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.
BACKGROUND: A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits. OBJECTIVE: The study aimed to explore the experiences of patients who participated in the NeCR program. METHODS: A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile, >35th percentile, and > 70% percentile) in the improvement of health-promoting behaviors. RESULTS: Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers. CONCLUSIONS: Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.
- MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc * rehabilitace MeSH
- lidé MeSH
- následná péče MeSH
- propuštění pacienta MeSH
- reprodukovatelnost výsledků MeSH
- role ošetřovatelky MeSH
- telemedicína * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits. OBJECTIVE: The study aimed to explore the experiences of patients who participated in the NeCR program. METHODS: A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile, >35th percentile, and > 70% percentile) in the improvement of health-promoting behaviors. RESULTS: Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers. CONCLUSIONS: Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.
- MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc * rehabilitace MeSH
- lidé MeSH
- následná péče MeSH
- propuštění pacienta MeSH
- reprodukovatelnost výsledků MeSH
- role ošetřovatelky MeSH
- telemedicína * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: Exercise-based cardiac rehabilitation (CR) is a beneficial tool for the secondary prevention of cardiovascular diseases with, however, low participation rates. Telerehabilitation, intergrading mobile technologies and wireless sensors may advance the cardiac patients' adherence. This study will investigate the efficacy, efficiency, safety and cost-effectiveness of a telerehabilitation programme based on objective exercise telemonitoring and evaluation of cardiorespiratory fitness. METHODS AND ANALYSIS: A supervised, parallel-group, single-blind randomised controlled trial will be conducted. A total of 124 patients with coronary disease will be randomised in a 1:1 ratio into two groups: intervention telerehabilitation group (TELE-CR) (n=62) and control centre-based cardiac rehabilitation group (CB-CR) (n=62). Participants will receive a 12-week exercise-based rehabilitation programme, remotely monitored for the TELE-CR group and standard supervised for the CB-CR group. All participants will perform aerobic training at 70% of their maximal heart rate, as obtained from cardiopulmonary exercise testing (CPET) for 20 min plus 20 min for strengthening and balance training, three times per week. The primary outcomes will be the assessment of cardiorespiratory fitness, expressed as peak oxygen uptake assessed by the CPET test and the 6 min walk test. Secondary outcomes will be the physical activity, the safety of the exercise intervention (number of adverse events that may occur during the exercise), the quality of life, the training adherence, the anxiety and depression levels, the nicotine dependence and cost-effectiveness. Assessments will be held at baseline, end of intervention (12 weeks) and follow-up (36 weeks). ETHICS AND DISSEMINATION: The study protocol has been reviewed and approved by the Ethics Committee of the University of Thessaly (1108/1-12-2021) and by the Ethics Committee of the General University Hospital of Larissa (3780/31-01-2022). The results of this study will be disseminated through manuscript publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT05019157.
- MeSH
- jednoduchá slepá metoda MeSH
- kardiovaskulární rehabilitace * metody MeSH
- koronární nemoc * rehabilitace MeSH
- kvalita života MeSH
- lidé MeSH
- nositelná elektronika * MeSH
- randomizované kontrolované studie jako téma MeSH
- telerehabilitace * metody MeSH
- terapie cvičením metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- protokol klinické studie MeSH
This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.
- MeSH
- COVID-19 * MeSH
- kardiorespirační zdatnost * MeSH
- kardiovaskulární rehabilitace * MeSH
- koronární nemoc rehabilitace MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie MeSH
- senioři MeSH
- telerehabilitace * MeSH
- terapie cvičením MeSH
- test chůzí MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Cardiovascular diseases are the world's most common causes of morbidity and mortality in the population, including Central Europe. Cardiac rehabilitation (CR) is an effective preventive approach that includes several core components. Physical training is identified as an integral and essential part of CR. Training can positively influence several cardiovascular risk factors in people diagnosed with coronary heart disease and prevent them from clinical events. Our study aims to research the method of high-intensity interval training (HIIT) in a home environment using telerehabilitation. We assume that the HIIT form of telerehabilitation, using a heart rate monitor as a tool for backing up training data, can improve cardiorespiratory fitness and lead to higher peak oxygen uptake than the traditional moderate-intensity continuous training (MICT). METHODS: This study is designed as a monocentral randomized controlled trial at University Hospital Brno in the Czech Republic. After the coronary heart event, the suitable patients will be randomized (1:1 ratio) and separated into 2 groups: the experimental HIIT group and the control MICT group. Both groups undergo a 12-week telerehabilitation with a 1-year follow-up period. Study participants will be telemonitored during physical training in their home environment via a heart rate monitor and a web platform. Once a week, the patients will give their feedback and motivation by a telephone call.The primary outcome observed will be the effect of intervention expressed by changes in cardiorespiratory fitness. Secondary outcomes will be the health-related quality of life, anxiety, training adherence, body composition, safety, and satisfaction. DISCUSSION: The HIIT is widely researched predominantly in a center-based supervised form. Our study differs from others by the use of telemedicine and smart technologies in home-based settings. Previous home-based cardiac telerehabilitation studies have focused primarily on MICT, which has demonstrated feasibility, and results have shown similar improvements as center-based CR. There is a presumption that HIIT may be superior to MICT. However, it can be complicated to self-dose the method in the home environment. Investigators expect that HIIT research will provide insight into the possibilities of telemedicine feasibility, effect, and limitations of coronary heart disease patients' use at low to moderate cardiovascular risk.
