Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Examining Risk Factors Related to Cardiac Rehabilitation Cessation Among Patients With Advanced Heart Failure.","authors":"Sharnendra K Sidhu, Bernard S Kadosh, Ying Tang, Greg Sweeney, Alicia Pierre, Jonathan Whiteson, Edward Katz, Alex Reyentovich, John A Dodson","doi":"10.1097/HCR.0000000000000904","DOIUrl":"https://doi.org/10.1097/HCR.0000000000000904","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac rehabilitation (CR) is beneficial in heart transplant and left ventricular assist device (LVAD) recipients, but patterns of attendance remain poorly understood. We describe CR adherence and cessation in this population.</p><p><strong>Methods: </strong>We performed a retrospective review of heart transplant and LVAD recipients who attended ≥1 CR session at a tertiary medical center (2013-2022). Complete adherence was defined as attending 36 sessions. Primary reasons for cessation before 36 sessions were recorded. We compared post-operative complications, duration of hospitalization, and readmissions between participants with and without complete adherence using logistic and linear regressions. Among participants with complete adherence, we compared changes in metabolic equivalent of task (MET), exercise time, and peak oxygen uptake using paired sample t tests.</p><p><strong>Results: </strong>There were 137 heart transplant and LVAD recipients (median age 56.9 years, 74% male) who attended CR. Among them, 91% either completed 36 CR sessions or <24 sessions. Among those without complete adherence (n = 74), 72% reported medical reasons, and 15% reported personal reasons for cessation. Compared to those who completed CR, those without complete adherence experienced more post-operative complications (44% vs 24%, P = .02) and major bleeding (23% vs 7%, P = .02) prior to CR. Participants with complete adherence experienced significant improvements in exercise time (142.5 seconds), MET (0.4), and peak oxygen uptake (1.4 mL/kg/min).</p><p><strong>Conclusions: </strong>Nearly half of heart transplant and LVAD recipients in CR completed all 36 sessions. Those with complete adherence experienced significant improvements in exercise measures, underscoring the important benefits of CR in this population.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545702","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":"Exploring the Promising Impact of Pulmonary Rehabilitation on Gait and Balance in Patients With COPD: A Systematic Review and Meta-Analysis.","authors":"Mobina Khosravi, Sedigheh Sadat Naimi, Seyed Mohammadreza Shokouhyan, Aysan Nemati, Mohsen Abedi","doi":"10.1097/HCR.0000000000000900","DOIUrl":"https://doi.org/10.1097/HCR.0000000000000900","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is commonly associated with respiratory difficulties, but it also presents with musculoskeletal problems. The objective of this systematic review and meta-analysis was to evaluate the effects of pulmonary rehabilitation (PR) on balance and gait in patients with COPD.</p><p><strong>Review methods: </strong>We conducted a comprehensive search of 4 databases, including PubMed, Google Scholar, Science Direct, and Web of Science, from inception to November 2023. The review included studies reporting the association between COPD status and balance and gait using PR. Two independent reviewers examined the titles and abstracts, extracted the data using a standardized form, and assessed the risk of bias of the included articles.</p><p><strong>Summary: </strong>A total of 14 studies with 320 patients in the study groups and 188 controls were included in the analysis. The risk of bias in the included studies was medium to high. The results showed that PR non-statistically significantly improved balance, as demonstrated by moderate effect sizes in the Timed Up and Go (standardized mean difference [SMD] = 0.1: 95% CI, -1.41 to 1.69) and Berg Balance Scale (SMD = -0.39: 95% CI, -1.30 to 0.53). However, the impact of PR on gait function was less clear, with mixed results. The study findings highlight the positive but non-significant effects of PR on balance in individuals with COPD. The results suggest that PR programs could include exercises that target balance improvement to enhance the overall quality of patients. However, further research is needed to determine the optimal duration and intensity of these exercises to achieve maximum benefits for patients with COPD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288065","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":"Remote Exercise Engagement Among Individuals With Cardiovascular Disease: A Systematic Review of Barriers and Facilitators.","authors":"Ana Paula Delgado Bomtempo, Emilia Main, Gabriela Lima de Melo Ghisi","doi":"10.1097/HCR.0000000000000899","DOIUrl":"https://doi.org/10.1097/HCR.0000000000000899","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature regarding barriers and facilitators to remote exercise among individuals with cardiovascular diseases (CVD).