Cardiac Rehabilitation Training Research Articles

The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial Revascularization Performed on Multiple Coronary Artery Lesions.

To observe the effect of cardiac rehabilitation (CR) in patients with partial revascularization performed on multiple coronary artery lesions and explore its possible mechanism. A total of 400 patients with multiple coronary artery lesions were enrolled and randomly divided into a complete revascularization group and a CR group, with 200 cases in each group. Target lesion revascularization was performed radically in the complete revascularization group, while it was partially completed in the CR group, and postoperative CR was performed. All the patients were put under conventional treatment. Left ventricular end diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety and levels of serum nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF) were evaluated and compared between two groups before and after training. There was no significant difference in LVEDD, LVEF, 6-MWD, quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two groups before training (p>0.05). 1 year later, compared with the complete revascularization group, the occurrence of major adverse events in the CR group declined (p>0.05); the measurements of LVEDD decreased and LVEF increased (p>0.05), 6-MWD increased significantly (p<0.05), quality-of-life scores were higher (p<0.05), the levels of serum NO, NOS, and SOD increased noticeably, and the levels of serum VEGF decreased significantly in the CR group (p<0.05). There were significant differences within the same group, before and after training (p<0.05). Cardiac rehabilitation training, not increase in the incidence of adverse events, is effective and safe after partial revascularization in patients with multiple coronary artery lesions, which has notable clinical advantages in promoting patients' exercise endurance and quality-of-life by improving the nitric oxide synthase system and antioxidant system and reducing the level of VEGF.

Approaches to choosing the intensity of aerobic training in cardiac rehabilitation

Approaches to choosing the intensity of aerobic training in cardiac rehabilitation

Application of home-based resistance training in cardiac rehabilitation for patients with coronary heart disease

Application of home-based resistance training in cardiac rehabilitation for patients with coronary heart disease

A Bibliometric Analysis of High-Intensity Interval Training in Cardiac Rehabilitation.

As global quality of life has improved, the risk factors for cardiovascular diseases have gradually increased in prevalence. People have consequently sought to improve their health through physical exercise. High-intensity interval training (HIIT) is a cardiac rehabilitation (CR) tool that has been of great interest for several years. However, its feasibility and safety remain controversial. This study aimed to explore hot research topics and new directions regarding the role of HIIT in CR and to describe the dynamic development of the field. We used the Web of Science Core Collection database to develop visualizations using CiteSpace software (v.6.1.R2). The number of articles published, institutional collaboration networks, author partnerships, and keyword co-occurrence and clustering were used to analyze the impact of HIIT on CR. Our results showed that Norway, Canada, and the United States were the most prominent contributors to this field. Articles by Nigam, A and Juneau, M had the highest number of citations. The Norwegian University of Science and Technology had performed the most in-depth research in this area. The European Journal of Preventive Cardiology had published the most articles. The United States had the highest number of publishing journals. Relevant issues focused on coronary artery disease, exercise capacity, heart failure, cardiorespiratory fitness, and physical activity. HIIT in heart transplantation may be at the forefront of research in this field and future studies should focus on this topic. HIIT-based CR can therefore improve the exercise capacity and quality of life of cardiovascular patients and improve patient compliance in a safe manner.

Second Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 (COVID-19) Outbreak.

Background: We previously reported the results of a questionnaire survey of 37 cardiac rehabilitation (CR) training facilities conducted during April 2020, in Japan.Methods and Results: We conducted a second questionnaire survey in 38 CR training facilities to explore the preventive measures against Coronavirus Disease 2019 (COVID-19) after a nationwide state of emergency was declared and to investigate differences between the 2 surveys. No significant differences were observed, except for the requirement for patients to wear surgical masks during CR (P=0.01) in the second survey. Thirty-four facilities (89%) continued CR with innovations, 61% revised their instruction manuals (vs. 46% in the first survey), and, in 39%, patients requested resumption of ambulatory CR and training videos.Conclusions: In the second survey, 74% of facilities were unable to continue conventional group ambulatory CR; however, patients maintained their physical activity and exercise regimens and managed their illnesses with the aid of telephones and mobile devices.

