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Mitropoulos A, Anifanti M, Koukouvou G, Ntovoli A, Alexandris K, Kouidi E. Exploring the effects of real-time online cardiac telerehabilitation using wearable devices compared to gym-based cardiac exercise in people with a recent myocardial infarction: a randomised controlled trial. Front Cardiovasc Med 2024; 11:1410616. [PMID: 38903965 PMCID: PMC11188591 DOI: 10.3389/fcvm.2024.1410616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024] Open
Abstract
Background Exercise-based cardiac rehabilitation (CR) is a non-pharmacological multidisciplinary programme for individuals after myocardial infarction (MI) that offers multiple health benefits. One of the greatest barriers to CR participation is the travel distance to the rehabilitation centre. Remotely monitored CR appears to be at least as effective in improving cardiovascular risk factors and exercise capacity as traditional centre-based CR. Nevertheless, the efficacy of remotely monitored CR in individuals with a recent MI has yet to be examined. Methods A total of 30 individuals (8 women, 22 men) after a recent (i.e., <4 weeks) MI were randomly allocated into two groups (online home-based and gym-based groups). Both groups underwent a 26-week CR programme three times per week. All patients performed baseline and 24-week follow-up measurements where peak oxygen uptake (VO2peak), mean daily steps, distance, and calories were assessed. Results The online group showed an improvement in mean daily steps (p < 0.05) and mean daily distance (p < 0.05) at 24 weeks compared to the gym-based group. The paired-sample t-test showed that all the assessed variables were statistically (p < 0.001) improved for both groups at 24 weeks. Pearson's r demonstrated positive correlations between VO2peak and mean daily distance (r = 0.375), and negative correlations between VO2peak and muscle (r = -0.523) and fat masses (r = -0.460). There were no exercise-induced adverse events during the study. Conclusion Our findings might indicate that a real-time online supervised CR exercise programme using wearable technology to monitor the haemodynamic responses in post-MI patients is equally effective as a gym-based exercise programme.
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Affiliation(s)
- A. Mitropoulos
- Laboratory of Sport Medicine, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Lifestyle, Exercise and Nutritional Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, United Kingdom
| | - M. Anifanti
- Laboratory of Sport Medicine, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G. Koukouvou
- Laboratory of Sport Medicine, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A. Ntovoli
- Laboratory of Management of Sports Recreation and Tourism, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Physical Education, Sports Sciences Frederick University, Nicosia, Cyprus
| | - K. Alexandris
- Laboratory of Management of Sports Recreation and Tourism, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E. Kouidi
- Laboratory of Sport Medicine, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Athanasiou A, Papazachou O, Rovina N, Nanas S, Dimopoulos S, Kourek C. The Effects of Exercise Training on Functional Capacity and Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review. J Cardiovasc Dev Dis 2024; 11:161. [PMID: 38921661 PMCID: PMC11203630 DOI: 10.3390/jcdd11060161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation. The purpose of this systematic review is to evaluate the effectiveness of exercise training on functional capacity and quality of life (QoL) in patients with RA. We performed a search in four databases, selecting clinical trials that included community or outpatient exercise training programs in patients with RA. The primary outcome was functional capacity assessed by peak VO2 or the 6 min walking test, and the secondary outcome was QoL assessed by questionnaires. Seven studies were finally included, identifying a total number of 448 patients. The results of the present systematic review show a statistically significant increase in peak VO2 after exercise training in four out of seven studies. In fact, the improvement was significantly higher in two out of these four studies compared to the controls. Six out of seven studies provided data on the patients' QoL, with five of them managing to show statistically significant improvement after exercise training, especially in pain, fatigue, vitality, and symptoms of anxiety and depression. This systematic review demonstrates the beneficial effects of exercise training on functional capacity and QoL in patients with RA.
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Affiliation(s)
- Amalia Athanasiou
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (A.A.); (O.P.); (S.N.); (S.D.)
| | - Ourania Papazachou
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (A.A.); (O.P.); (S.N.); (S.D.)
- Department of Cardiology, “Helena Venizelou” Hospital, 10676 Athens, Greece
| | - Nikoletta Rovina
- 1st Department of Respiratory Medicine, Sotiria Chest Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Serafim Nanas
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (A.A.); (O.P.); (S.N.); (S.D.)
| | - Stavros Dimopoulos
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (A.A.); (O.P.); (S.N.); (S.D.)
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, 17674 Athens, Greece
| | - Christos Kourek
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (A.A.); (O.P.); (S.N.); (S.D.)
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), 11521 Athens, Greece
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Sukosd IE, Pescariu SA, Faur C, Danila AI, Prodan-Barbulescu C, Fira-Mladinescu O. Utility of Kansas City Cardiomyopathy Questionnaire (KCCQ) in Assessing Quality of Life among Patients with Heart Failure Undergoing Exercise Training Rehabilitation: A Systematic Review. Diseases 2024; 12:64. [PMID: 38667522 PMCID: PMC11049255 DOI: 10.3390/diseases12040064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
This systematic review evaluates the effectiveness of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in assessing quality of life improvements among patients with heart failure (HF) undergoing various forms of exercise training rehabilitation, including telemedicine and in-person modalities, across all stages of HF, irrespective of ejection fraction (EF) and clinical status. The aim was to collate evidence from studies employing the KCCQ as a measure of quality of life (QoL). A comprehensive search strategy was implemented across PubMed, Scopus, and Embase databases, adhering to the PRISMA guidelines, including literature up until October 2023. Inclusion criteria encompassed studies on patients diagnosed with HF undergoing exercise training rehabilitation assessed by KCCQ. Nine articles met the inclusion criteria, involving a total of 3905 patients from various global locations and conducted between 2012 and 2022. Results indicated significant heterogeneity in exercise interventions and patient characteristics. Notably, high-intensity interval training (HIIT) showed a marked improvement in KCCQ scores (from 68.0 to 80.0) compared to moderate continuous training (MCT) and control groups, underscoring its potential for enhancing QoL. Additionally, a significant improvement in the 6-min walking test (6MWT) outcomes was observed, with an average increase of 106 m (95% CI: 60, 152) in one study, reflecting physical capacity enhancements. However, the difference in KCCQ scores between intervention and control groups was not statistically significant in several studies. In conclusion, the KCCQ's effectiveness is highlighted by its ability to detect clinically meaningful improvements in QoL across diverse exercise modalities, including HIIT and MCT, tailored to the specific needs of HF populations. The consistent correlation between KCCQ score improvements and enhanced physical outcomes, such as the 6MWT, supports its reliability in capturing the nuanced benefits of exercise interventions on patient well-being.
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Affiliation(s)
- Ilona Emoke Sukosd
- Doctoral School, Department of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (I.E.S.); (C.P.-B.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Silvius Alexandru Pescariu
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cosmin Faur
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Alexandra Ioana Danila
- Department of Anatomy and Embriology, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Catalin Prodan-Barbulescu
- Doctoral School, Department of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (I.E.S.); (C.P.-B.)
- Department of Anatomy and Embriology, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- IInd Surgery Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Fira-Mladinescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department of Infectious Diseases, Discipline of Pulmonology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Abdeen HA, Helmy ZM, Elnaggar MI, Aldhahi MI, Taha MM, Marques-Sule E, Amin DI, Ibrahim BS, Abdel Aziz A, Castiglione V, Atef H. Different Continuous Training Intensities Improve Echocardiographic Parameters, Quality of Life, and Functional Capacity in Heart Failure Patients with Reduced Ejection Fraction. Int J Gen Med 2023; 16:3933-3945. [PMID: 37670928 PMCID: PMC10475351 DOI: 10.2147/ijgm.s420933] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background Multiple comorbidities and physiological changes play a role in a range of heart failure conditions and influence the most effective approach to exercise-based rehabilitation. This research aimed to examine and compare the outcomes of continuous training at three different intensities, focusing on left ventricular (LV) remodeling, functional capacity, and quality of life among patients with heart failure with reduced ejection fraction (HFrEF). Methods In this randomized control trial, a total of 60 male patients (average age: 54.33 ±2.35 years) with HFrEF were randomly allocated into three groups: 1) High-intensity continuous training group (HICT), 2) Moderate-intensity continuous training group (MICT), and 3) Low-intensity continuous training group (LICT). All the training was performed on a bicycle ergometer 3 times/week for 12 weeks. Echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, N-terminal pro-B-type natriuretic peptide (NT-proBNP), quality of life (Minnesota Living with Heart Failure Questionnaire), and functional capacity (6-minute walking test) were assessed before and the end of the study. Results The HICT group demonstrated the greatest improvements in all measured variables when compared to the other two groups (P < 0.05). These findings were consistent across all measured outcomes. Conclusion It was determined that HICT appears to yield the most favorable outcomes in enhancing echocardiographic measures, NT-proBNP levels, quality of life, and functional capacity among HFrEF patients.
