scholarly journals The Effect of Home-Based Cardiac Rehabilitation on Functional Capacity, Behavior, and Risk Factors in Patients with Acute Coronary Syndrome in China

2017 ◽  
Vol 2 (2) ◽  
pp. 253-264 ◽  
Author(s):  
Rongjing Ding ◽  
Jianchao Li ◽  
Limin Gao ◽  
Liang Zhu ◽  
Wenli Xie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Coronary Syndrome ◽  
Home Based

Cardiac Rehabilitation after an Acute Coronary Syndrome: The Impact in Elderly Patients

Cardiology ◽  
2015 ◽  
Vol 131 (3) ◽  
pp. 177-185 ◽  
Author(s):  
Patrícia Rodrigues ◽  
Mário Santos ◽  
Maria João Sousa ◽  
Bruno Brochado ◽  
Diana Anjo ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Heart Rate Recovery ◽  
Real Life ◽  
The Elderly ◽  
Chronotropic Response ◽  
Coronary Syndrome ◽  
Supervised Exercise ◽  
The Impact

Introduction: Cardiac rehabilitation (CR) has been shown to decrease mortality and morbidity, improve the control of risk factors and the quality of life of patients with coronary artery disease. However, the elderly are underrepresented in most studies and in real-life CR programs. Our goal was to evaluate the impact of CR after an acute coronary syndrome in the elderly population. Methods: A cutoff of 65 years was used to dichotomize age. Our main focus was on the effects of ambulatory supervised exercise training on several surrogate markers, namely total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, body mass index, fasting glucose, glycated hemoglobin, probrain natriuretic peptide, International Physical Activity Questionnaire score, maximal exercise capacity, chronotropic response index and heart rate recovery. We evaluated those variables at the beginning and at the end of phase II of the CR program (after 3 months) and repeated the treadmill test at 12 months. Results: A total of 548 patients with a recent acute coronary syndrome were enrolled; 37% were 65 years old or older. Both age groups had a statistically significant improvement in all the evaluated parameters. Interestingly, at 12 months both groups maintained the improvement in functional capacity seen immediately after 3 months. Conclusions: The benefits of CR in terms of functional capacity, metabolic profile and other prognostic parameters were significant in both younger and older patients. Therefore, all eligible patients should be referred to CR programs, irrespective of age.

Abstract 16831: Effect of a Virtual Cardiac Rehabilitation Program on Functional Capacity and Risk Factor Modification in Veterans With Ischemic Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arash Harzand ◽  
Alexander A Vakili ◽  
Michelle Davis-Watts ◽  
Rene Nazar ◽  
Phyllis Wright ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Ischemic Heart ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Home Based

Background: Cardiac rehabilitation (CR) is a comprehensive lifestyle change program proven to reduce cardiovascular disease (CVD) risk and improve quality of life in patients with ischemic heart disease but remains highly underutilized (<20% of eligible patients) due to the inconvenience and cost of attending a facility-based program. We evaluated the efficacy of a home-based, virtual CR program using mobile health (mHealth) in veterans with coronary artery disease (CAD) on improving functional capacity, CVD risk factors, and depressive symptoms. Methods: We enrolled 196 Veterans with a qualifying CR diagnosis between May 2016 and April 2020. All participants underwent baseline functional evaluation with a 6-minute walk test (6MWT), followed by a 12-week home-based, virtual CR program delivered via the Movn smartphone app (Movn by Moving Analytics). The Movn app featured daily alerts to exercise, a digital diary to record activity and vital signs, and connectivity with a health coach who remotely monitored participants through an integrated dashboard and scheduled weekly phone visits. We compared the risk factor profile pre-intervention versus post-intervention with paired t-tests. Results: Among enrolled Veterans, the mean (SD) age was 61 (9) years, 95% were male, and 50% were black. A majority (63%) completed the full 12-week virtual CR program including an exit visit. Participants completed an average of 10.4 ± 1.9 (range 3–13) phone visits with the coach. There were concurrent improvements in 6MWT distance (443.9 vs. 481.9 meters; mean difference [MD], 38 meters; 95% CI, 26.6 – 50.8, P<0.001), low-density lipoprotein cholesterol (80 vs. 69 mg/dL, MD, -10.9; 95% CI, -17.9 to -3.9, P=0.003), body mass index (31.1 vs 30.8; MD, -0.33; 95% CI, -0.60 to -0.06; P=0.001), and PHQ-9 depression scores (7.4 vs. 6; MD, -1.4, 95% CI, -2.4 to -0.44; P=0.005) among program completers. Conclusions: Among veterans with ischemic heart disease, a virtual CR program results in moderate improvements in functional capacity, CVD risk factors, and mood. The durability of these effects and whether virtual CR improves longer-term outcomes such as readmissions, survival, and cost remain to be determined.

scholarly journals Third phase of cardiac rehabilitation after acute coronary syndrome: prevalence of diabetes and its risk factors

