Improvement In Physical Capacity Research Articles

Do patients maintain improvement in physical capacity achieved after hybrid telerehabilitation implemented as part of managed care after acute myocardial infarction program at one-year follow-up?

Abstract Background Managed Care after Acute Myocardial Infarction (MC-AMI) is a one-year comprehensive care program dedicated to patients with acute coronary syndrome introduced in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid rehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of MC-AMI program. Purpose The purpose of this study was to evaluate whether the effect of improving physical capacity achieved after 5-week HTR was maintained during one-year follow-up. Methods The study enrolled 84 patients (90% males, aged 57.5 ± 10.2 years, LVEF 54,6 ± 6.8%) who underwent a 5-week HTR based on Nordic walking training and completed the entire one-year MC-AMI program. Unless there were contraindications, HTR began no later than 14 days after discharge from the hospital and consisted of an initial phase (1 week) conducted in an outpatient center and 4 weeks of telemonitored exercise training at home, five times weekly. Exercise capacity was assessed by comparing the exercise test results at baseline (before HTR), immediately after HTR and at the end of one-year MC-AMI program. Results HTR resulted in significant improvement in workload [METS] and workload duration in exercise test. This valuable effects were maintained after one-year follow-up. All results are presented in Table 1 and Figure 1. Conclusion The improvement in physical capacity achieved after 5-week of the hybrid telerehabilitation was maintained in patients who completed MC-AMI program in one-year follow-up.

Effectiveness of hybrid comprehensive telerehabilitation in women with heart failure - subanalysis of the TELEREH-HF RCT

Abstract Background Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). Purpose: The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2 peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were made before and after intervention/observation. Results: Women constituted 11.5 % of population in the TELEREH-HF study. Forty women in HCTR group and 44 women in UC group completed HCTR and observation respectively. HCTR resulted in significant improvement in VO2peak, workload duration and QoL. We did not observe these favorable results in the UC group except for an increase workload duration. In the HCTR group, there was a significantly greater improvement in physical component of QoL than in the UC group. All results are presented in Table 1. In neither group were there deaths nor major adverse events related to exercise training. Conclusion In women with HF, hybrid comprehensive telerehabilitation is safe and resulted in a significant improvement in physical capacity and QoL.

Feasibility and therapeutic potential of [177Lu]Lu-FAPI-2286 in patients with advanced metastatic sarcoma.

The unique expression pattern of fibroblast activation protein (FAP) in stromal and tumor cells, particularly in sarcomas, and its absence in normal tissues, have positioned it as a promising theragnostic approach for the detection and treatment of various cancer types. The objective of this prospective study is to assess the feasibility, safety, biodistribution, and therapeutic efficacy of [177Lu]Lu-FAPI-2286 in patients with advanced metastatic sarcoma. Eight patients with advanced metastatic sarcoma, who were unresectable or had experienced disease recurrence following conventional treatments, underwent PTRT (peptide-targeted radionuclide therapy) using [177Lu]Lu-FAPI-2286. Prior to the treatment, confirmation of tumor uptake was obtained through [68Ga]Ga-FAPI-2286 PET/CT. After four cycles of PTRT with [177Lu]Lu-FAPI-2286 (6660-7400 MBq), with a 6-8-week interval between each cycle, no grade 3 or 4 side effects were observed in the patients, and the treatment was well tolerated by all participants. The results demonstrated a 52.37% reduction in the average volume of the primary tumor, accompanied by a significant decrease in SUVmax and TBR of the metastatic lesions (29.67% and 43.66% respectively), especially in cases of lung metastasis. Furthermore, besides the improvement in physical capacity, there was a noticeable reduction in pain, an increase in overall survival, and enhanced satisfaction with the treatment reported by the patients. [177Lu]Lu-FAPI-2286 PTRT, utilized for diverse cancer types, exhibited favorable tolerability in sarcoma patients, with minimal side effects, long-lasting retention of the radiopeptide within the tumor, and promising therapeutic effects. Preliminary findings of this prospective study need to be confirmed through further clinical trials.

