PURPOSE OF REVIEW: A critical evaluation of contemporary literature regarding the role of big data, artificial intelligence, and digital technologies in precision cardio-oncology care and survivorship, emphasizing innovative and groundbreaking endeavors. RECENT FINDINGS: Artificial intelligence (AI) algorithm models can automate the risk assessment process and augment current subjective clinical decision tools. AI, particularly machine learning (ML), can identify medically significant patterns in large data sets. Machine learning in cardio-oncology care has great potential in screening, diagnosis, monitoring, and managing cancer therapy-related cardiovascular complications. To this end, large-scale imaging data and clinical information are being leveraged in training efficient AI algorithms that may lead to effective clinical tools for caring for this vulnerable population. Telemedicine may benefit cardio-oncology patients by enhancing healthcare delivery through lowering costs, improving quality, and personalizing care. Similarly, the utilization of wearable biosensors and mobile health technology for remote monitoring holds the potential to improve cardio-oncology outcomes through early intervention and deeper clinical insight. Investigations are ongoing regarding the application of digital health tools such as telemedicine and remote monitoring devices in enhancing the functional status and recovery of cancer patients, particularly those with limited access to centralized services, by increasing physical activity levels and providing access to rehabilitation services. SUMMARY: In recent years, advances in cancer survival have increased the prevalence of patients experiencing cancer therapy-related cardiovascular complications. Traditional cardio-oncology risk categorization largely relies on basic clinical features and physician assessment, necessitating advancements in machine learning to create objective prediction models using diverse data sources. Healthcare disparities may be perpetuated through AI algorithms in digital health technologies. In turn, this may have a detrimental effect on minority populations by limiting resource allocation. Several AI-powered innovative health tools could be leveraged to bridge the digital divide and improve access to equitable care.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Limited empirical evidence is available regarding the effect of technology-assisted cardiac rehabilitation (TACR) among coronary heart disease (CHD) patients with central obesity. AIM: To determine the effects of 12-week TACR on health outcomes of patients with CHD. DESIGN: Two-arm randomized controlled trial. SETTING: Cardiovascular department of a regional hospital. POPULATION: Coronary heart disease patients with central obesity. METHODS: The study randomized 78 hospitalized CHD patients to receive either the 12-week TACR intervention or usual care. Guided by social cognitive theory, the intervention began with an in-person assessment and orientation session to assess and identify individual risks and familiarize with the e-platform/device before discharge. After discharge, patients were encouraged to visit the interactive CR website for knowledge and skills acquisition, data uploading, use the pedometer for daily step tracking, and interact with peers and professionals via social media for problem-solving and mutual support. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). RESULTS: Participants in the intervention group showed significant improvement in daily steps at six weeks but not 12 weeks (T1: β=2713.48, P=0.03; T2:β=2450.70, P=0.08), weekly sitting minutes (T1: β=-665.17, P=0.002; T2: β=-722.29, P=0.02), and total (vigorous, moderate, and walking) exercise at 12-week (β=-2445.99, P=0.008). Improvement in health-promoting lifestyle profile (T1: β=24.9, P<0.001; T2: β=15.50, P<0.001), smoking cessation (T2: β=-2.28, P<0.04), self-efficacy (T2: β=0.63, P=0.02), body mass index (T1:β =-0.97, P=0.03; T2: β=-0.73, P=0.04) and waist circumferences (T1: β =-1.97, P=0.003; T2: β =-3.14, P=0.002) were identified. CONCLUSIONS: Results indicated the effectiveness of the TACR intervention in improving healthy behaviors and anthropometric parameters for CHD patients with central obesity. Individual assessment, collaborative action planning, and ongoing obesity management support should be highlighted in TACR programs for CHD patients. CLINICAL REHABILITATION IMPACT: Central obesity should be assessed and highlighted in TACR intervention as an independent risk factor that requires corresponding behavior change and body fat management.
