated superiority over widely used guideline-directed intensity domains for %HRpeak and %HRR. The new methods showed consistent performance across both VTs with lower MAPE (VT1: 7.1%, VT2: 5.0%), 'good' ICC for VT1 (0.81, 0.82) and 'excellent' for VT2 (0.93). Guideline-based exercise intensity domains had higher MAPE (VT1: 6.8%-21.3%, VT2: 5.1%-16.7%), 'poor' to 'good' ICC for VT1, and 'poor' to 'excellent' for VT2, indicating inconsistencies related to specific VTs across guidelines. CONCLUSION Developed and validated HR predictive equations and the optimized %HRR for CMD patients for determining VT1 and VT2 outperformed the guideline-based exercise intensity domains and showed ergometer interchangeability. They offer a superior alternative for prescribing moderate intensity exercise when CPET is unavailable.
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Affiliation(s)
- Juliana Goulart Prata Oliveira Milani
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, DF, Brazil
| | - Mauricio Milani
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, DF, Brazil
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Felipe Vilaça Cavallari Machado
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Biomedical Research Institute (BIOMED), Faculty of Medicine and Life Sciences, Hasselt, Belgium
| | - Matthias Wilhelm
- Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Thimo Marcin
- Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Italy
| | | | - Maarten Falter
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Cardiology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Bruno Bonnechere
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, University of Hasselt, Diepenbeek, Belgium
- Centre of expertise in Care Innovation, Department of PXL - Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
| | - Raf Meesen
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Fabrício Braga
- Laboratório de Performance Humana, Rio de Janeiro, Brazil
- State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Graziella França Bernardelli Cipriano
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, DF, Brazil
- Rehabilitation Sciences Programme, University of Brasilia (UnB), Brasilia, DF, Brazil
| | | | - Kenneth Verboven
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Biomedical Research Institute (BIOMED), Faculty of Medicine and Life Sciences, Hasselt, Belgium
| | - Gerson Cipriano Junior
- Graduate Programme in Health Sciences and Technologies, University of Brasilia (UnB), Brasilia, DF, Brazil
- Graduate Program in Human Movement and Rehabilitation of Evangelical (PPGMHR), UniEVANGÉLICA, Anápolis, Brazil
| | - Dominique Hansen
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- Biomedical Research Institute (BIOMED), Faculty of Medicine and Life Sciences, Hasselt, Belgium
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Vieira MC, Mendes FDSNS, da Silva PS, da Silva GMS, Mazzoli-Rocha F, de Sousa AS, Saraiva RM, de Holanda MT, Kasal DAB, Costa HS, Borges JP, Reis MS, Rodrigues Junior LF, Hasslocher-Moreno AM, do Brasil PEAA, Mediano MFF. Effect of an exercise-based cardiac rehabilitation program on quality of life of patients with chronic Chagas cardiomyopathy: results from the PEACH randomized clinical trial. Sci Rep 2024; 14:8208. [PMID: 38589582 PMCID: PMC11001987 DOI: 10.1038/s41598-024-58776-3] [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: 06/21/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024] Open
Abstract
To investigate the effect of an exercise-based cardiac rehabilitation program on the quality of life (QoL) of patients with chronic Chagas cardiomyopathy (CCC). PEACH study was a single-center, superiority randomized clinical trial of exercise training versus no exercise (control). The sample comprised Chagas disease patients with CCC, left ventricular ejection fraction < 45%, without or with HF symptoms (CCC stages B2 or C, respectively). QoL was assessed at baseline, after three months, and at the end of six months of follow-up using the SF-36 questionnaire. Patients randomized for the exercise group (n = 15) performed exercise training (aerobic, strength and stretching exercises) for 60 min, three times a week, during six months. Patients in the control group (n = 15) were not provided with a formal exercise prescription. Both groups received identical nutritional and pharmaceutical counseling during the study. Longitudinal analysis of the effects of exercise training on QoL, considering the interaction term (group × time) to estimate the rate of changes between groups in the outcomes (represented as beta coefficient), was performed using linear mixed models. Models were fitted adjusting for each respective baseline QoL value. There were significant improvements in physical functioning (β = + 10.7; p = 0.02), role limitations due to physical problems (β = + 25.0; p = 0.01), and social functioning (β = + 19.2; p < 0.01) scales during the first three months in the exercise compared to the control group. No significant differences were observed between groups after six months. Exercise-based cardiac rehabilitation provided short-term improvements in the physical and mental aspects of QoL of patients with CCC.Trial registration: ClinicalTrials.gov Identifier: NCT02517632; August 7, 2015.
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Affiliation(s)
- Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
- Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, RJ, Brazil.
| | | | - Paula Simplício da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | | | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Andrea Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Marcelo Teixeira de Holanda
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Daniel Arthur Barata Kasal
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
- Internal Medicine Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Henrique Silveira Costa
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, MG, Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil
| | - Michel Silva Reis
- Faculty of Physical Therapy, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luiz Fernando Rodrigues Junior
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
- Department of Physiological Sciences, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, RJ, Brazil
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Gomes-Neto M, Durães AR, Conceição LSR, Saquetto MB, Alves IG, Smart NA, Carvalho VO. Some types of exercise interventions are more effective than others in people with coronary heart disease: systematic review and network meta-analysis. J Physiother 2024; 70:106-114. [PMID: 38503676 DOI: 10.1016/j.jphys.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/22/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
QUESTION What are the effects of different types of exercise treatments on oxygen consumption, quality of life and mortality in people with coronary heart disease? DESIGN Systematic review with network meta-analysis of randomised controlled trials. PARTICIPANTS Adults with coronary heart disease. INTERVENTION Exercise interventions including aerobic (continuous or high-intensity interval) training, resistance training, respiratory muscle exercises, water-based exercises, yoga, Tai chi, Qigong exercises and a combination of different types of exercise. OUTCOME MEASURES Oxygen consumption, quality of life and mortality. RESULTS This review included 178 randomised controlled trials with 19,143 participants. Several exercise interventions improved peak oxygen consumption (mL/kg/min): high-intensity interval training (MD 4.5, 95% CI 3.7 to 5.4); combined water-based exercises and moderate-intensity continuous training (MD 3.7, 95% CI 1.3 to 6.0); combined aerobic and resistance exercise (MD 3.4, 95% CI 2.5 to 4.3); water-based exercises (MD 3.4, 95% CI 0.6 to 6.2); combined respiratory muscle training and aerobic exercise (MD 3.2, 95% CI 0.6 to 5.8); Tai chi (MD 3.0, 95% CI 1.0 to 5.0); moderate-intensity continuous training (MD 3.0, 95% CI 2.3 to 3.6); high-intensity continuous training (MD 2.7, 95% CI 1.6 to 3.8); and resistance training (MD 2.2, 95% CI 0.6 to 3.7). Quality of life was improved by yoga (SMD 1.5, 95% CI 0.5 to 2.4), combined aerobic and resistance exercise (SMD 1.2, 95% CI 0.6 to 1.7), moderate-intensity continuous training (SMD 1.1, 95% CI 0.6 to 1.6) and high-intensity interval training (SMD 0.9, 95% CI 0.1 to 1.6). All-cause mortality was reduced by continuous aerobic exercise (RR 0.67, 95% CI 0.53 to 0.86) and combined aerobic and resistance exercise (RR 0.58, 95% CI 0.36 to 0.94). Continuous aerobic exercise also reduced cardiovascular mortality (RR 0.56, 95% CI 0.42 to 0.74). CONCLUSION People with coronary heart disease may use a range of exercise modalities to improve oxygen consumption, quality of life and mortality. REGISTRATION PROSPERO CRD42022344545.
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Affiliation(s)
- Mansueto Gomes-Neto
- Postgraduate Program in Health Science, Federal University of Sergipe, Aracaju, Brazil; Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil.
| | - Andre Rodrigues Durães
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | | | | | - Iura Gonzalez Alves
- Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Neil A Smart
- Department of Exercise and Sports Science, University of New England, Armidale, Australia
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Alves da Cruz M, Laurino M, Christofaro D, Ghisi G, Vanderlei L. Long-term effects of virtual reality-based therapy in cardiovascular rehabilitation: A longitudinal study. Physiother Theory Pract 2024; 40:727-735. [PMID: 36567613 DOI: 10.1080/09593985.2022.2160222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/12/2022] [Accepted: 12/12/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND In Cardiovascular Rehabilitation (CR), patient adherence to the maintenance phase is a major challenge. Virtual reality-based therapy (VRBT) promotes acute hemodynamic and autonomic repercussions similar to traditional rehabilitation and can increase patient adherence to the program. However, it is unknown whether the combination of VRBT to a traditional CR manages to maintain or even improve clinical and autonomic variables in long term. OBJECTIVE To analyze whether VRBT combination in a traditional CR can maintain or improve clinical and autonomic variables in cardiac patients in the maintenance phase of these programs. METHODS Twenty-six volunteers (62.04 ± 12.22 years) were evaluated, who underwent an initial assessment and two other assessments (in the sixth and 12th week) of the following outcomes: systolic and diastolic blood pressure, respiratory rate, pulse saturation of oxygen, heart rate, perceived exertion, and cardiac autonomic modulation, using linear and non-linear heart rate variability methods. RESULTS Except for the apparent lack of clinical significance observed in Shannon Entropy, LF (nu), and HF (nu), the combination of VRBT as routine in a traditional program did not cause significant changes in the analyzed variables. CONCLUSION combination of VRBT was able to maintain the chronic hemodynamic and autonomic repercussions caused by traditional CR.
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Affiliation(s)
- Mayara Alves da Cruz
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Maria Laurino
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Diego Christofaro
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Gabriela Ghisi
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M4G2V7, Canada
| | - Luiz Vanderlei
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
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Nascimento IDO, Geisel PP, de Faria VC, Ferreira AP, Passos BR, Prado D, Parreira VF, Gomes Pereira D. Comparison of home-based rehabilitation and a centre-based exercise in terms of functional capacity, muscle oxygenation and quality of life in people with peripheral arterial disease: a protocol for a randomised controlled trial. BMJ Open 2024; 14:e080071. [PMID: 38553076 PMCID: PMC10982778 DOI: 10.1136/bmjopen-2023-080071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/08/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Peripheral arterial disease (PAD) is increasingly prevalent, and supervised physical exercise programmes are recommended as the first-line treatment. However, these programmes are underused. Alternative delivery models may be able to expand treatment coverage. The objective of this study was to compare a home-based exercise programme (HBEP) and a centre-based exercise (CBE) in terms of their effects on functional capacity, peripheral muscle oxygenation and quality of life in individuals with PAD. METHODS AND ANALYSIS This single-blind, parallel randomised clinical trial will consist of two groups: HBEP and CBE. A qualitative analysis will be carried out to investigate acceptability and satisfaction. The primary outcome will be functional capacity, assessed by the incremental shuttle walk test. Secondary outcomes will include functional capacity, assessed by a treadmill walking test; peripheral muscle oxygenation and quality of life; and self-reported functional impairment, risk factors, morbidity, level of physical activity, adherence, acceptability and satisfaction. The intervention protocols will consist of 12 weeks of intermittent walking until claudication symptoms, three times a week. Participants randomly assigned to the CBE group will participate in supervised face-to-face sessions. The HBEP group will perform exercises at home with remote supervision, monitored by a pedometer and heart rate monitor, and subjective perception of effort during each session will be recorded by participants in a training diary; follow-up will be conducted by telephone calls. Statistical analyses will follow the intention-to-treat principle. Participants allocated to the HBEP group will be interviewed about their experience of remote treatment using a qualitative approach. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee of the Universidade Federal de Minas Gerais. The results will be disseminated in a peer-reviewed journal and presented at international congresses. This research has the potential to improve the care of people with PAD because if home-based rehabilitation demonstrates effectiveness, it could be considered an alternative or support resource to the usual centre-based treatment models, expanding access, coverage and participation in vascular physiotherapy TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-97vy9n7 on 14 April 2022.
