Cardiac Rehabilitation Exercise Research Articles

The Effectiveness of Remote Exercise Rehabilitation Based on the "SCeiP" Model in Homebound Patients With Coronary Heart Disease: Randomized Controlled Trial.

While exercise rehabilitation is recognized as safe and effective, medium- to long-term compliance among patients with coronary heart disease (CHD) remains low. Therefore, promoting long-term adherence to exercise rehabilitation for these patients warrants significant attention. This study aims to investigate the impact of remote exercise rehabilitation on time investment and related cognitive levels in homebound patients with CHD. This study utilizes the SCeiP (Self-Evaluation/Condition of Exercise-Effect Perception-Internal Drive-Persistence Behavior) model, alongside WeChat and exercise bracelets. A total of 147 patients who underwent percutaneous coronary intervention in the cardiovascular department of a grade III hospital in Jiangsu Province from June 2022 to March 2023 were selected as study participants through convenience sampling. The patients were randomly divided into an experimental group and a control group. The experimental group received an exercise rehabilitation promotion strategy based on the "SCeiP" model through WeChat and exercise bracelets, while the control group followed rehabilitation training according to a standard exercise rehabilitation guide. The days and duration of exercise, levels of cardiac rehabilitation cognition, exercise planning, and exercise input were analyzed before the intervention and at 1 month and 3 months after the intervention. A total of 81 men (55.1%) and 66 women (44.9%) were recruited for the study. The completion rate of exercise days was significantly higher in the experimental group compared with the control group at both 1 month (t145=5.429, P<.001) and 3 months (t145=9.113, P<.001) after the intervention. Similarly, the completion rate of exercise duration was significantly greater in the experimental group (t145=3.471, P=.001) than in the control group (t145=5.574, P<.001). The levels of autonomy, exercise planning, and exercise input in the experimental group were significantly higher than those in the control group at both 1 month and 3 months after the intervention (P<.001). Additionally, the experimental group exhibited a significant reduction in both process anxiety and outcome anxiety scores (P<.001). Repeated measures ANOVA revealed significant differences in the trends of cognitive function related to cardiac rehabilitation between the 2 patient groups over time: autonomy, F1,145(time×group)=9.055 (P<.001); process anxiety, F1,145(time×group)=30.790 (P<.001); and outcome anxiety, F1,145(time×group)=28.186 (P<.001). As expected, the scores for exercise planning (t145=2.490, P=.01 and t145=3.379, P<.001, respectively) and exercise input (t145=2.255, P=.03 and t145=3.817, P<.001, respectively) consistently demonstrated superiority in the experimental group compared with the control group at both 1 and 3 months after the intervention. Interestingly, we observed that the levels of exercise planning and exercise input in both groups initially increased and then slightly decreased over time, although both remained higher than the preintervention levels (P<.001). The remote health intervention based on the "SCeiP" model effectively enhances exercise compliance, exercise planning, exercise input, and cognitive levels during cardiac rehabilitation in patients with CHD. Chinese Clinical Trial Registry ChiCTR2300069463; https://www.chictr.org.cn/showproj.html?proj=192461.

Psychophysiological profile of ischemic patients according to their resting heart rate variability: one step closer to training individualization

Ischemic heart disease continues to be a major cause of morbidity and mortality around the world. Nowadays, research is focusing on the role of the brain-heart axis in autonomic nervous system balance. Resting heart rate variability (HRV) could help to identify the readiness of ischemic patients to achieve cardiac rehabilitation exercise stimulus in a safer manner. The objectives of the study were i) to analyze the resting HRV in ischemic cardiopathy, determining whether it was below or within its normal range, and ii) to identify the effect of the psychophysiological parameters of age, body mass index (BMI), blood pressure, cardiorespiratory fitness, and quality of life. This was a cross-sectional study of patients affected by ischemic cardiopathy. The patients were divided into the nonNormal-HRV or Normal-HRV group according to their normal resting HRV. The HRV temporal and frequency domains were recorded along with heart rate and blood pressure, BMI, cardiorespiratory fitness and auto-perception. The sample comprised men with an average age of 58.64±9.54 years. In total, 43.92% were below their normal resting-HRV range. They were older (P&lt;.001, d=.856), had worse auto-perception (P&lt;.001, d=.473), and higher systolic and lower diastolic blood pressure (P&lt;.001, d=.446; P=.007, d=.29). HRV domains correlated directly (P&lt;.05) with diastolic blood pressure and inversely with heart rate and age. The percentage of low resting-HRV scores in ischemic patients was higher than expected and was conditioned by age, blood pressure and heart rate. Moreover, the patients had worse auto-perception. All these factors should be considered to optimize cardiac rehabilitation programs.