AIMS: Tailored education is recommended for cardiac patients, yet little is known about information needs in areas of the world where it is most needed. This study aims to assess (i) the measurement properties of the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale and (ii) patient's information needs globally. METHODS AND RESULTS: In this cross-sectional study, English, simplified Chinese, Portuguese, or Korean versions of the INCR-S were administered to in- or out-patients via Qualtrics (January 2022-November 2023). Members of the International Council of Cardiovascular Prevention and Rehabilitation community facilitated recruitment. Importance and knowledge sufficiency of 36 items were rated. Links to evidence-based lay education were provided where warranted. A total of 1601 patients from 19 middle- and high-income countries across the world participated. Structural validity was supported upon factor analysis, with five subscales extracted: symptom response/medication, heart diseases/diagnostic tests/treatments, exercise and return-to-life roles/programmes to support, risk factors, and healthy eating/psychosocial management. Cronbach's alpha was 0.97. Construct validity was supported through significantly higher knowledge sufficiency ratings for all items and information importance ratings for all subscales in cardiac rehabilitation (CR) enrolees vs. non-enrolees (all P < 0.001). All items were rated as very important-particularly regarding cardiac events, nutrition, exercise benefits, medications, symptom response, risk factor control, and CR-but more so in high-income countries in the Americas and Western Pacific. Knowledge sufficiency ranged from 30.0 to 67.4%, varying by region and income class. Ratings were highest for medications and lowest for support groups, resistance training, and alternative medicine. CONCLUSION: Identification of information needs using the valid and reliable INCR-S can inform educational approaches to optimize patients' health outcomes across the globe.
- MeSH
- dospělí MeSH
- kardiovaskulární rehabilitace * normy metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci srdce rehabilitace diagnóza psychologie MeSH
- odhad potřeb * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- psychometrie * MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- vzdělávání pacientů jako téma * MeSH
- zdraví - znalosti, postoje, praxe * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- validační studie MeSH
BACKGROUND: Telerehabilitation is a practical option for individuals with multiple sclerosis (MS) to engage in sustained physical activity without -visiting a rehabilitation facility. The aim of this systematic review was to evaluate the feasibility, effectiveness, safety, and adherence of exercise-based telerehabilitation as compared with usual care for MS patients. METHODS: A comprehensive literature search adhering to PRISMA guidelines was conducted, focusing on studies published in English since 2000. The systematic review protocol was registered in PROSPERO. The selection process involved strict criteria, including studies focusing on people with MS, telerehabilitation centred on regular exercise, a control group receiving usual care, valid exercise testing, and adherence to randomized controlled trial principles. Methodological quality was assessed using the TESTEX tool, ensuring rigour in study design and reporting. RESULTS: Among the 281 records screened, 10 studies met the criteria. Telerehabilitation interventions varied in format and outcomes were assessed using diverse exercise tests and questionnaires. Despite variations, the studies collectively demonstrated promising feasibility and safety, with minimal withdrawals and minor adverse events. Effectiveness varied, with 5 out of 10 studies showing significant improvements in the intervention group. Adherence rates ranged from 38% to 100%. CONCLUSION: In most of the assessed aspects, telerehabilitation is comparable to regular centre-based rehabilitation.