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Affiliation(s)
| | - Patrícia Paulino Geisel
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Valéria Cristina de Faria
- Marinha do Brasil, Belo Horizonte, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Paula Ferreira
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Brazil
| | - Bruno Rezende Passos
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Déborah Prado
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Danielle Gomes Pereira
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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de Almeida JAB, Florêncio RB, Leite JC, Monteiro KS, Gualdi LP. Self-efficacy measurement instruments for individuals with coronary artery disease: A systematic review. PLoS One 2024; 19:e0299041. [PMID: 38437222 PMCID: PMC10911622 DOI: 10.1371/journal.pone.0299041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
INTRODUCTION Over the past decade, there has been a heightened interest in evaluating self-efficacy among patients with coronary artery disease (CAD). A significant number of instruments have been developed and validated, yet the need remains to assess the quality of their studies and their properties. OBJECTIVES To evaluate the measurement properties and link the content extracted from self-efficacy instrument items for individuals with CAD to the International Classification of Functioning, Disability, and Health (ICF). METHODOLOGY The study was conducted following the Cochrane systematic review guidelines and COnsensus norms for Selection of health Measuring INstruments (COSMIN), registered under CRD42021262613. The search was carried out on MEDLINE (Ovid), Web of Science, EMBASE, and PsycINFO, including studies involving the development and validation of self-efficacy instruments for individuals with CAD, without language or date restrictions. Data extraction was performed in May 2022 and updated in January 2023 and all the steps of this review were carried out by two different collaborators and reviewed by a third when there were divergences. Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommended by COSMIN was used to determine the quality of evidence as high, moderate, low, or very low. Instrument categorization was carried out per COSMIN recommendations, according to the construct of interest and study population into three categories (A, B, or C). RESULTS A total of 21 studies from 12 instruments were identified. The best-rated instruments received a recommendation of B, which means, additional validation studies are needed. Barnason Efficacy Expectation Scale (BEES) showed high-quality evidence for structural, construct, criterion, and internal consistency validity; Cardiac Self-Efficacy Scale (CSES) demonstrated high quality for content, structural, cross-cultural validity, and internal consistency; Self-efficacy for Appropriate Medication Use (SEAMS) achieved a high level for structural, criterion, and internal consistency validity; Cardiovascular Management Self-Efficacy Scale exhibited high-level validity for structural, criterion, construct, and internal consistency. The CSES showed content linkage with all domains of the ICF, as well as the highest number of linkages with the categories. CONCLUSIONS Instruments with a B-level recommendation hold potential for use. More studies assessing measurement properties are needed to reinforce or improve these recommendations. The CSES stands out as the most comprehensive instrument concerning the ICF.
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Affiliation(s)
| | - Rêncio Bento Florêncio
- Professor of department of Physical Therapy Graduate, Centro Universitário Natalense, Natal, RN, Brazil
| | - Jéssica Costa Leite
- Professor of department of Physical Therapy Graduate, Centro Universitário UNIFACISA, Campina Grande, PB, Brazil
| | - Karolinne Souza Monteiro
- Professor of department of Physical Therapy and Rehabilitation Sciences Graduate Program, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Lucien Peroni Gualdi
- Professor of department of Physical Therapy and Rehabilitation Sciences Graduate Program, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
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Cotie LM, Vanzella LM, Pakosh M, Ghisi GLDM. A Systematic Review of Clinical Practice Guidelines and Consensus Statements for Cardiac Rehabilitation Delivery: Consensus, Divergence, and Important Knowledge Gaps. Can J Cardiol 2024; 40:330-346. [PMID: 38376955 DOI: 10.1016/j.cjca.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND After 2020, clinical practice recommendations have been released to inform cardiac rehabilitation (CR) programs of best practices for post-COVID programming. The objective of this systematic review was to identify and summarize recommendations from clinical practice guidelines (CPGs) and consensus statements for CR delivery postpandemic. METHODS Five databases (March 2020 through April 2023), grey literature and Web sites of CR international associations were searched. Inclusion criteria were local, national, and international association-endorsed CPGs, and/or position, expert, and scientific statements related to CR delivery (program models, program elements, and core components). Two researchers independently screened the citations for inclusion. The Appraisal of Guidelines for Research and Evaluation (AGREE) II was used for quality assessment. Results were analyzed in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guidelines. RESULTS Overall, 4890 records were identified; 4 CPGs, 9 position/scientific statements, and 6 expert/Delphi consensus papers were included. All guidelines/statements included information related to program delivery models, with 95% endorsing the use of virtual, hybrid, home-based, and telerehabilitation, especially during the pandemic. Outside of the context of COVID-19, program components including referral, CR indications, CR contraindications, timing, and structure were included in the 4 CPGs and 2 of 15 statements. Recommendations related to CR core components were primarily focused on exercise, with no changes since before the pandemic except for COVID-19 considerations for safety. One guideline was specific to women, and 1 scientific statement to heart failure with preserved ejection fraction. CONCLUSIONS Although 19 documents were identified, CR delivery in low resource settings and for culturally and linguistically diverse populations require attention. Additionally, few recommendations on nutrition, psychosocial counselling, and patient education were reported.
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Affiliation(s)
- Lisa M Cotie
- University Health Network Cardiovascular Prevention and Rehabilitation Program, Toronto, Ontario, Canada
| | - Lais M Vanzella
- University Health Network Cardiovascular Prevention and Rehabilitation Program, Toronto, Ontario, Canada
| | - Maureen Pakosh
- Library and Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Gabriela Lima de Melo Ghisi
- KITE Research Institute, University Health Network and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
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Lima EA, Rodrigues G, Mota BC, Castro SS, Mesquita RB, Leite CF. Which Components of The International Classification of Functioning, Disability and Health (ICF) are Covered by Cardiac Rehabilitation Assessment Tools among Individuals with Heart Failure? Heart Lung 2024; 63:65-71. [PMID: 37806100 DOI: 10.1016/j.hrtlng.2023.09.010] [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: 06/09/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The therapeutic assessment of functioning in cardiac rehabilitation from the perspective of the International Classification of Functioning, Disability and Health (ICF) can provide a biopsychosocial approach to health care. However, it is unclear which components are reflected in the instruments used for cardiac rehabilitation in individuals with heart failure (HF). OBJECTIVES To investigate which ICF components (body function, structures, activities, participation, environmental factors, and personal factors) are represented in the assessment instruments used in individuals with HF and to identify the most appropriate instrument to use based on the inclusion of these factors. METHODS Forty-four clinical trials included in an updated Cochrane systematic review that investigated the effects of exercise-based cardiac rehabilitation in patients with HF were reviewed. The instruments were analyzed to extract significant concepts linked to the ICF codes. RESULTS A total of 12 outcomes and 40 instruments were identified. The concepts were linked to 2466 codes in the following ICF components: body functions (41.8%), activities (29.7%), participation (8.4%), environmental factors (3.8%), personal factors (1.3%), and body structures (1.0%); other concepts (13.9%) were classified as not covered by ICF. None of the instruments presented concepts linked to all ICF components. The Minnesota Living with Heart Failure Questionnaire (MLHFQ), however, demonstrated comprehensive coverage of the ICF components, with the exception of body structure. CONCLUSIONS Body function was the most frequently detected ICF component. Individual instruments did not provide a comprehensive perspective on the functioning level of individuals with HF. The MLHFQ provided the greatest coverage of ICF components.
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Affiliation(s)
- Eriadina Alves Lima
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Gezabell Rodrigues
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Beatriz Carneiro Mota
- Department of Physical Therapy, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Rafael Barreto Mesquita
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil; Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil; Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
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10
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Barcellos SR, Joras ADR, Constanzi AP, Souza END. Construction and validation of an educational booklet for patients in the postoperative period of cardiac surgery: a methodological study. Rev Bras Enferm 2023; 76:e20220621. [PMID: 38055473 DOI: 10.1590/0034-7167-2022-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/12/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to construct and validate an educational booklet for self-care of patients in the postoperative period of cardiac surgery. METHODS methodological study, including bibliographic survey, construction of the booklet and validation with judges and the target audience. For validation with judges, the Health Educational Content Validation Instrument was used, and with the target audience, an instrument was used with questions related to organization, writing style, appearance and motivation. To analyze the judges' answers, the content validation index was used. RESULTS the booklet was prepared with 14 topics. The content validation index among the eight judges was 1 and the concordance index among the ten patients was above 80%. The final version of the material was made available in printed format. CONCLUSION the educational booklet was developed and validated by judges and the target audience, serving as an educational support tool for self-care of patients in the postoperative period of cardiac surgery.
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Affiliation(s)
- Sônia Regina Barcellos
- Universidade de Caxias do Sul. Caxias do Sul, Rio Grande do Sul, Brazil
- Hospital Pompéia. Caxias do Sul, Rio Grande do Sul, Brazil
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11
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dos Santos DS, Queiroz CO, Dias CMCC, Cipriano G, Borges QO, Ritt LEF. Prediction of Peak Oxygen Consumption in Patients with Heart Disease Based on Performance on the Timed Up and Go Test. Arq Bras Cardiol 2023; 120:e20230338. [PMID: 38126569 PMCID: PMC10789370 DOI: 10.36660/abc.20230338] [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: 05/18/2023] [Revised: 08/14/2023] [Accepted: 10/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Central Illustration : Prediction of Peak Oxygen Consumption in Patients with Heart Disease Based on Performance on the Timed Up and Go Test CPET: cardiopulmonary exercise test; TUG: timed up and go test; VO2peak: peak oxygen consumption. BACKGROUND The use of the timed up and go (TUG) test to assess cardiorespiratory fitness in patients with heart disease has not been well defined in the literature. OBJECTIVES Test the association between TUG and peak oxygen consumption (VO2peak), construct an equation based on TUG to predict VO2peak, and determine a cutoff point to estimate VO2peak ≥ 20 mL/kg/min. METHODS This cross-sectional study included 201 patients with coronary artery disease or heart failure, between 36 and 92 years of age, who underwent TUG and cardiopulmonary exercise test. Correlation, ROC curve, multiple linear regression, and Bland-Altman analyses were performed. The significance level was set at p < 0.05. RESULTS The mean age of the total sample was 67 ± 13 years, and 70% of participants were male. The mean VO2peak was 17 ± 6 mL/kg/min, and the mean TUG time was 7 ± 2.5 seconds. The correlation between VO2peak and TUG was r = -0.54 (p < 0.001), and R2 was 0.30. The following equation was developed based on TUG: V O 2 peak = 33.553 + ( - 0.149 × age ) + ( - 0.738 × TUG ) + ( - 2.870 × sex ) ; a value of 0 was assigned to the male sex and 1 to the female sex (adjusted R: 0.41; adjusted R2: 0.40). The VO2peak estimated by the equation was 18.81 ± 3.2 mL/kg/min, and the VO2peak determined by cardiopulmonary exercise test was 18.18 ± 5.9 mL/kg/min (p > 0.05). The best cutoff point in the TUG for VO2peak ≥ 20 mL/kg/min was ≤ 5.47 seconds (area under the curve: 0.80; 95% confidence interval: 0.74 to 0.86). CONCLUSIONS TUG and VO2peak showed a significant association. A prediction equation for VO2peak was developed and validated internally with good performance. The cutoff point in the TUG to predict VO2peak ≥ 20 mL/kg/min was ≤ 5.47 seconds.