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Affiliation(s)
- Heba A Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Zeinab M Helmy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Moustafa I Elnaggar
- Faculty of Physical Therapy, Heliopolis University for Sustainable Development, Giza, Egypt
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Mona Mohamed Taha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Doaa I Amin
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | | | | | - Vincenzo Castiglione
- Fondazione Toscana Gabriele Monasterio; “Health Science” Interdisciplinary Research Center, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Hady Atef
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
- School of Allied Health Professions (SAHP), Keele University, Staffordshire, UK
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Wang TC, Chen PL, Liao WC, Tsai IC. Differential Impact of Exercises on Quality-of-Life Improvement in Breast Cancer Survivors: A Network Meta-Analysis of Randomized Controlled Trials. Cancers (Basel) 2023; 15:3380. [PMID: 37444490 DOI: 10.3390/cancers15133380] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to assess the effectiveness of various exercise interventions in enhancing the quality of life for breast cancer survivors. To achieve this, randomized controlled trials were identified from major electronic databases, focusing on the relationship between exercise and quality of life in breast cancer survivors. The primary outcome was the impact of exercise on quality of life 12 weeks after the intervention, with a secondary outcome comparing dropout rates between intervention groups and a regular care control group. The study protocol was registered with INPLASY (INPLASY202340007). A network meta-analysis of nine randomized controlled trials involving 725 participants was conducted, examining aerobic and strength training, aerobic activity, yoga, and strength exercise. Results showed that aerobic and strength training was the most effective intervention, significantly improving the quality of life of breast cancer survivors (1.31; 95% confidence interval: 0.49 to 2.12). Aerobic activity had a borderline effect (0.83; 0.03 to 1.63), while no exercise interventions were associated with an increased dropout risk compared to the control group (regular care). The study concluded that concurrent aerobic and strength training can improve breast cancer survivors' quality of life after 12 weeks of intervention without increasing dropout risk compared to regular care.
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Affiliation(s)
- Tzu-Chieh Wang
- Doctoral Program, Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Nursing, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | | | | | - I-Chen Tsai
- InnovaRad, Taichung 407217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Congenital Heart Disease Study Group, Asian Society of Cardiovascular Imaging, Seoul 13572, Republic of Korea
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Pestana SMDC, Vermelho ACMA, Martins MMFPDS. Ganhos com o programa de reabilitação e ensino à pessoa com insuficiência cardíaca (Programa REPIC). REVISTA PORTUGUESA DE ENFERMAGEM DE REABILITAÇÃO 2023. [DOI: 10.33194/rper.2023.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introdução: Apesar dos avanços no tratamento, a insuficiência cardíaca é uma doença crónica, cuja incidência aumenta com a idade. Os internamentos por descompensação mantêm-se elevados, pelo que é crucial priorizar estratégias para a autogestão, tais como o ensino, o acompanhamento e os programas de reabilitação cardíaca. Face ao exposto, este estudo teve como objetivo verificar o impacto do programa REPIC na qualidade de vida, nível de conhecimentos e adesão ao exercício físico.
Metodologia: Estudo quantitativo com desenho antes-após de grupo único realizado numa amostra de 110 pessoas com insuficiência cardíaca, sujeitos a um programa de reabilitação e educação para a saúde durante o internamento e com follow-up telefónico, ao final de um mês, seis meses e um ano após a alta clínica.
Resultados e Discussão: A maioria dos participantes são do sexo masculino (66%) e a amplitude da idade varia entre 30 e 89, com uma média de 64,3 anos e um desvio padrão de 14,4. A análise dos dados evidenciou uma melhoria estatisticamente significativa no conhecimento sobre a doença, bem como na perceção da qualidade de vida nas dimensões mobilidade, cuidados pessoais, atividades habituais e nível geral de saúde (p=0,01). O incremento no tempo de exercício físico após o programa REPIC foi confirmado com resultado estatisticamente significativo [t (109)=6,03; p=0,019]. Os resultados obtidos demonstram os benefícios da educação para a saúde e do acompanhamento telefónico de enfermagem, nomeadamente a melhoria no nível de conhecimentos sobre a doença, na qualidade de vida e na adesão ao exercício físico.
Conclusão: O programa REPIC permitiu reforçar o processo educativo, potenciar os comportamentos de autogestão, melhorar a qualidade de vida e aumentar a duração do exercício físico.
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Sousa JP, Mendonça D, Teixeira R, Gonçalves L. Do adrenergic alpha-antagonists increase the risk of poor cardiovascular outcomes? A systematic review and meta-analysis. ESC Heart Fail 2022; 9:2823-2839. [PMID: 35894772 PMCID: PMC9715777 DOI: 10.1002/ehf2.14012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022] Open
Abstract
Due to concerns regarding neurohormonal activation and fluid retention, adrenergic alpha-1 receptor antagonists (A1Bs) are generally avoided in the setting of heart disease, namely, symptomatic heart failure (HF) with reduced ejection fraction (HFrEF). However, this contraindication is mainly supported by ancient studies, having recently been challenged by newer ones. We aim to perform a comprehensive meta-analysis aimed at ascertaining the extent to which A1Bs might influence cardiovascular (CV) outcomes. We systematically searched PubMed, Cochrane Central Register of Controlled Trials and Web of Science for both prospective and retrospective studies, published until 1 December 2020, addressing the impact of A1Bs on both clinical outcomes-namely, acute heart failure (AHF), acute coronary syndrome (ACS), CV and all-cause mortality-and on CV surrogate measures, specifically left ventricular ejection fraction (LVEF) and exercise tolerance, by means of exercise duration. Both randomized controlled trials (RCTs) and studies including only HF patients were further investigated separately. Study-specific odds ratios (ORs) and mean differences (MDs) were pooled using traditional meta-analytic techniques, under a random-effects model. A record was registered in PROSPERO database, with the code number CRD42020181804. Fifteen RCTs, three non-randomized prospective and two retrospective studies, encompassing 32 851, 19 287, and 71 600 patients, respectively, were deemed eligible; 62 256 patients were allocated to A1B, on the basis of multiple clinical indications: chronic HF itself [14 studies, with 72 558 patients, including seven studies with 850 HFrEF or HF with mildly reduced ejection fraction (HFmrEF) patients], arterial hypertension (four studies, with 44 184 patients) and low urinary tract symptoms (two studies, with 6996 patients). There were 25 998 AHF events, 1325 ACS episodes, 955 CV deaths and 33 567 all-cause deaths. When considering only RCTs, A1Bs were, indeed, found to increase AHF risk (OR 1.78, [1.46, 2.16] 95% CI, P < 0.00001, i2 2%), although displaying no significant effect on neither ACS nor CV or all-cause mortality rates (OR 1.02, [0.91, 1.15] 95% CI, i2 0%; OR 0.95, [0.47, 1.91] 95% CI, i2 17%; OR 1.1, [0.84, 1.43] 95% CI, i2 17%, respectively). Besides, when only HF patients were evaluated, A1Bs revealed themselves neutral towards not only ACS, CV, and all-cause mortality events (OR 0.49, [0.1, 2.47] 95% CI, i2 0%; OR 0.7, [0.21, 2.31] 95% CI, i2 21%; OR 1.09, [0.53, 2.23] 95% CI, i2 17%, respectively), but also AHF (OR 1.13, [0.66, 1.92] 95% CI, i2 0%). As for HFrEF and HFmrEF, A1Bs were found to exert a similarly inconsequential effect on AHF rates (OR 1.01, [0.5-2.05] 95% CI, i2 6%). Likewise, LVEF was not significantly influenced by A1Bs (MD 1.66, [-2.18, 5.50] 95% CI, i2 58%). Most strikingly, exercise tolerance was higher in those under this drug class (MD 139.16, [65.52, 212.8] 95% CI, P < 0.001, i2 26%). A1Bs do not seem to exert a negative influence on the prognosis of HF-and even of HFrEF-patients, thus contradicting currently held views. These drugs' impact on other major CV outcomes also appear trivial and they may even increment exercise tolerance.
