Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Distinguishing Hybrid Cardiac Rehabilitation Models and Comparing Their Effectiveness: A Systematic Review.","authors":"Pamela Tanguay, Nicole Marquis, Pierre Faivre, Pierre Philippe Wilson Registe, Sara-Maude Boucher, Katarina Laevski, Jacob Leblanc, Mathieu Bélanger","doi":"10.1097/HCR.0000000000000986","DOIUrl":"10.1097/HCR.0000000000000986","url":null,"abstract":"<p><strong>Purpose: </strong>Unlike center-based cardiac rehabilitation (CBCR), hybrid cardiac rehabilitation (HCR) combines both center-based and home-based training sessions. However, there are various types of HCR, and it remains unclear which type is most effective. This study aimed to classify HCR models and compare their effectiveness relative to CBCR.</p><p><strong>Review methods: </strong>We extracted original studies on HCR effectiveness from 3 databases: Medline, CINAHL, and SPORTDiscus. Inclusion criteria required that the HCR model incorporate a mix of exercise sessions in both a center setting and at home and at least 1 additional core component of cardiac rehabilitation (i.e., education, multidisciplinary care, psychosocial support, or medical risk management). Data on functional capacity, health-related quality of life (HRQoL), level of physical activity (PA), anxiety, depression, adherence, satisfaction, and long-term effects were extracted.</p><p><strong>Summary: </strong>Twenty-six studies were identified, and HCR were classified into 3 types: (1) sequential programs (initial CBCR followed by home-based cardiac rehabilitation only); (2) progressive programs (gradual shift from center-based to home-based); (3) simultaneous programs (CBCR with concurrent home-based sessions). All 3 HCR models achieved results comparable to those of CBCR in terms of functional capacity, HRQoL, anxiety, and depression. Participants reported high levels of adherence and satisfaction with HCR programs. However, the effectiveness of HCR programs on PA levels and long-term effects remains inconclusive. The three HCR models provide similar outcomes to CBCR and thus appear to be promising alternatives to CBCR.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 1","pages":"1-15"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Breathing Reserve at Peak Treadmill Exercise: Influence of Sex and Fitness.","authors":"Mauricio Milani, Juliana Goulart Prata Oliveira Milani, Felipe Vilaça Cavallari Machado, Graziella França Bernardelli Cipriano, Dominique Hansen, Gerson Cipriano Junior, J Alberto Neder","doi":"10.1097/HCR.0000000000000969","DOIUrl":"10.1097/HCR.0000000000000969","url":null,"abstract":"<p><strong>Purpose: </strong>A low breathing reserve (peak ventilation [Epeak]/estimated maximum ventilation [Emax] ≤ 15%) is recommended as the decision node to indicate abnormal ventilatory limitation during incremental cycle ergometry. Given higher Epeak during weight-bearing exercise, we aim to establish which coefficients should multiply the forced expiratory volume in 1 second (FEV1) to reduce the prevalence of a low breathing reserve in healthy subjects undergoing treadmill exercise.</p><p><strong>Methods: </strong>We determined the coefficients for FEV1 multiplication associated with <5% prevalence of a low breathing reserve in 3544 healthy individuals aged 20 to 80 years. We then contrasted their performance in differentiating healthy subjects (N = 148) from patients with chronic obstructive pulmonary disease (COPD) (N = 133) in an external validation sample.</p><p><strong>Results: </strong>A low breathing reserve was found in 22% and 6% of women versus 48% and 17% of men when FEV1 was multiplied by 35 and 40, respectively. Sex-adjusted coefficients required to decrease the prevalence of a low breathing reserve ranged from 33 and 48 in women versus 36.5 and 50 in men in those showing peak oxygen uptake <80% and >120% predicted, respectively. Breathing reserve using the new sex- and fitness-adjusted coefficients were superior to previous values in differentiating health from disease, regardless of COPD severity.