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Affiliation(s)
- Danilo Silva dos Santos
- Escola Bahiana de Medicina e Saúde PúblicaUnidade Acadêmica BrotasSalvadorBABrasilEscola Bahiana de Medicina e Saúde Pública – Unidade Acadêmica Brotas, Salvador, BA – Brasil
| | - Ciro Oliveira Queiroz
- Universidade Estadual do Sudoeste da BahiaJequieBrasilUniversidade Estadual do Sudoeste da Bahia – Campus de Jequie, Jequie – Brasil
| | - Cristiane Maria Carvalho Costa Dias
- Escola Bahiana de Medicina e Saúde PúblicaUnidade Acadêmica BrotasSalvadorBABrasilEscola Bahiana de Medicina e Saúde Pública – Unidade Acadêmica Brotas, Salvador, BA – Brasil
| | - Gerson Cipriano
- Universidade de BrasíliaBrasíliaDFBrasilUniversidade de Brasília, Brasília, DF – Brasil
| | - Queila Oliveira Borges
- Hospital Cardio PulmonarCentro de Estudos ClínicosSalvadorBABrasilHospital Cardio Pulmonar – Centro de Estudos Clínicos, Salvador, BA – Brasil
| | - Luiz Eduardo Fonteles Ritt
- Escola Bahiana de Medicina e Saúde PúblicaUnidade Acadêmica BrotasSalvadorBABrasilEscola Bahiana de Medicina e Saúde Pública – Unidade Acadêmica Brotas, Salvador, BA – Brasil
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12
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Dalçóquio TF, Alves Dos Santos M, Silva Alves L, Bittar Brito Arantes F, Ferreira-Santos L, Pinto Brandão Rondon MU, Furtado RHM, Gehlen Ferrari A, Genestreti Rizzo PR, Salsoso R, Franci A, Moreira Baracioli L, de Nazare Nunes Alves MJ, Negrão CE, Nicolau JC. Effects of exercise on platelet reactivity after myocardial infarction: a randomized clinical trial. Platelets 2023; 34:2139821. [PMID: 36377063 DOI: 10.1080/09537104.2022.2139821] [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: 07/02/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022]
Abstract
Exercise training (ET) can lower platelet reactivity in patients with cardiovascular risk factors. However, the effects of ET on platelet reactivity in higher-risk patients is unknown. The aim of this study was to evaluate the effects of ET on platelet reactivity in patients with recent myocardial infarction (MI). Ninety patients were randomly assigned 1 month post-MI to the intervention (patients submitted to a supervised ET program) or control group. All patients were on dual antiplatelet therapy (DAPT). Platelet reactivity by VerifyNow-P2Y12 (measured by P2Y12 reaction units - PRUs) test was determined at baseline and at the end of 14 ± 2 weeks of follow-up at rest (primary endpoint), and multiplate electrode aggregometry (MEA) adenosine diphosphate (ADP) and aspirin (ASPI) tests were performed immediately before and after the maximal cardiopulmonary exercise test (CPET) at the same time points (secondary endpoints). Sixty-five patients (mean age 58.9 ± 10 years; 73.8% men; 60% ST elevation MI) completed follow-up (control group, n = 31; intervention group, n = 34). At the end of the follow-up, the mean platelet reactivity was 172.8 ± 68.9 PRUs and 166.9 ± 65.1 PRUs for the control and intervention groups, respectively (p = .72). Platelet reactivity was significantly increased after the CPET compared to rest at the beginning and at the end of the 14-week follow-up (among the intervention groups) by the MEA-ADP and MEA-ASPI tests (p < .01 for all analyses). In post-MI patients on DAPT, 14 weeks of supervised ET did not reduce platelet reactivity. Moreover, platelet reactivity was increased after high-intensity exercise (ClinicalTrials.gov: NCT02958657; https://clinicaltrials.gov/ct2/show/NCT02958657).
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Affiliation(s)
- Talia Falcão Dalçóquio
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mayara Alves Dos Santos
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Leandro Silva Alves
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Flávia Bittar Brito Arantes
- Hospital das Clinicas, Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Larissa Ferreira-Santos
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Remo Holanda M Furtado
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Aline Gehlen Ferrari
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Roberto Genestreti Rizzo
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rocio Salsoso
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Andre Franci
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Luciano Moreira Baracioli
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Carlos Eduardo Negrão
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Carlos Nicolau
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Viana SMDNR, de Bruin VMS, Vasconcelos RS, Nogueira ANC, Mesquita R, de Bruin PFC. Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study. Respir Med 2023; 220:107441. [PMID: 37944829 DOI: 10.1016/j.rmed.2023.107441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Melatonin (MLT), the main product of the pineal gland, is involved in muscle tissue repair and regeneration, besides several other important physiologic functions. In COPD, MLT administration can improve lung oxidative stress and sleep quality, but its potential effects on the outcomes of pulmonary rehabilitation (PR) have not been previously investigated. A randomized controlled trial was undertaken to test the hypothesis that a combined approach of rehabilitative exercise training and MLT supplementation could maximize functional performance, health status and quality of life in patients with COPD. Thirty-nine individuals with COPD referred to a supervised PR program at the Federal University of Ceara, Brazil, were randomized to receive MLT (3 mg/day; n = 18) or placebo (n = 21). Exercise capacity (6-min walk test - 6MWT), health status (COPD assessment test), and quality of life (airways questionnaire 20) were investigated as primary outcomes. No differences were observed at baseline in demographic, anthropometric and clinical characteristics between MLT and placebo groups. At the end of PR, superiority of the MLT group was demonstrated in improvement in the distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01), health status (-11 ± 6 vs. -3 ± 5; p < 0.01), and quality of life (-6.9 ± 3.0 vs. -1.9 ± 2.4; p < 0.01), compared to the placebo group. In conclusion, MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.
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Affiliation(s)
| | | | | | | | - Rafael Mesquita
- Federal University of Ceara, Fortaleza, Brazil; Masters Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, CE, Brazil
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14
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Fraga IB, Caballero LG, Lago PD, de Oliveira JLC, Scherer M, Haeffner MP, Rabelo-Silva ER. Perceived dyspnea and experience of hospitalized patients with acute decompensated heart failure undergoing an early MObilization protocol with immersive Virtual rEality: MOVE study protocol for a parallel superiority randomized clinical trial. Trials 2023; 24:751. [PMID: 38001540 PMCID: PMC10675897 DOI: 10.1186/s13063-023-07786-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Immersive virtual reality (VR) is an innovative strategy for inpatient rehabilitation programs. Using immersive VR in early mobilization protocols has not yet been investigated in the setting of hospitalized patients with acute decompensated heart failure (ADHF), especially to improve perceived dyspnea, a common symptom of heart failure (HF). METHODS This is a single-center parallel superiority randomized clinical trial. The study will be conducted at a public teaching hospital in Brazil from January 2023 to January 2024. The sample will include adult patients with ADHF hospitalized for at least 24 h, randomly assigned in a 1:1 ratio to the control (standard early mobilization protocol conducted in the intensive care unit (ICU)) or intervention group (the same standard early mobilization protocol but associated with immersive VR). The primary outcome will be assessing perceived dyspnea, and the secondary outcome will be assessing patient experience. DISCUSSION Using immersive VR in early mobilization protocols in the ICU is expected to improve perceived dyspnea in patients with ADHF as well as patient experience regarding care. This study has the potential to increase patient adherence to early mobilization protocols in the setting of ADHF as well as to promote a positive patient experience. Filling this gap could promote the rational incorporation of technologies in health care. TRIAL REGISTRATION This study protocol is in its first version. CLINICALTRIALS gov NCT05596292. Registered on 1 December 2022.
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Affiliation(s)
- Iasmin Borges Fraga
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Larissa Gussatschenko Caballero
- Graduate Program Program of the School of Nursing, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Cardiology Division and Heart Failure Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Pedro Dal Lago
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Marina Scherer
- Cardiology Division and Heart Failure Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Mauren Porto Haeffner
- Cardiology Division and Heart Failure Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Eneida Rejane Rabelo-Silva
- Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Graduate Program Program of the School of Nursing, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Cardiology Division and Heart Failure Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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15
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Althoff A, Vieira AM, da Silveira LS, Benetti M, Karsten M. Aerobic Exercise Prescription in Cardiac Rehabilitation Based on Heart Rate from Talk Test Stages and 6-Minute Walk Test. Arq Bras Cardiol 2023; 120:e20230086. [PMID: 37820173 PMCID: PMC10519355 DOI: 10.36660/abc.20230086] [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: 02/06/2023] [Revised: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited. OBJECTIVE To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET). METHODS Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman's test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT-), and at the peak of the 6MWT. Pearson's or Spearman's test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%. RESULTS The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT- (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT- (p = 0.68). CONCLUSIONS HR at TT+ and TT- reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.