To Observe the Effect of Cardiac Rehabilitation Training and Nursing after Stenting for Acute Myocardial Infarction

To Observe the Effect of Cardiac Rehabilitation Training and Nursing after Stenting for Acute Myocardial Infarction

Resistance training during cardiac rehabilitation improves physical performance in patients with coronary artery disease: a randomised controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency Background Resistance training (RT) is an adjunct exercise therapy to aerobic training (AT) in cardiac rehabilitation, but it remains unknown whether the dose-dependent relationship between RT load (high load [HL] vs. low load [LL]) and improvement in anthropometry, body composition and physical performance exists in patients with coronary artery disease (CAD). Purpose The aim of our study was to investigate the effects of HL-RT and LL-RT on top of AT in comparison to AT on anthropometry, body composition and physical performance in patients with CAD. Methods A total of 79 patients with a stable CAD were randomised to HL-RT+AT (n = 21), LL-RT+AT (n = 19) or AT (n = 19) and performed 36 training sessions. Fifty-nine patients with mean (SD) age 61 (8) years and left ventricular ejection fraction 53 (9) % completed the study. AT progressed from 50 % to 80% of peak power output achieved at baseline cardiopulmonary exercise test, and RT progressed from 70% of one repetition maximum (1-RM) to 80% of 1-RM in HL-RT group, and from 35% of 1-RM to 40% of 1-RM in LL-RT group. We measured anthropometry (body mass, waist and hip circumference, and waist to hip circumference ratio), body composition (lean body mass and %, body fat mass and %, and phase angle) and physical performance evaluating upper muscle strength (arm curl and hand grip test) and lower muscle strength (five sit-to stand test, up-and-go test, heel raise test), mobility (gait speed test), flexibility (back scratch test, sit-and-reach test), balance (stork balance test) and submaximal endurance (6 min walk test distance) at baseline and post-training. Results Waist circumference and waist-to-hip circumference ratio decreased significantly following LL-RT (both p &amp;lt; 0.01), without post-training differences between training interventions in other anthropometry measures and body composition measures (all p &amp;gt; 0.079). HL-RT and LL-RT induced improvements in all physical performance measures, while AT alone did not improve gait speed, upper limb flexibility and performance of up-and-go test. HL-RT was associated with greater improvement in gait speed (+12 %, p =0.044), arm curl test (+13 %, p = 0.037) and time of Up-and-go test (+9 %, p &amp;lt;0.001) compared to AT group, while LL-RT improved more time of Up-and-Go test (+18 %, p &amp;lt; 0.001) and time of five sit-to-stands (+14 %, p = 0.016) compared to AT. There was no difference between HL-RT and LL-RT in post-training change of physical performance measures. Conclusions The addition of RT to AT is associated with greater improvements in submaximal muscle strength and mobility compared to AT and should be encouraged in future multimodal exercise-based cardiac rehabilitation.

Influence of cardiopulmonary exercise test on platelet function in patients with coronary artery diseases on antiplatelet therapy

BackgroundCardiac rehabilitation reduces mortality and morbidity rate of patients with coronary artery diseases (CAD); however, acute exercise stimulation may also increase the thrombotic risk through platelet activation. Studies on the effects of cardiac rehabilitation on platelet function have been sparse.MethodsA total of 28 patients (24 men and 4 women; average age = 54.6 ± 8 years old) with stable CAD were enrolled in this study and divided into Aspirin-treated (n = 11; Aspirin group) and dual-antiplatelet-treated group (DAPT group; n = 17). Symptom-limited cardiopulmonary exercise test (CPET) with a cycle ergometer was performed on all the patients. Before and after CPET, platelet function was evaluated using light transmission aggregometry and whole blood flow cytometry.ResultsAll patients completed the CPET without provoked cardiac events, and the mean value of peak oxygen uptake (Peak Vo2) was 19.3 ± 3 ml/(kg min). Prior to CPET, platelet aggregation was significantly suppressed in DAPT group compared to Aspirin group (43.0 ± 21.5 vs. 72.9 ± 7.5, p < 0.001). CPET promoted platelet aggregation in Aspirin group (72.9 ± 7.5 vs. 80.9 ± 7.6, p = 0.005) and DAPT group (43.0 ± 21.5 vs. 50.1 ± 20.9, p = 0.010), and platelet count was increased in Aspirin (210.9 ± 54.6 vs. 227.5 ± 58.1, p = 0.001) and DAPT group (217.5 ± 63.8 vs. 229.7 ± 63.7, p = 0.001). However, the expression levels of CD62p and PAC-1 were not affected by CPET in both groups.ConclusionSymptom-limited CPET enhanced platelet aggregation in patients with CAD despite treatment with antiplatelet, mainly via platelet count augmentation, but not through single platelet activation.Trial registration: Effects of high intensity interval training versus moderate intensity continue training in cardiac rehabilitation on platelet function of patients with coronary heart diseases: a exploratory randomized controlled trial.ChiCTR-INR-17010717. Registered 23 February 2017, https://www.chictr.org.cn/edit.aspx?pid=18206&htm=4.