Cardiac rehabilitation and prescription exercise training for heart failure’s patients

Cardiovascular rehabilitation is a multidisciplinary approach that includes exercise instruction, reduction of cardiac risk factors, psychosocial assessment, and result evaluation. Cardiovascular rehabilitation (CR), which includes exercise training, has been shown to significantly improve people with heart failure's quality of life, functional ability, and hospitalizations for heart failure-related conditions. There are so many benefits that are crucial for patients that they must be implemented fully in every health center. The objective for all healthcare practitioners must be to include CR in the regular, normal management of HF patients. Keyword: cardiac rehabilitation, exercise, exercise training, heart failure

Exploring the effects of a real-time cardiac telerehabilitation using wearable devices in people with coronary artery disease following a recent myocardial infarction: a randomised controlled trial

Abstract Background Exercise-based cardiac rehabilitation (CR) is a non-pharmacological multidisciplinary program for individuals after myocardial infarction (MI), that offers multiple health benefits. One of the greatest barriers to CR participation is the travelling distance to the rehabilitation centre. Remotely monitored CR appears to be at least as effective in improving cardiovascular risk factors and exercise capacity as traditional centre-based CR. Nevertheless, the efficacy of a remotely monitored CR in people with recent MI has yet to be examined. Purpose The aim of this randomised controlled trial was to assess the effects of a real-time cardiac telerehabilitation monitored by wearable devices in people with recent MI. Methods Thirty people (8 women, 22 men) with CAD following a recent (i.e., &amp;lt; 4 week) MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 26-week CR, thrice per week. All patients performed the baseline and 24 weeks follow up measurements where peak oxygen uptake (VO2peak), mean daily steps, distance and calories were assessed. Results The online group showed improved in mean daily steps (P&amp;lt;0.05) and mean daily distance (P&amp;lt;0.05) at 24 weeks compared to the gym-based group. The paired sample t-test showed that all the assessed variables were statistically (P&amp;lt;0.001) improved for both groups at 24 weeks. Pearson’s r demonstrated positive correlations between VO2peak and mean daily distance (r= .375), and negative correlations between VO2peak and muscle (r= -.523) and fat masses (r= -.460). There was no exercise-induced adverse events during the study. Conclusion Our findings might indicate that a real-time online supervised CR exercise programme using wearable technology to monitor the hemodynamic responses in CAD post MI patients is equally effective to a gym-based exercise programme.Individualized scanwatch report

The Impacts of Cardiac Rehabilitation Exercise Therapy in Patients Following Percutaneous Coronary Intervention: Systematic Review

The Impacts of Cardiac Rehabilitation Exercise Therapy in Patients Following Percutaneous Coronary Intervention: Systematic Review

A case report of cardiac rehabilitation in coronary artery aneurysm combined with acute ST segment elevation myocardial infarction.

Coronary artery aneurysm (CAA), marked by diffuse or localized dilation of artery, can cause life-threatening complications in acute coronary syndrome. This report presents a case of CAA combined with acute ST-segment elevation myocardial infarction, successfully treated with cardiac rehabilitation exercise therapy, offering insights for clinical practice.