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Affiliation(s)
- Amanda Althoff
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Ariany Marques Vieira
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- Montreal Behavioral Medicine CentreCIUSSS du Nord-de-l’Île-de-MontréalMontrealCanadáMontreal Behavioral Medicine Centre, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal – Canadá
| | - Lucas Santos da Silveira
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Magnus Benetti
- PPGCMHUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Ciências do Movimento Humano (PPGCMH) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Marlus Karsten
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
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16
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Mazzoli-Rocha F. Exercise training in chronic Chagas cardiomyopathy: Promising preliminary evidence, but long-term large clinical trials are still needed. IJC HEART & VASCULATURE 2023; 48:101272. [PMID: 37794958 PMCID: PMC10545930 DOI: 10.1016/j.ijcha.2023.101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 10/06/2023]
Affiliation(s)
- Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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17
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Menezes MG, Fronza VA, Franzoni L. Aerobic Exercise Prescription: The Talk Test Rises Over the 6-Minute Walk Test. Arq Bras Cardiol 2023; 120:e20230636. [PMID: 37909576 PMCID: PMC10586818 DOI: 10.36660/abc.20230636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Márcio Garcia Menezes
- Universidade Federal do Rio Grande do SulPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul, Porto Alegre, RS – Brasil
| | - Vitor Augusto Fronza
- Universidade Federal do Rio Grande do SulPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul – Grupo de Pesquisa em Cardiologia do Exercício (CardioEx), Porto Alegre, RS – Brasil
| | - Leandro Franzoni
- Universidade Federal do Rio Grande do SulPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul, Porto Alegre, RS – Brasil
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Inês Gonzáles A, Lavarda do Nascimento G, da Silva A, Bernardo-Filho M, da Cunha de Sá-Caputo D, Sonza A. Whole-body vibration exercise in the management of cardiovascular diseases: A systematic review. J Bodyw Mov Ther 2023; 36:20-29. [PMID: 37949560 DOI: 10.1016/j.jbmt.2023.04.057] [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: 02/07/2022] [Revised: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are an important public health problem, representing about 45% of deaths in the world. Its management is linked to medications, changes in lifestyle, and physical exercise, with the whole-body vibration exercises (WBV) being a promising therapeutic resource. This study aims to investigate the effects of WBV in isolation or associated with other types of exercises in the management of CVDs. METHODS A systematic review following the PRISMA guidelines and registered on the PROSPERO platform was carried out. The search took place in the databases PubMed, Cochrane, PEDro, Lilacs, and Science Direct, from the beginning of the databases until January 2021. Descriptors related to WBV and CVD were used. The selected studies were assessed for quality, risk of bias, and level of evidence. RESULTS In all, 84 studies were identified, and of these, three were included. The intervention protocols used were analyzed, in addition to the effects of WBV on hemodynamic, cardiovascular, vascular/arterial, and muscle parameters. CONCLUSION The use of different WBV protocols, in isolation, in the improvement of the parameters mentioned above in individuals with CVD is plausible, with significant responses acutely or chronically and can be considered as a safe and effective training resource.
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Affiliation(s)
- Ana Inês Gonzáles
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Gabriella Lavarda do Nascimento
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Amanda da Silva
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Mario Bernardo-Filho
- Laboratory of Mechanical Vibrations and Integrative Practices - LAVIMPI, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Biology Institute and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, 20950-003, Brazil; Post-graduate Program in Clinical and Experimental Pathophysiology, State University of Rio de Janeiro, Rio de Janeiro, 20551-030, Brazil
| | - Danúbia da Cunha de Sá-Caputo
- Laboratory of Mechanical Vibrations and Integrative Practices - LAVIMPI, Department of Biophysics and Biometrics, Roberto Alcântara Gomes Biology Institute and Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, RJ, 20950-003, Brazil; Post-graduate Program in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, 20.551-030, Brazil
| | - Anelise Sonza
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Physical Therapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
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19
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Dourado LOC, Jordão CP, Assumpção CRA, de Matos LDNJ. In the Cardiac Rehabilitation Era, is There a "No-Option" Refractory Angina Patient?: A Case Report. Arq Bras Cardiol 2023; 120:e20230007. [PMID: 37878880 PMCID: PMC10567080 DOI: 10.36660/abc.20230007] [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: 01/23/2023] [Revised: 05/04/2023] [Accepted: 07/17/2023] [Indexed: 10/27/2023] Open
Abstract
Exercise-based cardiac rehabilitation, an effective and safe adjuvant treatment recommended to patients with coronary artery disease, is scarcely applied to patients with refractory angina (RA) due to difficulties related to safety, trainning prescription and their clinical management. This case report presents an instance of a "no-option" patient with RA, who was included in a 12-week exercise program, in sessions consisted of 40 minutes of treadmill aerobic exercise, three times a week, and intensity prescribed between ischemic/angina threshold and ventilatory threshold 1, obtained in the cardiopulmonary exercise test; mild to moderate angina was allowed during training. Furthermore, 15 minutes of moderate-intensity resistance training (large group muscle exercises, two sets of 8 to 12 repetitions) was performed. At the end of the protocol, the patient presented an important improvement in functional performance (VO 2 peak 17.0 ml/kg/min to 27.3 ml/kg/min), angina threshold (HR 68 bpm to 95 bpm), and intensity chest pain (levels 7 to 5) with no clinical adverse events during the period. Exercise-based cardiac rehabilitation was safe, even in the occurrence of angina/ischemia during training, according to tolerability to symptoms and other warning clinical signs.
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Affiliation(s)
- Luciana Oliveira Cascaes Dourado
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Camila Paixão Jordão
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Hospital Israelita Albert EinsteinSão PauloSPBrasil Hospital Israelita Albert Einstein , São Paulo , SP – Brasil
| | - Camila Regina Alves Assumpção
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
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20
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Oliveira GMMD, Almeida MCCD, Rassi DDC, Bragança ÉOV, Moura LZ, Arrais M, Campos MDSB, Lemke VG, Avila WS, Lucena AJGD, Almeida ALCD, Brandão AA, Ferreira ADDA, Biolo A, Macedo AVS, Falcão BDAA, Polanczyk CA, Lantieri CJB, Marques-Santos C, Freire CMV, Pellegrini D, Alexandre ERG, Braga FGM, Oliveira FMFD, Cintra FD, Costa IBSDS, Silva JSN, Carreira LTF, Magalhães LBNC, Matos LDNJD, Assad MHV, Barbosa MM, Silva MGD, Rivera MAM, Izar MCDO, Costa MENC, Paiva MSMDO, Castro MLD, Uellendahl M, Oliveira Junior MTD, Souza OFD, Costa RAD, Coutinho RQ, Silva SCTFD, Martins SM, Brandão SCS, Buglia S, Barbosa TMJDU, Nascimento TAD, Vieira T, Campagnucci VP, Chagas ACP. Position Statement on Ischemic Heart Disease - Women-Centered Health Care - 2023. Arq Bras Cardiol 2023; 120:e20230303. [PMID: 37556656 PMCID: PMC10382148 DOI: 10.36660/abc.20230303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Walkiria Samuel Avila
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Andreia Biolo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | | | | | | | | | - Celi Marques-Santos
- Universidade Tiradentes (UNIT), Aracaju, SE - Brasil
- Hospital São Lucas Rede D'Or São Luis, Aracaju, SE - Brasil
| | | | - Denise Pellegrini
- Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS - Brasil
| | | | - Fabiana Goulart Marcondes Braga
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Lara Terra F Carreira
- Cardiologia Nuclear de Curitiba, Curitiba, PR - Brasil
- Hospital Pilar, Curitiba, PR - Brasil
| | | | | | | | | | | | | | | | | | | | | | - Marly Uellendahl
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
- DASA - Diagnósticos da América S/A, São Paulo, SP - Brasil
| | - Mucio Tavares de Oliveira Junior
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | - Ricardo Quental Coutinho
- Faculdade de Ciências Médicas da Universidade de Pernambuco (UPE), Recife, PE - Brasil
- Hospital Universitário Osvaldo Cruz da Universidade de Pernambuco (UPE), Recife, PE - Brasil
| | | | - Sílvia Marinho Martins
- Pronto Socorro Cardiológico de Pernambuco da Universidade de Pernambuco (PROCAPE/UPE), Recife, PE - Brasil
| | | | - Susimeire Buglia
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | | | | | - Thais Vieira
- Universidade Tiradentes (UNIT), Aracaju, SE - Brasil
- Rede D'Or, Aracaju, SE - Brasil
- Hospital Universitário da Universidade Federal de Sergipe (UFS), Aracaju, SE - Brasil
| | | | - Antonio Carlos Palandri Chagas
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
- Centro Universitário Faculdade de Medicina ABC, Santo André, SP - Brasil
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21
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Milani JGPO, Milani M, Cipriano GFB, Hansen D, Cipriano Junior G. Exercise intensity domains determined by heart rate at the ventilatory thresholds in patients with cardiovascular disease: new insights and comparisons to cardiovascular rehabilitation prescription recommendations. BMJ Open Sport Exerc Med 2023; 9:e001601. [PMID: 37533593 PMCID: PMC10391816 DOI: 10.1136/bmjsem-2023-001601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives To compare the elicited exercise responses at ventilatory thresholds (VTs: VT1 and VT2) identified by cardiopulmonary exercise testing (CPET) in patients with cardiovascular disease (CVD) with the guideline-directed exercise intensity domains; to propose equations to predict heart rate (HR) at VTs; and to compare the accuracy of prescription methods. Methods A cross-sectional study was performed with 972 maximal treadmill CPET on patients with CVD. First, VTs were identified and compared with guideline-directed exercise intensity domains. Second, multivariate linear regression analyses were performed to generate prediction equations for HR at VTs. Finally, the accuracy of prescription methods was assessed by the mean absolute percentage error (MAPE). Results Significant dispersions of individual responses were found for VTs, with the same relative intensity of exercise corresponding to different guideline-directed exercise intensity domains. A mathematical error inherent to methods based on percentages of peak effort was identified, which may help to explain the dispersions. Tailored multivariable equations yielded r2 of 0.726 for VT1 and 0.901 for VT2. MAPE for the novel VT1 equation was 6.0%, lower than that for guideline-based prescription methods (9.5 to 23.8%). MAPE for the novel VT2 equation was 4.3%, lower than guideline-based methods (5.8%-19.3%). Conclusion The guideline-based exercise intensity domains for cardiovascular rehabilitation revealed inconsistencies and heterogeneity, which limits the currently used methods. New multivariable equations for patients with CVD were developed and demonstrated better accuracy, indicating that this methodology may be a valid alternative when CPET is unavailable.
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Affiliation(s)
| | - Mauricio Milani
- Graduate Programme in Health Sciences and Technologies, University of Brasilia, Brasilia, Brazil
- REVAL/BIOMED, Hasselt University, Hasselt, Belgium
| | - Graziella França Bernardelli Cipriano
- Graduate Programme in Health Sciences and Technologies, University of Brasilia, Brasilia, Brazil
- Rehabilitation Sciences Programme, University of Brasilia, Brasilia, Brazil
| | - Dominique Hansen
- REVAL/BIOMED, Hasselt University, Hasselt, Belgium
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Gerson Cipriano Junior
- Graduate Programme in Health Sciences and Technologies, University of Brasilia, Brasilia, Brazil
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22
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Taylor RS, Fredericks S, Jones I, Neubeck L, Sanders J, De Stoutz N, Thompson DR, Wadhwa DN, Grace SL. Global perspectives on heart disease rehabilitation and secondary prevention: a scientific statement from the Association of Cardiovascular Nursing and Allied Professions, European Association of Preventive Cardiology, and International Council of Cardiovascular Prevention and Rehabilitation. Eur Heart J 2023; 44:2515-2525. [PMID: 37477626 PMCID: PMC10361025 DOI: 10.1093/eurheartj/ehad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/26/2023] [Accepted: 03/30/2023] [Indexed: 07/22/2023] Open
Abstract
Cardiovascular disease is a leading cause of death, morbidity, disability, and reduced health-related quality of life, as well as economic burden worldwide, with some 80% of disease burden occurring in the low- and middle-income country (LMIC) settings. With increasing numbers of people living longer with symptomatic disease, the effectiveness and accessibility of secondary preventative and rehabilitative health services have never been more important. Whilst LMICs experience the highest prevalence and mortality rates, the global approach to secondary prevention and cardiac rehabilitation, which mitigates this burden, has traditionally been driven from clinical guidelines emanating from high-income settings. This state-of-the art review provides a contemporary global perspective on cardiac rehabilitation and secondary prevention, contrasting the challenges of and opportunities for high vs. lower income settings. Actionable solutions to overcome system, clinician, programme, and patient level barriers to cardiac rehabilitation access in LMICs are provided.
