Rehabilitation Of Cardiovascular Patients Research Articles

Health aspects of aerobic interval training in the rehabilitation of the patients with cardiovascular diseases

Purpose: The aim of this study was to review the literature analyzing the effects of aerobic interval training in the rehabilitation of cardiovascular patients. Methods: Research data was collected considering the inclusion and exclusion criteria of the research studies published in English. In order for the study to be included in the analysis, it had to meet the following criteria: year of publication (2004–2022), respondents were people with cardiovascular disease, and the studies included in this review must contain data on disease, training programme and outcomes. Papers without full texts available and systematic review studies were excluded. The first search identified 71 articles. In the initial assessment carried out in accordance with the inclusion and exclusion criteria, 15 articles were found suitable and were included in the study, while 20 studies were excluded for being duplicates, 28 studies excluded for not having the full text available and eight for non-compliance. Results: The reviewed materials indicate that aerobic interval training has an impact on VO2 max, functional abilities, Vo2 peak and functional capacity in the rehabilitation of cardiovascular diseases, especially in the elderly. The duration of the programme in most studies has a similar time range from 10 to 16 weeks. The programmes that showed the best effects are related to aerobic interval training, from 2 to 3 times per week with moderate (50–60% of VO2 max) or high intensity (80–90% of VO2 max). Conclusion: Studies indicate that properly dosed physical activity contributes to a better lifestyle for people with cardiovascular diseases. All 15 studies showed positive effects of aerobic interval training in cardiovascular disease rehabilitation.

Deep learning-based dynamic ventilatory threshold estimation from electrocardiograms

Background and objectiveThe ventilatory threshold (VT) marks the transition from aerobic to anaerobic metabolism and is used to assess cardiorespiratory endurance. A conventional way to assess VT is cardiopulmonary exercise testing, which requires a gas analyzer. Another method for measuring VT involves calculating the heart rate variability (HRV) from an electrocardiogram (ECG) by computing the variability of heartbeats. However, the HRV method has some limitations. ECGs should be recorded for at least 5 minutes to calculate the HRV, and the result may depend on the utilized ECG preprocessing algorithms. MethodsTo overcome these problems, we developed a deep learning-based model consisting of long short-term memory (LSTM) and convolutional neural network (CNN) for a lead II ECG. Variables reflecting subjects' physical characteristics, as well as ECG signals, were input into the model to estimate VT. We applied joint optimization to the CNN layers to generate an informative latent space, which was fed to the LSTM layers. The model was trained and evaluated on two datasets, one from the Bruce protocol and the other from a protocol including multiple tasks (MT). ResultsAcceptable performances (mean and 95% CI) were obtained on the datasets from the Bruce protocol (−0.28[−1.91,1.34] ml/min/kg) and the MT protocol (0.07[−3.14,3.28] ml/min/kg) regarding the differences between the predictions and labels. The coefficient of determination, Pearson correlation coefficient, and root mean square error were 0.84, 0.93, and 0.868 for the Bruce protocol and 0.73, 0.97, and 3.373 for the MT protocol, respectively. ConclusionsThe results indicated that it is possible for the proposed model to simultaneously assess VT with the inputs of successive ECGs. In addition, from ablation studies concerning the physical variables and the joint optimization process, it was demonstrated that their use could boost the VT assessment performance of the model. The proposed model enables dynamic VT estimation with ECGs, which could help with managing cardiorespiratory fitness in daily life and cardiovascular rehabilitation in patients.

Water aerobic training in cardiac rehabilitation programs

Water aerobic training can be considered as an additional method of exercise in the rehabilitation of cardiovascular patients. The review examines the physiological effects of water training, the potential of its use in different categories of cardiac patients, its advantages, dosing the load and monitoring its intensity in the aquatic environment. The practical aspects of aqua aerobic training are discussed, and research data on its safety and effectiveness in cardiac rehabilitation programs is provided.

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.