</p><p><strong>Review methods: </strong>Six databases were searched (inception-December 2023). Studies including barriers and facilitators for remote exercise reported by individuals living with CVD were considered. Quality was rated using the Mixed Methods Assessment Tool (MMAT). Results were synthesized following a thematic analysis approach. Characteristics of interventions were reported using the Template for Intervention Description and Replication (TIDieR).</p><p><strong>Summary: </strong>From an initial pool of 8543 records, 18 studies met the inclusion criteria. Among these, 13 were qualitative studies, with individual interviews being the most frequent data extraction method. Nine studies received 5/5 MMAT scores (ie, high quality). Twelve studies reported remote exercise interventions, mostly delivered within cardiac rehabilitation, by physiotherapists, nurses, and dietitians, predominantly via telephone calls or videoconferences, with only one study incorporating text messages. Five key themes influencing remote exercise interventions were identified: technology (encompassing access and literacy, self-monitoring/motivation, and security concerns), individual health considerations (health/personal aspects and coronavirus disease-2019), social factors (support from health care team and family/social support), environment (facilities), and logistical factors (time and displacement). Several themes served as both facilitators and barriers. Key insights for remote exercise interventions included mobile accessibility, interactive chat sessions, minimal click interactions, short sessions, personalized feedback, and flexible timing. Results emphasize the importance of promoting social interaction and support between participants and health care teams to mitigate barriers and enhance facilitators in remote exercise interventions for individuals with CVD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288067","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":"A Comparison of Rural and Urban Differences in Geographic Proximity to Outpatient Stroke Rehabilitation Services in Tennessee.","authors":"Phoebe M Tran, Benjamin Fogelson, Robert E Heidel, Raj Baljepally","doi":"10.1097/HCR.0000000000000898","DOIUrl":"https://doi.org/10.1097/HCR.0000000000000898","url":null,"abstract":"<p><strong>Purpose: </strong>Great travel distances and long travel times can be barriers to outpatient stroke rehabilitation services (OSR) receipt, but there is limited information on differences in proximity to specific OSR services between urban and potentially medically underserved rural areas. Accordingly, we compared travel distance and time to the nearest service for different OSR services between rural and urban counties in Tennessee.</p><p><strong>Methods: </strong>We conducted data scraping on Google Maps to locate Tennessee facilities offering any of the 13 American Heart Association recognized OSR services. We conducted manual validation by calling located facilities and visiting facility websites. We used the Wilcoxon rank sum test to examine if mean travel distance and time to a specific OSR service differed significantly between rural and urban counties.</p><p><strong>Results: </strong>All OSR services but audiology were available in Tennessee. In rural counties, social work had the highest median of mean travel distance (135.2 km), chaplaincy the highest median of mean travel time (113.5 min), and physical therapy the lowest distance (37.7 km) and time (36.3 min). Except for social work, rural counties had significantly higher travel distance and time than urban counties (P < .01) for all OSR services.</p><p><strong>Conclusions: </strong>Rural Tennessee counties had significantly higher travel distance and time for almost all OSR services compared to urban areas. These findings from a largely rural state with high stroke risk factor prevalence suggest that additional focus on establishing maximum travel limits for OSR are warranted to overcome transportation barriers to enhance post-stroke services access in similar areas.