Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Pulmonary Restriction in Patients With a Fontan Circulation: Determinants, Deterioration Over Time, and Clinical Implications.","authors":"Gaston van Hassel, Rolf M F Berger, Eryn T Liem, Elke S Hoendermis, Johannes M Douwes, Marinus A J Borgdorff, Joost P van Melle, Brigitte W M Willemse","doi":"10.1097/HCR.0000000000001020","DOIUrl":"10.1097/HCR.0000000000001020","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary restriction is common in patients with a Fontan circulation and is associated with impaired quality of life. Studies often fail to accurately define pulmonary restriction, and few have investigated its predictors, longitudinal course, and clinical implication. We investigate the prevalence and determinants of pulmonary restriction in patients with a Fontan circulation, the evolution of pulmonary function over time, and the relationship between pulmonary function and exercise capacity.</p><p><strong>Methods: </strong>This longitudinal study included 85 patients with a Fontan circulation who underwent serial pulmonary function measurements and exercise testing over an 11-year period. According to established criteria, pulmonary restriction was defined as a total lung capacity (TLC) z score < -1.645.</p><p><strong>Results: </strong>Mean age ± SD was 20 ± 10 years. Median (IQR) TLC, forced vital capacity (FVC), and diffusing capacity of the lungs for carbon monoxide z scores were -0.98 (-1.98, -0.25), -0.82 (-1.52, -0.19), and -2.30 (-3.04, -1.44). Twenty-eight patients (33%) had pulmonary restriction. A longer time since Fontan completion and undergoing 2 or more thoracotomies increased the odds of developing pulmonary restriction. The FVC z score was associated with log 2 percentage of predicted peak oxygen uptake ( β = .08, P = .025), and FVC z scores declined by 0.06 per year ( P = .009).</p><p><strong>Conclusion: </strong>Pulmonary restriction is prevalent in patients with a Fontan circulation. Multiple thoracotomies and a longer time since Fontan completion predict the development of pulmonary restriction. The FVC, not TLC, is associated with lower exercise tolerance. This emphasizes the importance of muscle-dependent pulmonary ventilation. Finally, FVC z scores are decreased in adolescence and deteriorate faster than in the general population.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"265-272"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105615","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":"What Cardiopulmonary Rehabilitation Professionals Should Know About Fall and Fracture Prevention: A Narrative Review.","authors":"Lora M Giangregorio","doi":"10.1097/HCR.0000000000001044","DOIUrl":"10.1097/HCR.0000000000001044","url":null,"abstract":"<p><strong>Purpose: </strong>Fractures due to osteoporosis are common. Cardiovascular disease and osteoporosis share common risk factors (eg, age, smoking, high alcohol intake, diabetes). Some interventions used to treat cardiovascular disease or related risk factors could increase bone loss or fracture risk (eg, medications that increase fall risk, bariatric surgery-related weight loss). Thus, health care professionals delivering cardiopulmonary rehabilitation would benefit from understanding how to prevent falls and fractures.</p><p><strong>Review methods: </strong>This narrative review will provide an overview of the evidence from clinical trials, meta-analyses, and guidelines related to exercise for fracture prevention and will provide practical tips for cardiopulmonary rehabilitation professionals on how to integrate fall and fracture prevention into assessment, education, and exercise prescription.</p><p><strong>Summary: </strong>The cardiopulmonary rehabilitation setting represents an opportunity to identify people at risk of fragility fractures and implement strategies to reduce the risk of falls and fractures. Screen for fall and fracture risk using available guidelines, tools, and algorithms so that you can modify your approach to assessment and exercise prescription. Be aware of medications or comorbid health conditions that may increase fall and fracture risk. Emphasize the importance of resistance training for overall health and maintaining or increasing muscle and bone strength. There is very strong evidence that multicomponent exercise interventions that include balance and functional training can prevent falls, so recommend balance training exercises for all older adults. Take steps to tailor assessment and exercise prescription to minimize falls and fractures during cardiopulmonary rehabilitation sessions, and maximize improvements in balance, bone strength, and physical functioning.