Cardiovascular Rehabilitation in Patients with Cancer

Advances in cancer treatment have increased patient survival, as well as susceptibility to cardiovascular disease, not only due to the increase in risk factors but also as a result of the treatment itself.Cardiotoxicity related to antineoplastic drugs is one of the most feared cardiovascular effects during or after chemotherapy treatment, and it is associated with unfavorable prognosis in cancer survivors. Moreover, it reduces physical capacity and quality of life. In this scenario, the multimodal model of cardio-oncological rehabilitation has [...]

Rehabilitation of cardiovascular patients in Istria: yesterday, today, tomorrow

Rehabilitation of cardiovascular patients in Istria: yesterday, today, tomorrow

Організація реабілітаційної допомоги хворим на ішемічну хворобу серця на амбулаторному етапі: проблеми та перспективи

Аbstract. Cardiac rehabilitation, based on physical training and correction of risk factors for cardiovascular diseases, is one of the most important means for improving the prognosis in patients with ischemic heart disease. In Ukraine, the vast majority of cardiac patients do not receive the benefits of cardiac rehabilitation. Insufficient implementation of modern cardiorehabilitation programs at the outpatient stage of treatment is an urgent problem in Ukraine. Objective. To consider modern approaches to the organization of rehabilitation care for patients with ischemic heart disease at the outpatient stage. Methods. Analysis and generalization of data from foreign and domestic scientific literature. Results. The system of rehabilitation of cardiovascular patients, which currently operates in Ukraine, is outdated and dangerous. A large number of complications among cardiac patients are due to a lack of effective rehabilitation care for patients with ischemic heart disease after their discharge from the inpatient department. Development and implementation of the latest cardiorehabilitation programs with account for foreign experience and national context will allow to continue rehabilitation of patients with ischemic heart disease at the outpatient stage and reduce the percentage of complications and mortality among the thematic contingent. Numerous studies have demonstrated the importance of cardiorehabilitation in the prevention and treatment of ischemic heart disease. Insufficient implementation of modern cardiac rehabilitation programs in Ukraine leads to high prevalence of risk factors associated with coronary factors and high mortality among cardiac patients. This problem requires a set of institutional changes and alterations in health and social protection policies. Much attention should be paid to the organization of effective outpatient cardiorehabilitation care, which will allow more effective control of cardiometabolic risk factors and increase patient adherence to treatment.

Particularities of cardiovascular rehabilitation in patients with chronic cor pulmonale

Particularities of cardiovascular rehabilitation in patients with chronic cor pulmonale

РЕАБІЛІТАЦІЯ ХВОРИХ ІЗ СЕРЦЕВО-СУДИННОЮ ПАТОЛОГІЄЮ.

Серцево-судинні захворювання зумовлюють основні проблеми громадського здоров’я. В Україні проводиться комплекс заходів, спрямованих на створення системи реабілітації серцево-судинних хворих як доповнення до системи лікувально-профілактичної допомоги. Подальшого опрацювання потребують відпрацювання наступності в організації лікувально-профілактичних і реабілітаційних заходів у хворих із серцево-судинною патологією.Мета дослідження вивчення впливу високого рівня артеріального тиску (АТ) на формування реакцій відповідей при проведенні фізичної реабілітації хворих із серцево-судинною патологією на санаторному етапі лікування.Матеріали і методи. Обстежено 175 хворих, з них 100 пацієнтів із артеріальною гіпертензією (АГ) та 75 – з ішемічною хворобою серця (ІХС). У всіх хворих виконували комплекс обстежень, які включали добовий моніторинг АТ, визначення толерантності до фізичних навантажень за даними 6-хвилинного тесту ходьби, тредміл-тесту.Результати досліджень та їх обговорення. Установлено, що серед факторів, що супроводжують неадекватну відповідь на фізичне навантаження, важливе місце посідають як рівень АТ, так і нестабільність артеріальної гіпертензії у процесі відновного лікування, а також ступінь реакції АТ на дозовані фізичні навантаження. У пацієнтів із несприятливим перебігом відновного періоду, незважаючи на своєчасне відновлення коронарного кровотоку, мали місце стійкі середньодобові рівні систолічного та діастолічного АТ у поєднанні з високими значеннями цих показників на висоті фізичного навантаження як у ранньому, так і пізньому реабілітаційному періодах. У хворих з ІХС при неадекватній відповіді на дозовані фізичні навантаження відмічалися тахікардія, короткочасний біль за груднинною, іноді ядуха.Висновки. Основними реабілітаційними заходами при серцево-судинних захворюваннях є дотримання індивідуальної реабілітаційної програми, рухового режиму, раціонального харчування та усунення факторів ризику. Для фізичної реабілітації хворих із серцево-судинною патологією важливим є комплексний підхід, медикаментозний контроль АТ, поліпшення коронарного резерву, раціональне поєднання різних методів лікування, максимальне використання природних факторів, широке застосування санаторно-курортного лікування, кліматотерапії.