Telerehabilitation after acute coronary syndrome warrants a similar improvement in physical performance as stationary rehabilitation regardless of the age profile of the compared groups

Abstract During the COVID-19 pandemic, the availability of cardiac rehabilitation (CR) was limited. On the other hand, during the epidemic hazard period, patients after acute coronary syndromes (ACS) required careful control and ensuring their improvement after the coronary event. The aim of this study was to assess whether CR conducted during the epidemic threat in remote mode ensures similar improvement in physical performance as rehabilitation conducted in stationary mode before the pandemic COVID-19. Material and methods In this one-center study, the demographic and clinical profiles in the groups of patients after ACS who completed a stationary CR before COVID-19 era or telerehabilitation during the COVID-19 pandemic were compared. The workload on the initial and final exercise tests (ExT) obtained by patients was assessed, as well as the values of differences between the final and initial ExT were compared. 359 patients (pts) participating in stationary CR before October 2020 and 60 pts - in telerehabilitation after July 2021 were included. Both, stationary and tele- CR were performed according to the guidelines of Working Group for Cardiac Rehabilitation of the national cardiac society. Telemedic platform was used to control ECG, blood pressure and body mass of pts participating in telerehabilitation. Statistical analysis included U Mann-Whitney test, T Student test and chi square test. Results The improvment of physical performance did not differ significantly between both groups. The pts who completed telerehabilitation were significantly older than those who completed stationary CR. The values of other parameter, like percent of females, BMI, percent of pts with arterial hypertension and diabetes mellitus type 2 or ejection fraction of left ventricle did not differ significanty between compared groups. The results of statistical analysis are presented in the table below. Conclusions In our center, telerehabilitation after acute coronary syndrome guaranteed an equally good improvement in physical capacity, which was observed in stationary rehabilitation patients, regardless of the difference in the age profile of the compared groups. These results encourage popularization of the cardiac rehabilitation mode with the remote control of the ECG, blood pressure and body weight.Comparison of the study groups

Effectiveness of hybrid comprehensive telerehabilitation in heart failure patients with permanent atrial fibrillation - subanalysis of the TELEREH-HF RCT

Abstract Background Atrial fibrillation (AF) negatively impacts physical fitness and quality of life (QoL). Little is known about efficacy of hybrid comprehensive telerehabilitation (HCTR) in heart failure (HF) patients with AF. Purpose The purpose of this study was to assess safety and effectiveness of HCTR in HF patients with permanent AF. Methods The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2 peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were made before and after intervention/observation. Results There were 73 patients with permanent AF in HCTR group and 72 patients with permanent AF in UC group. HCTR resulted in a significant improvement in VO2peak and workload duration. We did not observe these favorable results in the UC group. In the HCTR group, there was a significantly greater improvement in physical component of QoL than in the UC group. All results are presented in Table 1. In neither group were there deaths nor major adverse events. Conclusion In HF patients with permanent AF, hybrid comprehensive telerehabilitation is safe and resulted in a significant improvement in physical capacity and physical component of QoL.

A dedicated amputee sports programme improves physical functioning and sports participation

Objective: People with a lower-limb amputation often have a sedentary lifestyle and increasing physical activity is important to optimize their health and quality of life. To achieve this the Amputee Parateam programme was developed. Amputee Parateam is a sports programme that addresses important physical, environmental, and social barriers for sports participation. This programme was evaluated in terms of various aspects of physical functioning and health. Design: Repeated measures design. Patients: Thirteen participants with a lower-limb amputation, with a median age of 51 (interquartile range (IQR) 40–63). Methods: Measurements were performed at T0 (baseline), T1 (after 6 weeks) and T2 (follow-up after 12 months). Outcome measures were walking ability, functional mobility, daily activity, health-related quality of life, and adherence to sports at follow-up. Results: Walking ability and functional ability significantly improved between T0 and T1. Adherence to sports at follow-up was high, with 11/13 participants still practicing sports weekly. There were no significant changes in daily activity or health-related quality of life. Conclusions: The Amputee Parateam programme successfully improved walking ability and functional mobility and resulted in a high adherence to sports among the participants. However, these improvements in physical capacity did not lead to less sedentary behaviour in daily life.