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Affiliation(s)
- Rod S Taylor
- Former ACNAP Science committee member, Professor of Population Health, School of Health and Well Being, University of Glasgow, Glasgow G12 8QQ, UK
| | - Suzanne Fredericks
- ACNAP Science committee member, Professor, Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada
| | - Ian Jones
- ACNAP Science committee member, Professor of Cardiovascular Nursing, Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Lis Neubeck
- ACNAP President, Professor and Head of Cardiovascular Health, Centre for Cardiovascular Health, Edinburgh Napier University, Edinburgh, UK
| | - Julie Sanders
- ACNAP Science committee chair, Director of Clinical Research, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, UK
- Clinical Professor of Cardiovascular Nursing, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Noemi De Stoutz
- ESC Patient forum representative, Member of ‘Cuore Matto’ and Global ARCH, Zumikon, Switzerland
| | - David R Thompson
- EAPC representative, Professor of Nursing, School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Deepti N Wadhwa
- ACNAP Young community member, Associate Professor, MVPS College of Physiotherapy, Nashik, India
| | - Sherry L Grace
- ICCPR Immediate past-Chair, Professor, Faculty of Health, York University, Toronto, Canada
- KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Canada
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23
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Nery RM, dos Santos AC, Garcia EL. Exercise-Based Cardiac Rehabilitation (ECBR): New Frontiers in the Post-Novel Coronavirus. Arq Bras Cardiol 2023; 120:e20230120. [PMID: 37042881 PMCID: PMC10392857 DOI: 10.36660/abc.20230120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Affiliation(s)
- Rosane Maria Nery
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cardiologia do exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cardiologia do exercício (CardioEx), Porto Alegre, RS – Brasil
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cirurgia vascular e exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cirurgia vascular e exercício (VascoEx), Porto Alegre, RS – Brasil
- Hospital de Clínicas de Porto AlegreServiço de fisiatria e reabilitaçãoPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Serviço de fisiatria e reabilitação, Porto Alegre, RS – Brasil
| | - Antonio Cardoso dos Santos
- Hospital de Clínicas de Porto AlegreServiço de fisiatria e reabilitaçãoPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Serviço de fisiatria e reabilitação, Porto Alegre, RS – Brasil
- Universidade Federal do Rio Grande do SulDepartamento de cirurgiaPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul, Departamento de cirurgia, Porto Alegre, RS – Brasil
| | - Eduardo Lima Garcia
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cirurgia vascular e exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cirurgia vascular e exercício (VascoEx), Porto Alegre, RS – Brasil
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24
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Silva CGDSE. Is There a Role for Religion and Spirituality in Cardiac Rehabilitation? Arq Bras Cardiol 2023; 120:e20230088. [PMID: 37018792 PMCID: PMC10392855 DOI: 10.36660/abc.20230088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
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25
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von Flach MDRT, Ritt LEF, Santana Junior FGD, Correia MVF, Claro TC, Ladeia AM, Oliveira QBD, Rocha MS, Feitosa CM, Santos M, Stein R. Spirituality, Functional Gain, and Quality of Life in Cardiovascular Rehabilitation. Arq Bras Cardiol 2023; 120:e20220452. [PMID: 36946856 DOI: 10.36660/abc.20220452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/16/2022] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Religiosity and spirituality have been associated with higher recovery rates, greater adherence to treatments, and better levels of quality of life in patients with heart disease. OBJECTIVES To evaluate the association between spirituality, functional gain, and improved quality of life in patients in a cardiovascular rehabilitation program. METHODS This prospective cohort study evaluated the association between functional and quality of life gains during a cardiovascular rehabilitation program and a religiosity/spirituality index based on a validated scale. Depression, anxiety, and stress symptoms were screened for control purposes. P values < 0.05 were considered significant for all analyses. RESULTS The study followed 57 patients (66 ± 12 years old; 71.7% male; 76% with coronary artery disease). The Spearman correlation coefficient did not show any associations between increases in functional capacity and organizational (rs = 0.110; p = 0.421), non-organizational (rs = -0.007; p = 0.421), or intrinsic (rs = -0.083; p = 0.543) religiosity. Furthermore, no associations were detected between the results of a quality of life score and organizational (rs = 0.22; p = 0.871), non-organizational (rs = 0.191; p = 0.159), or intrinsic (rs = 0.108; p = 0.429) religiosity. CONCLUSION No association was detected between functional and quality of life gains and organizational, non-organizational, or intrinsic religiosity in this sample of patients undergoing cardiovascular rehabilitation.
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Affiliation(s)
| | - Luiz Eduardo Fonteles Ritt
- Hospital Cardio Pulmonar - Centro de Estudos Clínicos , Salvador , BA - Brasil
- Escola Bahiana de Medicina e Saúde Pública - Pós-Graduação em Medicina e Saúde Humana , Salvador , BA - Brasil
| | | | | | | | - Ana Marice Ladeia
- Escola Bahiana de Medicina e Saúde Pública - Pós-Graduação em Medicina e Saúde Humana , Salvador , BA - Brasil
| | | | - Mario Seixas Rocha
- Fundação Bahiana para Desenvolvimento das Ciências (FBDC), Salvador , BA - Brasil
| | | | - Maeve Santos
- Fundação Bahiana para Desenvolvimento das Ciências (FBDC), Salvador , BA - Brasil
| | - Ricardo Stein
- Universidade Federal do Rio Grande do Sul , Porto Alegre , RS - Brasil
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26
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Jardim IDSC, Milani M, Castro I, Hansen D, Karsten M, Cahalin LP, Cipriano GFB, Cipriano G. Impact of COVID-19's on Cardiovascular Rehabilitation Programs in Brazil: An Online Survey-Based Cross-Sectional Study. Arq Bras Cardiol 2023; 120:e20220135. [PMID: 36921154 PMCID: PMC9973047 DOI: 10.36660/abc.20220135] [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: 02/22/2022] [Accepted: 11/16/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had an impact on cardiovascular rehabilitation (CR) programs in Brazil. OBJECTIVES To describe the characteristics of CR programs in Brazil, the impacts of the first epidemiological wave of COVID-19 (first 60 days) on the programs and present the initiatives used to overcome the impacts. METHOD This cross-sectional and retrospective study utilized a specific online survey. Participants were coordinators of CR programs. Variables were presented by Brazilian geographic region and as the following categories: demographic, clinical and operational characteristics. The significance level for statistical analysis was set at 5%. RESULTS Fifty-nine CR programs were responsible for 5,349 patients, of which only 1,817 were post-acute cardiovascular events, which corresponded to 1.99% of hospitalized patients in the month prior to the survey (n=91,231). The greatest impact was the suspension of on-site activities, which occurred similarly in areas with the highest and the lowest rates of COVID-19 in the period. Forty-five programs (75%) were shortly interrupted, while three (5%) were ended. All 42 programs that already used remote rehabilitation strategies noticed a substantial increase in activities, based primarily on the use of media and video calling. Only three (5%) considered safe to see patients during the first 60 days. CONCLUSIONS There was a reduction in the number of CR programs with the COVID-19 pandemic. Telerehabilitation activities increased during the first two months of the COVID-19 pandemic, but this was not enough to overcome the reduction in CR program activities across Brazil.
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Affiliation(s)
- Iara de Sousa Cezário Jardim
- Programa de Pós Graduação em Ciências da Reabilitação (PPGCR), Universidade de Brasília (UNB), Brasília, DF - Brasil
| | - Mauricio Milani
- Fitcordis, Brasília, DF - Brasil.,Programa de Pós Graduação em Ciências e Tecnologias em Saúde (PPGCTS), Universidade de Brasília (UNB), Brasília, DF - Brasil
| | - Isac Castro
- Universidade de São Paulo, São Paulo, SP - Brasil
| | | | - Marlus Karsten
- Programa de Pós-graduação em Fisioterapia (PPGFT), Universidade do Estado de Santa Catarina, Florianópolis, SC - Brasil
| | | | | | - Gerson Cipriano
- Programa de Pós Graduação em Ciências da Reabilitação (PPGCR), Universidade de Brasília (UNB), Brasília, DF - Brasil
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27
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Viana AMN, Vieira MC, Mazzoli-Rocha F, Silva RS, Frota AX, Costa HS, Borges JP, Sperandio da Silva GM, da Silva PS, Hasslocher-Moreno AM, Saraiva RM, de Sousa AS, Mendes FDSNS, Mediano MFF. Comparative effects of a cardiovascular rehabilitation program on functional capacity in patients with chronic chagasic cardiomyopathy with or without heart failure. Disabil Rehabil 2023; 45:51-56. [PMID: 35007459 DOI: 10.1080/09638288.2021.2024282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the effects of cardiovascular rehabilitation (CR) on functional capacity of patients with chronic chagasic cardiomyopathy (CCC) and to compare the responses between CCC patients without and with heart failure (HF). MATERIALS AND METHODS A longitudinal observational retrospective study was carried out including 36 patients with CCC without HF (stage B2 [n = 7]) and with HF (stage C [n = 29]), who participated in a CR program. Functional capacity was assessed by a maximal progressive cardiopulmonary exercise test performed on a treadmill. The longitudinal effects of the CR on functional capacity were determined by linear mixed models that included an interaction term to evaluate the differential responses between patients without and with HF. RESULTS Significant improvements in peak oxygen consumption, resting heart rate and blood pressure, and maximum pulmonary ventilation were observed for the overall study sample, with no apparent differential effects according to the presence of HF. CONCLUSIONS CR significantly improved functional capacity of patients with CCC. The responses to CR appear to be similar among patients without and with HF, reinforcing the need for its inclusion as a standard treatment strategy of CCC.Implications for rehabilitationExercise-based cardiovascular rehabilitation (CR) is a safe strategy that improves functional capacity, cardiac function, and quality of life in patients with several cardiovascular diseases, and recent studies also suggested a potential beneficial effect of CR in chronic chagasic cardiomyopathy (CCC).In this observational study, CR seems to equally improve exercise capacity, resting heart rate, resting blood pressure, and maximum pulmonary ventilation in patients with CCC without (stage B2) and with heart failure (stage C).Cardiovascular rehabilitation should be included as a standard treatment strategy for patients with CCC, regardless the severity of cardiomyopathy.