</p><p><strong>Conclusion: </strong>Higher coefficients for FEV1 multiplication are required to estimate Emax at peak treadmill exercise in men than in women, increasing as a function of cardiorespiratory fitness in both sexes. These data are poised to improve the yield of cardiopulmonary exercise tests in accurately indicating pathological ventilatory limitation in patients with respiratory diseases.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 1","pages":"35-43"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dose-Response Relationship of Aerobic Exercise on Cardiorespiratory Fitness in Cardiac Rehabilitation: A SYSTEMATIC REVIEW AND META-ANALYSIS.","authors":"Blake E G Collins, Brett A Gordon, Daniel W T Wundersitz, David Carey, Michael I C Kingsley","doi":"10.1097/HCR.0000000000000963","DOIUrl":"10.1097/HCR.0000000000000963","url":null,"abstract":"<p><strong>Objective: </strong>To explore the incremental dose-response effect of aerobic exercise-based cardiac rehabilitation programs (ExCRP) on cardiorespiratory fitness in comparison to non-exercise controls among people with coronary heart disease (CHD).</p><p><strong>Review methods: </strong>Medline, CINAHL, Cochrane, SCOPUS, and SPORTDiscus were searched from January 1, 2000 until December 4, 2023. Articles were eligible for selection if they satisfied the following criteria: randomized controlled studies assessing change in cardiorespiratory fitness among people with CHD in non-exercise and aerobic intervention groups, established peak oxygen uptake via cardiopulmonary exercise test, minimum of 4-week program duration, and reported frequency, intensity, and duration of prescribed exercise. The study was prospectively registered (PROSPERO ID: CRD42021274924).</p><p><strong>Summary: </strong>Thirty-three studies, including 1901 participants were included in the continuous dose-analysis. A significant difference in cardiorespiratory fitness was identified between ExCRP and non-exercise control that favored exercise by 3.4 (3.0-3.9) mL·kg -1 ·min -1 . No difference existed between interval and continuous training when matched for exercise dose. Dose-response analyses identified a significant increase in cardiorespiratory fitness (3.4 [2.9-5.5] mL·kg -1 ·min -1 ) associated with program completion, with no additional benefit related to increased exercise dose. When compared to non-exercise control, participating in ExCRP with a minimum total program intervention dose of 2194 metabolic equivalent minutes significantly improves cardiorespiratory fitness. However, no additional benefit was discernible from higher exercise doses. Although the recommended dose for ExCRP augments medical treatment and is sufficient to improve cardiorespiratory fitness, it is likely that the narrow range in prescribed exercise dose and variations in the fidelity of exercise interventions limit interpretation.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E53-E70"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Upper Extremity Exercise Capacity and Associated Variables in Individuals With Heart Failure.","authors":"Habibe Durdu, Ertan Aydin","doi":"10.1097/HCR.0000000000000977","DOIUrl":"10.1097/HCR.0000000000000977","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship of upper extremity exercise capacity (UEEC) with activities of daily living (ADL), handgrip strength, handgrip endurance, and anthropometric and clinical characteristics in patients with heart failure (HF).</p><p><strong>Methods: </strong>In 48 patients with HF and 50 age- and sex-matched healthy controls, we evaluated UEEC, handgrip strength and endurance, and AD using the 6-minute pegboard ring test (6PBRT), a hydraulic hand dynamometer, and the London Chest Activity of Daily Living (LCADL) scale, respectively.