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"234-243"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205194","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 Importance of a \"Second Chance\": Hospitalized Patients Who Decline Outpatient Cardiac Rehabilitation May Attend if Rereferred After Discharge.","authors":"Anna Cichon, Patrick Schilling, Sheehan Choudhury, Carol Haywood, Tara Lagu, Quinn R Pack","doi":"10.1097/HCR.0000000000001049","DOIUrl":"10.1097/HCR.0000000000001049","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E22-E24"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205171","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":"In Memoriam: MARK A. WILLIAMS, PhD, MAACVPR.","authors":"Reed Humphrey","doi":"10.1097/HCR.0000000000001061","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001061","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 4","pages":"233"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283874","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 Early Cardiac Rehabilitation Post-Cardiac Arrest on Functional Capacity, Psychological Health, and Quality of Life.","authors":"Jan Riess, Elisa Alba Schmidt, Stephen J Foulkes, Jan Vontobel, David Niederseer, Mark J Haykowsky","doi":"10.1097/HCR.0000000000001042","DOIUrl":"10.1097/HCR.0000000000001042","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E25-E27"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205187","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":"Talk Test for the Prescription of Aerobic Exercise in Cardiovascular Disease: Which Stage is Most Appropriate?","authors":"Amanda Althoff, Amanda Mohr, Geovana Zimermann, Taina de Souza Lopes, Lucas Santos da Silveira, Marlus Karsten","doi":"10.1097/HCR.0000000000001022","DOIUrl":"10.1097/HCR.0000000000001022","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine which stage of the Talk Test (TT) represents the most appropriate workload for prescribing aerobic exercise in cardiovascular rehabilitation.</p><p><strong>Methods: </strong>Individuals with cardiovascular disease underwent a 3-day evaluation. Day 1: cardiopulmonary exercise test; day 2: 2 incremental TT (conventional and with gas analysis); day 3: 2 constant workload TT (CWTT) based on the intensities of the stages last positive (LPTT) and first equivocal (EQTT). Friedman's test was used to compare the heart rate (HR) and oxygen uptake ( ) from the CWTT with the first and second ventilatory thresholds (VT1 and VT2). The association between HR and of VT and CWTT was analyzed using Spearman's correlation coefficient. Chi-square test was used to analyze the proportion of individuals who reached the moderate intensity zone during the CWTTs, considering HR, HR reserve (HRR), and .</p><p><strong>Results: </strong>Thirty-two individuals (23 male, 61 ± 10 years) were included. Heart rate in LPTT was similar to VT1 and lower than VT2 ( P < .001). The HR in EQTT was higher than the VT1 ( P = .002) and lower than VT2 ( P < .001). The during CWTT was similar to VT1 and lower than VT2 ( P < .001). The EQTT showed a higher proportion of individuals with HR and between the VT (HR: 70% vs 53%, P = .026; : 48% vs 31%, P = .023), as well as with HRR in the moderate intensity zone ( P = .025).</p><p><strong>Conclusions: </strong>Exercise intensity similar to the EQTT promotes HR and responses more consistent with the recommended exercise intensity (moderate). This stage represents the most appropriate workload for aerobic exercise prescription in cardiovascular rehabilitation.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"290-295"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105624","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":"Social Inequality in the Comprehensive Cardiac Rehabilitation Pathway: A Nationwide Cohort Study Across Hospitals and Primary Health Care Centers.","authors":"Marie Louise Svendsen, Jens Refsgaard, Mette Bredsgaard, Thomas Maribo","doi":"10.1097/HCR.0000000000001019","DOIUrl":"10.1097/HCR.0000000000001019","url":null,"abstract":"<p><strong>Purpose: </strong>To examine socioeconomic differences in the nonpharmacological cardiac rehabilitation (CR) pathway from hospital discharge to CR completion in hospital and primary care settings.</p><p><strong>Methods: </strong>This nationwide cohort study included patients hospitalized with ischemic heart disease between April 1, 2019, and March 31, 2022. Follow-up continued through December 31, 2022, focusing on nonutilization of 11 CR components, including: delayed CR needs assessment (>14 days) and physical exercise training (>29 days); lack of patient education, physical exercise training, test of cardiorespiratory fitness (CRF), depression screening, improvement in CRF (<10% increase), smoking cessation, and finalizing CR meeting; and completion of <75% of planned exercise sessions and dropout. Socioeconomic differences were analyzed by educational attainment, income, occupation, and cohabitant status.</p><p><strong>Results: </strong>Among 45 497 hospitalized patients with ischemic heart disease, 43% (n = 19 573) participated in CR. Only 25% received a CR needs assessment within 14 days of discharge. Socioeconomic differences were demonstrated throughout the CR pathway, except for the finalizing meeting, improvement in CRF, and smoking cessation. The odds of nonutilization among patients with lower educational attainment ranged between 8% higher odds of delayed CR needs assessment (adjusted OR = 1.08: 95% CI, 1.01-1.15) and 31% higher odds of no CRF test (adjusted OR = 1.31: 95% CI, 1.18-1.45).