Physiotherapy intervention in outpatient cardiovascular rehabilitation in patients after aortic valve surgery

Physiotherapy intervention in outpatient cardiovascular rehabilitation in patients after aortic valve surgery

Feedback control of oxygen uptake profiles during robotics‐assisted treadmill exercise

Gait rehabilitation robots have potential for cardiovascular rehabilitation of patients with neurological deficits. A novel method was developed to guide exercise intensity by feedback control of oxygen uptake rate with a focus on tracking ramps as typically applied in maximal exercise testing. This approach is important as prior observations have noted a non-linear oxygen uptake response to increasing work rate, whereas a linear progression of exercise intensity is desirable. The proposed oxygen-uptake controller has embedded within it a human-in-the-loop feedback system for control of mechanical work rate which takes its target work rate from the automatic oxygen uptake control loop. Results of step and ramp tracking of target oxygen-uptake profiles, and disturbance rejection tests, demonstrated the technical feasibility and accuracy of the approach. Comparison with open-loop tests demonstrated clearly that the feedback system linearises the oxygen-uptake response and that linear progression of exercise intensity leads to higher peak oxygen uptake values. Further work will focus on clinical feasibility and the potential for cardiovascular rehabilitation in patients with neurological deficits.

EFFECTS OF CARDIOVASCULAR REHABILITATION IN PATIENTS ADMITTED TO THE “Dr Benedek Geza” Hospital of Rehabilitation IN CARDIOVASCULAR Diseases, COVASNA

Background. Cardiovascular rehabilitation is an important objective of the treatment of cardiovascular patients in general, and ischemic heart disease patients in particular. The aim of the study is to monitor the effects of long-term cardiovascular rehabilitation in patients readmitted to the “Dr Benedek Geza” Hospital of Rehabilitation in Cardiovascular Diseases Covasna. Material and methods. The study included 92 patients with a mean age of 66.31±9 years, of which 63% women, who had two successive admissions to the “Dr Benedek Geza” Hospital of Rehabilitation in Cardiovascular Diseases, Covasna. At both admissions, all patients were evaluated for the presence of the main cardiovascular risk factors. All patients attended cardiovascular rehabilitation programs, including physical training, climatotherapy, CO2 baths, mofette therapy, aerotherapy, electrotherapy .. We mention that cardioprotective therapy (aspirin, angiotensin enzyme converting inhibitors, beta-blockers and statins) did not undergo major changes from one admission to the other. Results. More than half of the patients had the following risk factors: hypertension 79.35%, dyslipidemia - 64.13%, overweight and obesity - 76.4%. The complex rehabilitation programs attended by the patients consisted of physical training - 33.7%, CO2 baths - 85.9%, mofette therapy - 53.3%, aerotherapy - 96.7%, electrotherapy - 88%. A comparison of the main cardiovascular risk factors during both admissions showed no significant differences between these, except for LDL-cholesterol (3.15±1.26 vs 2.58±1.65 mmol/dl, p=0.004) and HDL-cholesterol (1.06±0.61 vs 1.194±0.41 mmol/dl, p=0.075) In conclusion, in cardiovascular patients, obtaining improvements of cardiovascular risk factors requires long-term cardiovascular rehabilitation programs, in parallel to the application of measures for lifestyle change and for secondary drug prevention.