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Affiliation(s)
- José Pedro Sousa
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Diogo Mendonça
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Rogério Teixeira
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Lino Gonçalves
- Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
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Prokopidis K, Isanejad M, Akpan A, Stefil M, Tajik B, Giannos P, Venturelli M, Sankaranarayanan R. Exercise and nutritional interventions on sarcopenia and frailty in heart failure: a narrative review of systematic reviews and meta-analyses. ESC Heart Fail 2022; 9:2787-2799. [PMID: 35840310 PMCID: PMC9715780 DOI: 10.1002/ehf2.14052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/16/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
The purpose of this review is to describe the present evidence for exercise and nutritional interventions as potential contributors in the treatment of sarcopenia and frailty (i.e. muscle mass and physical function decline) and the risk of cardiorenal metabolic comorbidity in people with heart failure (HF). Evidence primarily from cross-sectional studies suggests that the prevalence of sarcopenia in people with HF is 37% for men and 33% for women, which contributes to cardiac cachexia, frailty, lower quality of life, and increased mortality rate. We explored the impact of resistance and aerobic exercise, and nutrition on measures of sarcopenia and frailty, and quality of life following the assessment of 35 systematic reviews and meta-analyses. The majority of clinical trials have focused on resistance, aerobic, and concurrent exercise to counteract the progressive loss of muscle mass and strength in people with HF, while promising effects have also been shown via utilization of vitamin D and iron supplementation by reducing tumour necrosis factor-alpha (TNF-a), c-reactive protein (CRP), and interleukin-6 (IL-6) levels. Experimental studies combining the concomitant effect of exercise and nutrition on measures of sarcopenia and frailty in people with HF are scarce. There is a pressing need for further research and well-designed clinical trials incorporating the anabolic and anti-catabolic effects of concurrent exercise and nutrition strategies in people with HF.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
| | - Masoud Isanejad
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
| | - Asangaedem Akpan
- Department of Musculoskeletal Biology, Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
- Aintree University HospitalLiverpool University Hospitals NHS Foundation TrustLiverpoolUK
| | - Maria Stefil
- Liverpool Centre for Cardiovascular ScienceUniversity of LiverpoolLiverpoolUK
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Behnam Tajik
- Kuopio Musculoskeletal Research UnitUniversity of Eastern FinlandKuopioFinland
- National Institute for Health Research Northwest Coast CRNLiverpoolUK
| | - Panagiotis Giannos
- Department of Life Sciences, Faculty of Natural SciencesImperial College LondonLondonUK
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Rajiv Sankaranarayanan
- Liverpool Centre for Cardiovascular ScienceUniversity of LiverpoolLiverpoolUK
- Liverpool Heart and Chest Hospital NHS Foundation TrustLiverpoolUK
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Wen Z, Zhang T. EXERCISE RESISTANCE EFFECT ON ADVERSE REACTION RATE IN HEART FAILURE. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228052022_0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Heart Failure is a common disease in the elderly. In the end stage, patients usually accompany a reduction in fat content and lean body mass in addition to heart failure. Objective: Study the exercise resistance effects and adverse reaction rate in patients with heart failure. Methods: 52 patients with chronic heart failure (38 males, age 67 ± 2.2 years) were randomly divided into two groups. According to New York Heart Association Functional Classification, 27 patients with grade II and 25 with grade I was randomly divided. The experimental group was submitted to aerobic exercises under heart rate control for seven months and the control group with no exercise prescription. In the comparison, the 6-minute walk test and a cardiac function test were employed by Agilent 4500 EcoDoppler at a frequency of 2.5MHz. The indices of systolic and left ventricular function were recorded on ECG simultaneously using the improved Simpsons method, and the following indices were measured: left ventricular systolic and end-diastolic; left ventricular ejection fraction; left ventricular diastolic function; early, late peak velocity and its ratio; mitral valve diastole. Results: Compared to the control group, heart rate decreased to different degrees (P < 0.05), exercise endurance increased significantly (P < 0.01), and left ventricular function index improved significantly (P < 0.01). Conclusion: We observed a positive impact of aerobic exercise directed at the rehabilitation of the cardiovascular system and mental health in elderly patients. Evidence Level II; Therapeutic Studies – Investigating the results.
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Affiliation(s)
- Zebin Wen
- Taiyuan University of Technology, China
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Conde-Pipó J, Bouzas C, Mariscal-Arcas M, Tur JA. Association between Functional Fitness and Health-Related Quality of Life in the Balearic Islands' Old Adults with Metabolic Syndrome. Nutrients 2022; 14:nu14091798. [PMID: 35565767 PMCID: PMC9103052 DOI: 10.3390/nu14091798] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/14/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022] Open
Abstract
Research assessing the relationship between functional fitness (FF) and health-related quality of life (HRQoL) is still scarce. The objective of this research is to assess the association between FF and HRQoL in older adults with metabolic syndrome (MetS) from Balearic Islands (Spain). The design is a cross-sectional, descriptive, and comparative study involving 209 participants (42.2% women). The sociodemographic data and medical history of the participants were collected. Physical activity was evaluated using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Anthropometrics and blood pressure were measured. Glucose, total cholesterol, high-density lipoprotein cholesterol, and triglyceride plasma levels were measured. A battery of functional fitness tests was applied. HRQoL was measured with the Spanish version of the SF-36 questionnaire. Adherence to the Mediterranean dietary pattern was assessed. In older subjects with MetS, a higher FF score and, within it, endurance, lower body strength, one-leg balance, and agility are positively associated with lower physical function (p < 0.001; d = 0.56), better general health (p = 0.019; d = 0.35), and better summary physical component of HRQoL (p < 0.001; d = 0.57). The FF score and HRQoL physical component are both positively associated with high levels of physical activity (ORadj = 10.3, IC 4.19−28.2, p < 0.001; ORadj = 3.25, IC 1.44−7.72, p < 0.005). Older adults with MetS should consider practicing physical activity above the general recommendations to improve their functional fitness and health status and quality of life.
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Affiliation(s)
- Javier Conde-Pipó
- Department of Didactics of Musical, Plastic and Corporal, Faculty of Education Sciences, University of Granada, 18071 Granada, Spain;
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain;
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Miguel Mariscal-Arcas
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, 18071 Granada, Spain;
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain;
- Health Institute of the Balearic Islands (IDISBA), 07120 Palma de Mallorca, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-971-1731; Fax: +34-971-173184
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11
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Pan X, Song M, Pan X. SPORTS TRAINING TO DETECT THE HEART RATE AND BODY TEMPERATURE OF ADOLESCENTS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228022021_0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Due to the increase in the number of only children in China, mental illness in adolescents is on the rise, which affects the development of students’ physical and mental health. Objective: To study the effect of exercise training on the heart rate of adolescents. Methods: The students in the badminton and tai chi optional courses in the school's second grade were randomly selected for moderate-intensity badminton and tai chi training. Results: The mood score of the moderate-intensity tai chi test was between 44 and 51 points, and that of the moderate-intensity badminton experiment was between 42 and 49 points. The heart rate of the moderate-intensity tai chi test was 90 ~ 117 beats/min, and that of the moderate-intensity badminton test was 121 ~ 142 beats/min. Therefore, moderate-intensity badminton training has a significant influence on adolescents’ heart rate and mood. Conclusions: Moderate-intensity badminton exercise can improve adolescent's health and mood. It also has a positive effect on maintaining and stabilizing adolescents’ mental health. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Xiugang Pan
- Sports Center of Xi'an Jiaotong University, China
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12
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Yang F, Tan Y, Xiao M. EFFECT OF EXERCISE ON EARLY REHABILITATION OF PATIENTS WITH NEUROLOGICAL DISORDERS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228012021_0452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Acute cerebral infarction refers to the deficiency of the blood supply to the brain and the damage of tissue function. Objective: To study the effect of exercise training in early rehabilitation of patients with hemiplegia treated in the neurology department. Methods: Ninety-six patients with acute cerebral infarction hemiplegia were studied. According to the order of admission, 96 patients were divided into a control group and an early recovery group, with 48 patients in each group. Results: Before early rehabilitation, there was no statistical significance in NIHSS and FUGL-Meyer scores between the two groups (P > 0.05). After early rehabilitation,the NIHSS score of early rehabilitation group was lower than both its pre-early-rehab score and the control group score, while the FUGL-Meyer score was higher than both its pre-early-rehab and the control group score (P<0.05). Before early rehabilitation, there was no significant difference in the GQOLI-74 score between the two groups (P > 0.05). After early rehabilitation, the GQOLI-74 score was higher in the early rehabilitation group than both its pre-early-rehab score and the control group score (P<0.05). Conclusions: The clinical effect of early rehabilitation training in acute cerebral infarction patients with hemiplegia is significant and can further improve the clinical treatment of patients and their quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Fen Yang
- General Hospital of The Yangtze River Shipping, China
| | - Yihu Tan
- Hubei Provincial Hospital of Integrated Chinese & Western Medicine, China
| | - Ming Xiao
- General Hospital of The Yangtze River Shipping, China
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13
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Bai Y, Hua B, Zhang F, Zhou W, Deng B. Effect of different intensity exercises intervention on cardiovascular functions and quality of life on patients with chronic heart failure: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28554. [PMID: 35029219 PMCID: PMC8757934 DOI: 10.1097/md.0000000000028554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Exercise training can improve exercise capacity, quality of life, and reduce hospitalization time in chronic heart failure (CHF) patients. Various training protocols have been studied in CHF, but there is no consensus on the optimal exercise intensity for the rehabilitation of cardiac patients. Therefore, systematic evaluation of the effects of different exercise intensities on the efficacy of cardiac function and quality of life in patients with CHF was done. METHODS Computer searches of PubMed, Web of Science, The Cochrane Library, Embase, SinoMed, the China National Knowledge Infrastructure, Wanfang, and VIP databases were conducted to collect randomized controlled trials of different exercise intensities applied to patients with CHF. Study selection and data extraction will be performed simultaneously by two independent reviewers, using the PEDro scale for quality assessment of the included literature. Publication bias will be assessed by funnel plot, and Begg and Egger tests. The I2 statistic and the chi-square (χ2) test will be used to assess heterogeneity. In addition, subgroup analyses will be performed for different left ventricular ejection fraction populations and different intervention cycles. All meta-analyses will be performed using Revman5.3 software. RESULTS The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed. CONCLUSION This meta-analysis may provide more reliable, evidence-based evidence for the choice of exercise intensity in patients with CHF. REGISTRATION NUMBER CRD42021276529.