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288064","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":"Sex Differences in Changes in Cardiorespiratory Fitness and Additional Health Outcomes Following Exercise Training in Adults With Atrial Fibrillation: A Systematic Review and Meta-Analysis.","authors":"Sol Vidal-Almela, Isabela R Marçal, Jennie Wong, Tasuku Terada, Bao-Oanh Nguyen, Albert M Joensen, Mark T Mills, Jesse Bittman, Denis Prud'Homme, Jennifer L Reed","doi":"10.1097/HCR.0000000000000891","DOIUrl":"10.1097/HCR.0000000000000891","url":null,"abstract":"<p><strong>Purpose: </strong>Improving cardiorespiratory fitness (CRF) through exercise training is associated with lower morbidity and mortality in patients with atrial fibrillation (AF). Smaller CRF improvements have been suggested in females than males with cardiovascular disease following exercise training. This systematic review compared changes in CRF (primary) and additional physical and mental health outcomes following exercise training between females and males with AF.</p><p><strong>Review methods: </strong>Five bibliographic databases were searched to identify prospective studies implementing exercise training in patients with AF. The mean difference (MD) in the change following exercise training was compared between sexes using random-effects meta-analyses.</p><p><strong>Summary: </strong>Sex-specific data were obtained from 19 of 63 eligible studies, with 886 participants enrolled in exercise training (n = 259 [29%] females; female: 68 ± 7 years, male: 66 ± 8 years). Exercise training was 6 weeks to 1 year in duration and mostly combined moderate- to vigorous-intensity aerobic and resistance training, 2 to 6 d/wk. Changes in CRF did not differ between sexes (MD = 0.15: 95% CI, -1.08 to 1.38 mL O2/kg/min; P = .81; I2 = 27%). Severity of AF (MD = 1.00: 95% CI, 0.13-1.87 points; I2 = 0%), general health perceptions (MD = -3.71: 95% CI, -6.88 to -0.55 points; I2 = 22%), and systolic blood pressure (MD = 3.11: 95% CI, 0.14-6.09 mmHg; I2 = 42%) improved less in females than in males. Females may benefit from more targeted exercise training programs given their smaller improvement in several health outcomes than males. However, our findings are largely hypothesis-generating, considering the limited sample size and underrepresentation of females (29% females in our review vs 47% females with AF globally).</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140203","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 Exercise Systolic Blood Pressure and Risk of Stroke in Men With and Without Cardiovascular Disease.","authors":"Sae Young Jae, Jun Gyo Gwon, Sudhir Kurl, Setor K Kunutsor, Jari A Laukkanen","doi":"10.1097/HCR.0000000000000889","DOIUrl":"10.1097/HCR.0000000000000889","url":null,"abstract":"<p><strong>Purpose: </strong>We tested the hypothesis that an exaggerated exercise systolic blood pressure (ESBP) would be associated with the risk of stroke in men with and without a history of cardiovascular disease (CVD).</p><p><strong>Methods: </strong>An ESBP was defined as a maximal systolic blood pressure (SBP) ≥ 210 mmHg during graded exercise testing on a stationary bike until volitional fatigue in 2410 men aged 42 to 61 yr at baseline.</p><p><strong>Results: </strong>Over a median 27-yr follow-up, 419 incident stroke events occurred. In a multivariable adjusted model, men with an ESBP had a significantly increased risk of stroke in the entire cohort (HR = 1.41: 95% CI, 1.15-1.74). This association was still significant following further adjustment for resting SBP (HR = 1.25: 95% CI, 1.01-1.56). In subgroup analysis, ESBP was modestly associated with an increased risk of stroke in men with a history of CVD (HR = 1.37: 95% CI, 0.98-1.93), with no strong evidence of an association in men without a history of CVD (HR = 1.20: 95% CI, 0.90-1.60).