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Affiliation(s)
- Aline Maria Nunes Viana
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Health Center, Veiga de Almeida University, Rio de Janeiro, Brazil
| | - Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, Brazil
| | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rudson Santos Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Aline Xavier Frota
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Henrique Silveira Costa
- Physical Therapy Department, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paula Simplício da Silva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Andrea Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
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28
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Milani M, Milani JGPO, Cipriano G. Encaminhamento de Angina Refratária para Reabilitação Cardiovascular: Um Paciente Negligenciado. Arq Bras Cardiol 2022; 119:754-755. [DOI: 10.36660/abc.20220695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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29
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Oliveira J, Gentil P, Naves JP, Souza Filho LF, Silva L, Zamunér AR, de Lira CA, Rebelo A. Effects of High Intensity Interval Training versus Sprint Interval Training on Cardiac Autonomic Modulation in Healthy Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12863. [PMID: 36232163 PMCID: PMC9566246 DOI: 10.3390/ijerph191912863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND For the prevention of cardiovascular diseases, the practice of physical exercises is an effective strategy in improving or maintaining cardiorespiratory health; however, a lack of time is a barrier to access and interval training appears as possible facilitator. This study aims to compare the effects of two interval training protocols on cardiac autonomic modulation in healthy women. METHODS we conducted a randomized clinical trial with 43 women with a mean age of 29.96 ± 6.25 years, allocated into two groups; high-intensity interval training (HIIT) consisting of four four-minute high-intensity sprints interspersed with three minutes of active recovery and the Sprint interval training (SIT) with four 30-s sprints all-out, interspersed with four minutes of recovery (active or passive). RESULTS the HIIT group presented better results for the patterns without variation (0V) variables (p = 0.022); Shannon entropy (p = 0.004) Conditional Entropy (p = 0.025). However, there was a significant group effect for some variables, Oxygen Volume (VO2) (p = 0.004), Square root of the mean quadratic differences between the adjacent normal R-R intervals (p = 0.002) and standard deviation of all normal R-R intervals recorded in a time interval (p = 0.003), demonstrating an improvement independent of the protocol. CONCLUSION we conclude that eight weeks of interval training were able to produce positive effects on cardiac autonomic modulation in healthy women, with better results for HIIT in this population.
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Affiliation(s)
- Jordana Oliveira
- Department of Physiotherapy, Araguaia University Center, Goiania 74223-060, Brazil
- Faculty of Medicine, Goias Federal University, Goiania 74690-900, Brazil
| | - Paulo Gentil
- Faculty of Physical Education and Dance, Goias Federal University, Goiania 74690-900, Brazil
| | - João Pedro Naves
- Faculty of Physical Education and Dance, Goias Federal University, Goiania 74690-900, Brazil
| | - Luiz Fernando Souza Filho
- Faculty of Medicine, Goias Federal University, Goiania 74690-900, Brazil
- Department of Physiotherapy, Estacio de Sá de Goias University Center, Goiania 74063-010, Brazil
| | - Lucas Silva
- Department of Physiotherapy, Araguaia University Center, Goiania 74223-060, Brazil
| | - Antonio Roberto Zamunér
- Laboratory of Clinical Research in Kinesiology, Department of Kinesiology, Universidad Católica del Maule, Talca 34809112, Chile
| | - Claudio Andre de Lira
- Faculty of Physical Education and Dance, Goias Federal University, Goiania 74690-900, Brazil
| | - Ana Rebelo
- Faculty of Medicine, Goias Federal University, Goiania 74690-900, Brazil
- Institute of Biological Sciences, Federal University of Goias, Goiania 74690-900, Brazil
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Rocha GDS, Aquino JCF. A New Look at the Importance of Multidisciplinary Group Interventions in Cardiac Rehabilitation. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20220105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Almeida JAB, Florêncio RB, Lemos DA, Leite JC, Monteiro KS, Peroni Gualdi L. Self-efficacy instruments for individuals with coronary artery disease: a systematic review protocol. BMJ Open 2022; 12:e062794. [PMID: 35882460 PMCID: PMC9330326 DOI: 10.1136/bmjopen-2022-062794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Self-efficacy is associated with management of diseases, psychological well-being, improved quality of life and rehabilitation adherence. Several instruments related to behaviour or specific disease (eg, coronary artery disease (CAD)) assess self-efficacy. The evaluation of cardiac self-efficacy in individuals with CAD will support healthcare professionals to improve self-efficacy via interventions; therefore, a suitable instrument is crucial. This systematic review aims to assess measurement properties, methodological quality and content of outcome measures of cardiac self-efficacy instruments for individuals with CAD. METHODS AND ANALYSIS The study has been developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and Consensus Norms for Selection of Health Measuring Instruments (COSMIN). The following databases will be searched: MEDLINE (Ovid), Web of Science, EMBASE and PsycINFO. Studies assessing measurement properties of cardiac self-efficacy instruments for individuals with CAD will be included. No date or language restrictions will be applied to the search. Two independent authors will be responsible for assessing the eligibility of studies. Methodological quality of studies will be assessed using the COSMIN RoB Checklist, and the Grading of Recommendations, Assessment, Development and Assessment will be used to assess the quality of each study. Two authors will independently evaluate the content of instruments and link this to the International Classification of Functioning, Disability and Health. ETHICS AND DISSEMINATION This study does not require ethics committee approval since it is based on previously published data. Evidence from this systematic review will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences. PROSPERO REGISTRATION NUMBER CRD42021262613.
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Affiliation(s)
- Jose Alexandre Barbosa Almeida
- Rehabilitation Sciences Graduate Program, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Rêncio Bento Florêncio
- Rehabilitation Sciences Graduate Program, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Darllane Azevedo Lemos
- Rehabilitation Sciences Graduate Program, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Jéssica Costa Leite
- Physical Therapy Graduate Program, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Karolinne Souza Monteiro
- Department of Physical Therapy, Rehabilitation Sciences Graduate Program, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Lucien Peroni Gualdi
- Department of Physical Therapy, Rehabilitation Sciences Graduate Program, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
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Vieira AM, Martins EM, Althoff A, Rech DA, Ribeiro GDS, Matte DL, Karsten M. Application and Measurement Properties of the Talk Test in Cardiopulmonary Patients: A Systematic Review. Rev Cardiovasc Med 2022; 23:225. [PMID: 39076925 PMCID: PMC11266803 DOI: 10.31083/j.rcm2307225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 07/31/2024] Open
Abstract
Background The talk test (TT) evaluates the exercise intensity by measuring speech comfort level during aerobic exercise. There are several application protocols available to assess individuals with cardiopulmonary diseases. However, the measurement properties of the TT were not systematically reviewed yet. Methods A systematic review was developed, registered (CRD420181068930), and reported according to PRISMA Statement. Randomized clinical trials, cross-sectional studies, or series cases were identified through multiple databases and were selected if they presented concomitant speech provocation and an exercise test. Included studies were evaluated based on methodological quality (adapted New Castle-Ottawa Scale), descriptive quality (STROBE Statement), and risk of bias (COSMIN bias risk scale). Results Ten studies were included. Seven studies presented moderate to high quality and the majority presented good scores according to the STROBE statement. Four hundred and fourteen subjects performed the TT, the majority being patients with coronary artery disease. The test validity was supported by the included studies. Talk Test reliability was considered satisfactory, although only one study presented an adequate reliability analysis. The studies found a correlation between the last positive stage of the TT with the first ventilatory threshold. Workload, oxygen uptake, and heart rate in the last positive stage of the TT were not different from the same parameters related to the first ventilatory threshold. Conclusions The evidence indicates that the TT is suitable as an alternative tool for the assessment and prescription of exercise in individuals with cardiovascular diseases. The stage when the individual is still able to speak comfortably is suggested as the intensity for aerobic exercise prescription. As there is still no well-defined and fully explored TT protocol, caution is required when interpreting the TT results.
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Affiliation(s)
- Ariany Marques Vieira
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC H4J 1C5, Canada
| | - Edgar Manoel Martins
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
| | - Amanda Althoff
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Physical Therapy Undergraduate Program, Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
| | - Daiana Aparecida Rech
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Physical Therapy Undergraduate Program, University of Vale do Itajaí (UNIVALI), 88302-901 Itajaí, SC, Brazil
| | - Gustavo dos Santos Ribeiro
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Graduate Program in Rehabilitation Sciences (PPG-CR), Federal University of Health Sciences of Porto Alegre (UFCSPA), 90050-170 Porto Alegre, RS, Brazil
| | - Darlan Laurício Matte
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Physical Therapy Undergraduate Program, Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
| | - Marlus Karsten
- Physical Therapy Graduate Program (PPGFT), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Research Group on Cardiovascular Health and Exercise (GEPCardio), Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Physical Therapy Undergraduate Program, Santa Catarina State University (UDESC), 88080-350 Florianópolis, SC, Brazil
- Graduate Program in Rehabilitation Sciences (PPG-CR), Federal University of Health Sciences of Porto Alegre (UFCSPA), 90050-170 Porto Alegre, RS, Brazil
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Simões VAL, Mendes FDSNS, Avellar AM, da Silva GMS, Carneiro FM, Silva PS, Mazzoli-Rocha F, Silva RS, Vieira MC, Costa CJDN, de Sousa AS, Rosalino CMV, Nobre PFDS, de Holanda MT, Costa HS, Saraiva RM, Hasslocher-Moreno AM, Castro R, Mediano MFF. Cost-effectiveness of an exercise-based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study. Trop Med Int Health 2022; 27:630-638. [PMID: 35644993 DOI: 10.1111/tmi.13784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The present study aimed to perform a cost-effectiveness analysis of an exercise-based cardiovascular rehabilitation (CR) program in patients with chronic Chagas cardiomyopathy (CCC). METHODS Cost-effectiveness analysis alongside a randomised clinical trial evaluating the effects of a 6-month exercise-based CR program. The intervention group underwent 3 weekly exercise sessions. The variation of peak oxygen consumption (VO2peak ) was used as a measurement of clinical outcome. Cost information from all healthcare expenses (examinations, healthcare visits, medication and hospitalisation) were obtained from the medical records in Brazilian reais (R$) and transformed into dollars using the purchasing power parity ($PPP). The longitudinal costs variation was evaluated through linear mixed models, represented by β coefficient, adjusted for the baseline values of the dependent variable. The cost-effectiveness evaluation was determined through an incremental cost-effectiveness ratio using the HEABS package (Stata 15.0). RESULTS The intervention group presented higher costs with healthcare visits (β = +3317.3; p < 0.001), hospitalisation (β = +2810.4; p = 0.02) and total cost (β = +6407.9; p < 0.001) after 3 months of follow-up. Costs related to healthcare visits (β = +2455.8; p < 0.001) and total cost (β = +4711.4; p < 0.001) remained higher in the intervention group after 6 months. The CR program showed an incremental cost-effectiveness ratio (ICER) of $PPP 1874.3 for each increase of 1.0 ml kg-1 min-1 of VO2peak . CONCLUSIONS The CR program can be considered a cost-effective alternative and should be included as an intervention strategy in the care of patients with CCC.