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Affiliation(s)
- Yan Bai
- Department of Nursing, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bin Hua
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fan Zhang
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenqin Zhou
- Nursing Teaching and Research Department, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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14
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Effects of different exercise programs on cardiorespiratory reserve in HFpEF: a systematic review and meta-analysis. Hellenic J Cardiol 2021; 64:58-66. [PMID: 34861401 DOI: 10.1016/j.hjc.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/09/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
HFpEF represents an heterogeneous syndrome with complex pathophysiologic substrate and multiple clinical manifestations. Much attention has been recently focused on cardiac rehabilitation programs for HFpEF patients and studies have examined the effects of exercise training on this specific population. This systematic review and meta-analysis included studies of adult patients with HFpEF and evaluated the impact of exercise on cardiorespiratory fitness variables measured during CPET. The primary outcome was the difference between groups in the change of peak oxygen uptake (Δpeak VO2). Literature search involved PubMed/MEDLINE, Cochrane/CENTRAL and Scopus databases. From an initial 5,143 literature records, we identified 18 studies fulfilling inclusion criteria; 11 studies with 515 patients were finally included in primary outcome analysis. Δpeak VO2 between baseline and study-end was significantly higher in the groups of exercise training versus control (WMD 2.25 ml/kg/min, 95%CI 1.81-2.70). Exercise training resulted in greater change in the 6MWT distance (WMD 2.25 meters, 95%CI 1.81-2.70). Health related quality of life (WMD: -3.36, 95%CI -9.42-2.70, I2=14%, p=0.33) and echocardiographic indexes of diastolic function showed no differences between exercise and control groups at study end. In subgroup analysis, no difference between resistance versus aerobic exercise was noted on Δpeak VO2, but high intensity interval training showed greater increase in peak VO2 versus aerobic exercise (WMD 1.62 ml/kg/min, 95%CI 0.96-2.29, I2=0%, p=0.82). Exercise training in HFpEF results in significant improvements in peak VO2 and 6MWT distance compared to controls. High intensity interval training may offer greater enhancement of exercise capacity of these patients than standard aerobic exercise.
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15
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Guo R, Wen Y, Xu Y, Jia R, Zou S, Lu S, Liu G, Cui K. The impact of exercise training for chronic heart failure patients with cardiac resynchronization therapy: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25128. [PMID: 33787595 PMCID: PMC8021321 DOI: 10.1097/md.0000000000025128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systematically review the current published literature on the impact of exercise training (ET) in chronic heart failure (CHF) patients who were conducted cardiac resynchronization therapy (CRT). METHODS PubMed, EMBASE, and the Cochrane Library of Controlled Trails databases were searched for trials comparing the additional effects of ET in CHF patients after CRT implantation with no exercise or usual care control up until 2020.03.07. We independently screened the literature, extracted data, employed the tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) to evaluate study quality and risk of bias, and performed meta-analysis with Revman 5.3 software. RESULTS Eight trials were identified for qualitative analysis and 7 randomized controlled trails (RCTs) included 235 participants (120 ET; 115 controls) for quantitative analysis. The results showed that the maximal workload (mean difference [MD] 26.32 W, 95% CI 19.41-33.23; P < .00001, I2 = 0%) and the exercise duration (MD 68.95 seconds, 95% CI 15.41-122.48; P = .01, I2 = 76%) had significant improvement in the ET group versus control. Subgroup analysis showed that compared with control, the change in peak oxygen uptake (VO2) (MD 3.05 ml/kg/minute, 95% CI 2.53-3.56; P < .00001, I2 = 0%), left ventricular ejection fraction (LVEF) (MD 4.97%, 95% CI 1.44-8.49; P = .006, I2 = 59%), and health related quality of life (HRQoL) (the change in Minnesota living with heart failure questionnaire [MLHFQ]: MD -19.96, 95% CI -21.57 to -18.34; P < .00001, I2 = 0%) were significantly improved in the light to moderate intensity training (non-HIT) group, while there seemed no statistical difference of above endpoints in the high intensity training (HIT) group. CONCLUSION During the short term (up to 6 months), non-HIT could improve exercise capacity, cardiac function, and HRQoL in CHF patients with CRT. However, due to the small number of participants, a high-quality large-sample multicenter trial is demanded.
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Affiliation(s)
- Ran Guo
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Yi Wen
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Ying Xu
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Ruikun Jia
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Song Zou
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Sijie Lu
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
| | - Guobin Liu
- Department of Cardiology, The First People's Hospital of Jintang County, Sichuan, China
| | - Kaijun Cui
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University
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16
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Gao M, Huang Y, Wang Q, Gu Z, Sun G. Comparative effectiveness of exercise training program in patients with heart failure: protocol for a systematic review of randomised controlled trials and network meta-analysis. BMJ Open 2021; 11:e043160. [PMID: 33727267 PMCID: PMC7970284 DOI: 10.1136/bmjopen-2020-043160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Heart failure (HF) is an end-stage of numerous heart diseases including hypertension, coronary heart disease and arrhythmia, in which the heart is unable to perform its circulatory function with sufficient efficiency due to structural or functional dysfunction (systolic or diastolic alterations). Strategies such as exercise rehabilitation may improve cardiac function, exercise capacity and health-related quality of life and reduce anxiety and depression in patients with HF. However, the relative effectiveness as well as the hierarchy of exercise interventions have not been well established, although various exercise options are available. Therefore, this protocol proposes to conduct a network meta-analysis (NMA) aiming to compare the effectiveness of different types of exercise training in patients with HF. METHODS AND ANALYSIS PubMed, Embase and the Cochrane Library will be searched from inception to March 2021 for relevant randomised controlled trials. Other resources, such as Google Scholar and Clinical Trials.gov will also be considered. Studies assessing exercise rehabilitation in patients with HF will be selected. Two independent reviewers will identify eligible trials. The PEDro risk of bias assessment tool will be used to assess the quality of the included studies. Bayesian NMA will be used when possible to determine the comparative effectiveness of the different exercise interventions. The mean ranks and surface will estimate the ranking probabilities for the optimal intervention of various treatments under the cumulative ranking curve. Subgroup, sensitivity and meta-regression will be conducted to explain the included studies' heterogeneity if possible. We will also use the Grading of Recommendations, Assessment, Development, and Evaluation system to assess the strength of evidence. ETHICS AND DISSEMINATION This systematic review and NMA will synthesise evidence on the effectiveness of the different exercises in patients with HF. The results will be submitted to a peer-reviewed journal. No ethical approval will be required because the data used for the review will be exclusively extracted from published studies. PROSPERO REGISTRATION NUMBER CRD42020165870.
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Affiliation(s)
- Min Gao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yangxi Huang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qianyi Wang
- Department of Nursing, Jiangyin People's Hospital of Jiangsu Province, Jiangyin, Jiangsu, China
| | - Zejuan Gu
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guozhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, China
- Department of Cardiology Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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17
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Cardiac Rehabilitation in Heart Failure. ACTA ACUST UNITED AC 2021; 3:1-14. [PMID: 36263110 PMCID: PMC9536716 DOI: 10.36628/ijhf.2020.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/06/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022]
Abstract
Heart failure (HF) is a complex clinical syndrome caused by a structural and/or functional cardiac abnormality, resulting in reduced organ perfusion. The goals of treatment in patients with HF are to improve functional capacity and quality of life, and to reduce mortality. Cardiac rehabilitation (CR) including exercise training is one of the treatment options, and current guidelines recommend CR as safe and effective for patients with HF. CR has been known to improve exercise capacity and quality of life, minimize HF progression, and lower mortality in patients with HF. Improvement of vascular endothelial function, activation of the neurohormonal system, increase of mitochondrial oxygen utilization in peripheral muscles, and increase of chronotropic responses are possible mechanisms of the beneficial effects of exercise-based CR in HF. Although CR has been shown to decrease morbidity and mortality, it is underutilized in clinical practice. Despite the existence of concrete evidence of clinical benefits, the CR participation rates of patients with HF range from only 14% to 43% worldwide, with high dropout rates after enrollment. These low participation rates have been attributed to several barriers, including patient factors, professional factors, and service factors. The motivation for participating in CR and for overcoming the patients' barriers for CR before discharge should be provided to each patient. Current guidelines strongly recommend applying a CR program to all eligible patients with HF.
