Part Of Cardiac Rehabilitation Program Research Articles

Considerations for Measurement of Sodium Intake.

Current salt consumption is the major risk factor for hypertension and consequently cardiovascular disease (CVD). Accurate measurement of Na intake is an important component of developing dietary interventions to treat hypertension and lower CVD risk. Given that existing methods have a large subject burden, quick and practical ways to assess Na intake in individuals, particularly in hypertensive subjects, are needed. Such tools may be used for motivation to quantify salt intake and to set targets for lifestyle changes for prevention of CVD within a clinic setting. Patients at high risk of development of CVD may be identified and targeted for motivational interviewing. They may also be used as part of cardiac rehabilitation programs and will allow individuals to measure their own intake and to see the results of their individual action.

Utility of the 6-minute walk test in assessing maintenance of physical activity after cardiac rehabilitation

Evaluation of therapeutic patient education (TPE) is an integral part of cardiac rehabilitation programs. An important component of this involves assessing continued physical activity (PA) after rehabilitation. Few tools are available to assess the maintenance of physical activity, and we argue that use of a field test like the 6-minute walk test (6MWT) can provide some useful indicators. Objective: to study the utility of the 6MWT as a tool for assessing maintenance of PA in post-rehabilitation follow-up. Methods: we conducted a retrospective study of 168 patients (133 men and 35 women) with a mean age of 60.65 years (+/-9.7). First, we analyzed the data from a stress test (ST) and a 6MWT at the beginning and end of rehabilitation. We then analyzed the data from a 6MWT and an International Physical Activity Questionnaire (IPAQ) performed six months after the end of rehabilitation. Results: there was a significant correlation between the 6MWT and the initial and final ST (r=0.5456, p<0.001 for the initial ST, r= 0.604, p<0.001 for the final ST), confirming the validity of using this test in cardiac rehabilitation. We observed a slight correlation between the 6MWT and the IPAQ (r=0.3923, p<0.001) six months post-rehabilitation. The IPAQ results show that patients with a significant level of physical activity during the week maintain their 6MWT distance. Conclusion: the 6MWT is a reliable test in cardiac rehabilitation. It can be used in conjunction with the IPAQ to assess patient adherence to physical activity guidelines in post-rehabilitation follow-up.

The role and impact of physical medicine and rehabilitation in cardiac rehabilitation programs around the world

While the role of Physical Medicine and Rehabilitation (PMR) in most areas of medicine is well-established, little is known about the role of PMR in cardiac rehabilitation (CR). This study assessed the frequency with which CR programs were part of PMR departments, how often PMR physicians lead CR programs and were on CR staff, and the impact of this globally for the first time. In this cross-sectional study, an online survey was administered to CR programs globally. National medical associations and local champions facilitated program identification. One hundred and eleven out of 203 (54.7%) countries in the world offer CR, of which data were collected in 93 (83·78%; n = 1082 surveys, 32.1% response). CR was part of a PMR department in 251 (23.19%) programs. Programs had more equipment when they were within PMR departments, such as bicycle ergometers (97.48% vs. 87.69%, P < 0.0001) and body composition analyzers (43.58% vs. 37.05%, P = 0.0172). PMR physicians were the type of provider with overall responsibility in 12.42% ( n = 123) of programs, with the highest rate in Southeast Asia ( n = 12, 38.71%). When responsibility was under PMR, some cardiac indications were more likely to be accepted, such as cardiomyopathy (61.11% vs. 38.89%, P = 0.0005); moreover, alternative CR models (e.g., home-based) were more frequently offered (80.51% vs. 67.13%, P = 0.0024). PMR physicians were part of the team in 389 (43.37%) CR programs. When part of the team, more non-cardiac diagnoses were accepted (34.04% vs. 17.63%, P < 0.0001), like stroke (36.71% vs. 25.32%, P = 0.0005). Overall, 7.07 ± 0.13/10 core components were offered by programs, with a significantly higher number offered where a PMR physician was on the team ( P < 0.0001). We found significant differences among programs based on the PMR involvement in the program. PMR physicians should more often be part of CR programs, as this could result in benefits for patients.

Emerging Data Support Benefits of Yoga for Patients With Heart Disease.

Diaphragmatic breathing techniques that 1 patient learned during a yoga-based cardiac rehabilitation class helped him overcome the stress and anxiety he often felt in the waiting room of his cardiologist’s office. The patient, like many seen by Sara Chambers, RN, BSN, assistant nurse manager in Cardiac Rehabilitation at Palm Beach Gardens Medical Center, said yoga helped him learn valuable coping techniques he uses in daily life. “Cardiac patients in particular tend to have a lot of stress,” said Chambers, who is is among the >20 million, or 9.5%, of US individuals who practice yoga, according to the 2012 National Health Interview Survey. Now, an emerging body of evidence suggests that yoga, which combines breathing exercises, strengthening and stretching poses, and relaxation techniques, can be beneficial for individuals with heart conditions or other chronic diseases. It seems to have comparable safety to other forms of exercise. “There are multiple studies that [suggest] that regular yoga practice with breathing exercises can increase lung volume, decrease heart rate and blood pressure, help regulate the parasympathetic and sympathetic nervous systems, lower anxiety, and physical endurance,” said Chambers. Although many forms of exercise can be beneficial for patients with chronic diseases, the unique aspect of yoga “is the strong focus on breathing technique and …

Myocardial Infarction and Exercise Training: Evidence from Basic Science.

