Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Impact of Sternal Precautions on Clinical and Patient-Reported Outcomes in Patients Undergoing Cardiac Surgery via Sternotomy: A SCOPING REVIEW.","authors":"Mitti Blakoe, Rikke Gottlieb, Ida Elisabeth Højskov, Dorte Bæk Olsen, Sune Damgaard, Jan Christensen","doi":"10.1097/HCR.0000000000001025","DOIUrl":"10.1097/HCR.0000000000001025","url":null,"abstract":"<p><strong>Purpose: </strong>Patients undergoing cardiac surgery via sternotomy are typically advised to follow sternal precautions for 8 to 12 weeks post-operatively. These precautions vary across surgical centers, and current recommendations are primarily based on heterogeneous studies and expert opinion. This scoping review aimed to map the impact of upper body movement and sternal precaution strategies on clinical and patient-reported outcomes within 1 year post-operatively in adult patients undergoing cardiac surgery via sternotomy.</p><p><strong>Review methods: </strong>The review was reported based on the PRISMA-ScR (Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies included randomized controlled trials; nonrandomized controlled trials; quasi-experimental, prospective, and retrospective cohort studies; mixed methods studies; case studies; case-control studies; and cross-sectional studies. Studies were considered eligible if they included patients ≥18 years undergoing cardiac surgery via sternotomy and examined the relationship between sternal precautions or upper body movement strategies within 12 weeks post-operatively and any clinical or patient-reported outcomes within 1 year post-operatively. The systematic literature search was conducted in March 2025 in 6 databases.</p><p><strong>Summary: </strong>Of 16 464 unique records screened, 12 studies involving 2853 patients were included. These studies found that neither weighted upper body movement strategies nor less restrictive sternal precautions negatively affect sternal wound infections, sternal stability, pain, length of hospital stay, readmissions, or health-related quality of life. Positive improvements were found in functional status and discharge disposition in patients following a less restrictive sternal regimen. The body of evidence indicates that weighted upper body movement strategies and less restrictive sternal precautions do not negatively affect the investigated clinical or patient-reported outcomes post-sternotomy.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"168-175"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093333","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":"Mortality and Cardiovascular Outcomes in Relation to Cigarette Smoking and Secondhand Smoke: SALUTARY IMPACT OF SMOKING BANS.","authors":"Barry A Franklin, Hadley T Ninow, Isaac J Wedig, Steven J Elmer","doi":"10.1097/HCR.0000000000001031","DOIUrl":"10.1097/HCR.0000000000001031","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E19-E21"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480633","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":"Patients Who \"No-Show\" in Cardiac Rehabilitation: CHARACTERISTICS AND ATTENDANCE.","authors":"Anna Cichon, Patrick Schilling, Sumsen Thapa, Karen Riska, Peter K Lindenauer, Quinn R Pack","doi":"10.1097/HCR.0000000000001028","DOIUrl":"10.1097/HCR.0000000000001028","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E16-E18"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473765","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":"A Cross-Sectional Examination of Sex-Based Differences in Cardiac Rehabilitation Participation From the Behavioral Risk Factor Surveillance System.","authors":"Shweta Gore, Amol M Karmarkar, Lin-Na Chou, Sabrina J Mily, Amit Kumar","doi":"10.1097/HCR.0000000000001011","DOIUrl":"10.1097/HCR.0000000000001011","url":null,"abstract":"<p><strong>Purpose: </strong>Following an acute myocardial infarction (AMI), females often experience worse outcomes than males. However, sex-specific disparities in cardiac rehabilitation (CR) participation, along with the roles of income and education, have not been thoroughly investigated. This study examined sex-specific differences in CR participation following AMI and how education and income mediate this association.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from the Behavioral Risk Factor Surveillance System for adults aged ≥45 years with a history of AMI who responded to a CR participation question in 2009 (n = 1289) and 2017 (n = 1383), across 4 states and Washington, DC. The study outcome was participation in CR following AMI. Mediation and moderation analyses were performed to examine the effects of sex, education, and income on CR participation.</p><p><strong>Results: </strong>Females were significantly less likely to participate in CR than males. Mediation analysis revealed a negative association between sex and CR participation, mediated by income and education ( β = -.135, SE = 0.024, P < .001), along with a significant direct effect ( β = -.383, SE = 0.083, P < .001). Moderation analysis showed that females were less likely to participate in CR across several subgroups: White females compared with White males (OR = 0.70: 95% CI, 0.58-0.85), married females compared with married males (OR = 0.50: 95% CI, 0.38-0.67), and significantly lower among females across both age groups.</p><p><strong>Conclusions: </strong>Female participation in CR remains significantly lower than males, partially mediated by lower education and income levels. These findings underscore the need for targeted strategies to enhance CR awareness, accessibility, and adherence among females.