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Affiliation(s)
| | | | - Alexandre Monken Avellar
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Fernanda Martins Carneiro
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paula Simplício Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Flavia Mazzoli-Rocha
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rudson Santos Silva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcelo Carvalho Vieira
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Centre for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, Brazil
| | | | - Andrea Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Henrique Silveira Costa
- Department of Physical Therapy, Faculty of Healthy and Biological Sciences, Federal University of Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Roberto Magalhães Saraiva
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Rodolfo Castro
- Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Institute of Collective Health, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
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Rodrigues GDF, Vieira DDR, Ruschel PP, Seelig C, Coronel C, Barbiero SM. Interdisciplinary Group Intervention on Nutritional Profile, Quality of Life, and Stress During Cardiopulmonary Rehabilitation: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Stein R, Milani M, Abreu A. Qual é o Cenário Atual da Reabilitação Cardíaca no Brasil e em Portugal? Arq Bras Cardiol 2022; 118:858-860. [PMID: 35613185 PMCID: PMC9368881 DOI: 10.36660/abc.20220210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Comment on: "Resting Oxygen Uptake Value of 1 Metabolic Equivalent of Task in Older Adults: A Systematic Review and Descriptive Analysis.". Sports Med 2022; 52:2003-2005. [PMID: 35038141 DOI: 10.1007/s40279-021-01617-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
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Pitta NC, Furuya RK, Freitas NDO, Dessotte CAM, Dantas RAS, Ciol MA, Schmidt A, Rossi LA. Effect of an educational program on physical activity in individuals undergoing their first percutaneous coronary intervention: A randomized clinical trial. Braz J Phys Ther 2022; 26:100443. [PMID: 36206592 PMCID: PMC9539789 DOI: 10.1016/j.bjpt.2022.100443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 08/07/2022] [Accepted: 09/12/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Educational programs designed for specific populations to improve regular physical activity need to be tested. OBJECTIVES To evaluate the effectiveness of an educational program, when compared to usual care, on improving physical activity 5 to 7 months after hospital discharge in adult patients undergoing their first percutaneous coronary intervention. METHODS Randomized controlled trial with two groups: usual care (n = 56) and educational program (n = 53) interventions. Data on sociodemographic and clinical characteristics were collected and the Baecke-Habitual Physical Activity Questionnaire, Self-efficacy Scale for Physical Activity, and Hospital Anxiety and Depression Scale were administered at baseline and follow-up. Participants in the educational program received an intervention based on Social Cognitive Theory, focused on physical activity, followed by three telephone calls. The usual care group received the hospital routine information. Unadjusted and adjusted differences between the two groups in mean score changes (with 95% confidence intervals [CI]) were calculated for all outcomes. RESULTS At follow-up, the educational program group showed higher mean ± standard deviation scores than the usual care group for practice of physical activity (7.94 ± 1.84 vs. 6.90 ± 1.89) and for self-efficacy (3.98 ± 3.75 vs. 2.52 ± 3.12). Adjusting for baseline outcome, the difference in mean change between groups was 0.89 (95% CI: 0.32, 1.46) for physical activity and 2.30 (95% CI: 1.12, 3.49) for self-efficacy. There were no statistical differences between groups in symptoms of anxiety and depression. CONCLUSION The educational program may be an effective intervention in increasing habitual physical activity and self-efficacy for physical activity in individuals with coronary artery disease.
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Affiliation(s)
- Natássia Condilo Pitta
- Postgraduate Program in Fundamental Nursing, Ribeirão Preto College of Nursing, Universidade de São Paulo, Bairro Quinta da Primavera, Avenida Luiz Octávio da Silva Whitaker 1550, Comp. 2303, Ribeirão Preto, SP CEP 14022-098, Brazil.
| | - Rejane Kiyomi Furuya
- Paraná Federal Institute of Education, Science and Technology, Federal Institute of Paraná, Londrina, PR, Brazil
| | | | - Carina Aparecida Marosti Dessotte
- General and Specialised Nursing Department, Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rosana Aparecida Spadoti Dantas
- General and Specialised Nursing Department, Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcia Aparecida Ciol
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - André Schmidt
- Department of Internal Medicine, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Lidia Aparecida Rossi
- General and Specialised Nursing Department, Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Calegari L, Moreira I, Falkowski A, Reolão JBC, Karsten M, Deresz LF. Agreement between heart rate at first ventilatory threshold on treadmill and at 6-min walk test in coronary artery disease patients on β-blockers treatment. J Exerc Rehabil 2021; 17:362-368. [PMID: 34805026 PMCID: PMC8566104 DOI: 10.12965/jer.2142488.244] [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: 08/16/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to verify the accuracy of the agreement between heart rate at the first ventilatory threshold (HRVT1) and heart rate at the end of the 6-min walk test (HR6MWT) in coronary artery disease (CAD) patients on β-blockers treatment. This was a cross-sectional study with stable CAD patients, which performed a cardiopulmonary exercise test (CPET) on a treadmill and a 6-min walk test (6MWT) on nonconsecutive days. The accuracy of agreement between HRVT1 and HR6MWT was evaluated by Bland–Altman analysis and Lin’s concordance correlation coefficient (rc), mean absolute percentage error (MAPE), and standard error of estimate (SEE). Seventeen stable CAD patients on β-blockers treatment (male, 64.7%; age, 61±10 years) were included in data analysis. The Bland–Altman analysis revealed a negative bias of −0.41±6.4 bpm (95% limits of agreements, −13 to 12.2 bpm) between HRVT1 and HR6MWT. There was acceptable agreement between HRVT1 and HR6MWT (rc=0.84; 95% confidence interval, 0.63 to 0.93; study power analysis=0.79). The MAPE of the HR6MWT was 5.1% and SEE was 6.6 bpm. The ratio HRVT1/HRpeak and HR6MWT/HRpeak from CPET were not significantly different (81%±5% vs. 81%±6%, P=0.85); respectively. There was a high correlation between HRVT1 and HR6MWT (r=0.85, P<0.0001). Finally, the results of the present study demonstrate that there was an acceptable agreement between HRVT1 and HR6MWT in CAD patients on β-blockers treatment and suggest that HR6MWT may be useful to prescribe and control aerobic exercise intensity in cardiac rehabilitation programs.
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Affiliation(s)
- Leonardo Calegari
- Physical Therapy Department, Faculdade Especializada da Área da Saúde do Rio Grande do Sul (FASURGS), Passo Fundo, RS, Brazil
| | - Igor Moreira
- Physical Therapy Department, Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Andrei Falkowski
- Physical Therapy Department, Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | | | - Marlus Karsten
- Departamento de Fisioterapia, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil.,Graduate Program in Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil.,Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Luís Fernando Deresz
- Physical Education Department, Health Sciences Institute, Universidade Federal de Juiz de Fora, Governador Valadares, Brazil.,Post Graduation Program in Health Applied Sciences, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil.,Research Group Ciência, Saúde e Desempenho Físico, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
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Campos MDSB, Buglia S, Colombo CSSDS, Buchler RDD, Brito ASXD, Mizzaci CC, Feitosa RHF, Leite DB, Hossri CAC, Albuquerque LCAD, Freitas OGAD, Grossman GB, Mastrocola LE. Position Statement on Exercise During Pregnancy and the Post-Partum Period - 2021. Arq Bras Cardiol 2021; 117:160-180. [PMID: 34320089 PMCID: PMC8294738 DOI: 10.36660/abc.20210408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Susimeire Buglia
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.,Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | - Rica Dodo Delmar Buchler
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.,Ergometria DASA, São Paulo, SP - Brasil
| | | | | | | | - Danielle Batista Leite
- Real Hospital Português, Recife, PE - Brasil.,Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
| | | | | | | | - Gabriel Blacher Grossman
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil.,Clínica Cardionuclear, Porto Alegre, RS - Brasil
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Bourscheid G, Just KR, Costa RR, Petry T, Danzmann LC, Pereira AH, Pereira AA, Franzoni LT, Garcia EL. Effect of different physical training modalities on peak oxygen consumptions in post-acute myocardial infarction patients: systematic review and meta-analysis. J Vasc Bras 2021; 20:e20210056. [PMID: 34404997 PMCID: PMC8354336 DOI: 10.1590/1677-5449.210056] [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: 04/08/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022] Open
Abstract
Physical training can increase peak oxygen uptake (VO2peak) in people who have suffered acute myocardial infarction (AMI). However, there is still a gap in the literature in relation to the effectiveness of different types of interventions. Therefore, the aim of the present study was to evaluate the effects of different physical training modalities on VO2peak in post-AMI patients. The following databases were used: PubMed (MEDLINE), Cochrane Library, Scopus, and Pedro. Studies that evaluated aerobic exercise, strength exercise, or combined exercise were included. Six studies met eligibility criteria. Aerobic exercise increased VO2peak by 6.07 ml.kg-1.min-1 when compared to the control group (CG) (p = 0.013). The comparison between combined exercise and control group detected a difference of 1.84 ml.kg-1.min-1, but this was not significant (p = 0.312). We therefore conclude that aerobic exercise is the only modality that is effective for increasing VO2peak compared to a control group.
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Affiliation(s)
| | | | - Rochelle Rocha Costa
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Faculdade SOGIPA, Porto Alegre, RS, Brasil.
| | - Thalia Petry
- Universidade Federal de Santa Maria – UFSM, Santa Maria, RS, Brasil.