In 2016, cardiovascular disease remains the first cause of mortality worldwide [1]. Coronary artery disease, which is the most important precursor of myocardial infarction (MI), is the main component of total cardiovascular mortality, being responsible for approximately seven million of deaths [1]. In approximately 20% of infarcted patients, MI is recurrent in the first year after the event [2]. Moreover, among cardiovascular disease, coronary artery disease accounts for the most increased index of life years lost due to morbidity and/or mortality [1]. Sedentarism highly contributes to cardiovascular disease burden, especially for coronary artery disease, and is also one of the MI risk factors [3]. For many years, it was recommended to avoid physical activity after a cardiovascular event; nowadays, it is a consensus that exercise training (ET) should be part of cardiac rehabilitation programs. There is increasing evidence confirming that, when adequately prescribed and supervised, ET after MI can prevent future complications and increase the quality of life and longevity of infarcted patients [4, 5]. ET after MI follows international specialized guidelines; however, there are different protocols adopted by several societies worldwide in cardiac rehabilitation [6], and there is still lack of information on which type and regimen of exercise may be the ideal after MI, as well as how these exercises act to promote beneficial effects to cardiovascular and other organic systems. Thus, experimental studies are important contributors to elicit mechanisms behind clinical results, and to test and compare different ET protocols. Therefore, exercise prescription can be optimized, individualized, and safely practiced by patients. In this chapter, we present a brief review of MI pathophysiology followed by an updated discussion of the most relevant discoveries regarding ET and MI in basic science.

Should Tai Chi be part of cardiac rehabilitation programme for patients with chronic heart failure?

Should Tai Chi be part of cardiac rehabilitation programme for patients with chronic heart failure?

Hemodynamic responses during aerobic and resistance exercise.

Resistance training has become an accepted part of cardiac rehabilitation programs. Because of the potential for a high afterload to have a negative impact on left ventricular function, there has been concern regarding the safety of resistance training for patients with congestive heart failure. This study addressed this concern by studying 12 healthy volunteers, 12 patients with stable coronary artery disease, and 12 patients with stable congestive heart failure during upright cycling at 90% of ventilatory threshold, and during one set of 10 repeated leg presses, shoulder presses, and biceps curls at 60% to 70% of 1-repetition maximum. Left ventricular function was measured by echocardiography. The pattern of changes in heart rate, blood pressure, left ventricular ejection fraction, wall thickness, and left ventricular internal diameters was similar across all three groups of subjects, although there were large differences in absolute values. Despite elevations in diastolic and mean arterial pressures during resistance exercise, there was no evidence of significant rest-to-exercise deterioration in left ventricular function during leg press (ejection fraction, 60%-59%, 56%-55%, and 38%-37%), shoulder press (66%-65%, 59%-53%, and 38%-35%), or biceps curls (63%-58%, 53%-54%, and 35%-36%), as compared with cycle ergometry (63%-69%, 51%-57%, and 35%-42%) in the healthy control subjects, the patients with coronary artery disease, and the patients with congestive heart failure, respectively. Left ventricular function remains stable during moderate-intensity resistance exercise, even in patients with congestive heart failure, suggesting that this form of exercise therapy can be used safely in rehabilitation programs.

Association of Sociodemographic Factors with Barriers Reported by Patients Receiving Nutrition Counseling as Part of Cardiac Rehabilitation

Nutrition education is an important part of cardiac rehabilitation programs ( (1) Travers K.D. Tan M.H. McCleave A.P. Murphy A. Whiting S. Evaluation of a motivational education program for cardiovascular risk reduction effects on knowledge and behavior. J Nutr Educ. 1992; 24: 109-115 Google Scholar , (2) Karvetti R-.L. Hämäläinen H. Long-term effects of nutrition education on myocardial infarction patients a 10-year follow-up study. Nutr Metab Cardiovasc Dis. 1993; 3: 185-192 Google Scholar ). The nutritional aims of Finnish cardiac rehabilitation programs are to effect permanent, favorable changes in diet, nutrient intake, and serum lipid levels. Similar recommendations are part of cardiac rehabilitation programs in the United States ( (3) Wenger N.K. Froelicher E.S. Smith L.K. Ades P.A. Berra K. Blumenthal J.A. Certo C.M.E. Dattilo A.M. Davis D. DeBusk R.F. Drozda Jr, J.P. Fletcher B.J. Franklin B.A. Gaston H. Greenland P. McBride P.E. McGregor C.G.A. Oldridge N.B. Piscatella J.C. Rogers F.J. Cardiac Rehabilitation as Secondary Prevention. Clinical Practice Guideline Quick Reference Guide for Clinicians, No. 17. US Dept of Health and Human Service, Public Health Service, Agency for Health Care Policy and Research and National Heart, Lung, and Blood Institute, Rockville, Md1995 Google Scholar ). Nutrition education has only limited value, however, if patients do not follow the advice.