Changes in body satisfaction during and after a 5-month handcycle training period and associations with physical capacity and body composition in individuals with a physical impairment

Purpose To investigate: (1) changes in body satisfaction during five months of handcycle training and one year after the training period; (2) whether longitudinal changes are dependent on sex, waist circumference and severity of the physical impairment; (3) associations between changes in physical capacity or body composition, and body satisfaction. Materials and methods Individuals (N = 143) with health conditions such as spinal cord injury filled out the Adult Body Satisfaction Questionnaire: at the start of the training (T1), directly after the training period (T2); and four months (T3) and one year after the training period (T4). At T1 and T2, physical capacity was determined with an upper-body graded exercise test, and waist circumference was measured. Handcycling classification was used as a proxy for the severity of impairment. Results Multilevel regression analyses showed that body satisfaction significantly increased during the training period and significantly decreased back to pre-training levels at follow-up. Individuals with more severe impairments showed a larger decrease at T4. Improvements in physical capacity and waist circumference were significantly associated with improvements in body satisfaction. Conclusions Body satisfaction significantly increased during the training period, but significantly decreased during follow-up. Additional efforts might be necessary to keep individuals engaged in long-term exercise.

P493 ASSOCIATION BETWEEN IMPROVEMENT IN PHYSICAL FITNESS AND ANTHROPOMETRIC PARAMETERS WITH MAINTENANCE OF PHYSICAL EXERCISE HABITS IN A POPULATION OF PATIENTS WITH ISCHEMIC HEART DISEASE UNDERGOING A REHABILITATION CYCLE WITH 6 MONTHS FOLLOW–UP

Abstract Background Increased physical activity is associated with a reduction in all–cause mortality and may increase life expectancy, an effect strongly linked to a reduction in the risk of cardiovascular (CV) disease. Regular aerobic exercise (EX) results in modest reductions in waist circumference (CIRC) (associated with CV mortality) and visceral adipose tissue. Vigorous intensity EX may offer greater benefits than moderate intensity. Aim of the study: To evaluate whether the continuation of EX after Cardiac Rehabilitation (CR) leads to an improvement in physical capacity and parameters related to CV pathology of patients (PZ) with ischemic heart disease (IC). Methods retrospective observational study on patients referred to the Outpatient CR of the O.C. S.M. del Prato (Feltre) from January 2018 to May 2021. Of the initial population of 270 PZ, 47 did not show up at the f.–up, 22 did not perform 6MWT at the f.–up and 33 had CR indications other than IC. The Outpatient CR consisted of 10 monthly sessions with 3 modalities: • educational (ED) + supervised EX • ED only • online (Covid period). Supervised EX: soft bodyweight gymnastics (30 min) + 30 minutes monitored moderate to vigorous supervised EX on stationary bikes and treadmills ED: frontal lessons (1–2 h) multidisciplinary (doctor, nurse, dietician, psychologist) aimed at improving the patient‘s management of CV disease and risk factors. On–line: soft bodyweight gymnastics (30 min) + ED by videoconference The f.–up was on average 6 months after the CR. Statistical processing with Jamovi 2.3.13 Materials and methods: At admission to CR and at f.–up, weight, height, CIRC, calculated BMI were measured, performed 6–minute walk test (6MWT) with Borg scale detection. At the f.–up a questionnaire was self–administered and adherence to EX, bodyweight exercise, how often, attendance at a gym, use of heart rate monitor (CF), etc. were declared. Conclusions The 6MWT improves in a statistically significant way in all PZs at f.–up except in those who declare not to perform EF. Significant improvements in CIRC, BMI and Borg were observed in PCS performing EX more frequently weekly (2–4 times), using CF and in PCS undergoing complete RC (ED + EX). No predictors of improvement at 6 months of the examined variables were identified.