Effect of Mobile Internet Technology in Health Management of Heart Failure Patients Guiding Cardiac Rehabilitation.

In this paper, we are going to explore the effect of mobile Internet technology in health management for the heart failure patients with cardiac rehabilitation. To implement and evaluate its effects in real environment, a total of 60 heart failure patients were divided, preferably in random fashion, into two groups of 30 cases, i.e., control and observation groups. The former group has received the routine home cardiac rehabilitation after discharge, and the latter group, i.e., observation, has received home cardiac rehabilitation based on mobile medical technical guidance after discharge. The 6 min walking test, Minnesota Cardiac Dysfunction Quality of Life Scale score, cardiac function index, and cardiac rehabilitation training compliance were matched between these groups specifically before and after the intervention. After 12 weeks of intervention, the 6 min walking test, Minnesota Cardiac Dysfunction Quality of Life Scale score, B-type natriuretic peptide of N-terminal, end-diastolic diameter preferably left ventricular, left ventricular ejection fraction, and compliance of training, specifically in the observation group, were better than the control group whereas statistically significant differences were observed, i.e., P < 0.01. Home cardiac rehabilitation guided by mobile Internet technology can improve the function of cardiac, exercise tolerance, life's quality, and compliance of patients with heart failure.

Outpatient Cardiac Rehabilitation Closure and Home-Based Exercise Training During the First COVID-19 Lockdown in Austria: A Mixed-Methods Study.

ObjectiveTo assess the impact of the closure of group-based cardiac rehabilitation (CR) training during the first COVID-19 lockdown in spring 2020 on patients’ physical activity, cardiorespiratory fitness, and cardiovascular risk, and to describe the patient experience of lockdown and home-based exercise training during lockdown.DesignMixed methods study. Prospectively collected post-lockdown measurements were compared to pre-lockdown medical record data. Quantitative measurements were supplemented with qualitative interviews about the patient experience during lockdown.SettingOutpatient CR centre in Salzburg, Austria.ParticipantsTwenty-seven patients [six female, mean (SD) age 69 (7.4) years] who attended weekly CR training sessions until the first COVID-19 lockdown in March 2020.Outcome Measure(s)Quantitative: exercise capacity (maximal ergometer test, submaximal ergometer training), cardiovascular risk (Framingham risk score, blood pressure, body mass index, lipids). Qualitative: individual semi-structured interviews.ResultsExercise capacity had significantly reduced from pre- to post-lockdown: mean (SD) power (W) in maximal ergometry 165 (70) vs. 151 (70), p < 0.001; submaximal ergometer training 99 (40) vs. 97 (40), p = 0.038. There was no significant difference in Framingham risk score and other cardiovascular risk factors. Qualitative data showed that almost all patients had kept physically active during lockdown, but 17 (63%) said they had been unable to maintain their exercise levels, and 15 (56%) felt their cardiorespiratory fitness had deteriorated. Many patients missed the weekly CR training and the motivation and sense of community from training together with others. Several patients stated that without professional supervision they had felt less confident to carry out home-based exercise training at high intensity.ConclusionThis study highlights the importance of group-based supervised exercise training for patients who engage well in such a setting, and the detrimental impact of disruption to this type of CR service on physical activity levels and exercise capacity. Additionally, learning from the COVID-19 pandemic may inform the development and implementation of remote CR modalities going forward.