</p><p><strong>Conclusions: </strong>These findings suggest that the heightened risk of stroke related to ESBP response in a general population-based sample of men may be primarily driven by a history of CVD. The results underscore the importance of considering exercise blood pressure response when interpreting stress tests, particularly in individuals with pre-existing CVD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055669","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":"Impact of VO 2peak on the Clinical Outcomes of Older Patients With Coronary Heart Disease in China.","authors":"Ying-Yue Zhang, Xiao-Li Liu, Xin Hu, Rong Hu, Yong Xu, Jing Ma","doi":"10.1097/HCR.0000000000000894","DOIUrl":"10.1097/HCR.0000000000000894","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to explore the role of cardiopulmonary exercise test parameters, especially peak oxygen uptake (VO 2peak ), in predicting the incidence of adverse cardiovascular events in older Chinese patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>Older patients with CHD who underwent cycle ergometer cardiopulmonary exercise test at the Cardiac Rehabilitation Clinic of Chinese PLA General Hospital from July 1, 2015 to January 31, 2020 were enrolled. The follow-up intervals were 6 mo. Cox regression was used to analyze the relationship between VO 2peak and adverse cardiovascular events. Restricted cubic splines and subgroup analyses were used to observe the relationship between VO 2peak and the hazard ratio (HR) of the primary end point event (PEE), which included a composite of all-cause death, nonfatal recurrent myocardial infarction, unscheduled revascularization, and stroke. The composite end point event was the PEE combined with cardiac rehospitalization.</p><p><strong>Results: </strong>A total of 1223 participants (mean age 68 ± 5 yr) were included. Median follow-up was 68 mo. Mean VO 2peak was 16.5 ± 4.0 mL/kg/min, and VO 2peak was an independent predictor of the PEE (HR = 0.929; 95% CI, 0.891-0.970; P = .001). This association was further validated by restricted cubic spline and subgroup analyses. Peak oxygen uptake was also an independent risk factor for the composite end point event (HR = 0.968; 95% CI, 0.941-0.996; P = .025).</p><p><strong>Conclusion: </strong>In conclusion, VO 2peak is an independent risk factor for adverse cardiovascular events in older Chinese patients with CHD, and more optimal therapy should be recommended to patients with lower VO 2peak .</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055673","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":"Effects of Isometric Handgrip Training on Ambulatory Blood Pressure in Individuals Over 18 Years Old: A Systematic Review and Meta-Analysis.","authors":"Marcelo de Santana Oliveira, Paulo Henrique Melo, Marilia de Almeida Correia, Aline Mendes Gerage, Raphael Mendes Ritti-Dias, Breno Quintella Farah","doi":"10.1097/HCR.0000000000000880","DOIUrl":"10.1097/HCR.0000000000000880","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to analyze the effects of isometric handgrip training (IHT) on ambulatory blood pressure (BP) in individuals aged 18 yr and older.</p><p><strong>Review methods: </strong>A systematic review and meta-analysis was performed in Medline and Web of Science, encompassing studies published until July 2023, as well as the gray literature. We calculated the mean difference (MD) and 95% CI using an inverse variance method with a random effects model.</p><p><strong>Summary: </strong>Considering both published and unpublished studies, we observed an effect of IHT on awake diastolic BP (MD = -2.02; 95% CI, -3.89 to -0.15 mmHg; P = .03). There were no significant effects on 24-hr systolic BP (MD = -1.31; 95% CI, -3.84 to 1.22 mmHg; P = .31), asleep systolic BP (MD = -0.84; 95% CI, -3.31 to 1.63 mmHg; P = .50), awake systolic BP (MD = -0.93: 95% CI, -3.10 to 1.23 mmHg; P = .40), 24-hr diastolic BP (MD = -0.96; 95% CI, -2.65 to 0.74 mmHg; P = .27), or asleep diastolic BP (MD = -1.27; 95% CI, -3.22 to 0.67 mmHg; P = .20). In conclusion, the effects of IHT on ambulatory BP were observed primarily in awake diastolic BP among individuals over 18 yr of age.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055671","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":"Cardiac Rehabilitation: Importance of Blood Glucose Control Among Patients with Diabetes Post Acute Myocardial Infarction.","authors":"Rachael K Nelson, Micah N Zuhl","doi":"10.1097/HCR.0000000000000906","DOIUrl":"10.1097/HCR.0000000000000906","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140202","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":"Speed of Heart Rate Recovery After Orthostatic Stress as a Modifiable Risk Factor During Cardiac Rehabilitation.","authors":"Richard Armstrong, Greg Murphy, Peter Wheen, Lisa Brandon, Rose-Anne Kenny, Andrew O Maree","doi":"10.1097/HCR.0000000000000882","DOIUrl":"10.1097/HCR.0000000000000882","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140204","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}