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"204-210"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029738","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":"Comparative Efficacy of Pulmonary Rehabilitation in Patients With COPD, ILD, and Long COVID: PHYSICAL AND PSYCHOSOCIAL OUTCOMES.","authors":"Julia Berkowitz, Frederick Lu, Julianne DeAngelis, James Simmons, Wen-Chih Wu","doi":"10.1097/HCR.0000000000000997","DOIUrl":"10.1097/HCR.0000000000000997","url":null,"abstract":"<p><strong>Introduction: </strong>The benefits of pulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD) are well-established, but data on the relative efficacy of PR in patients with interstitial lung disease (ILD) and prolonged symptoms from coronavirus disease-2019 (Long COVID) remain limited. With the increasing prevalence of Long COVID, understanding the role of PR in this group is essential.</p><p><strong>Methods: </strong>Records of patients enrolled in PR between September 1, 2020, to November 30, 2022, at an academic health system were analyzed. Patients were categorized into COPD, ILD, and Long COVID groups based on primary referral diagnosis. Outcome measures included 6-minute walk test distance, COPD Assessment Tool, Modified Medical Research Council Questionnaire, and psychosocial assessments. Mixed-linear modeling for repeated measures compared pre- and post-PR outcomes within and across groups by referral diagnosis while adjusting for baseline covariates.</p><p><strong>Results: </strong>Of the 316 patients enrolled in PR, 192 completed PR. Demographics were similar across groups, though patients with Long COVID were younger, more likely to be Hispanic, and have higher body mass index than patients referred for COPD. Significant improvements were observed in functional capacity, dyspnea, quality of life, depression, anxiety, and stress in all 3 groups following PR without significant between-group differences in PR outcomes.</p><p><strong>Discussion: </strong>This single-center analysis suggests that PR was associated with significantly improved physical and psychosocial well-being in patients with COPD, ILD, and Long COVID with comparable outcomes across all groups. Future randomized-controlled trials are needed to confirm the benefits of PR for patients with Long COVID.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"176-181"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966157","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":"Assessing the Significance of Electrographically Positive Exercise Stress Tests in Patients Attending Cardiac Rehabilitation.","authors":"Andrea Van Damme, Stephanie K Nathanail, Eric C Parent, Yongzhe Hong, Jeevan Nagendran, Nabila Mahdi, Tanis Nelson, Tara C Meyer, Colleen Norris, Gabor T Gyenes, Michael D Kennedy","doi":"10.1097/HCR.0000000000000995","DOIUrl":"10.1097/HCR.0000000000000995","url":null,"abstract":"<p><strong>Purpose: </strong>Exercise stress tests (EST) are used to evaluate functional capacity before cardiac rehabilitation (CR). The prognostic value of EST to understand health outcomes in the year following an EST after participating in CR is not well understood.</p><p><strong>Methods: </strong>We reviewed charts of 488 patients (females, n = 64) who underwent an EST within 100 days of starting CR. The outcomes of revascularization, rehospitalization, mortality, and the combination of revascularization or mortality were compared between patients with positive EST (n = 38), negative EST (n = 123), and nondiagnostic EST (n = 327).</p><p><strong>Results: </strong>The positive EST group displayed significantly higher risk for revascularization or mortality within 1 year post-EST (HR = 13.6: 95% CI, 1.6-119.4; P = .018) compared with the negative EST group. Having a prior coronary artery bypass graft surgery independently increased the hazard of rehospitalization at 1 year (HR = 5.1: 95% CI, 1.9-13.5; P = .001) and the composite endpoint at 1 year (HR = 5.7: 95% CI, 1.6-19.7; P = .006) post-EST. The risk for rehospitalization in females (HR = 2.3: 95% CI, 1.0-5.3; P = .050) was greater than for males at 1 year, warranting future investigation into sex-based differences of long-term health outcomes post cardiac event.</p><p><strong>Conclusions: </strong>The utility of EST for patients referred to CR has been debated, but our results demonstrate that EST may provide valuable information for prognosis and decision-making in cardiac care pathways.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"190-196"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966164","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":"An Algorithm for the Optimal Location of Cardiac Rehabilitation Centers: A SPATIAL PERSPECTIVE.","authors":"Thiago Mauro de Lima Moraes, Luís Felipe Leite da Silva, Mauro Augusto Dos Santos, Bruno Dos Reis Jaccoud, Ronaldo Malheiros Gregorio, Erito M de Souza Filho","doi":"10.1097/HCR.0000000000001013","DOIUrl":"10.1097/HCR.0000000000001013","url":null,"abstract":"<p><strong>Purpose: </strong>Geographical distance from a patient's residence to a cardiac rehabilitation (CR) clinic is a significant barrier to the initiation and continuation of CR programs worldwide. This distance can adversely affect patient adherence and clinical outcomes, particularly among patients with high cardiovascular risk who require frequent and consistent CR sessions. Addressing this barrier may enhance the accessibility and effectiveness of CR services.</p><p><strong>Methods: </strong>A p -median optimization model was developed to strategically allocate resources for CR in Rio de Janeiro, Brazil. Six scenarios were created to accommodate patients with high cardiovascular risk, with the aim of identifying optimal clinic locations to minimize the average travel distance for patients.</p><p><strong>Results: </strong>The implementation of 4 additional CR clinics demonstrated a 14% to 17% improvement in accessibility, as indicated by a reduction in travel distances for the target patient population. The model also revealed a concentration of clinics within a single region of the city, underscoring disparities in access and highlighting the inequitable distribution of CR services.