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How Effective Is Aerobic Exercise Training in Improving Aerobic Capacity After Heart Transplant? A Systematic Review and Meta-analysis. Cardiopulm Phys Ther J 2020. [DOI: 10.1097/cpt.0000000000000159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Singh R, Pattisapu A, Emery MS. US Physical Activity Guidelines: Current state, impact and future directions. Trends Cardiovasc Med 2020; 30:407-412. [DOI: 10.1016/j.tcm.2019.10.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 10/02/2019] [Accepted: 10/06/2019] [Indexed: 01/26/2023]
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20
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Xiang K, Qin Z, Zhang H, Liu X. Energy Metabolism in Exercise-Induced Physiologic Cardiac Hypertrophy. Front Pharmacol 2020; 11:1133. [PMID: 32848751 PMCID: PMC7403221 DOI: 10.3389/fphar.2020.01133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
Physiologic hypertrophy of the heart preserves or enhances systolic function without interstitial fibrosis or cell death. As a unique form of physiological stress, regular exercise training can trigger the adaptation of cardiac muscle to cause physiological hypertrophy, partly due to its ability to improve cardiac metabolism. In heart failure (HF), cardiac dysfunction is closely associated with early initiation of maladaptive metabolic remodeling. A large amount of clinical and experimental evidence shows that metabolic homeostasis plays an important role in exercise training, which is conducive to the treatment and recovery of cardiovascular diseases. Potential mechanistic targets for modulation of cardiac metabolism have become a hot topic at present. Thus, exploring the energy metabolism mechanism in exercise-induced physiologic cardiac hypertrophy may produce new therapeutic targets, which will be helpful to design novel effective strategies. In this review, we summarize the changes of myocardial metabolism (fatty acid metabolism, carbohydrate metabolism, and mitochondrial adaptation), metabolically-related signaling molecules, and probable regulatory mechanism of energy metabolism during exercise-induced physiological cardiac hypertrophy.
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Affiliation(s)
- Kefa Xiang
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Zhen Qin
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Huimin Zhang
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Xia Liu
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
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Shi S, Shi J, Jia Q, Shi S, Yuan G, Hu Y. Efficacy of Physical Exercise on the Quality of Life, Exercise Ability, and Cardiopulmonary Fitness of Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis. Front Physiol 2020; 11:740. [PMID: 32792965 PMCID: PMC7393267 DOI: 10.3389/fphys.2020.00740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: Physical exercise is recommended to help prevent lifestyle diseases. The present study was designed to quantify the efficacy of physical exercise on the quality of life (QoL), exercise ability and cardiopulmonary fitness of patients with atrial fibrillation (AF). Method: A comprehensive systematic literature search was performed in Medline, Embase, Cochrane Library, Web of Science and PubMed databases (from 1970 to December 1st, 2019) for randomized controlled trials (RCTs) comparing physical exercise combined with AF routine treatments to routine treatments alone. The meta-analysis was conducted following PRISMA guidelines. Our main outcomes were QoL (measured by the Short-Form 36 scale, SF-36), exercise ability (measured by the 6-min walk test, 6MWT) and cardiopulmonary fitness (measured by peak oxygen uptake and resting heart rate). Quality assessments were conducted using the Cochrane Collaboration tool. Results: Twelve trials involving 819 patients met the criteria for analysis. The results showed that physical exercise improved the QoL by enhancing physical functioning [standardized mean difference (SMD) = 0.63, 95%CI: 0.18–1.09; p = 0.006], general health perceptions (SMD = 0.64, 95%CI: 0.35–0.93; p < 0.001) and vitality (SMD = 0.51, 95%CI: 0.31–0.71; p < 0.001); increased exercise ability by improving the 6MWT performance (SMD = 0.69, 95%CI: 0.19–1.119; p = 0.007); and enhanced peak VO2 (SMD = 0.37, 95%CI: 0.16–0.57; p < 0.001) while reducing resting heart rate (SMD = −0.39, 95%CI: −0.65 to −0.13; p = 0.004). In addition, meta-regression analysis showed that training mode (pphysicalfunctioning = 0.012, pgeneralhealthperceptions = 0.035) and training duration (p = 0.047) were the main factors of an intervention that influenced the effect size. Following sub-group analysis, we found that aerobics, Yoga and longer training durations (≥60 min) showed larger improvements. Conclusion: In summary, our meta-analysis shows that physical exercise has a positive effect on the QoL, exercise ability and cardiopulmonary fitness in AF patients. When physicians offer exercise recommendations to AF patients, they should consider both the training mode and training duration to achieve maximum results.
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Affiliation(s)
- Shuqing Shi
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Department of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jingjing Shi
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiulei Jia
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Department of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shuai Shi
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guozhen Yuan
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanhui Hu
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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22
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Abdelbasset WK, Osailan A. Sleep quality and ventilatory efficiency in elderly heart failure patients: a pilot study on the short-term effect of 4-week low-intensity aerobic exercise. ACTA ACUST UNITED AC 2020; 60:938. [PMID: 32720624 DOI: 10.18087/cardio.2020.6.n938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/07/2020] [Accepted: 03/19/2020] [Indexed: 11/18/2022]
Abstract
Background Sleep disturbance and ventilator inefficiency are considered two of the most critical complications for general human wellbeing, particularly in elderly heart failure (HF) patients. Studies examining the effect of low-intensity aerobic exercise in the treatment of sleep disturbance and ventilatory inefficiency in this population of patients are limited.Objective The purpose of the current pilot study was to check the effect of low-intensity aerobic exercise on the quality of sleep and ventilatory efficiency in elderly HF patients.Materials and methods Design: pilot study. SETTING outpatient physical therapy clinic within Cairo University regional hospital. PARTICIPANTS eight elderly HF patients (6 men, 2 women) with a mean age of 69.4±4.2 years. INTERVENTION participants were recruited for a low-intensity exercise program (40 to 50% of maximum heart rate for 30-40 minutes), five sessions weekly for four weeks. Exercise intensity was monitored during the sessions using heart rate. OUTCOME MEASURE sleep quality was assessed pre- and post- four weeks of exercise program usingthe Pittsburgh sleep quality index (PSQI) and ventilatory efficiency was assessed using cardiopulmonary exercise test.Results HF patients (II-III NYHA), mean age 69.4±4.2 years, body mass index 23.7±2.7 kg/m2, ejection fraction 32.7±4.5 %, VO2peak 16.27±4.2 ml/kg/min, VE/VCO2 30.81±12.7. The mean of global PSQI score ranged between 8.2 to 11.4 with a mean of 9.7±3.4 which indicates that the participants experienced sleep disturbance. The post-exercise assessment showed that patients have reported a significant improvement of all PSQI domains compared with baseline assessment (p<0.05). VO2peak significantly increased from 16.27±4.2 pre-intervention to 20.03±2.6 ml/kg/min post-intervention (p=0.049) whereas VE/VCO2 slightly decreased with a non-significant difference at the end of the study program (p=0.594) indicating animprovement of ventilator efficiencyand overall cardiorespiratory fitness.Conclusion Short-term application of low-intensity aerobic exercise (4 weeks) may improve the quality of sleep and ventilator efficiency in elderly HF patients. The study findings encourage elderly HF patients with sleep disturbance to adhere to the exercise training program. Also, cardiac rehabilitation programs with low intensity of aerobic exercise should be proposed to these patients by their health care provider.