</p><p><strong>Results: </strong>Clinical characteristics were similar between patients with HF (mean age 63.21 ± 8.55 years, 42% female) and healthy controls (mean age 60.16 ± 8.64 years, 54 % female, P > .05). Patients with HF had significantly reduced 6PBRT scores (Cohen's d = - 1.906), handgrip strength (Cohen's d = - 0.595), and handgrip endurance (Cohen's d = - 1.791), as well as higher LCADL scores (Cohen's d = 1.628) compared to healthy controls ( P < .05). The 6PBRT score showed strong positive correlation with handgrip endurance (r = 0.595, P < .001) and moderate positive correlation with total work capacity (r = 0.497, P < .001). The LCADL %total revealed a moderate negative correlation with handgrip strength (r = - 0.495, P < .001) and total work capacity (r = - 0.493, P < .001) and a moderate positive correlation with body mass index (r = 0.477, P  = .001) in patients with HF. Performance of ADL was not correlated to 6PBRT score in patients with HF. Also, the diagnosis of HF and handgrip endurance were the strongest predictors for 6PBRT score ( P < .05).</p><p><strong>Conclusions: </strong>Patients with HF exhibited a clinically significant decrease in their UEEC. Based on our findings, this decline is likely associated with handgrip endurance.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"435-443"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 JCRP Year in Review.","authors":"Todd M Brown","doi":"10.1097/HCR.0000000000001003","DOIUrl":"10.1097/HCR.0000000000001003","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"45 6","pages":"385-386"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinesiophobia After Atrial Fibrillation Ablation: Associated Risk Factors and Impacts on Postprocedural Syndrome.","authors":"Kexin Wang, Zhe Wang, Caiyi Jin, Weizhu Ju, Minglong Chen","doi":"10.1097/HCR.0000000000000970","DOIUrl":"10.1097/HCR.0000000000000970","url":null,"abstract":"<p><strong>Purpose: </strong>Exercise-based cardiac rehabilitation (CR) after atrial fibrillation (AF) ablation is beneficial for patients with AF; however, kinesiophobia has been demonstrated to be a significant barrier to CR. The aim of the study was to investigate the perioperative risk factors for kinesiophobia, as well as its impact on postprocedural syndrome after AF ablation.</p><p><strong>Methods: </strong>Consecutive patients with paroxysmal AF who underwent ablation between January 2023 and April 2023 were included. Kinesiophobia and exercise self-efficacy were assessed 48 to 72 hours after ablation. Scheduled follow-up was conducted 1, 2, 3, and 6 months after the procedure.</p><p><strong>Results: </strong>Among the 87 patients enrolled, 54 (62%) suffered from a high level of postoperative kinesiophobia. Patients with kinesiophobia were more likely to suffer from postoperative nonspecific symptoms ( P < .001) and decreased exercise tolerance ( P < .001) during early recovery period. The anesthesia method (OR = 0.05: 95% CI, 0.01-0.17) and preoperative European Heart Rhythm Association (EHRA) score (OR = 6.60: 95% CI, 1.85-26.95) were important risk factors for postoperative kinesiophobia. The anesthesia method and preoperative EHRA score were associated with nonspecific symptoms and decreased exercise tolerance, which is fully mediated by kinesiophobia.</p><p><strong>Conclusions: </strong>Kinesiophobia was significantly correlated with adverse experiences during the early recovery period after AF ablation. The choice of anesthesia, management of AF-related symptoms, and patient education are crucial for reducing kinesiophobia.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"426-434"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Physical Activity, Cardiorespiratory Fitness, and Health Care Costs.","authors":"Isaac J Wedig, Hadley T Ninow, Barry A Franklin, Steven J Elmer","doi":"10.1097/HCR.0000000000000971","DOIUrl":"10.1097/HCR.0000000000000971","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E71-E72"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-Based Rehabilitation With Health Coaching in Patients Living With Bronchiectasis.","authors":"Caitlin Batzlaff, Johanna Hoult, Roberto Benzo","doi":"10.1097/HCR.0000000000000983","DOIUrl":"10.1097/HCR.0000000000000983","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"447-449"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Rehabilitation Program With Blood Pressure-Guided Exercise Intensity Restrictions for Patients With Thoracic Aortic Dissection or Aneurysm.","authors":"Karoline Stentoft Rybjerg Larsen, Mariann Tang, Jacob William Budtz-Lilly, Lotte Sørensen","doi":"10.1097/HCR.0000000000000965","DOIUrl":"10.1097/HCR.0000000000000965","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic disease presents a significant risk of mortality and morbidity, with hypertension considered the primary driver of disease progression. Blood pressure naturally increases during physical activity, and patients need guidance on the optimal level of exercise. The purpose of this study was to evaluate change in cardiopulmonary fitness after attending a rehabilitation program using blood pressure-guided exercise intensity.