A Review of Exercise-Based Rehabilitation Strategies in Patients with Myocardial Infarction: Focus on High-Intensity Interval Training

Background and Aim : Despite progressive improvement in medical therapy and standard care, Exercisebased rehabilitation programs have been shown to to have beneficial cardiovascular effects in patients with myocardial infarction through a multifactorial effect. This review study aimed to evaluate exercise-based cardiac rehabilitation strategies in patients with myocardial infarction with special focus on high intensity interval training, as a growing field of research was conducted. Material and Methods: This is a systematic review study on articles published, without limitation Year, by searching in reputable databases such as PabMed, Science Direct, Google Scholar, Scopus, Springer. Also in the process of searching for articles on the keywords microRNAs (miRNA) and myocardial infarction "," cardiac rehabilitation and myocardial infarction "," cardiac rehabilitation and high-intensity interval training (HIIT) ", high-intensity interval training (HIIT) and Myocardial infarction was used. Ethical considerations: All Ethical principles in writing this article have been observed according to the instructions of the National Ethics Committee and the COPE regulations. Results: High-intensity interval training (HIIT) is a safe and effective exercise strategy to improve cardiac function in MI, and to prevent abnormal changes in mass, size, geometry, and cardiac function after MI, and Applies significant changes in molecular targets and cell pathway. Conclusion: Therefore, HIIT targets myocardial necroptosis due to oxidative stress, protects the heart against adverse left ventricular regeneration after MI, and can be considered an integral part of post-MI cardiac rehabilitation programs.

Comparative analysis of aerobic cardiorespiratory training of high and moderate intensity in cardiac surgery profile patients

Aim. The aim of our study was to conduct a comparative analysis of aerobic high-intensity interval training and constant moderate intensity training in cardiac rehabilitation of adult patients after open-heart surgery, namely after coronary artery bypass grafting (CABG).&#x0D; Material and methods. 137 patients after CABG were included in the study. 90.4% of patients were consider as class I of chronic heart failure after surgery. Cardiorespiratory trainings were initiate in 4 weeks after surgery, using cycling by veloergometers. Two groups were compare according to rehabilitation programs: one carried out constant aerobic trainings of moderate and medium intensity, and the other, aerobic high-intensity interval trainings. Supervised trainings were carry out for 150 minutes per week. Total length of trainings was 47 weeks. Long-term trainings were distantly monitore.&#x0D; Results. Ergospirometric results as well as results of echocardiography were significantly improve after training course. These results were more significant in high-intensity interval training group, compared to moderate intensity-training group. VO2, heart rate and training power significantly improved. Body mass index significantly diminished in high-intensity interval training group, compared to moderate intensity-training group. In 7 weeks after training ominously decreased blood triglycerides and increased high-density lipoproteins.&#x0D; Conclusion. Cardiorespiratory trainings ameliorate mitochondrial biogenesis, carbohydrate and lipid metabolism, promote to reduce abdominal obesity and other crucial risk factors of coronary patients. Aerobic high-intensity interval cardiac trainings are as safe as moderate intensity cardiac trainings, and in some issues, they outperform moderate intensity cardiac trainings.

Effectiveness of additional resistance and balance training and telephone support program in exercise-based cardiac rehabilitation on quality of life and physical activity: Randomized control trial