- MeSH
- adherence pacienta MeSH
- cvičení * MeSH
- lidé MeSH
- roztroušená skleróza * rehabilitace MeSH
- telerehabilitace * MeSH
- terapie cvičením * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
BACKGROUND: Evidence-based nursing practice (EBNP) has been regarded core competencies in nursing practice and education. Defining evidence-based nursing practice and translating evidence into nursing practice by nursing students who are green to clinical practice in their education journey remain unclear. AIM: To explore how pre-registered nursing students define and characterize evidence-based nursing practice as they participate in their clinical practicum. DESIGN: This study used an interpretive phenomenological qualitative study design. SETTINGS AND PARTICIPANTS: Twenty nursing students were interviewed for their clinical practicum experience from four universities, one nursing college and one hospital-based nursing school in Hong Kong. METHODS: Data was generated through semi-structured in-depth interview and analyzed following interpretative phenomenological analysis guidelines, using a cyclical coding process. RESULTS: Four themes emerged regarding nursing students' definition of EBNP, highlighting that EBNP is 'identifying a reliable learning source', by which they can 'rationalize their nursing practice', and enabling them to 'establish care standard through critical thinking', and eventual 'fostering their professionalism' to improve health outcomes and reduce potential harms. CONCLUSION: Nursing students defined and characterized evidence-based nursing practice as core competencies in accompany their practicum that enables them to learn and grow professionally with a universal desire to be qualified, cope with doubt, and improve patient outcome. They recognized the challenges in identifying evidence and emphasized conservative approach to validate the evidence to avoid patient harm. Students expressed doubt towards their instructors EBNP when observing procedures untaught at school, which requires the curriculum model to foster students' skills in applying and appraising evidence and instructors' capacity to rationalize and role model EBNP.
- MeSH
- dospělí MeSH
- klinické kompetence * normy MeSH
- kvalitativní výzkum * MeSH
- lidé MeSH
- ošetřovatelství založené na důkazech * MeSH
- rozhovory jako téma metody MeSH
- studenti ošetřovatelství * psychologie MeSH
- studium ošetřovatelství bakalářské * normy metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Hongkong MeSH
BACKGROUND: Cardiac rehabilitation is a beneficial multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to substantial disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person cardiac rehabilitation, however, older adults are under-reported with effectiveness, feasibility, and usability remains unclear. METHODS: The study randomized 43 older adults (84 % males) to the 12-week CTR intervention or standard of care. Guided by Social Cognitive Theory, participants received individualized in-person assessment and e-coaching sessions, followed by CTR usage at home. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). RESULTS: Participants in the CTR intervention group showed significant improvement in daily steps (T1: β = 4126.58, p = 0.001; T2: β = 5285, p = 0.01) and health-promoting lifestyle profile (T1: β = 23.26, p < 0.001; T2: β = 12.18, p = 0.008) across study endpoints. Twenty participants completed the intervention, with 40 % used the website for data-uploading or experiential learning, 90 % used the pedometer for tele-monitoring. Improving awareness of rehabilitation and an action focus were considered key facilitators while physical discomforts and difficulties in using the technology were described as the main barriers. CONCLUSIONS: The CTR is feasible, safe and effective in improving physical activity and healthy behaviors in older adults with CHD. Considering the variation in individual cardiovascular risk factors, full-scale RCT with a larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Participation in cardio-oncological rehabilitation is low, and the effects incline to decrease after the initial rehabilitation term. Home-based exercise has the potential to enhance involvement in cardio-oncology rehabilitation and was demonstrated to be feasible, safe, and helpful in increasing short-term cardiorespiratory fitness. The lasting effects on cardiorespiratory fitness and physical activity are uncertain. Hence, a novel approach via telehealth management based on objectively measured exercise at home was proposed. OBJECTIVES: To improve self-monitoring, such as self-confidence, behavioral change, and goal setting for individual exercise, and afterward, increase long-term effects concerning cardiorespiratory fitness. DESIGN: This randomized controlled trial compares a 12-week guided home exercise telehealth intervention with a center-based exercise intervention of the same duration and intensity of exercise in lymphoma cancer survivors entering cardio-oncology rehabilitation after treatment. Participants will be instructed to exercise gradually at 60-85% of their maximum heart rate for 30-50 min 3 times a week. Participants will receive individual remote guidance (feedback about frequency, duration, and exercise intensity) by preferred contact (phone call, text message) once a week based on shared exercise data through the web platform. The primary outcome is a change in cardiorespiratory fitness expressed as maximal oxygen uptake assessed through cardiopulmonary exercise test at baseline, 12 weeks, and 1 year. Secondary objectives are quality of life, muscle strength, body composition, incidence of adverse events, and exercise adherence. This study will determine whether a telehealth model is effective and safe compared to a center-based model in cancer survivors and whether exercise prescriptions are followed by participants. Additionally, an overview of the long-term effectiveness of telehealth cardio-oncology rehabilitation will be provided. This approach aligns with the trend of moving non-complex healthcare services into the patients' home environment. TRIAL REGISTRATION: ClinicalTrials.Gov Identifier: NCT05779605.