- MeSH
- kardiovaskulární rehabilitace metody MeSH
- koronární nemoc rehabilitace MeSH
- lidé MeSH
- randomizované kontrolované studie jako téma MeSH
- telerehabilitace * MeSH
- vysoce intenzivní intervalový trénink * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
- Geografické názvy
- Česká republika MeSH
AIM: Interventional cardiovascular training programmes provide a prescription of optimal form and safe intensity. They are part of the second phase of cardiovascular rehabilitation which is a key point in the whole tertiary-preventive care for patients with coronary artery disease. The patients are hemodynamically adapted to a normal physical load, their aerobic capacity is gradually increased, and they learn principles of regular aerobic-resistance exercise. The aim of this study is to assess the impact of modified aerobic-resistance exercise on cardiorespiratory indicators in patients after acute coronary event, and evaluate the differences between monitored parameters in different age groups. METHODS: The study was conducted on a group of 106 patients (85% of men) of an average age of 60.4 ± 10.9 years, with left ventricular ejec- tion fraction of 57.4 ± 7.2%. All subjects went through an acute coronary event. The time elapsed between the occurence of a coronary event and the beginning of the training programme was 35 ± 8 days. In patients after coronary artery bypass grafting, the time passed was 50 ± 16 days on average. All patients received a two-month aerobic-resistance training with a frequency of three times a week. The length of a training unit was set to 100 minutes (out of which 60 minutes were allocated to individual aerobic training). RESULTS: A significant negative correlation between age and average values of monitored parameters was observed. Even though the values of all parameters are decreasing with increasing age, a shift towards higher values in all parameters occurred after completing the training programme. The study reveals that there are interindividual differences between the parameter values. Asignificant difference in individual parameters was found between different age groups. The result of the study shows that a given parameter could characterize each age group. Completing the interventional training programme also led to a significant increase of exercise tolerance (1.8 ± 0.3 vs. 2.0 ± 0.4 W/kg; p < 0.001) and of peak oxygen consumption (22.8 ± 4.5 vs. 25.9 ± 5.5 ml/kg/min, p < 0.001). CONCLUSION: Interindividual differences between the parameter values have been identified. This could be helpful in methodological conception of preventive training programmes for patients suffering from cardiovascular disease. The mutual connection between the parameter values and age groups does not relate only to a safer training intensity determination, but also to a more precisely targeted application of different training modalities in order to achieve an optimal final training effect.
- MeSH
- akutní koronární syndrom chirurgie rehabilitace MeSH
- cvičení MeSH
- fyzická vytrvalost MeSH
- koronární nemoc rehabilitace terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nestabilní angina pectoris rehabilitace MeSH
- sekundární prevence MeSH
- senioři MeSH
- tělesná výkonnost MeSH
- terapie cvičením metody MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
Je známo, že ve vyspělých zemích je ischemická choroba srdeční (ICHS) u pacientů s diabetes mellitus (DM) nejčastější příčinou smrti. Diabetici mají 2–4krát vyšší riziko vzniku kardiovaskulárních onemocnění ve srovnání s jedinci bez diabetu. Průběh akutních koronárních syndromů u diabetiků bývá doprovázen větším počtem komplikací než u nediabetiků, zároveň má i horší prognózu. Diabetes mellitus u pacientů s ICHS představuje významné přídatné riziko, zahrnující sníženou schopnost adaptace kardiovaskulárního systému na zátěž, která vyplývá z dysfunkce levé komory, z přítomnosti diabetické kardiovaskulární autonomní neuropatie (KAN) a dalších abnormalit, které diabetes doprovázejí v rámci metabolického syndromu. Jsou prezentována rizika a specifická opatření pro rehabilitaci diabetiků s ICHS. Z literárních údajů vyplývá, že kardiovaskulární rehabilitace přináší pacientům s diabetem po akutní koronární příhodě srovnatelný prospěch jako nediabetikům; týká se to hlavně zlepšení zátěžové kapacity, která je považována za významný prediktor kardiovaskulární morbidity a mortality. Je zdůrazněn komplexní charakter kardiovaskulární rehabilitace, která zahrnuje nejen vlastní fyzický trénink, ale opatření dietní k redukci obezity, farmakoterapii, protikuřáckou intervenci, kontrolu krevního tlaku a dyslipoproteinemie.
- MeSH
- cvičení MeSH
- diabetes mellitus 2. typu komplikace mortalita patofyziologie MeSH
- koronární nemoc patofyziologie rehabilitace terapie MeSH
- lidé MeSH
- rehabilitace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Cardiovascular rehabilitation lasting 12 weeks of combined training in a group of 48 male patients with chronic ischemic heart disease (ejection fraction higher than 50%) led to improvement of physical fitness and parameters of transport system. Patients improved quality of life significantly.
- MeSH
- ergometrie metody MeSH
- financování vládou MeSH
- koronární nemoc rehabilitace MeSH
- kvalita života MeSH
- lidé MeSH
- muži MeSH
- průzkumy a dotazníky MeSH
- techniky cvičení a pohybu statistika a číselné údaje využití MeSH
- výkonnost MeSH
- zátěžová echokardiografie metody statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
The study was aimed at evaluation of the effect of eight-week combined training (combination of aerobic and resistance load) on functional capacity, aerobic capacity and maximal attained load in 1-RM test in women with ischemic heart disease (IHF). 14 women with IHF were examined. Before the starting and after the finishing of the rehabilitation program spiroergometry was carried out up to the symptom-limited maximum. Before the starting of resistance training 1-RM test was carried out. After the completion of the rehabilitation program symptom-limited oxygen uptake and maximal attained load, evaluated by 1-RM test, were significantly increased.
- MeSH
- ergometrie statistika a číselné údaje MeSH
- infarkt myokardu prevence a kontrola MeSH
- koronární nemoc rehabilitace terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- tělesná výchova metody statistika a číselné údaje MeSH
- tělesná výkonnost fyziologie MeSH
- výkonnost fyziologie MeSH
- ženy MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