| | | | - Adamastor Humberto Pereira
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Alexandre Araújo Pereira
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Leandro Tolfo Franzoni
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Eduardo Lima Garcia
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
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Nicolau JC, Feitosa Filho GS, Petriz JL, Furtado RHDM, Précoma DB, Lemke W, Lopes RD, Timerman A, Marin Neto JA, Bezerra Neto L, Gomes BFDO, Santos ECL, Piegas LS, Soeiro ADM, Negri AJDA, Franci A, Markman Filho B, Baccaro BM, Montenegro CEL, Rochitte CE, Barbosa CJDG, Virgens CMBD, Stefanini E, Manenti ERF, Lima FG, Monteiro Júnior FDC, Correa Filho H, Pena HPM, Pinto IMF, Falcão JLDAA, Sena JP, Peixoto JM, Souza JAD, Silva LSD, Maia LN, Ohe LN, Baracioli LM, Dallan LADO, Dallan LAP, Mattos LAPE, Bodanese LC, Ritt LEF, Canesin MF, Rivas MBDS, Franken M, Magalhães MJG, Oliveira Júnior MTD, Filgueiras Filho NM, Dutra OP, Coelho OR, Leães PE, Rossi PRF, Soares PR, Lemos Neto PA, Farsky PS, Cavalcanti RRC, Alves RJ, Kalil RAK, Esporcatte R, Marino RL, Giraldez RRCV, Meneghelo RS, Lima RDSL, Ramos RF, Falcão SNDRS, Dalçóquio TF, Lemke VDMG, Chalela WA, Mathias Júnior W. Brazilian Society of Cardiology Guidelines on Unstable Angina and Acute Myocardial Infarction without ST-Segment Elevation - 2021. Arq Bras Cardiol 2021; 117:181-264. [PMID: 34320090 PMCID: PMC8294740 DOI: 10.36660/abc.20210180] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- José Carlos Nicolau
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Gilson Soares Feitosa Filho
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil
- Centro Universitário de Tecnologia e Ciência (UniFTC), Salvador, BA - Brasil
| | - João Luiz Petriz
- Hospital Barra D'Or, Rede D'Or São Luiz, Rio de Janeiro, RJ - Brasil
| | | | | | - Walmor Lemke
- Clínica Cardiocare, Curitiba, PR - Brasil
- Hospital das Nações, Curitiba, PR - Brasil
| | | | - Ari Timerman
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | - José A Marin Neto
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Ribeirão Preto, SP - Brasil
| | | | - Bruno Ferraz de Oliveira Gomes
- Hospital Barra D'Or, Rede D'Or São Luiz, Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | | | | | - Carlos Eduardo Rochitte
- Hospital do Coração (HCor), São Paulo, SP - Brasil
- Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | - Edson Stefanini
- Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | - Felipe Gallego Lima
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | | | - José Maria Peixoto
- Universidade José do Rosário Vellano (UNIFENAS), Belo Horizonte, MG - Brasil
| | - Juliana Ascenção de Souza
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Lilia Nigro Maia
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP - Brasil
| | | | - Luciano Moreira Baracioli
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Luís Alberto de Oliveira Dallan
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Luis Augusto Palma Dallan
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Luiz Carlos Bodanese
- Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS - Brasil
| | | | | | - Marcelo Bueno da Silva Rivas
- Rede D'Or São Luiz, Rio de Janeiro, RJ - Brasil
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ - Brasil
| | | | | | - Múcio Tavares de Oliveira Júnior
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Nivaldo Menezes Filgueiras Filho
- Universidade do Estado da Bahia (UNEB), Salvador, BA - Brasil
- Universidade Salvador (UNIFACS), Salvador, BA - Brasil
- Hospital EMEC, Salvador, BA - Brasil
| | - Oscar Pereira Dutra
- Instituto de Cardiologia - Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS - Brasil
| | - Otávio Rizzi Coelho
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP), Campinas, SP - Brasil
| | | | | | - Paulo Rogério Soares
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | | | | | | | | | - Roberto Esporcatte
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Talia Falcão Dalçóquio
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - William Azem Chalela
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Wilson Mathias Júnior
- Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
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42
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Teixeira JAC. The Importance of Post-Infarction Exercise Programs. Arq Bras Cardiol 2021; 116:793-794. [PMID: 33886730 PMCID: PMC8121403 DOI: 10.36660/abc.20210109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- José Antônio Caldas Teixeira
- Universidade Federal Fluminense - Medicina Clínica, Niterói, RJ - Brasil.,Fit Labor Centro de Performance Humana, Niterói, RJ - Brasil
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43
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Tozato C, Ferreira BFC, Dalavina JP, Molinari CV, Alves VLDS. Cardiopulmonary rehabilitation in post-COVID-19 patients: case series. Rev Bras Ter Intensiva 2021; 33:167-171. [PMID: 33886866 PMCID: PMC8075336 DOI: 10.5935/0103-507x.20210018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/19/2020] [Indexed: 01/08/2023] Open
Abstract
The natural history of the disease, and the treatment of post-COVID-19 patients, are still being built. Symptoms are persistent, even in mild cases, and the infection consequences include fatigue, dyspnea, tachycardia, muscle loss, and reduced functional capacity. Regarding cardiopulmonary rehabilitation, there seems to be an improvement in functional capacity, quality of life, and prognosis with the 6-Minute Walk Test used as a prognostic and therapeutic evaluator. Therefore, this case series report aims to present our experience with four cases of different severity levels, involved in a post-COVID-19 cardiopulmonary rehabilitation program. These patients were assessed with the 6-Minute Walk Test, peripheral muscle strength, and double product at rest, to assess the results after a three-month rehabilitation protocol of at least 300 minutes per week. The four patients had their distance covered during the walk test increased between 16% and 94%. Peripheral muscle strength was improved by 20% to six times the baseline values, and double product at rest was reduced by 8% to 42%. The cardiopulmonary rehabilitation program had a positive impact on these cases, improving functional capacity despite the different severity levels in these post-COVID-19 cases.
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Affiliation(s)
- Cláudia Tozato
- Serviço de Fisioterapia, Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brasil.,Instituto de Assistência Médica ao Servidor Público Estadual "Francisco Morato de Oliveira" - São Paulo (SP), Brasil
| | | | - Jonathan Pereira Dalavina
- Serviço de Fisioterapia, Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brasil
| | - Camila Vitelli Molinari
- Serviço de Fisioterapia, Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brasil
| | - Vera Lúcia Dos Santos Alves
- Serviço de Fisioterapia, Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brasil.,Faculdade de Ciências Médicas, Irmandade da Santa Casa de São Paulo - São Paulo (SP), Brasil.,Programa de Mestrado Profissional em Ciência e Tecnologia em Saúde, Universidade de Mogi das Cruzes - Mogi das Cruzes (SP), Brasil
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44
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Costa RVC. Cardiovascular Rehabilitation at Distance: A New Moment. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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45
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Silva CGDSE. Reduction in Platelet Activation: A Potential Mechanistic Link between Regular Exercise and Its Benefits for Coronary Artery Disease. Arq Bras Cardiol 2021; 116:441-442. [PMID: 33909772 PMCID: PMC8159569 DOI: 10.36660/abc.20201198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Christina Grüne de Souza e Silva
- Clínica de Medicina do ExercícioRio de JaneiroRJBrasilClínica de Medicina do Exercício – CLINIMEX, Rio de Janeiro, RJ – Brasil.,Correspondência: Christina Grüne de Souza e Silva • Rua Siqueira Campos 93. CEP 22031-072, Copacabana, RJ – Brasil. E-mail:
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46
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Costa RVC. A Collaboration to Stop Smoking. Arq Bras Cardiol 2021; 116:36. [PMID: 33566962 PMCID: PMC8159517 DOI: 10.36660/abc.20200458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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47
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Frota AX, Vieira MC, Soares CCS, da Silva PS, da Silva GMS, Mendes FDSNS, Mazzoli-Rocha F, Veloso HH, da Costa AD, Lamas CDC, Valete-Rosalino CM, Gonçalves TR, Costa HS, Rodrigues LF, Mediano MFF. Functional capacity and rehabilitation strategies in Covid-19 patients: current knowledge and challenges. Rev Soc Bras Med Trop 2021; 54:e07892020. [PMID: 33533821 PMCID: PMC7849325 DOI: 10.1590/0037-8682-0789-2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/15/2020] [Indexed: 12/15/2022] Open
Abstract
Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.
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Affiliation(s)
- Aline Xavier Frota
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Marcelo Carvalho Vieira
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | - Paula Simplício da Silva
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | | | | | - Flavia Mazzoli-Rocha
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Henrique Horta Veloso
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Ananda Dutra da Costa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Cristiane da Cruz Lamas
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
| | - Claudia Maria Valete-Rosalino
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de Janeiro, Departamento de Otorrinolaringologia e Oftalmologia, Rio de Janeiro, RJ, Brasil
- Conselho Nacional de Desenvolvimento Científico e Tecnológico, Programa de Produtividade em Pesquisa, Brasília, DF, Brasil
| | - Tatiana Rehder Gonçalves
- Universidade Federal do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil
| | - Henrique Silveira Costa
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, Diamantina, MG, Brasil
| | - Luiz Fernando Rodrigues
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Estado do Rio de Janeiro, Departamento de Ciências Fisiológicas, Rio de Janeiro, RJ, Brasil
| | - Mauro Felippe Felix Mediano
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
- Instituto Nacional de Cardiologia, Departamento de Pesquisa e Educação, Rio de Janeiro, RJ, Brasil
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48
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Karsten M, Vieira AM, Ghisi GLDM. Brazilian Cardiovascular Rehabilitation Guideline: Values and LimitationsReply. Arq Bras Cardiol 2021; 115:1208-1209. [PMID: 33470328 PMCID: PMC8133740 DOI: 10.36660/abc.20200995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Marlus Karsten
- Universidade do Estado de Santa Catarina - Programa de Pós-graduação em Fisioterapia, Florianópolis, SC - Brasil.,Universidade Federal de Ciências da Saúde de Porto Alegre - Programa de Pós-graduação em Ciências da Reabilitação,Porto Alegre, RS - Brasil
| | - Ariany Marques Vieira
- Concordia University - Department of Health, Kinesiology, and Applied Physiology, Montreal, Quebec - Canadá.,Montreal Behavioural Medicine Centre - CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, Quebec - Canadá
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49
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Grossman GB, Sellera CAC, Hossri CAC, Carreira LTF, Avanza AC, Albuquerque PFD, Milani M, Mastrocola LE, Ritt LEF, Freitas OGAD, Carvalho TD, Chalela WA, Ghorayeb N, Meneghelo RS, Nunes MB, Serra SM. Position Statement of the Brazilian Society of Cardiology Department of Exercise Testing, Sports Exercise, Nuclear Cardiology, and Cardiovascular Rehabilitation (DERC/SBC) on Activities Within its Scope of Practice During the COVID-19 Pandemic. Arq Bras Cardiol 2020; 115:284-291. [PMID: 32876199 PMCID: PMC8384272 DOI: 10.36660/abc.20200797] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Gabriel Blacher Grossman
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
- Clínica Cardionuclear, Porto Alegre, RS - Brasil
| | - Carlos Alberto Cyrillo Sellera
- Santa Casa de Misericórdia de Santos, Santos, SP - Brasil
- Faculdade de Medicina da Universidade Metropolitana de Santos, Santos, SP - Brasil
| | | | - Lara Terra F Carreira
- Hospital Nossa Senhora do Pilar, Curitiba, PR - Brasil
- Cardiologia Nuclear Curitiba, Curitiba, PR - Brasil
| | - Antônio Carlos Avanza
- Universidade Vila Velha, Vitória, ES - Brasil
- Clínica Centrocor, Vitória, ES - Brasil
| | | | | | | | - Luiz Eduardo Fonteles Ritt
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil
- Hospital Cardiopulmonar, Salvador, BA - Brasil
| | | | - Tales de Carvalho
- Clínica de Prevenção e Reabilitação Cardiosport, Florianópolis, SC - Brasil
- Universidade do Estado de Santa Catarina, Florianópolis, SC - Brasil
| | - William Azem Chalela
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFM-USP),São Paulo, SP - Brasil
- Sociedade Beneficente de Senhoras Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Nabil Ghorayeb
- Hospital do Coração (Hcor), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia,São Paulo, SP - Brasil
| | - Romeu Sergio Meneghelo
- Instituto Dante Pazzanese de Cardiologia,São Paulo, SP - Brasil
- Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
| | | | - Salvador Manoel Serra
- Centro de Cardiologia do Exercício do Instituto Estadual de Cardiologia Aloysio de Castro (CCEx/IECAC), Rio de Janeiro, RJ - Brasil
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