Specific training methods in the art of classical dance

Arts performers, especially actors, dancers, choreographers, show directors, are increasingly involved in the optimization of physical training and motor skills techniques to help them improve the interpretive performance during the shows. As well the scenic expression forms progressively require the improvement of physical capacities, such as: strength, velocity, endurance and coordination. In fact the examples described stimulate the ability of the human body (or the individual body segment) to perform a certain type of physical action (by engaging and stimulating effort) in the shortest time (velocity), as long as possible (endurance), to overcome a greater weight (force) in the most effective development of motor skills (coordination) - which includes several factors as: mobility, agility, motor memory, etc. – all determined by the artist`s physical training practice

Functional Capacity and Physical Activity Level in Patients with Chronic Kidney Disease undergoing Hemodialysis

To minimize the problems resulting from chronic kidney disease, the practice of physical activities is indicated and consequently the improvement of physical capacity. Therefore, the aim of this study was to analyze the correlation between functional capacity and physical activity level in patients with chronic kidney disease undergoing hemodialysis. This cross-sectional study was conducted with 24 individuals at hemodialysis clinic in the northwestern portion of the state of Rio Grande do Sul/Brazil. The outcome variables were distance traveled on the six-minute walk test (6MWT) and physical activity level determined by the average number of steps per day measured using a pedometer (objective measure) as well as the International Physical Activity Questionnaire (IPAQ) (subjective measure). It was shown that the distance travelled on the 6MWT was not correlated with the average number of steps per day or results of the IPAQ. In contrast, a moderate correlation was found between the two physical activity measures (pedometer and IPAQ). The patients were classified as insufficiently active and also had low functional capacity, with a mean of 53.93% of the predicted distance on the 6MWT. It is concluded that no significant correlation was found between functional capacity measured using the 6MWT and physical activity level measured using a pedometer and the IPAQ. A moderate correlation was found between the pedometer and IPAQ. The patients were insufficiently active and achieved low percentages of the predicted distance on the 6MWT.

Ballet after breast cancer: investigating the feasibility and acceptability of a novel 16-week classical ballet intervention for breast cancer survivors

PurposeThe “Ballet after breast cancer” study sought to investigate the feasibility and acceptability of a 16-week classical ballet intervention for breast cancer survivors, delivered face-to-face and/or online.MethodsBreast cancer survivors were recruited to take part in 2 × 1-h ballet classes per week for 16 weeks. Primary outcomes of feasibility and acceptability were assessed according to rates of enrolment and attendance and participant feedback via questionnaire. Secondary outcomes included quality of life (QOL), upper-body disability, shoulder range of motion (ROM), muscular strength, aerobic capacity, and physical activity levels. Associations between rate of attendance and changes in secondary measures were explored.ResultsThirty-one participants (62% of eligible individuals) enrolled in the program. Twenty-nine women commenced the intervention [53.3 ± 10.8 years (Mean ± SD)], attending 77.6% [67.6, 87.5] (Mean [95% CI]) of sessions. Based on these rates of enrolment and attendance, and participant feedback, the program was deemed feasible and acceptable to participants. Significant improvements in shoulder ROM and reductions in sedentary behaviour were achieved. Participants also reported improvements in physical capacity and psychological, social, and cognitive wellbeing.ConclusionsThe “Ballet after breast cancer” program, delivered face-to-face and/or online, was feasible and acceptable to breast cancer survivors. Improvements in shoulder ROM achieved doing ballet were pertinent given the adverse effects of upper-body morbidity on breast cancer survivor QOL. Improvements in physical activity behaviour and perceived benefits to wellbeing also support the use of ballet to mitigate QOL impairment after treatment.Implications for cancer survivorsThe physical demands and the fun, creative, and social characteristics of ballet promote improvement across multiple domains of health and wellbeing. Ballet shows promise as an activity to improve QOL and increase long-term engagement in health-promoting physical activity after breast cancer.

Measurement of health-related quality of life post aortic valve replacement via minimally invasive incisions

