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Cardiopulmonary rehabilitation

Joseph T Patterson, Kyle Tillinghast, Derek Ward
BACKGROUND: Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. METHODS: Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences...
February 17, 2018: Journal of Arthroplasty
Carmen A Sima, Benny C Lau, Carolyn M Taylor, Stephan F van Eeden, W Darlene Reid, Andrew W Sheel, Ashley R Kirkham, Pat G Camp
BACKGROUND: Myocardial infarction (MI) remains under-recognized in chronic lung disease (CLD) patients. Rehabilitation health professionals need accessible clinical measurements to identify the presence of prior MI in order to determine appropriate training prescription. OBJECTIVES: To estimate prior MI in CLD patients entering a pulmonary rehabilitation program, as well as its association with heart rate parameters such as resting heart rate and chronotropic response index...
March 14, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Violeta González-Salvado, Cristian Abelairas-Gómez, Carlos Peña-Gil, Carmen Neiro-Rey, Roberto Barcala-Furelos, José Ramón González-Juanatey, Antonio Rodríguez-Núñez
AIM: Early basic life support is crucial to enhance survival from out-of-hospital cardiac arrest but rates remain low, especially in households. High-risk groups' training has been advocated, but the optimal method is unclear. The CArdiac REhabilitation and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two basic life support educational strategies implemented in a cardiac rehabilitation program. METHODS: A community intervention study including consecutive patients enrolled on an exercise-based cardiac rehabilitation program after acute coronary syndrome or revascularization was conducted...
March 12, 2018: Resuscitation
Frederikus A Klok, Stefano Barco
In addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of "post-PE syndrome" of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied...
February 2018: Hämostaseologie
Samuel Wittekind, Wayne Mays, Yvette Gerdes, Sandra Knecht, John Hambrook, William Border, John Lynn Jefferies
Patients with a Fontan circulation have impaired exercise capacity. Cardiac rehabilitation (CR) has shown promise in enhancing peak exercise parameters in this population, but an improvement in submaximal exercise has not been consistently demonstrated. We assessed the hypothesis that participation in CR will be associated with more efficient oxygen extraction and ventilation during submaximal exercise. In this prospective study, pediatric Fontans completed two 60 min CR sessions per week for 12 weeks. Cardiopulmonary exercise testing and stress echocardiography were performed at baseline and last CR session, and then compared with a paired sample t test...
March 9, 2018: Pediatric Cardiology
Caroline M Van De Heyning, Catherine De Maeyer, Nele Pattyn, Paul J Beckers, Véronique A Cornelissen, Kaatje Goetschalckx, Nadine Possemiers, Emeline M Van Craenenbroeck, Jens-Uwe Voigt, Luc Vanhees, Bharati Shivalkar
BACKGROUND: Increase of exercise capacity (peak VO2 ) after cardiac rehabilitation improves outcome in patients with coronary artery disease (CAD). Systolic and diastolic function have been associated with peak VO2 , but their role towards improvement of exercise capacity remains unclear. It is unknown which exercise intensity has the most beneficial impact on left ventricular (LV) geometry and function in CAD patients without heart failure. METHODS: 200 stable CAD patients without heart failure were randomized to 3months of aerobic interval training (AIT) or aerobic continuous training (ACT)...
April 15, 2018: International Journal of Cardiology
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
Xiankun Chen, Wei Jiang, Xiaoli Lin, Cecilia Stålsby Lundborg, Zehuai Wen, Weihui Lu, Gaetano Marrone
BACKGROUND: Exercise-based cardiac rehabilitation is a beneficial therapy for patients with chronic heart failure. The delivery of exercise-based cardiac rehabilitation should adopt an evidence-based approach, as well as be culturally appropriate and sensitive to individual needs and preferences. The Baduanjin Eight-Silken-Movements with Self-efficacy Building for Heart Failure (BESMILE-HF) program is the first to apply a traditional Chinese exercise, Baduanjin, as the core component in an exercise-based cardiac rehabilitation program...
March 1, 2018: Trials
Wendell L Bernardes, Rafael A Montenegro, Walace D Monteiro, Raul de Almeida Freire, Renato Massaferri, Paulo Farinatti
Bernardes, WL, Montenegro, RA, Monteiro, WD, de Almeida Freire, R, Massaferri, R, and Farinatti, P. Optimizing a treadmill ramp protocol to evaluate aerobic capacity of hemiparetic poststroke patients. J Strength Cond Res 32(3): 876-884, 2018-A correct assessment of cardiopulmonary capacity is important for aerobic training within motor rehabilitation of poststroke hemiparetic patients (PSHPs). However, specific cardiopulmonary exercise testing (CPET) for these patients are scarce. We proposed adaptations in a protocol originally developed for PSHPs by Ovando et al...
March 2018: Journal of Strength and Conditioning Research
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
Susan M Linder, Anson B Rosenfeldt, Andrew S Bazyk, Mandy Miller Koop, Sarah Ozinga, Jay L Alberts
Background Individuals with stroke present with motor control deficits resulting in the abnormal activation and timing of agonist and antagonist muscles and inefficient movement patterns. The analysis of pedaling biomechanics provides a window into understanding motor control deficits, which vary as a function of workload. Understanding the relationship between workload and motor control is critical when considering exercise prescription during stroke rehabilitation. Objectives To characterize pedaling kinematics and motor control processes under conditions in which workload was systematically increased to an eventual patient-specific maximum...