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Affiliation(s)
- Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Ahmad Osailan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Cosiano MF, Jannat-Khah D, Lin FR, Goyal P, McKee M, Sterling MR. Hearing Loss and Physical Functioning Among Adults with Heart Failure: Data from NHANES. Clin Interv Aging 2020; 15:635-643. [PMID: 32440106 PMCID: PMC7211960 DOI: 10.2147/cia.s246662] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/09/2020] [Indexed: 01/14/2023] Open
Abstract
Background Hearing loss (HL) is associated with poor physical functioning among older adults, yet this association has not been examined in heart failure (HF), a disease in which both hearing loss and poor physical functioning are highly prevalent. We investigated whether this association exists in HF since HL represents a potentially modifiable risk factor for poor physical functioning. Methods We studied adults aged ≥70 years with self-reported HF in the National Health and Nutrition Examination Survey (NHANES). HL was assessed and categorized using pure-tone averages. Activities of daily living (ADLs), instrumental ADLs (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA) were assessed. Negative binomial regression was used to examine the association between HL and physical functioning Results One hundred eighty-one participants comprised our population. Those with ≥ moderate HL had more difficulty with ADLs (37.0% vs 24.0%, p=0.02), IADLs (36.0% vs 23.0%, p=0.05), and LEM (37.3% vs 20.0%, p=0.009), compared to participants with none or mild HL. In multivariable models, ≥ moderate HL was significantly associated with difficulty in physical functioning across four of the five domains: ADLs: PR: 1.71 (95% CI: 1.07-2.72); IADLs: PR: 1.71 (1.24-2.34); LEM: PR: 1.51 (1.01-2.26); and GPA: PR: 1.19 (1.00-1.41). Conclusion Among older adults with HF, moderate or greater HL was associated with a higher prevalence of difficulty with ADLs, IADLs, and LEM, compared to mild or no HL.
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Affiliation(s)
- Michael F Cosiano
- Weill Cornell Medical College, Weill Cornell Medicine, New York, NY, USA
| | | | - Frank R Lin
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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Shoemaker MJ, Dias KJ, Lefebvre KM, Heick JD, Collins SM. Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure. Phys Ther 2020; 100:14-43. [PMID: 31972027 DOI: 10.1093/ptj/pzz127] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/15/2019] [Accepted: 06/10/2019] [Indexed: 12/12/2022]
Abstract
The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, have commissioned the development of this clinical practice guideline to assist physical therapists in their clinical decision making when managing patients with heart failure. Physical therapists treat patients with varying degrees of impairments and limitations in activity and participation associated with heart failure pathology across the continuum of care. This document will guide physical therapist practice in the examination and treatment of patients with a known diagnosis of heart failure. The development of this clinical practice guideline followed a structured process and resulted in 9 key action statements to guide physical therapist practice. The level and quality of available evidence were graded based on specific criteria to determine the strength of each action statement. Clinical algorithms were developed to guide the physical therapist in appropriate clinical decision making. Physical therapists are encouraged to work collaboratively with other members of the health care team in implementing these action statements to improve the activity, participation, and quality of life in individuals with heart failure and reduce the incidence of heart failure-related re-admissions.
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Affiliation(s)
- Michael J Shoemaker
- Department of Physical Therapy, Grand Valley State University, 301 Michigan NE, Suite 200, Grand Rapids, MI 49503 (USA). Dr Shoemaker is a board-certified clinical specialist in geriatric physical therapy
| | - Konrad J Dias
- Physical Therapy Program, Maryville University of St Louis, St Louis, Missouri. Dr Dias is a board-certified clinical specialist in cardiovascular and pulmonary physical therapy
| | - Kristin M Lefebvre
- Department of Physical Therapy, Concordia University St Paul, St Paul, Minnesota. Dr Lefebvre is a board-certified clinical specialist in cardiovascular and pulmonary physical therapy
| | - John D Heick
- Department of Physical Therapy, Northern Arizona University, Flagstaff, Arizona. Dr Heick is a board-certified clinical specialist in orthopaedic physical therapy, neurologic physical therapy, and sports physical therapy
| | - Sean M Collins
- Physical Therapy Program, Plymouth State University, Plymouth, New Hampshire
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25
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Xing Y, Yang SD, Wang MM, Feng YS, Dong F, Zhang F. The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly. Front Physiol 2020; 11:270. [PMID: 32390856 PMCID: PMC7194188 DOI: 10.3389/fphys.2020.00270] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/09/2020] [Indexed: 12/11/2022] Open
Abstract
Worldwide, elderly people have a higher prevalence of myocardial infarction (MI), which is associated with body function aging and a sedentary lifestyle. In addition to medication, exercise training is a well-established supplementary method to prevent and treat cardiovascular diseases (CVDs). Substantial evidence has shown the value of different intensity exercise programs in the prevention and treatment of MI, and exercise rehabilitation programs are also applicable to elderly patients with MI. Although exercise rehabilitation programs could significantly improve function, quality of life (QoL), and lower mortality and morbidity for people with MI, such programs are underused because their mechanisms are not accurately elucidated. To promote the application of exercise therapy for MI, this review summarizes the benefits and mechanisms of exercise rehabilitation for post-MI patients and provides rationalized proposals for outpatient cardiac rehabilitation.
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Affiliation(s)
- Ying Xing
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Si-Dong Yang
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, Australia
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Man-Man Wang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ya-Shuo Feng
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fang Dong
- Department of Clinical Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Feng Zhang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Orthopedic Biomechanics Key Laboratory, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Feng Zhang,
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26
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Wang MH, Yeh ML. Respiratory training interventions improve health status of heart failure patients: A systematic review and network meta-analysis of randomized controlled trials. World J Clin Cases 2019; 7:2760-2775. [PMID: 31616691 PMCID: PMC6789387 DOI: 10.12998/wjcc.v7.i18.2760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/04/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Prior studies indicate that doing breathing exercises improves physical performance and quality of life (QoL) in heart failure patients. However, these effects remain unclear and contradictory.
AIM To determine the effects of machine-assisted and non-machine-assisted respiratory training on physical performance and QoL in heart failure patients.
METHODS This was a systematic review and network meta-analysis study. A literature search of electronic databases was conducted for randomized controlled trials (RCTs) on heart failure. Respiratory training interventions were grouped as seven categories: IMT_Pn (inspiratory muscle training without pressure or < 10% maximal inspiratory pressure, MIP), IMT_Pl (inspiratory muscle training with low pressure, 10%-15% MIP), IMT_Pm (inspiratory muscle training with medium pressure, 30%-40% MIP), IMT_Ph (inspiratory muscle training with high pressure, 60% MIP or MIP plus aerobics), Aerobics (aerobic exercise or weight training), Qi_Ex (tai chi, yoga, and breathing exercise), and none. The four outcomes were heart rate, peak oxygen uptake (VO2 peak), 6-min walking distance test (6MWT), and Minnesota Living with Heart Failure QoL. The random-effects model, side-splitting model, and the surface under the cumulative ranking curve (SUCRA) were used to test and analyze the data.
RESULTS A total of 1499 subjects from 31 RCT studies were included. IMT_Ph had the highest effect sizes for VO2 peak and 6MWT, IMT_Pm highest for QoL, and Qi_Ex highest for heart rate. Aerobics had the second highest for VO2 peak, Qi_Ex second highest for 6MWT, and IMT_Ph second highest for heart rate and QoL.
CONCLUSION This study supports that high- and medium-intensity machine-assisted training improves exercise capacity and QoL in hospital-based heart failure patients. After hospital discharge, non-machine-assisted training continuously improves cardiac function.
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Affiliation(s)
- Mei-Hua Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
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Steinberg BA, Piccini JP. Tackling Patient-Reported Outcomes in Atrial Fibrillation and Heart Failure: Identifying Disease-Specific Symptoms? Cardiol Clin 2019; 37:139-146. [PMID: 30926015 DOI: 10.1016/j.ccl.2019.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Atrial fibrillation (AF) and heart failure (HF) both significantly affect morbidity and mortality and also account for high symptom burden and impaired health-related quality of life (hrQoL). Several well-designed and broadly implemented patient-reported outcome instruments are available for both AF and HF and can easily measure hrQoL in each disease process. A better understanding of the diverse phenotypes of AF and HF, as well as the heterogeneous treatment effects of disease-specific interventions, is necessary to further disentangle the complex relationship between symptoms of AF and HF.
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Affiliation(s)
- Benjamin A Steinberg
- Division of Cardiovascular Medicine, University of Utah Health Sciences Center, 30 North 1900 East, Room 4A100, Salt Lake City, UT 84132, USA.
| | - Jonathan P Piccini
- Duke University Medical Center, Durham, NC, USA; Duke Center for Atrial Fibrillation, Duke University Medical Center, Duke Clinical Research Institute, DUMC #3115, Durham, NC 27705, USA
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Oldridge N, Pakosh M, Grace SL. A systematic review of recent cardiac rehabilitation meta-analyses in patients with coronary heart disease or heart failure. Future Cardiol 2019; 15:227-249. [PMID: 31161796 DOI: 10.2217/fca-2018-0085] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: The aim of the project was to conduct a systematic review of meta-analyses of supervised, home-based or telemedicine-based exercise cardiac rehabilitation (CR) published between July 2011 and April 2018. Materials & methods: Evidence on mortality, hospitalization, peak VO2, exercise capacity, muscle strength and health-related quality of life in patients with coronary heart disease or heart failure referred to CR was obtained by searching six electronic databases. Results: Of the 127 point estimates identified in the 30 CR meta-analyses identified (mortality, n = 12; hospitalization, n = 11; VO2, n = 40; exercise capacity, n = 20; strength, n = 18; health-related quality of life, n = 26), 60% were statistically significant and 35% clinically important. Conclusion: The statistical data are sufficiently robust to promote strategies to improve referral to and participation in CR although evidence for clinical importance needs to be further investigated.