Impact of cardiac rehabilitation exercise frequency on exercise capacity in patients with coronary artery disease: a retrospective study

ABSTRACT Cardiac rehabilitation (CR) significantly improves cardiovascular outcomes in patients with coronary artery disease (CAD). International guidelines vary in the minimum recommended frequency of supervised exercise from 1 to 3 sessions per week. This is the first study in the Middle East and North African regions assessing the impact of 2 versus 3 days/week of supervised exercise on peak exercise capacity in patients with CAD. Single-center retrospective cohort study involving 362 patients enrolled in the only CR center in the State of Qatar. Only high-quality data was included by strict evaluation of compliance to the exercise intervention. Fifty patients who underwent a symptom-limited exercise test before and after CR were included (31 patients on 2 days/week, 19 on 3 days/week). No significant differences were observed in baseline characteristics between groups. Exercise intervention differed significantly between groups in exercise training frequency (2 days/week: 1.97 ± 0.2 vs. 3 days/week: 2.7 ± 0.3; p < 0.00). Peak exercise capacity as peak metabolic equivalents of task (MET) significantly increased in both groups (2 days/week: Pre 8.3 ± 2.4 vs. Post 9.4 ± 2.9, p-value 0.00; 3 days/week: Pre 7.4 ± 1.6 vs. Post 8.4 ± 2.0, p-value 0.00). No significant difference was observed between groups for change in Peak Exercise Capacity (2 days/week 1.1 ± 1.1 vs. 3 days/week 1.0 ± 0.9, p = 0.87). When the total number of exercise sessions is equal, supervised exercise frequencies of 2 and 3 days/week may significantly and equally improve peak exercise capacity in patients with CAD.

The Effect of Resistance Training on Markers of Cachexia in Patients with Heart Failure: A Systematic Review and Meta‐Analysis

ABSTRACTBackgroundCachexia is a metabolic syndrome characterised by muscle wasting that is highly prevalent in subjects with heart failure (HF) and negatively affects physical function, quality of life, morbidity and mortality. Resistance training has been recently incorporated into cardiac rehabilitation exercise programmes to increase muscle strength in patients with HF. This systematic review and meta‐analysis aim to assess the effects of resistance training on markers of cachexia in patients with HF.MethodsFour electronic databases (MEDLINE, Embase, CENTRAL and CINAHL) were searched to identify randomised controlled trials (RCTs) evaluating the effects of resistance training‐only programmes on published criteria for cachexia assessment including muscle strength, body composition (e.g. lean mass/muscle mass) or biochemical markers of cachexia (e.g. inflammatory markers) in patients with HF. Studies were selected based on pre‐specified inclusion and exclusion criteria, with a risk of bias assessment carried out. Meta‐analyses of muscle strength outcomes were completed using RevMan 5.4.1.ResultsNine studies were included in this review. Pooled analysis of one repetition‐maximum strength test of the lower [SMD 0.67 (95% Cl – 0.12, 1.22) p‐value = 0.02] and upper extremities [SMD 1.20 (95% Cl – 0.62, 1.79) p‐value &lt;0.0001] showed a significant increase in muscle strength associated with resistance training, which are both important indicators of physical function. Resistance training did not increase muscle strength during rapid movements measured via peak torque at 60, 90 or 180°/s. There were no significant results recorded for changes in body composition and biochemical markers of cachexia. There were inconsistent findings for the effect of resistance training on quality of life. No studies reported findings on measures of anorexia or fatigue.ConclusionsThe findings of this review reveal the potential benefits of resistance training in preserving and enhancing muscle strength in patients with HF who are at risk of cardiac cachexia. Despite inconclusive results on body composition and quality of life, the inclusion of resistance training in cardiac rehabilitation guidelines has the potential to address issues of muscle weakness and frailty. Specific resistance training protocol recommendations to prevent or treat the development of cachexia cannot be made without the publication of more robust RCTs, specifically examining cachectic patients with heart failure with careful assessment of clinical outcomes of markers of cachexia.