Objectives To evaluate 20 days and 3 months follow-up effectiveness of cardiac rehabilitation (CR) enhanced by resistance/balance training and telephone-support program compared to usual CR care in improving quality of life, clinical course and physical activity behavior. Design Single-centre randomized controlled trial. Setting Inpatient CR clinic Subjects 116 (76.1 ± 6.7 years, 50% male) patients 14.5 ± 5.9 days after valve surgery/intervention were randomized to intervention group (IG, n = 60) or control group (CG, n = 56). Intervention Additional resistance/balance training (3 days/week) during phase-II CR and telephone-support program during 3-month follow-up. CG patients were provided with usual CR care. Main measures Short Form 36 Health Survey scales, European Quality of Life 5 Dimensions 3 Level Version QoL index, visual analog scale, clinical course, and physical activity behavior assessed with standardized questionnaires. Results IG reported statistically significant higher mental component score (48.5 ± 6.91 vs. 40.3 ± 11.21 at the baseline, 50.8 ± 9.76 vs. 42.6 ± 9.82 after 20 days, 49.4 ± 8.45 vs. 40.5 ± 8.9 after 12 weeks follow up), general health (48.6 ± 3.17 vs. 45.0 ± 2.95 at the baseline, 53.6 ± 3.02 vs. 43.8 ± 2.55 after 20 days, 53.2 ± 3.11 vs. 44.2 ± 3.07 after 12 weeks) and role limitations due to emotional problems (48.5 ± 15.2 vs. 27.7 ± 11.5 at the baseline, 72.7 ± 12.6 vs. 30.5 ± 11.2 after 20 days, 66.6 ± 14.2 vs. 36.1 ± 11.2 after 12 weeks) in all three assessments (p < 0.05). CG patients had more documented hospital admissions (4 (8%) vs 10 (25%), p = 0.027), atrial fibrillation paroxysms (3 (6.0%) vs. 10 (35.0%), p = 0.011) and blood pressure swings (13 (26%) vs. 20 (50%), p = 0.019). IG patients chose more different physical activities (1.7 ± 0.7 vs. 1.25 ± 0.63, p = 0.002), spent more time being physical active every day (195.6 ± 78.6 vs. 157.29 ± 78.8, p = 0.002) Conclusions The addition of resistance/balance exercises and telephone-support program 12 weeks after to the CR could linked to higher physical activity levels and fewer clinical complications but did not lead to a significant improvement in quality of life.

The impact of a cardiac rehabilitation course on BDNF level changes and functional capacity in acute myocardial infarction patients

Background: Acute myocardial infarction refers to a reduction or amputation of coronary artery circulation leading to myocardial necrosis. BDNF is expressed in atherosclerotic arteries, vascular smooth muscle, and endothelial cells and is involved in angiogenesis, the inflammatory response, and apoptosis of myocardial regeneration after infarction. The aim of this study was to evaluate the effect of a cardiac rehabilitation period on changes in BDNF levels and functional capacity in patients with acute myocardial infarction. Methods: The present study was performed on 30 men with acute coronary syndrome with a pretest-posttest design and the samples were randomly divided into experimental and control groups. The experimental group performed a cardiac rehabilitation program for 6 weeks. The control group did not perform any training during this period. Before and after the rehabilitation program, BDNF levels were measured by the American Diaplus Kit in terms of picograms per milliliter and participants' functional capacity by a modified Bruce test. Analysis of covariance was used to compare BDNF levels and functional capacity of cardiac rehabilitation and control groups. Discussion &amp; Conclusion: Data were analyzed by covariance and the results showed that cardiac rehabilitation training had a significant effect on increasing BDNF levels and functional capacity (P≤0.05). In general, it can be said that cardiac rehabilitation exercise program can play an important role in improving the physical and physiological condition of patients with acute myocardial infarction.

Validation of open-source step-counting algorithms for wrist-worn tri-axial accelerometers in cardiovascular patients

BackgroundAccurate quantification of daily steps in a cardiovascular patient population is of high importance for primary and secondary prevention. While sensor derived step counts have been sufficiently validated for hip-worn devices and commercial wrist-worn devices, there is a lack of knowledge on validity of freely available step counting algorithms for raw acceleration data collected at the wrist. Research questionHow accurate are step-counting algorithms for wrist worn tri-axial accelerometers in a cardiac rehabilitation training setting? MethodsTwo step counting algorithms (Windowed Peak Detection, Autocorrelation) for tri-axial accelerometers (Axivity AX-3), were tested. Steps were recorded by chest-mounted GoPro video cameras as gold standard. Cardiovascular patients without neurological impairments enrolled in an ambulatory rehabilitation program were recruited. Recordings were performed during one 45–90 min outdoor physical therapy session of which 5-min segments of six movement categories, namely Walking, Running, Nordic, Stairs, Arm Movement [AM] With [+] and Without [-] Walking [W] were identified and analyzed. Mean absolute difference and mean absolute percentage error [MAPE] with regard to true steps measured from video are reported to report accuracy. ResultsTraining sessions of 22 patients were recorded and analyzed. Steps were overestimated during AM-W and underestimated during Walking, Running and Stairs. Windowed Peak Detection algorithm was more accurate during AM+W and AM-W and Autocorrelation performed better during Nordic. A MAPE of close or below 10% was achieved by both algorithms for the categories: Walking, Running, Stairs and Nordic. SignificanceBoth algorithms provided accurate results for estimation of step counts in a controlled setting of a cardiovascular patient population. The quantification of daily number of steps recorded by wrist-worn accelerometers delivering raw data analyzed by freely available algorithms is a cost-effective option for research studies.