2021 ◽  
Vol 5 (4) ◽  
pp. 176-184
Author(s):  
I.V. Druk ◽  
◽  
O.Yu. Korennova ◽  
M.V. Savchenko ◽  
L.V. Shukil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Blood Glucose ◽  
Cardiac Rehabilitation ◽  
De Novo ◽  
Shape Index ◽  
Coronary Syndrome ◽  
Third Phase ◽  
A Body Shape Index

Aim: to determine risk factors for type 2 diabetes (T2D) in patients with the prior acute coronary syndrome (ACS) in the 3rd phase of cardiac rehabilitation. Patients and Methods: retrospective analysis of medical records of 200 patients (151 men, 75.5%) was performed. The mean age was 61.7±9.6 years. All patients attended a 12-month cardiac rehab program that included adequate pharmacotherapy (atorvastatin monotherapy or atorvastatin plus ezetimibe), physical and psychological rehabilitation, therapeutic feeding, and preventive group consultations (health schools). Both quantitative (fasting blood glucose, weight, body mass index, waist circumference, hip circumference, a body shape index) and qualitative (overweight, obesity, other risk factors for T2D, diabetes, de novo diabetes) parameters were studied. Results: in patients with prior ACS, a high prevalence of conventional and additional risk factors for T2D (≥ 6 risk factors were revealed in 90% of patients) was reported in the 3rd phase of cardiac rehab. After completing the cardiac rehab program, the prevalence of T2D in patients with prior ACS was 24% thereby demonstrating a significant increase (p < 0.05). Additionally, a significant increase in the proportion of patients with high normal blood glucose (5.0–6.0 mmol/l) was reported. Unfavorable de novo abnormalities of carbohydrate metabolism (pre-diabetes, T2D plus pre-diabetes) were commonly revealed in patients with high normal blood glucose. Cardiac rehab program provided weight control in patients with T2D risk. A significant increase in waist circumference, a body shape index, the waist-to-height ratio was reported thus demonstrating redistribution of fat mass and an increase in visceral fat. These signs may indicate an unfavorable trend of increased insulin resistance. Conclusions: searching for risk factors of unfavorable metabolic abnormalities identified and means to optimize management of these patients (including medical treatment) based on the assessment of metabolic benefits and drawbacks is required. KEYWORDS: acute coronary syndrome, cardiac rehabilitation, type 2 diabetes, pre-diabetes, insulin resistance, risk factors, statins. FOR CITATION: Druk I.V., Korennova O.Yu., Savchenko M.V. et al. Third phase of cardiac rehabilitation after acute coronary syndrome: prevalence of diabetes and its risk factors. Russian Medical Inquiry. 2021;5(4):176–184 (in Russ.). DOI: 10.32364/2587-6821-2021- 5-4-176-184.

scholarly journals Cardiac Rehabilitation and Complementary Physical Training in Elderly Patients after Acute Coronary Syndrome: A Pilot Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 529
Author(s):  
Aurelija Beigienė ◽  
Daiva Petruševičienė ◽  
Vitalija Barasaitė ◽  
Raimondas Kubilius ◽  
Jūratė Macijauskienė
Keyword(s):  
Acute Coronary Syndrome ◽  
Muscle Strength ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Functional Capacity ◽  
Training Programs ◽  
Balance Training ◽  
Coronary Syndrome ◽  
Minute Walk

Background and Objectives: Nearly 23% of elderly patients hospitalized due to acute coronary syndrome have reduced muscle strength. It is assumed that these patients would better benefit from a complex training—a combination of endurance, strength, balance, coordination, and flexibility—in order to reduce the loss of muscle strength and mass and improve functional capacity. The aim of this study was to assess the effectiveness and safety of two different complementary resistance and balance training programs during short-term cardiac rehabilitation (CR) in elderly patients after a percutaneous or surgical intervention due to acute coronary syndrome. Materials and Methods: This randomized controlled trial was conducted from January 2020 to February 2021 in one Lithuanian rehabilitation hospital. A total of 63 participants who met the inclusion criteria were randomly assigned to three groups (at the ratio of 1:1:1): control (CG, n = 19), intervention 1 (IG-1, n = 26), and intervention 2 (IG-2, n = 18). All the patients attended a usual inpatient CR program of a mean duration of 18.7 ± 1.7 days, while the patients assigned to the intervention groups (IG-1 and IG-2) additionally received different resistance and balance training programs three days a week. Functional capacity, with 6-minute walk test (6MWT) and cardiopulmonary exercise testing (CPET), as well as physical performance, with the short physical performance battery (SPPB) test and one repetition maximum test (1RM) for leg press, were assessed at baseline and after CR. Results: The mean age of the participants was 72.9 ± 5.5 years; 73% were men. All parameters of functional capacity and physical performance improved significantly after CR (p < 0.05), except for peak VO2 that improved only in the IG-1. Comparison of CR effectiveness among the groups revealed no significant differences. Conclusions: All three rehabilitation programs were safe and well tolerated by elderly patients aged ≥65 years as well as improved functional capacity (6-minute walk distance and peak workload) and physical performance (SPPB and 1RM). Complementary resistance and balance training with traditional physical therapy means and exercises with mechanical devices did not show greater benefits for the results of physical performance compared with the usual CR program.

Sign in / Sign up

Export Citation Format

Share Document