Integrating the quantitative with the qualitative: findings from a mixed methods cardiac rehabilitation exercise trial

BackgroundCardiac rehabilitation is a core component of cardiovascular disease management. Eastern Corridor Medical Engineering-Cardiac Rehabilitation (ECME-CR) is a digital health platform for online cardiac rehabilitation exercise. We conducted a mixed methods pilot trial to evaluate ECME-CR. ObjectiveTo examine the difference between objectively measured outcomes and participant perceptions of benefits and improvements gained from participation in a cardiac rehabilitation exercise program. MethodsSeventeen participants (14 male, 3 female; age: 69.5 ± 7.3 years) took part and were allocated to one of two groups; an online exercise group (n = 8), or an in-person exercise (n = 9) group. Due to the COVID-19 pandemic, a pragmatic approach to group allocation was adopted. Objective outcomes were assessed at baseline and repeated following the intervention period, with the primary outcome being six-minute walk test distance. In addition to clinical outcome measurements, we undertook qualitative interviews with participants. ResultsOnly five participants demonstrated a clinically meaningful improvement in six-minute walk test distance, following the 8-week exercise program. The main theme emerging from the qualitative interviews was the valued benefits of the cardiac rehabilitation exercise program. Despite the lack of measurable physical change, participants self-defined a range of benefits they valued and attributed directly to participation in the cardiac rehabilitation exercise program. ConclusionThe findings from this study may offer a useful starting point for further study of community-based cardiac rehabilitation exercise and also highlight the benefit of adopting a mixed methods approach which considers both the objective outcomes measured as well as the subjective reports obtained from participants.

Exploring the effects of real-time online cardiac telerehabilitation using wearable devices compared to gym-based cardiac exercise in people with a recent myocardial infarction: a randomised controlled trial.

Exercise-based cardiac rehabilitation (CR) is a non-pharmacological multidisciplinary programme for individuals after myocardial infarction (MI) that offers multiple health benefits. One of the greatest barriers to CR participation is the travel distance to the rehabilitation centre. Remotely monitored CR appears to be at least as effective in improving cardiovascular risk factors and exercise capacity as traditional centre-based CR. Nevertheless, the efficacy of remotely monitored CR in individuals with a recent MI has yet to be examined. A total of 30 individuals (8 women, 22 men) after a recent (i.e., <4 weeks) MI were randomly allocated into two groups (online home-based and gym-based groups). Both groups underwent a 26-week CR programme three times per week. All patients performed baseline and 24-week follow-up measurements where peak oxygen uptake (VO2peak), mean daily steps, distance, and calories were assessed. The online group showed an improvement in mean daily steps (p < 0.05) and mean daily distance (p < 0.05) at 24 weeks compared to the gym-based group. The paired-sample t-test showed that all the assessed variables were statistically (p < 0.001) improved for both groups at 24 weeks. Pearson's r demonstrated positive correlations between VO2peak and mean daily distance (r = 0.375), and negative correlations between VO2peak and muscle (r = -0.523) and fat masses (r = -0.460). There were no exercise-induced adverse events during the study. Our findings might indicate that a real-time online supervised CR exercise programme using wearable technology to monitor the haemodynamic responses in post-MI patients is equally effective as a gym-based exercise programme.

Therapeutic Effect of Cardiac Exercise Rehabilitation Program Based on Cardiopulmonary Exercise Test on Patients with Stable Coronary Heart Disease Complicated with Hypertension

Therapeutic Effect of Cardiac Exercise Rehabilitation Program Based on Cardiopulmonary Exercise Test on Patients with Stable Coronary Heart Disease Complicated with Hypertension

'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme.

Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.

Effects of different rehabilitation modality on cardiopulmonary function in patients with acute coronary syndrome after revascularization.