Effects of Cardiac Rehabilitation Training in Patients with Heart Failure Based on Traditional Chinese Exercise: A Systematic Review and Meta-Analysis.

Methods PubMed, Embase, Cochrane Library, and three Chinese databases, namely, China National Knowledge Network, Wanfang, and China Biomedical Network, were searched from the time of their inceptions through August, 2021. We retrieved the studies on the application of TCE-based cardiac rehabilitation in patients with HF. Based on the standard evaluation methods of Cochrane Reviewer's Handbook 5.1.0, two authors independently assessed the risk of bias and evaluated the methodological quality of the studies included. The RevMan 5.3 software was used for further meta-analysis. Additionally, the GRADEpro GDT web version was used to assess the quality of the evidence in these studies. Results Nine randomized controlled trials involving 721 patients were included in this analysis. The meta-analysis revealed that the TCE (experimental group) effectively improved the patient's motor function and endurance compared to walking or other activities (control group) (mean difference, MD = 68.23, 95% CI [54.55, 81.91]; P < 0.00001). From each subgroup analysis, the exercising ability of the experimental group was higher than that of the control group. The quality of life's score in the experimental group was lower than that of the control group (MD = −9.51, 95%CI [−17.84, −1.18]; P=0.03). The plasma B-type natriuretic peptide content in the experimental group was lower than that in the control group (MD = −59.77, 95%CI [−82.85, −36.7]; P < 0.00001). The number of hospitalizations (MD = −0.83, 95%CI [−0.98, −0.68]; P < 0.00001) and hospital costs in the experimental group (MD = −1.6, 95%CI [−1.89, −1.31]; P < 0.00001) were lower than those in the control group. However, no significant differences were observed in the left ventricular ejection fraction and maximal oxygen consumption between the two groups (MD = 1.38, 95%CI [−3.08, 5.84] and P=0.54; MD = −0.04, 95%CI [−1.62, 1.54] and P=0.96, respectively). From the current analysis, TCE can be considered a relatively safe exercise method. According to the GRADE evaluation results on the evidence level, the studies included were of moderate quality, low quality, or very low quality. Conclusions Our systematic review showed that TCE had potential benefits in improving patients' cardiac function, motor function, and quality of life. Therefore, TCE might be an effective adjuvant therapy in patients with HF. However, given the inclusion of the low-quality elucidations, further rigorous studies are urgently needed to confirm these results.

Effect of cardiac rehabilitation training on patients with coronary heart disease: a systematic review and meta-analysis.

In recent years, the incidence of heart disease has increased and patients are younger. Cardiac rehabilitation training has been proposed to improve the prognosis of patients with heart disease. Cardiac rehabilitation includes moderate-intensity continuous training (MCT) and high-intensity interval training (HIIT). These two training methods have different effects in improving the prognosis of patients. The aim of the present study was to improve reference for patients with cardiac rehabilitation. English databases, including PubMed, Cochrane Library, and Embase, were searched from the establishment of the database to April 2021 for randomized controlled trials (RCTs) of rehabilitation training at different intensities. RevMan 5.3 was used for the meta-analysis. A total of 8 articles (with a total of 465 patients) were included, including 236 patients in the experimental group and 229 patients in the control group. Different intensities of training had statistically significant differences in peak oxygen uptake [mean difference (MD): 1.21, 95% confidence interval (CI): -0.66 to 3.07, P=0.20] and the left ventricular ejection fraction difference (MD: 2.53, 95% CI: -2.10 to 7.17, P=0.28). Cardiac rehabilitation training can effectively improve the patient's cardiac function indicators and self-care ability, and reduce the incidence of cardiovascular disease (CVD). However, large-sample, multicenter, and long-term RCTs are needed to strengthen the findings of the study.

Resistance training in heart failure patients: a systematic review and meta-analysis.