- Publikační typ
- časopisecké články MeSH
- MeSH
- cvičení psychologie MeSH
- hudba * psychologie MeSH
- lidé MeSH
- sebeuplatnění * MeSH
- tolerance zátěže fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- komentáře MeSH
- úvodníky MeSH
BACKGROUND: Proprioception, the ability to sense the body's position and movement, is essential for athletic performance and physical well-being. The literature highlights the importance of proprioceptive training in rehabilitation, sports performance, injury prevention, and motor function enhancement. Targeted training programs can improve balance, coordination, motor learning, and overall physical performance. This systematic review aimed to examine the effects of proprioceptive training methods on sports and athletic performance. METHODS: A comprehensive search was conducted using the Web of Science, PubMed, and Scopus databases, and a literature review was performed based on the PICO criteria outlined in the abstract and title. RESULTS: Following the search, 178 articles were identified using relevant keywords, of which 19 directly addressed sports performance and were included in this study. The findings revealed that proprioceptive training had a positive influence on various aspects of athletic performance, including physiological capacity, balance, explosive strength, speed, agility, postural stability, knee joint position sense, muscle activation, reduction of chronic joint instability, dribbling, passing, and technical ball-control skills. CONCLUSIONS: These results indicate that proprioceptive training can be an effective strategy for experts and coaches to enhance athletes' physical performance. Primarily, proprioceptive exercises should be used inside and outside the training sessions to enable athletes to interact more effectively with their bodies, reduce the risk of injury, and improve power transfer.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The anthropometric characteristics of adolescent basketball athletes can determine their ability to produce muscle power. Lack of physical activity (PA) level or an increased sedentary life seem to be associated with the overall health status and the occurrence of knee injuries. The aim of this paper was to identify possible correlations between anthropometric characteristics, body composition, exposure time to electronic devices or screen time (ST), and PA level along with muscle power and dynamic knee valgus (DKV) in young basketball athletes. METHODS: Anthropometric and demographic characteristics were recorded. PA level was assessed through the International Physical Activity Questionnaire, and ST was assessed through a single question from the HELENA study. The Counter Movement Jump test was used for the evaluation of the lower limb muscle power, while the Single Leg Drop Jump test was used for the evaluation of the DKV via two-dimensional (2D) kinematic analysis. RESULTS: One hundred twenty-five adolescent basketball athletes (66.4% boys), 12 to 17 years old (13.94±1.58 years) participated. The Pearson index showed a statistically significant positive correlation between muscle power and height (r=0.788, P<0.001), while the Spearman Index showed a more minor but equally statistically significant positive correlation with Body Mass Index (rs=0.651, P<0.001) and age (rs=0.579, P<0.001). The ST (rs= -0.194, P=0.03) showed a weak negative correlation with DKV, while PA (r=0.85, P<0.001) showed a high, statistically significant, positive correlation. CONCLUSIONS: A high level of PA could play a key role in compensating and thus reducing the negative effects of high exposure to ST on the DKV.
- MeSH
- antropometrie MeSH
- basketbal * fyziologie MeSH
- biomechanika MeSH
- dítě MeSH
- dolní končetina * fyziologie MeSH
- index tělesné hmotnosti MeSH
- kolenní kloub fyziologie MeSH
- lidé MeSH
- mladiství MeSH
- pohyb fyziologie MeSH
- složení těla fyziologie MeSH
- svalová síla * fyziologie MeSH
- tělesná výška MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