To investigate the effects of different rehabilitation modalities on cardiopulmonary function in patients with acute coronary syndrome after revascularization. Two randomized controlled trials were conducted. All patients were stable for more than 48 h and less than 1 week after revascularization for acute coronary syndrome and were randomly assigned to Group A (home-based rehabilitation group) or Group B (center guided home-based rehabilitation group). The cardiopulmonary exercise test was mainly performed before and 3 months after cardiac rehabilitation (at the end of intervention). The primary endpoints of the study were peak oxygen uptake (VO2peak), and the secondary endpoints were maximum metabolic equivalents (METs), anaerobic threshold exercise load (Load AT), maximal workload (Load max), and anaerobic threshold oxygen uptake (VO2 AT). A total of 106 patients were included in the study, with 47 patients in Group A (with 6 losses) and 50 patients in Group B (with 3 losses). There were no significant difference between the two groups in terms of age, gender, body mass index (BMI), left ventricular ejection fraction(LVEF), low-density lipoprotein cholesterol(LDL-C),cardiovascular risk factors. In Group A, no significant differences in CPET indices were observed before and after the intervention. In Group B, values of maximum metabolic equivalents (METs), peak heart rate (PHR), anaerobic threshold exercise load (Load AT), maximal workload (Load max), maximum ventilation per minute (VE max), peak oxygen uptake (VO2peak), anaerobic threshold oxygen uptake (VO2 AT) and maximum oxygen pulse (VO2/HRmax) were higher than those before the intervention (P < 0.05). In addition, METs (max), Load AT, Load max, VO2 AT, and VO2peak in Group B were higher than those in group A (P < 0.05). The change rates of VO2peak, METs(max), PHR, Load max, VO2 AT, VE max, VO2/HR(max) in the two groups were significantly different before and after intervention (P < 0.05). Cardiac exercise rehabilitation is helpful for improving patients' cardiopulmonary endurance and quality of life. Moreover, rehabilitation modalities with regular hospital guidance can improve cardiopulmonary function in a shorter period,which seems to be more effective than a complete home-based rehabilitation model. http://www.chictr.org.cn, identifier (ChiCTR2400081034).

The role of exercise-based cardiac rehabilitation after percutaneous coronary intervention in patients with coronary artery disease: a meta-analysis of randomised controlled trials

Background this study was designed to analyse patient outcomes using a combination of PCI and exercise-based cardiac rehabilitation compared with PCI alone. Methods PCI can improve the survival rate of patients with coronary artery disease, but it can also cause vascular endothelial cell injury, thrombosis, and even restenosis. Early cardiac rehabilitation exercise is crucial for patients with coronary heart disease after PCI. Five databases were examined for randomised controlled trials involving early cardiac rehabilitation exercise and standard treatment in patients with coronary heart disease after PCI. The search period lasted from the creation of the database (2006) until December 2022. The outcomes including angina, arrhythmia, coronary restenosis, left ventricular ejection fraction, left ventricular end diastolic diameter, 6-min walk distance, total cholesterol, heart rate, systolic blood pressure and diastolic blood pressure. RevMan 5.3 was used to analyse the data, and the Cochrane Collaboration was used to assess the quality of evidence. Results A total of 1231 patients were enrolled in this study. Angina pectoris (RR = 0.24, 95% CI [0.10, 0.57], p = 0.001), Arrhythmia (RR = 0.17, 95% CI [0.05, 0.55], p = 0.003), Coronary artery restenosis (RR = 0.10, 95% CI [0.01, 0.76], p = 0.03). Conclusion Exercise after PCI improves LVEF, enhances 6MWD, lowers HR and minimises the risk of angina, arrhythmia and coronary artery restenosis in CHD patients. Exercise had no discernible effect on LVEDD, TC, SBP, or DBP.