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Affiliation(s)
- Neil Oldridge
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Maureen Pakosh
- University Health Network, Toronto Rehabilitation - Rumsey Cardiac Centre Library, Toronto, ON, Canada
| | - Sherry L Grace
- School of Kinesiology & Health Science, York University, & University Health Network Toronto, ON, Canada
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29
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Falz R, Fikenzer S, Holzer R, Laufs U, Fikenzer K, Busse M. Acute cardiopulmonary responses to strength training, high-intensity interval training and moderate-intensity continuous training. Eur J Appl Physiol 2019; 119:1513-1523. [PMID: 30963239 DOI: 10.1007/s00421-019-04138-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/03/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Long-term effects of exercise training are well studied. Acute hemodynamic responses to various training modalities, in particularly strength training (ST), have only been described in a few studies. This study examines the acute responses to ST, high-intensity interval training (HIIT) and moderate-intensity continuous training (MCT). METHODS Twelve young male subjects (age 23.4 ± 2.6 years; BMI 23.7 ± 1.5 kg/m2) performed an incremental exertion test and were randomized into HIIT (4 × 4-min intervals), MCT (continuous cycling) and ST (five body-weight exercises) which were matched for training duration. The cardiopulmonary (impedance cardiography, ergo-spirometry) and metabolic response were monitored. RESULTS Similar peak blood lactate responses were observed after HIIT and ST (8.5 ± 2.6 and 8.1 ± 1.2 mmol/l, respectively; p = 0.83). The training impact time was 90.7 ± 8.5% for HIIT and 68.2 ± 8.5% for MCT (p < 0.0001). The mean cardiac output was significantly higher for HIIT compared to that of MCT and ST (23.2 ± 4.1 vs. 20.9 ± 2.9 vs. 12.9 ± 2.9 l/min, respectively; p < 0.0001). VO2max was twofold higher during HIIT compared to that observed during ST (2529 ± 310 vs. 1290 ± 156 ml; p = 0.0004). Among the components of ST, squats compared with push-ups resulted in different heart rate (111 ± 13.5 vs. 125 ± 15.7 bpm, respectively; p < 0.05) and stroke volume (125 ± 23.3 vs. 104 ± 19.8 ml, respectively; p < 0.05). CONCLUSIONS Despite an equal training duration and a similar acute metabolic response, large differences with regard to the training impact time and the cardiopulmonary response give evident. HIIT and MCT, but less ST, induced a sufficient cardiopulmonary response, which is important for the preventive effects of training; however, large differences in intensity were apparent for ST.
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Affiliation(s)
- Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - Sven Fikenzer
- Medical Department IV-Cardiology, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany
| | - Roman Holzer
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Ulrich Laufs
- Medical Department IV-Cardiology, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany
| | - Kati Fikenzer
- Medical Department IV-Cardiology, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
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Cacciata M, Stromberg A, Lee JA, Sorkin D, Lombardo D, Clancy S, Nyamathi A, Evangelista LS. Effect of exergaming on health-related quality of life in older adults: A systematic review. Int J Nurs Stud 2019; 93:30-40. [PMID: 30861452 DOI: 10.1016/j.ijnurstu.2019.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Exercise through video or virtual reality games (i.e. exergames) has grown in popularity among older adults; however, there is limited evidence on efficacy of exergaming on well-being related to health in this population. This systematic review examined the effectiveness of exergaming on health-related quality of life in older adults. METHODS PRISMA guidelines for this systematic review. Several databases were searched using keywords to identify peer-reviewed journal articles in English. Randomized control trials that evaluated the effect of exergaming on health-related quality of life in older adults when compared to a control group and published between January 2007 to May 2017 were included. RESULTS Nine articles that in total included 614 older adults with varying levels of disability, mean age 73.6 + 7.9 years old, and 67% female were analyzed. Significant improvements in health-related quality of life of older adults engaged in exergaming were reported in three studies. Sample sizes were small in 7 of the studies (N < 60). The study participants, exergaming platforms, health-related quality of life instruments, study settings and length, duration and frequency of exergaming varied across studies. CONCLUSION Exergaming is a new emerging form of exercise that is popular among older adults. However, findings from this analysis were not strong enough to warrant recommendation due to the small sample sizes and heterogeneity in the study participants, exergaming platforms, health-related quality of life instruments, length, duration and frequency of the intervention and study settings. Further research is needed with larger sample sizes and less heterogeneity to adequately explore the true effects of exergaming on health-related quality of life of older adults.
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Affiliation(s)
- Marysol Cacciata
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA.
| | - Anna Stromberg
- Department of Medical and Health Services, Linkoping University, Sweden
| | - Jung-Ah Lee
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA
| | - Dara Sorkin
- Division of General Internal Medicine, University of California, Irvine, USA
| | - Dawn Lombardo
- Heart Failure Program, University of California Irvine Health, USA
| | - Steve Clancy
- Health Sciences and Nursing Science, University of California, Irvine, USA
| | - Adeline Nyamathi
- Sue and Bill Gross School of Nursing, University of California, Irvine, CA, 92697, USA
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Slimani M, Ramirez-Campillo R, Paravlic A, Hayes LD, Bragazzi NL, Sellami M. The Effects of Physical Training on Quality of Life, Aerobic Capacity, and Cardiac Function in Older Patients With Heart Failure: A Meta-Analysis. Front Physiol 2018; 9:1564. [PMID: 30483145 PMCID: PMC6241114 DOI: 10.3389/fphys.2018.01564] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/18/2018] [Indexed: 01/08/2023] Open
Abstract
Aim: The purposes of this meta-analysis were to quantify the effectiveness of physical training on quality of life (QoL), aerobic capacity, and cardiac functioning in older patients with heart failure (HF) and evaluate dose-response relationships of training variables (frequency, volume, and duration). Methods: Scholarly databases (e.g., PubMed/MEDLINE, Google Scholar, and Scopus) were searched, identifying randomized controlled trials that investigated the effectiveness of different training modes on QoL (assessed by the Minnesota Living with Heart Failure Questionnaire), aerobic capacity (assessed by the 6 min walk test) and cardiac function (assessed by left ventricular ejection fraction). Results: Twenty five studies were included with a total of 2,409 patients. Results showed that exercise training improved total QoL (small ES = -0.69; 95% CI -1.00 to 0.38; p < 0.001), aerobic capacity (small ES = 0.47; 95% CI 0.15-0.71; p = 0.002) and cardiac function (moderate ES = 0.91; 95% CI 0.37-1.45; p = 0.001). In addition, univariate analyses revealed the moderating variable 'training mode' significantly influenced aerobic capacity (Q = 9.97; p = 0.007), whereby, resistance training had the greatest effect (ES = 1.71; 95% CI 1.03-2.39; p < 0.001), followed by aerobic training (ES = 0.51; 95% CI 0.30-0.72; p < 0.001), and combined training (ES = 0.15; 95% CI -0.24 to 0.53; p = 0.45). Meta-regression analysis showed that only the duration of an intervention predicted the effect of physical training on QoL (coefficient = -0.027; p = 0.006), with shorter training durations (12 weeks) showing larger improvements. Conclusion: The present meta-analysis showed that physical training has positive effects on QoL, aerobic capacity, and cardiac function in older patients with HF. Practitioners should consider both training volume and mode when designing physical training programs in order to improve QoL and aerobic capacity in older patients with HF.