Aerobic training (AT) has been the primary mode of exercise training in cardiac rehabilitation. Historically, the reason for the prescription of AT was that it was speculated that although RT may be beneficial for some clinical outcomes, it may have an adverse effect on ventricular structure and function. However, RT has now made its way into current cardiac rehabilitation guidelines, including those directed towards patients with HF, albeit differences exist across institutions and guidelines. A systematic search of PubMed, EMBASE and Cochrane Trials Register on April 30, 2021, was conducted for exercise-based rehabilitation trials in HF. Randomised and controlled trials that reported on resistance training versus usual care or trials that directly compared RT to an AT intervention were included. Resistance training versus controls improves parameters of lower (SMD 0.76 (95%CI 0.26, 1.25, p = 0.003] and upper extremity muscle strength (SMD 0.85 (95%CI 0.35, 1.35), p = 0.0009], both key parameters of physical function throughout the lifespan. Importantly, RT in isolation, versus control, improves VO2peak [MD: 2.64ml/kg/min (95%CI 1.67, 3.60), p < 0.00001] and 6MWD [MD: 49.94m (95%CI 34.59, 65.29), p < 0.00001], without any detrimental effect on left ventricular parameters. Resistance training in HF patients is safe and improves parameters of physical function and quality of life. Where people with HF are unable to, or are not inclined to, partake in aerobic activity, RT alone is appropriate to elicit meaningful benefit.

Sex and Age Differences in Anxiety and Depression Levels Before and After Aerobic Interval Training in Cardiac Rehabilitation.

The objective of this study was to investigate sex and age differences in anxiety and depression among patients with cardiovascular disease at baseline and following aerobic interval training (AIT)-based cardiac rehabilitation (CR) and secondarily to compare dropout rates between sexes and age groups. Participants were younger (≤44 yr), middle-aged (45-64 yr), and older adults (≥65 yr). The AIT protocol consisted of: 4 × 4-min of high-intensity work periods at 85-95% peak heart rate (HR) interspersed with 3 min of lower-intensity intervals at 60-70% peak HR, twice weekly for 10 wk. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and following CR. At baseline, of 164 participants (32% female), 14 (35% female) were younger, 110 (33% female) were middle-aged, and 40 (30% female) were older. Older adults reported lower anxiety levels versus younger (4.4 ± 2.6 vs 7.8 ± 3.4 points, P = .008) and middle-aged adults (4.4 ± 2.6 vs 6.1 ± 3.6 points, P = .05). Baseline depression levels did not differ between age groups (P = .749). All age groups experienced a reduction in anxiety (younger =-2.67; middle-aged =-1.40; older =-0.85) and depression (younger =-1.50; middle-aged =-0.83; older =-0.70) levels following CR. Differences in dropout rates were observed between age groups (χ2[1] = 13.4, P = .001). Within each age group, 43% (female n = 2, male n = 4) of younger, 10% (female n = 8, male n = 3) of middle-aged, and 2.5% (female n = 0, male n = 1) of older participants dropped out. Younger and middle-aged adults experience higher levels of anxiety upon entry into CR compared with older adults. Cardiac rehabilitation was associated with significant reductions in anxiety and depression severity, yet dropout rates were highest among younger adults.

Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 Outbreak.

Background: Since the reporting of a cluster outbreak of coronavirus disease 2019 (COVID-19) in sports gyms, the Japanese Association of Cardiac Rehabilitation (CR) shared a common understanding of the importance of preventing patients and healthcare providers from contracting COVID-19. This questionnaire survey aimed to clarify the status of CR in Japan during the COVID-19 outbreak.Methods and Results: An online questionnaire survey was conducted in 37 Japanese CR training facilities after the national declaration of a state of emergency in 7 prefectures. Among these facilities, 70% suspended group ambulatory CR and 43% suspended cardiopulmonary exercise testing (CPX). In contrast, all facilities maintained individual inpatient CR. Of the 37 facilities, 95% required CR staff to wear a surgical mask during CR. In contrast, 50% of facilities did not require patients to wear a surgical mask during CR. Cardiac telerehabilitation was only conducted by a limited number of facilities (8%), because this method was still under development. In our survey, 30% of the facilities not providing cardiac telerehabilitation had specific plans for its future use.Conclusions: Our data demonstrate that ambulatory CR and CPX were suspended to avoid the spread of COVID-19. In the future, we need to consider CR resumption and develop new technologies for cardiovascular patients, including cardiac telerehabilitation.