BackgroundMinimally invasive aortic surgery is growing in popularity among surgeons. Although many clinical reports have proven both the safety and efficacy from a surgical point of view, there are few data regarding its impact on patients’ quality of life and whether there is a difference between ministernotomy and minithoracotomy from the patient perspective.MethodsThis prospective, questionnaire-based, nonrandomized study included 189 patients who underwent aortic valve replacement via a minimally invasive incision between May 2014 and December 2020 and completed at least 1 year of follow-up. The study uses the RAND SF 36-Item Health Survey 1.0 to assess and compare health-related quality of life between ministernotomy and minithoracotomy.ResultsThere was a statistically significant improvement in the minithoracotomy group with regard to physical functioning, role limitation due to a physical problem, and social functioning (79.69 ± 20.72, 75.28 ± 26.52, 87.91 ± 16.98) compared to the ministernotomy group (70.31 ± 22.88, 58.59 ± 31.17, 66.15 ± 27.32) with p values (0.0036, 0.0001, < 0.0001), respectively.ConclusionsBoth minimally invasive aortic valve incisions positively impacted patient quality of life. The minithoracotomy incision showed significant improvements in physical capacity and successful patient re-engagement in daily physical and social activities. This, in turn, positively improved their general health status compared to the 1-year preoperative status.Trial registration: This study was approved by the Research Ethics Committee (REC) at the Faculty of Medicine, Ain Shams University, under the number code (FWA 000017585, FAMSU R 91 /2021).

Early Physical Rehabilitation in Frail Patients Undergoing Coronary Artery Bypass Surgery

To date, there are insufficient data on the concept of exploring rehabilitation potential in older patients with frailty syndrome, while developing strategies to improve outcomes after cardiac surgery and reducing the number of postoperative complications remains a relevant topic. Aim. To assess safety and feasibility of early physical rehabilitation in frail patients undergoing coronary artery bypass grafting (CABG). Material and methods. The study included 49 patients with stable coronary artery disease (CAD) admitted for elective CABG with cardiopulmonary bypass (CPB). Patients were randomized into two groups according to the approach to physical rehabilitation: in the early rehabilitation group (n=22), treadmill workouts were conducted starting from the 7th postoperative day and continued at the second stage of inpatient rehabilitation. Patients in the control group (n=27) had no treadmill training. In the inpatient rehabilitation setting, the incidence and the type of complications were assessed; on the 6th day and 21-23 days after CABG, the results of the cardiopulmonary exercise testing (CPET) were analyzed. Results and discussion. The groups were similar in baseline intraoperative characteristics. Postoperative complications occurred in 18% of patients in the early rehabilitation group and in 48% of patients in the control group (p=0.037). In the group of patients with early rehabilitation, the rate of postoperative complications decreased by 4 times compared to the control group (OR – 0.24; 95% CI – 0.06-0.896). Peak oxygen consumption (p=0.03) and exercise tolerance (p=0.03) were significantly higher in the group of patients with the early rehabilitation according to CPET conducted three weeks after the surgery. At the present stage, it seems optimal to shift the start of physical rehabilitation in postoperative period to the earlier dates. Minimizing the patient’s immobilization period helps to optimize the course of the postoperative period. Conclusion. Early rehabilitation in the postoperative period of CABG in patients with frailty is associated with lower incidence of postoperative complications and improvements in physical capacity of patients by the end of the hospital stay

A Sustainable Swedish School Intervention with Extra Aerobic Exercise—Its Organization and Effects on Physical Fitness and Academic Achievement

Objectives:A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present aim was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health.Methods:In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics.Results:Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade.Conclusion:This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.

Rehabilitation of the unmotivated: remote cardiac rehabilitation among patients of all risk levels who reported unwillingness to participate in hospital-based rehabilitation