Comparing domain- and intensity-specific physical activity in coronary heart disease and non-CHD individuals

Although increase in physical activity is important to improve prognosis of cardiac patients in addition to hospital-based exercise cardiac rehabilitation, their physical activity levels are not properly understood. This study aimed to examine domain- and intensity-specific physical activity in individuals with coronary heart disease (CHD) and compare them with non-CHD individuals. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2019 were analyzed, including 1083 CHD patients and 38,532 non-CHD individuals. The inclusion criteria were age 19 years or older and data not missing for CHD information. Before and after propensity score matching (PSM) for age, sex, body mass index, education, household income, alcohol intake, and smoking status, domain (leisure, work, transportation)—and intensity (moderate, vigorous) -specific physical activity participation levels were compared between individuals with and without CHD. Before PSM, CHD individuals were older, less educated, more sedentary, and participated less in PAs compared to non-CHD individuals. After PSM, CHD individuals had similar levels of domain-specific PAs. However, they had higher work-related PA levels (29.7 ± 209.6 vs. 42.1 ± 291.3 min/week p = 0.022) and more sedentary time (487.2 ± 224.2 vs. 514.1 ± 228.7. p = 0.003) than those without CHD. Subgroup analysis revealed lower leisure-related PA in men with CHD (63.5 ± 165.5 vs. 47.3 ± 140.2, p < 0.05) and higher work-related PA in women with CHD (18.9 ± 159.7 vs. 57.1 ± 397.5, p < 0.01). Among those < 65 years of age, individuals with CHD spent more time sedentary than individuals without CHD. CHD individuals are not physically inactive compared with non-CHD individuals who are similar in sociodemographic status and lifestyle. CHD patients’ PA levels may have been underestimated.

Analysis of prescription compliance and influencing factors in cardiac rehabilitation after surgery in children with congenital heart disease based on generalized trust theory.

To understand the compliance, influencing factors, and action path of family cardiac rehabilitation exercise prescriptions for children after congenital heart disease surgery. A random sampling method was used to select 200 paediatric patients and their parents from a paediatric hospital in Shanghai. Among them, 57 cases (28.5%) of children's families followed the cardiac rehabilitation exercise prescription. Path analysis showed that peak oxygen uptake exerted a negative impact on the compliance of family cardiac-rehabilitation prescriptions for patients after congenital heart disease surgery through doctor-patient trust, with a standardized path coefficient of -0.246 (P = 0.001). Disease-related knowledge exerted a positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after congenital heart surgery through doctor-patient trust, with a standardized path coefficient of 0.353 (P < 0.001). The dimension of friend support in social support had a direct positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after cardiac surgery, with a standardized path coefficient of 0.641 (P = 0.006). The compliance of cardiac rehabilitation exercise prescription in children with congenital heart disease is not good and is affected by many factors, and there is a complex path relationship between various factors; the kilogram oxygen consumption of the child, the disease-related knowledge of the caregiver, and social support all play important roles in the compliance of the child's family's health prescription. ChiCTR2200062022.

Research Progress on Cardiac Exercise Rehabilitation in Patients with Chronic Heart Failure

Research Progress on Cardiac Exercise Rehabilitation in Patients with Chronic Heart Failure

Effects of different early cardiac rehabilitation exercise treatments on the prognosis of acute myocardial infarction patients receiving percutaneous coronary intervention

ObjectivesExercise rehabilitation is the core of Cardiac Rehabilitation (CR) and will improve the prognosis of patients receiving Percutaneous Coronary Intervention (PCI surgery). The current study retrospectively analyzed the effects of different exercise-based CR strategies on the prognosis of AMI patients receiving PCI treatment. MethodsClinicopathological information from 127 patients was collected and divided into different groups based on the exercise-based CR received, including Continuous Resistance Exercise (COR), Continuous Aerobic Exercise (COA), Interval Resistance Exercise (IVR), Interval Aerobic Exercise (IVA), Inspiratory Muscle Exercises (ITM), and Control. The differences regarding cardio-pulmonary function, hemodynamics, and life quality were analyzed against different CR strategies. ResultsAll the exercise-based CR strategies showed improving effects compared with patients in the Control group regarding cardio-pulmonary parameters, with IVR showing the strongest improving effects (IVR > ITM > COR > IVA > COA) (p < 0.05) at the first recoding point. However, the improving effects of exercise-based CR declined with time. Regarding the effects on hemodynamics parameters, the improving effects of exercise-based CR were only observed regarding LVEF, and the effects of IVR were also the strongest (IVR > COR > ITM > COA > IVA) (p < 0.05). Similar improving effects were also observed for 6MWT and life quality (IVR showing the strongest improving effects) (p < 0.05), which all declined three months after the surgery. ConclusionsThe current study showed that exercise-based CRs had better improving effects than the normal nursing strategy on the prognosis of AMI patients receiving PCI surgery.