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Affiliation(s)
- Maamer Slimani
- Department of Health Sciences (DISSAL), School of Public Health, Genoa University, Genoa, Italy
| | - Rodrigo Ramirez-Campillo
- Laboratory of Human Performance, Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos, Osorno, Chile
| | - Armin Paravlic
- Science and Research Centre, Institute for Kinesiology Research, Garibaldijeva, Koper, Slovenia
| | - Lawrence D. Hayes
- Active Ageing Research Group, University of Cumbria, Lancaster, United Kingdom
| | - Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), School of Public Health, Genoa University, Genoa, Italy
| | - Maha Sellami
- Sport Science Program, College of Arts and Sciences (QU-CAS), University of Qatar, Doha, Qatar
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Baird SO, Metts C, Conroy HE, Rosenfield D, Smits JA. Physical Activity and Community Engagement (PACE) to facilitate community reintegration among returning veterans: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2018; 11:136-141. [PMID: 30094389 PMCID: PMC6072908 DOI: 10.1016/j.conctc.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/08/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
There is a surprising lack of disseminable, community-based interventions for veterans experiencing difficulties during the reintegration process from military to civilian life. Physical Activity and Community Engagement (PACE) is a program which combines routine vigorous-intensity exercise with community engagement. The program builds on emergent evidence supporting the benefits of routine vigorous-intensity exercise among and establishing social connection. Using a randomized controlled trial (N = 60), we will obtain feasibility data and initial effect sizes for the early effects of PACE on reintegration difficulties.
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Affiliation(s)
- Scarlett O. Baird
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
- Corresponding author. Department of Psychology, University of Texas at Austin, 305 E. 23rd Street, Austin, TX, 78712, USA.
| | - Christopher Metts
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Haley E. Conroy
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Jasper A.J. Smits
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
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Dose-Response Relationship Between Exercise Intensity, Mood States, and Quality of Life in Patients With Heart Failure. J Cardiovasc Nurs 2018; 32:530-537. [PMID: 28353541 DOI: 10.1097/jcn.0000000000000407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND We conducted a secondary analysis to (1) compare changes in mood disorders and quality of life (QOL) among 4 groups of patients with heart failure in a home-based exercise program who had varying degrees of change in their exercise capacity and (2) determine whether there was an association between exercise capacity, mood disorders, and QOL. METHODS Seventy-one patients were divided into 4 groups based on changes in exercise capacity from baseline to 6 months: group 1showed improvements of greater than 10% (n = 19), group 2 showed improvements of 10% or less (n = 16), group 3 showed reductions of 10% or less (n = 9), and group 4 showed reductions of greater than 10% (n = 27). RESULTS Over time, patients in all 4 groups demonstrated significantly lower levels of depression and hostility (P < .001) and higher levels of physical and overall quality of life (P = .046). Group differences over time were noted in anxiety (P = .009), depression (P = .015), physical quality of life (P < .001), and overall quality of life (P = .002). Greater improvement in exercise capacity was strongly associated with lower depression scores (r = -0.49, P = .01). CONCLUSIONS An improvement in exercise capacity with exercise training was associated with a decrease in depression and anxiety and an increase in QOL in patients with heart failure.
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Abstract
Research has demonstrated that the high capacity requirements of the heart are satisfied by a preference for oxidation of fatty acids. However, it is well known that a stressed heart, as in pathological hypertrophy, deviates from its inherent profile and relies heavily on glucose metabolism, primarily achieved by an acceleration in glycolysis. Moreover, it has been suggested that the chronically lipid overloaded heart augments fatty acid oxidation and triglyceride synthesis to an even greater degree and, thus, develops a lipotoxic phenotype. In comparison, classic studies in exercise physiology have provided a basis for the acute metabolic changes that occur during physical activity. During an acute bout of exercise, whole body glucose metabolism increases proportionately to intensity while fatty acid metabolism gradually increases throughout the duration of activity, particularly during moderate intensity. However, the studies in chronic exercise training are primarily limited to metabolic adaptations in skeletal muscle or to the mechanisms that govern physiological signaling pathways in the heart. Therefore, the purpose of this review is to discuss the precise changes that chronic exercise training elicits on cardiac metabolism, particularly on substrate utilization. Although conflicting data exists, a pattern of enhanced fatty oxidation and normalization of glycolysis emerges, which may be a therapeutic strategy to prevent or regress the metabolic phenotype of the hypertrophied heart. This review also expands on the metabolic adaptations that chronic exercise training elicits in amino acid and ketone body metabolism, which have become of increased interest recently. Lastly, challenges with exercise training studies, which could relate to several variables including model, training modality, and metabolic parameter assessed, are examined.
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Affiliation(s)
- Stephen C. Kolwicz Jr.
- Heart and Muscle Metabolism Laboratory, Health and Exercise Physiology Department, Ursinus College, Collegeville, PA, United States
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Leggio M, Fusco A, Armeni M, D'Emidio S, Severi P, Calvaruso S, Limongelli G, Sgorbini L, Bendini MG, Mazza A. Pulmonary hypertension and exercise training: a synopsis on the more recent evidences. Ann Med 2018; 50:226-233. [PMID: 29363985 DOI: 10.1080/07853890.2018.1432887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 10/18/2022] Open
Abstract
The benefits of exercise training in virtually all humans, including those with a clinically stable chronic disease are numerous. The potential value lies in the fact that functional capacity is oftentimes significantly compromised. Exercise training not only play a role in reversing some of the pathophysiologic processes associated with chronic diseases but also improves clinical trajectory. Given the significant pathologic consequences associated with pulmonary hypertension and its implications for deteriorating right ventricular function as well as the perceived potential for a precipitous and possibly critical drop in cardiac output during periods of physical exertion, exercise training was historically not recommended for these patients. More recently, a promising body of literature demonstrating the safety and efficacy of exercise training (with benefit on exercise capacity, peak oxygen consumption and quality of life) in pulmonary hypertension patients has emerged, but the conclusion about the effects of exercise training were non-exhaustive and therefore there is still a lack of knowledge regarding exercise training for these patients. Thus, we aim to ascertain the current effectiveness of exercise rehabilitation for pulmonary hypertension by performing a brief overview on the latest currently available evidences in such an "at a glance" synopsis addressed to summarize/quantify the more recent existing body of literature. KEY MESSAGES Exercise training was historically not recommended in pulmonary hypertension. Recently, exercise training safety-efficacy in pulmonary hypertension has emerged. Exercise training should be recommended in addition to optimal medical therapy.
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Affiliation(s)
- Massimo Leggio
- a Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit , San Filippo Neri Hospital - Salus Infirmorum Clinic , Rome , Italy
| | - Augusto Fusco
- b Physical Medicine and Neurorehabilitation Operative Unit , Salus Infirmorum Clinic , Rome , Italy
| | - Massimo Armeni
- c Department of Research , EDUCAM (C.R.O.M.O.N., S.Os.I., A.I.R.O.P.) , Rome , Italy
| | - Stefania D'Emidio
- b Physical Medicine and Neurorehabilitation Operative Unit , Salus Infirmorum Clinic , Rome , Italy
| | - Paolo Severi
- a Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit , San Filippo Neri Hospital - Salus Infirmorum Clinic , Rome , Italy
- b Physical Medicine and Neurorehabilitation Operative Unit , Salus Infirmorum Clinic , Rome , Italy
| | | | - Giorgio Limongelli
- e Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit , Santo Spirito Hospital - Villa Betania Clinic , Rome , Italy
| | - Luca Sgorbini
- e Department of Medicine and Rehabilitation, Cardiac Rehabilitation Operative Unit , Santo Spirito Hospital - Villa Betania Clinic , Rome , Italy
| | | | - Andrea Mazza
- f Cardiology Division , Santa Maria della Stella Hospital , Orvieto , Italy
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Rodrigues B, Feriani DJ, Gambassi BB, Irigoyen MC, Angelis KD, Hélio José Júnior C. Exercise training on cardiovascular diseases: Role of animal models in the elucidation of the mechanisms. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700si0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Ding S, Gan T, Song M, Dai Q, Huang H, Xu Y, Zhong C. C/EBPB-CITED4 in Exercised Heart. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1000:247-259. [PMID: 29098625 DOI: 10.1007/978-981-10-4304-8_14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
C/EBPB is a crucial transcription factor, participating in a variety of biological processes including cell proliferation, differentiation and development. In the cardiovascular system, C/EBPB-CITED4 signaling is known as a signaling pathway mediating exercise-induced cardiac growth. After its exact role in exercised heart firstly reported in 2010, more and more evidence confirmed that. MicroRNA (e.g. miR-222) and many molecules (e.g. Alpha-lipoic acid) can regulate this pathway and then involve in the cardiac protection effect induced by endurance exercise training. In addition, in cardiac growth during pregnancy, C/EBPB is also a required regulator. This chapter will give an introduction of the C/EBPB-CITED4 signaling and the regulatory network based on this signaling pathway in exercised heart.
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Affiliation(s)
- Shengguang Ding
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Tianyi Gan
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Meiyi Song
- Division of Gastroenterology and Hepatology, Digestive Disease Institute, Shanghai Tongji Hospital, Tongji University School of Medicine, 389 Xin Cun Road, Shanghai, 200065, China
| | - Qiying Dai
- Metrowest Medical Center, Framingham, 01702, MA, USA.,Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Haitao Huang
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yiming Xu
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Chongjun Zhong
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, 226001, China.
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