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba medical center Introduction Remote cardiac rehabilitation (RCR) is recognized as a viable alternative to conventional, center-based rehabilitation. However, to achieve meaningful functional improvement, a high level of adherence and motivation to collaborate with the healthcare team, is necessary. The feasibility of RCR among patients who actively avoid hospital rehabilitation has not been adequately investigated by randomized studies. Method This year-long prospective study enrolled 60 cardiac patients at various risk levels, including those with heart transplants and heart failure, who refused to participate in conventional rehabilitation. Accordingly, 40 participants were randomized to a 6-month RCR program, while the remaining 20 received usual care in the community. Both groups were monitored for activity and self-reported outcomes. RCR is based on behavioral theories, includes multidisciplinary support, motivational and educational content, regular exercise, controlled by a smart sports watch, and transmitted to both the medical operations center and the patients mobile phone application. The main outcome was the change in Peak VO2, measured by the Cardiopulmonary Exercise Testing, after 4 months of intervention compared to baseline. Results The study included 60 patients, 82% men, aged 55 (±12), who were admitted to the 6-month RCR program mainly after myocardial infarction or coronary interventions (44%), heart failure (29%), cardiomyopathy (13.5%) and heart transplantation (10.5%). After RCR, there was a significant increase in Peak VO2 in the intervention group (+2.46±7.1 mL/(kg·min) compared to the control group (-0.72±7.9 mL/(kg·min) (p&amp;lt;0.001). High-density lipoprotein (HDL) levels also improved significantly. The average minutes per week of aerobic exercise was 221 (±124.74), which was 147% of the goal. The average minutes at the recommended target heart rate was 117.38 (±78.36), and the percentage of intensity of training was 69.39% (±15.11) of the maximum capacity. The average aerobic sessions per week was 5 (±3), while the resistance sessions was 0.8 (±0.74). The average daily step count in the intervention group was 9145 (±3860) versus 4445 (±3005; p&amp;lt;0.001). The surveys showed a significant improvement in patients’ mental and physical perception of health in the intervention vs. control group. Conclusion The adherence and results achieved by patients in RCR who avoided conventional rehabilitation were well within guideline recommendations, resulting in a significant improvement in physical capacity. Risk level, age, and lack of motivation at the beginning of the program were not barriers to achieving goals and cooperation.

A Sustainable Swedish School Intervention with Extra Aerobic Exercise—Its Organization and Effects on Physical Fitness and Academic Achievement

A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present purpose was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health. In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics. Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade. This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.

Relationship between physical capacity and depression in heart failure patients undergoing hybrid comprehensive telerehabilitation vs. usual care: subanalysis from the TELEREH-HF Randomized Clinical Trial.

The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation, and remote monitoring of cardiovascular implantable electronic devices might be an option to improve both physical capacity and depressive symptoms. The aim of the study was to investigate the influence of HCTR on depressive symptoms and physical capacity in heart failure (HF) patients in comparison with usual care (UC). The present analysis formed part of a multicentre, randomized trial that enrolled 850 HF patients (New York Heart Association I-III, left ventricular ejection fraction ≤ 40%). Patients were randomized 1:1 to HCTR or UC. Patients underwent an HCTR programme (1 week in hospital and 8 weeks at home; exercise training 5 times weekly) or UC with observation. The Beck Depression Inventory II (BDI-II) score (cut point for depression ≥ 14) was used to assess depression and the physical capacity was measured by peak oxygen consumption (peak VO2; mL/kg/min). Measurements were made before and after 9-week intervention/observation (HCTR/UC group). Both groups were comparable in terms of demographic and clinical characteristics. In HCTR group, at entry, 23% of the sample obtained BDI-II scores ≥14 vs. 27.5% in UC group. There were no significant differences between groups regarding ΔBDI-II score (P = 0.992) after 9-week HCTR/UC. There was a significant improvement in physical capacity only in the HCTR group in both patients with (P = 0.033) and without (P &lt; 0.001) depression. In HF patients, HCTR provided similar reduction of depressive symptoms as UC. HCTR resulted in a significant improvement in physical capacity in patients with and without depression.

C14. Benefit and Safety of Cardiac Rehabilitation Program in Pulmonary Hypertension Patient after Atrial Septal Defect Closure with Fenestration

Abstract Background ASD closure with surgical fenestration is purposed to reduce pulmonary hypertension (PH) crisis. PH is still found in patient conducting this procedure. Some issues told that PH patient should restrict activities due to complaints aggravation. Proper cardiac rehabilitation gives clinical improvements and safe for stable PH patient. Case summary A 20-year-old male, diagnosed as left to right shunt ASD with pulmonary hypertension (mPAP 41 mmHg, PVRI 4.86, and Qp/Qs 1.62), was conducted surgical closure with fenestration. Patient was given cardiac rehabilitation program from 6-minute walking test result. It was done twice a week for 1 month after surgery by walking on treadmill for 600 meters in 30 minutes and was increased 100 meters per meeting, the heart rate target was 107 – 125 beats per minute. The program evaluation by treadmill test on the last session showed increase of fitness capacity (9.33 METs from 2.34 METs) and decrease of symptoms. There was no incident during exercise. Education were given for PH evaluation and healthy lifestyle. Discussion Cardiac rehabilitation program was emphasized for PH management. Continuous and moderate intensity exercise is recommended than high intensity exercise. The cardiac rehabilitation program showed improvement of physical capacity, quality of life, and reduction of NT pro BNP by increasing peak oxygen uptake, anaerob threshold, pulmonary perfusion, muscle function and decreasing inflammatory response, oxidative stress, smooth muscle cell proliferation. It is save for stable PH patient under healthcare supervision.