</p><p><strong>Conclusions: </strong>The observed socioeconomic differences throughout the CR pathway underscore the need for targeted interventions to ensure early assessment of CR needs and participation in specific CR activities among patients with lower socioeconomic positions. This study identifies specific patient characteristics and CR activities as key markers for reducing these inequalities.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"281-289"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR) 2026 Spring Conference Abstracts.","authors":"","doi":"10.1097/HCR.0000000000001065","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001065","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 4","pages":"E28-E37"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283840","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":"Role of Case Management for Improving Cardiac Rehabilitation Participation in Women: A RANDOMIZED CONTROLLED TRIAL.","authors":"Sherrie Khadanga, Blair Yant, Patrick D Savage, Diann E Gaalema, Philip A Ades","doi":"10.1097/HCR.0000000000001040","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001040","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the benefits, cardiac rehabilitation (CR) is underutilized, particularly in women. Case management (CM) has been shown to reduce the risk of cardiovascular disease and improve health outcomes. The purpose of this study was to assess the effects of early CM added to electronic referral and a CR liaison (usual care [UC]) on increasing CR participation rate and adherence in women.</p><p><strong>Methods: </strong>A total of 109 female participants enrolled in the 4-month study; 56 were randomized to UC, while 53 were assigned to the intervention of CM. Demographic, psychosocial, and clinical data were obtained. Statistical methods included chi-square and nonpaired t-tests. A P value <.05 was used to determine significance. Within the whole sample, for those who attended 1 or more sessions of CR, univariate regressions were conducted to test associations between participant characteristics and number of sessions attended.</p><p><strong>Results: </strong>Participation rates (number attending at least 1 CR session) were similar between CM versus UC (77% vs 77%, respectively; P = .9). Furthermore, no differences were seen in number of CR sessions attended between groups (20.2 for CM vs 17.3 for UC, P = .7). Within participants who attended at least 1 session of CR, current smoking, anxiety, depression, cardiac-specific quality of life, and perceived social support were all significantly associated with number of sessions attended (all P < .05).</p><p><strong>Conclusion: </strong>When added to electronic referral with a CR liaison, CM did not improve CR participation or adherence in women. Continued efforts are needed to develop specific strategies to increase utilization of CR in women.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329785","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":"Children With Repaired Tetralogy of Fallot Spend Less Time in Moderate to Vigorous Physical Activity Than Healthy References.","authors":"Eva Gouwy, Graziëlla Eshuis, Mark-Jan Ploegstra, Chantal Lokhorst, Joost P van Melle, Rolf M F Berger, Johannes M Douwes","doi":"10.1097/HCR.0000000000001043","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001043","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity (PA) is important for well-being and prevention of acquired cardiovascular disease, including in patients with congenital heart disease. However, research on objectively measured PA in patients with repaired tetralogy of Fallot (rToF) is scarce. This study aims to describe PA in children with rToF, compare it to European reference data, and assess its relation to clinical parameters (right ventricle function, peak oxygen uptake, lung function, and muscle strength) and quality of life (QoL).</p><p><strong>Methods: </strong>We measured PA with an accelerometer for 7 consecutive days. The PA intensity levels and daily minutes per intensity level were classified based on vertical axis counts per minute. Age- and sex-based PA Z scores were compared with the reference Z score of 0. Linear regression was performed to assess relations between PA and clinical parameters and QoL, correcting for age and sex.</p><p><strong>Results: </strong>Forty-two patients with rToF spent a median (interquartile range) of 527 (457, 588) and 34 (21, 51) min/d in sedentary and moderate to vigorous PA (MVPA), respectively. Children with rToF spent less time performing MVPA compared with healthy reference data (P = .002). We could not demonstrate associations between PA and right ventricle function, peak oxygen uptake, muscle strength, pulmonary function, body mass index, or QoL (P > .05 for all analyses).</p><p><strong>Conclusions: </strong>Children with rToF are less active compared with healthy reference data, which could not be associated with clinical parameters or QoL. Further research into determinants and effects of PA beyond physical factors is needed to assess how we can improve physical capabilities in children with rToF.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225588","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}