</p><p><strong>Methods: </strong>The cohort included patients with thoracic aortic dissection (type A and B) and surgically operated thoracic aortic aneurysm. All participated in a rehabilitation program with maximum workload recommendations based on cardiopulmonary exercise tests which were performed before and after the rehabilitation program.</p><p><strong>Results: </strong>63 patients were included. At ventilatory threshold, workload increased by 17-32 watt and oxygen uptake by 1.8-2.9 ml/kg/min. 22 patients were able to perform both tests to exhaustion without exceeding blood pressure restrictions of 160-180 mmHg. These patients improved maximum workload by 20.6 watt (95% CI, 13.0-28.3) and peak oxygen uptake by 2.3 ml/kg/min (95% CI, 1.2-3.5). Only two cases of light dizziness at the end of test were reported.</p><p><strong>Conclusions: </strong>Generally, patients with aortic disease improved oxygen uptake and workload during the rehabilitation program. One-third of the patients were able to perform both cardiopulmonary exercise tests to exhaustion without exceeding blood pressure restrictions. No serious adverse events occurred during test or exercise.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"404-410"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Cardiovascular and Perceptual Responses During Guideline-Recommended and Self-Selected Intensity Exercises in Patients With Peripheral Artery Disease: A Randomized Crossover Study.","authors":"Deivide Rafael Gomes de Faria, Max Duarte de Oliveira, Hélcio Kanegusuku, Breno Quintella Farah, Tiago Peçanha, Nelson Wolosker, Gabriel Grizzo Cucato, Raphael Mendes Ritti-Dias, Marilia Almeida Correia","doi":"10.1097/HCR.0000000000000966","DOIUrl":"10.1097/HCR.0000000000000966","url":null,"abstract":"<p><strong>Purpose: </strong>Exercises with a self-selected intensity (SSI) have emerged as an alternative to guideline-recommended sessions to improve adherence to exercise programs. We compared the cardiovascular and perceptual responses during a walking exercise performed at SSI and in a session with intensity recommended by clinical guidelines.</p><p><strong>Methods: </strong>Twenty patients (mean 69.2 ± 7.7 years, 55% male, and mean ankle brachial index 0.59 ± 0.15) participated in two experimental sessions: guidelines (3-5 minutes of walking sets, 2-3 minutes of recovery, and moderate intensity by pain perception) and SSI (preferred walking speed and set duration) sessions. Blood pressure, heart rate, heart rate variability threshold, rating of perceived exertion, perception of pain, and affective response were assessed during the exercise.</p><p><strong>Results: </strong>Independent of time, perceived exertion (∆0.8: 95% CI, 0.1-1.5, P session  = .035) and pain (∆0.6: 95% CI, 0.3-0.9, P session < .001) were lower, while affective responses (∆-0.8: 95% CI, - 1.5 to -0.1, P session  = .029) were higher in SSI session compared to the guideline session. Independent of time, the heart rate (∆5.5: 95% CI, 1.2-9.8 beats/min, P session  = .013) was lower in the SSI session, while blood pressure responses were similar between sessions ( P session > .05). The time spent above the heart rate variability threshold was significantly lower in the SSI session (∆4.2: 95% CI, 1.6-7.0 minutes, P interaction  = .005).</p><p><strong>Conclusion: </strong>The SSI sessions promoted lower cardiovascular overload and better perceptual responses than guideline sessions in patients with symptomatic PAD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"411-417"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}