C14. Benefit and Safety of Cardiac Rehabilitation Program in Pulmonary Hypertension Patient after Atrial Septal Defect Closure with Fenestration

Abstract Background ASD closure with surgical fenestration is purposed to reduce pulmonary hypertension (PH) crisis. PH is still found in patient conducting this procedure. Some issues told that PH patient should restrict activities due to complaints aggravation. Proper cardiac rehabilitation gives clinical improvements and safe for stable PH patient. Case summary A 20-year-old male, diagnosed as left to right shunt ASD with pulmonary hypertension (mPAP 41 mmHg, PVRI 4.86, and Qp/Qs 1.62), was conducted surgical closure with fenestration. Patient was given cardiac rehabilitation program from 6-minute walking test result. It was done twice a week for 1 month after surgery by walking on treadmill for 600 meters in 30 minutes and was increased 100 meters per meeting, the heart rate target was 107 – 125 beats per minute. The program evaluation by treadmill test on the last session showed increase of fitness capacity (9.33 METs from 2.34 METs) and decrease of symptoms. There was no incident during exercise. Education were given for PH evaluation and healthy lifestyle. Discussion Cardiac rehabilitation program was emphasized for PH management. Continuous and moderate intensity exercise is recommended than high intensity exercise. The cardiac rehabilitation program showed improvement of physical capacity, quality of life, and reduction of NT pro BNP by increasing peak oxygen uptake, anaerob threshold, pulmonary perfusion, muscle function and decreasing inflammatory response, oxidative stress, smooth muscle cell proliferation. It is save for stable PH patient under healthcare supervision.

Relationships between physical capacity and depression in heart failure patients undergoing hybrid comprehensive telerehabilitation vs usual care results of the TELEREH-HF randomized clinical trial

Abstract Introduction The novel hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of cardiovascular implantable electronic devices might be an option to improve both physical capacity and depressive symptoms. Purpose The aim of the study was to investigate the influence of HCTR on depressive symptoms and physical capacity in heart failure (HF) patients in comparison with usual care (UC) alone. Methods The present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (New York Heart Association class I–III, left ventricular ejection fraction ≤40%). Patients were randomized 1:1 to HCTR plus UC or UC only. Patients underwent either an HCTR program (1 week in hospital and 8 weeks at home; exercise training 5 times weekly) or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Beck Depression Inventory II (BDI II) score (cut point for depression ≥14) was used to assess depression and the physical capacity was measured by peak oxygen consumption (peak VO2). Measurements were made before and after a 9-week intervention (HCTR group)/ observation (UC group). Results Both groups were comparable in terms of demographic, clinical characteristics and medical therapy. In HCTR group at entry 23% of the sample (n=88/382) obtaining BDI-II scores ≥14 vs 27.5% (n=107/389) in UC group. The BDI II score at study entry was 9.8±6.6 and after intervention was 9.2±6.6, p=0.016 (HCTR group) vs at entry 10.6±8.2 and after observation 10.0±8.3, p=0.022 (UC group). There were no significant differences between groups regarding ΔBDI II score p=0.992. There was a significant improvement in physical capacity assessed by peak VO2 only in the HCTR group, both in patients with (p=0.033) and without (p&amp;lt;0.001) depression (Table 1). These beneficial effects have not been observed in UC group. Conclusions In heart failure patients, HCTR provided similar reduction of depressive symptoms as UC. Hybrid comprehensive telerehabilitation resulted in a significant improvement in physical capacity both in patients with and without depression. Funding Acknowledgement Type of funding sources: Other. Main funding source(s): The National Centre for Research and Development, Warsaw, Poland.