"Challenges to Normalcy"- Perceived Barriers to Adherence to Home-Based Cardiac Rehabilitation Exercise in Patients with Chronic Heart Failure.

The aim of this study was to explore perceived barriers to adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure. A qualitative descriptive study was conducted in this study from May to July 2023. A purposive sampling approach was adopted to select patients with chronic heart failure. Semi-structured interviews were completed to collect qualitative data for exploring the perceived barriers. In addition, information saturation and validation strategies were adopted to prove the adequacy of qualitative data. Transcripts were analysed using thematic analysis. A total of 16 patients with chronic heart failure were included in this study. Analysis of the data revealed five main barriers to adherence to home-based cardiac rehabilitation in patients with chronic heart failure. These include (1) lack of knowledge, (2) activity intolerance, (3) exercise fear, (4) role conflict, and (5) lower exercise self-efficacy. This study delved deeper into understanding the challenges faced by chronic heart failure patients in adhering to home-based cardiac rehabilitation exercise. The development of precise and effective management and intervention strategies based on these barriers is necessary to improve patient compliance with home-based cardiac rehabilitation exercise.

The effects of cardiovascular rehabilitation in patients with heart failure with reduced ejection fraction - does gender really matter?

Abstract Background The prevalence of heart failure (HF) in the adult population appears to be 1-2%, and it rises with age. About ½ of HF patients have reduced ejection fraction (HFrEF). Although the positive effects of cardiac rehabilitation (CR) in patients with HFrEF are well known, women seem to participate in CR significantly less compared to men. Purpose To determine whether there is a difference in the effects of CR on the tolerance of physical strain and the quality of life (QOL) related to gender in examinees with HFrEF. Methods The study involved 225 pts with HFrEF, 190 men (84.4%) and 35 women (15.56%), who were referred to a three-week CR program. At baseline and the end of CR exercise stress test (EST) was taken. The QOL was assessed at the beginning and the end of CR by validated questionnaire Short-Form 36. Results Male pts showed better strain tolerance on the first and the second EST compared to female pts. However, both gender showed improvement in physical strain tolerance on the second EST by achieving higher strain level (men 2.17±0.85 vs. 2.56±0.88, p=0.000; women 1.74±0.7 vs. 2.14±0.77, p=0.001), and longer duration of EST (men 2.56±2.97 vs. 5.64±2.85, p=0.000; women 2.28±2.46 vs. 4.63±2.4, p=0.000). Also, significantly more male and female pts achieved submaximal heart rate on the second EST (p=0.000 for men, and p=0.046 for women). Furthermore, CR has led to an improvement in the QOL in both men and women. Namely, all parameters were better at the end of CR, both in men and women. However, statistically significant improvements in female pts were noted in physical functioning (40±16.96 vs. 70±6.12, p=0.034), and energy/fatigue (43±17.54 vs. 62±20.49, p=0.041). On the other hand, the statistical significance in male pts was reached in physical functioning (59.38±25.57 vs. 67.23±23.47, p=0.002), energy/fatigue (60.43±22.7 vs. 64.08±21.22, p=0.036), emotional well-being (71.31±20.97, vs. 74.29±21.18, p=0.011), body pain (63.64±26.95 vs. 71.93±23.58, p=0.000), and general health (48.94±14.7 vs. 55.27±18.1, p=0.000). Conclusion Women generally less participate in CR than men. Results indicated that CR improves exercise capacity and QOL in HFrEF patients, in both men and women. This is why CR needs improvement in the referral and participation of women.