</p><p><strong>Conclusions: </strong>The optimal allocation of CR clinics using an optimization model can significantly enhance healthcare system efficiency. This approach may ensure optimal resource distribution and treatment accessibility, aligning with the principles of value-based healthcare.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"197-203"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029801","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":"Availability and Scope of US Clinical Exercise Internship Experiences: A NATIONAL SURVEY.","authors":"Rachael K Nelson, Moriah R Persondek, Dina L Bittner, Steven J Keteyian, Dennis J Kerrigan, Micah N Zuhl","doi":"10.1097/HCR.0000000000001024","DOIUrl":"10.1097/HCR.0000000000001024","url":null,"abstract":"<p><strong>Purpose: </strong>An internship experience is vital in the training of clinical exercise physiologists (CEP), yet the availability and scope of clinical exercise internships throughout the United States have not been described. We evaluate the availability and scope of clinical exercise internship programs throughout the United States.</p><p><strong>Methods: </strong>Using a survey-based study design, we recruited clinicians (eg, CEP, nurses, respiratory therapists) via email to complete a 31-question survey covering facility characteristics, internship availability and scope, and knowledge/skills needed to work as a CEP.</p><p><strong>Results: </strong>Of the 295 completed surveys, 74% of the respondents, representing 42 US states, reported offering a clinical exercise internship. Among sites offering an internship, 88% included a pre-internship interview, while a few (7%) included a quiz (eg, electrocardiogram, cardiac medications) for evaluating potential student interns. Internship sites reported supervising 4 ± 3 interns annually, 41% included stress testing (96 ± 124 hours), 49% included Phase I experience (55 ± 81 hours), and 95% included Phase II experience (245 ± 134 hours). Additionally, 91% of the sites included other learning opportunities, including developing individualized treatment plans (83%) and working in pulmonary rehabilitation (71%), weight management programs (59%), human performance testing (16%), and exercise oncology (13%). Overall, 88% of all 295 respondents strongly agreed that a clinical internship experience is vital for training future CEP.</p><p><strong>Conclusion: </strong>Our survey data suggest that clinical internships for future CEP are felt to be an important part of student training, and most (95%) internship program settings surveyed include direct patient care experience in cardiac rehabilitation.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"228-231"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105467","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":"Verbal and Visuo-Graphic Measures of Illness Perceptions Predict Quality of Life and Symptoms Among Patients With Interstitial Lung Disease.","authors":"Charles F Emery, Ihsan Rodriguez, Nitin Bhatt, Vincent Esguerra, Alice Staaby","doi":"10.1097/HCR.0000000000001015","DOIUrl":"10.1097/HCR.0000000000001015","url":null,"abstract":"<p><strong>Purpose: </strong>Prior research indicates that verbal reports of illness perceptions are associated with quality of life among individuals with interstitial lung disease (ILD). However, individuals with diverse language and verbal abilities may have difficulty providing verbal ratings of illness status. This study evaluated both verbal and visuo-graphic measures of perceived illness as predictors of illness-related quality of life and self-reported pulmonary symptoms among individuals with ILD.</p><p><strong>Methods: </strong>This was a cross-sectional study in a convenience sample of patients with ILD recruited from a clinic setting. Forty adults (63% female; mean age: 62.8; range: 32-85 years) with ILD completed standard medical evaluations of pulmonary function and exercise capacity. Study participants also completed self-report questionnaires (pulmonary symptoms, illness-related quality of life, and illness perceptions) and the lung coloring task (LCT), a standardized visuo-graphic measure of illness perceptions developed for this study. The primary approach to data analysis was multiple regression analysis predicting illness-related quality of life and self-rated symptoms from pulmonary function, illness perceptions, and LCT.</p><p><strong>Results: </strong>Both forced vital capacity and illness perceptions were significant predictors of illness-related quality of life, accounting for approximately 55% of the variance. The symptom dimension of illness-related quality of life was predicted by forced vital capacity, illness perceptions, and LCT, accounting for approximately 40% of the variance.</p><p><strong>Conclusions: </strong>Illness perceptions are important for understanding illness-related quality of life among individuals with chronic lung disease. Visuo-graphic measures of illness perceptions may be especially useful for evaluating symptom experiences in chronic lung disease.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"182-189"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105605","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":"\"Fit for Surgery\": Physical Activity, Fitness, and Postoperative Outcomes.","authors":"Barry A Franklin, Hadley T Ninow, Isaac J Wedig, Steven J Elmer","doi":"10.1097/HCR.0000000000001008","DOIUrl":"10.1097/HCR.0000000000001008","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E10-E12"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966149","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}