Special Issue: The Promise of Cardio-Plasticity: Psychophysiological Approaches to Cardiovascular Rehabilitation

Special Issue: The Promise of Cardio-Plasticity: Psychophysiological Approaches to Cardiovascular Rehabilitation

Cardiovascular Rehabilitation in Patients With Diabetes

DEAR EDITOR-IN-CHIEF, W e read with great interest the article by Mourot et al 1 concerning cardiovascular rehabilitation in patients with diabetes. The prevalence of diabetes in patients with coronary artery disease (CAD) is known to be around 31% across Europe (Euro Heart Study) 2 ; thus, the evaluation of the physical performance of this group of patients after a period of cardiac rehabilitation (CR) is a stimulating topic and constitutes a daily issue in most CR units. Mourot et al have focused on 2 aspects of CR in this kind of patients: (1) a multidisciplinary approach (including education) is needed and it has to be tailored to the specific needs of the individual patient and (2) cardiorespiratory fitness is an independent predictor of long-term cardiac mortality in patients with diabetes and CAD and interventions to modify the exercise capacity are relevant, as they could have a positive prognostic impact. The great number of patients included in the study, the similarity of the 2 groups in terms of factors that influence exercise capacity and oxygen uptake (ie, age, sex, ejection fraction), and the accurate evaluation of the physical performance by cardiopulmonary exercise testing, the 6-minute walk test, and evaluation of hand strength make the conclusions of the study very significant. The authors demonstrate that in spite of a higher prevalence of risk factors and a lower initial performance, patients with CAD and diabetes can fully benefit from a multidisciplinary program of CR. However, we have concern about the methodology

Cardiovascular Rehabilitation in Patients With Diabetes

Cardiovascular Rehabilitation in Patients With Diabetes

Cardiovascular Rehabilitation in Patients With Diabetes

The cardiovascular disease risk profile and exercise capacity of coronary heart disease patients with type 2 diabetes mellitus (DM) were measured and compared with those of nondiabetic (NDM) patients before and after a 6-week multidisciplinary cardiac rehabilitation program. Subjects included 413 patients with DM (56.9 +/- 7.9 years) and 614 patients with NDM (56.8 +/- 10.3 years). At program entry, DM patients had a higher prevalence of risk factors (hypertension, hypercholesterolemia, hypertriglyceridemia, obesity, excess abdominal fat, and depression), had a lower peak oxygen uptake (14.3 +/- 4.4 vs 16.6 +/- 5.4 mL . kg . min; P < .001), and covered a shorter distance in the 6-minute walk test (404 +/- 117 m vs 445 +/- 116 m; P < .001) than NDM patients. At the end of the exercise program, all patients achieved significant improvements in physical capacity, which were similar in DM and NDM patients (+27.6 +/- 28.2% vs +30.5 +/- 27.7% for peak oxygen uptake and +21.0 +/- 31.5% vs +21.3 +/- 53.2% for the 6-minute distance test). DM patients with coronary heart disease had a higher prevalence of cardiovascular disease risk factors as well as lower physical capacity than NDM patients at the beginning of rehabilitation. All patients demonstrated improvement in exercise capacity after rehabilitation. More importantly, the extent of the improvement was similar in DM and NDM patients. This study, which involved a large population, emphasizes the capacity of DM patients to fully benefit from a multidisciplinary risk factor management program, including exercise training and educational programs.

Management and assessment of efficacy of rehabilitation of cardiovascular patients

Management and assessment of efficacy of rehabilitation of cardiovascular patients

Rehabilitation of the Cardiovascular Patient.

This very readable little book is addressed primarily to physicians, to encourage and help them in rehabilitation of cardiovascular patients. It emphasizes that the physician must take the responsibility for rehabilitation of his patient. This may mean a simple referral to a competent clinic or an involved, long-range program carried out mainly by a lone physician, as is still necessary in many, if not most, parts of the United States. Many concrete suggestions are given to help the physician on his own, especially in dealing with the patient with hemiplegia or hemiparesis. The child with heart disease is discussed briefly in two short chapters on rheumatic and congenital heart disease. There still appears to be no objective way of deciding what restrictions, if any, need be placed on the child with heart disease. The statement is made, however, that adults with rheumatic heart disease may work successfully in jobs requiring