February 15, 2018: Topics in Stroke Rehabilitation
Julio Cesar Silva de Sousa, Camila Torriani-Pasin, Amanda Barboza Tosi, Rafael Yokoyama Fecchio, Luiz Augusto Riani da Costa, Cláudia Lúcia de Moraes Forjaz
OBJECTIVE: To evaluate whether virtual reality games (VRG) in stroke survivors produce significant and reproducible heart rate (HR) and oxygen consumption (VO2) responses during their execution, corresponding to an intensity between the anaerobic threshold (AT) and the respiratory compensation point (RCP). DESIGN: Single subjects repeated measure design SETTING: Stroke survivors registered from a rehabilitation program PARTICIPANTS: Twelve chronic hemiparetic stroke survivors (10 men, 58 ± 12 years) rated at 3 or 4 in the Functional Ambulation Categories (FAC)...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
Gordon McGregor, Eric J Stöhr, David Oxborough, Peter Kimani, Rob Shave
BACKGROUND: Cardiac rehabilitation (CR) exercise training is beneficial after myocardial infarction (MI). Whilst the peripheral adaptations to training are well defined, little is known regarding the effect on left ventricular (LV) remodelling, particularly LV function. Efficient LV ejection and filling is achieved through deformation and rotation of the myocardium in systole and diastole - LV mechanics. The response of LV mechanics to CR exercise training in MI patients is unknown. METHODS: In this observational exploratory study, 36 (of 40 enrolled) male, MI patients completed either 10-weeks of twice-weekly gym based cardiovascular exercise at 60-80% VO2peak (n=18), or a non-exercise control period (n=18)...
January 31, 2018: Annals of Physical and Rehabilitation Medicine
Seiya Tanaka, Yoshihito Sanuki, Kiyoshi Ozumi, Takashi Harada, Hiromi Tasaki
There is no proven therapy for heart failure with preserved ejection fraction (HFpEF). Research has shown beneficial responses to cardiac rehabilitation (CR) among HF patients. To date, there are no reports comparing those responses between patients with HFpEF and those with reduced ejection fraction (HFrEF). The purpose of this study was to compare responses to CR in patients with HFpEF versus those with HFrEF. We included 78 consecutive patients (mean age 69 ± 15 years; 80% male) with HF in our CR unit who underwent cardiopulmonary exercise testing and brachial artery flow-mediated dilation (FMD) testing pre- and 5 months post-CR...
February 1, 2018: Heart and Vessels
Simon Nichols, Fiona Nation, Toni Goodman, Andrew L Clark, Sean Carroll, Lee Ingle
INTRODUCTION: Cardiac rehabilitation (CR) reduces all-cause and cardiovascular mortality in patients with coronary heart disease (CHD). Much of this improvement has been attributed to the beneficial effects of structured exercise training. However, UK-based studies have not confirmed this. Improvements in survival and cardiovascular health are associated with concurrent improvements in cardiorespiratory fitness (CRF). It is therefore concerning that estimated CRF improvements resulting from UK-based CR are approximately one-third of those reported in international literature...
January 27, 2018: BMJ Open
Yan-Wen Chen, Chi-Yen Wang, Yuan-Hui Lai, Ying-Chieh Liao, Yan-Kai Wen, Shin-Tsu Chang, Jin-Long Huang, Tsu-Juey Wu
BACKGROUND: Exercise tolerance and cardiac output have a major impact on the quality of life (QOL) of patients experiencing heart failure (HF). Home-based cardiac rehabilitation can significantly improve not only exercise tolerance but also peak oxygen uptake ((Equation is included in full-text article.)peak), and the QOL in patients with HF. The aim of this prospective study was to evaluate the beneficial effects of home-based cardiac rehabilitation on the quality of medical care in patients with chronic HF...
January 2018: Medicine (Baltimore)
Charles D Voigt, Guillermo Foncerrada, Raquel Peña, Ashley N Guillory, Clark R Andersen, Craig G Crandall, Steven E Wolf, David N Herndon, Oscar E Suman
OBJECTIVE: To investigate the efficacy of community-based exercise programs (COMBEX) in the rehabilitation of adult burn patients as compared to standard of care (SOC). DESIGN: Randomized controlled trial, with 2:1 randomization. SETTING: Assessments were performed in a hospital setting. The intervention was performed in a community setting. PARTICIPANTS: Adult patients with ≥ 30% total body surface area burns were randomized to participate in COMBEX (N = 31) or standard of care (SOC) (N = 14)...
January 20, 2018: Archives of Physical Medicine and Rehabilitation
Nobuhiko Arai, Hiroshi Kagami, Tomohiro Funabiki, Yutaka Mine, Makoto Inaba
BACKGROUND: Non-traumatic carotid artery injury with active extravasation, or carotid blowout syndrome (CBS), is relatively rare and highly difficult to treat because it is difficult to approach the lesions due to anatomical factors. It also involves quick progression and cerebral embolization risk caused by thrombi and carotid artery occlusion. Recently, covered stents were revealed to be effective for CBS. However, they have several disadvantages, such as their costs, rebleeding complications, or cerebral embolic risks...
January 17, 2018: World Neurosurgery
Liang Yan Zhang, Zi Jia Liu, Le Shen, Yu Guang Huang
Enhanced recovery after surgery (ERAS) is a new perioperative concept that aims to reduce perioperative stress response and accelerate rehabilitation of patients through a variety of optimized management. With the wider application of this concept,the effective implementation of ERAS program has become a new challenge. Cardiopulmonary exercise testing (CPET) has shown promising value in the preoperative assessment,perioperative optimization,and postoperative rehabilitation of ERAS. This article reviews the application of CPET in ERAS,with an attempt to provide evidence for more detailed and comprehensive ERAS program...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Daniel Stevens
INTRODUCTION: Lung hyperinflation is a potential mechanism limiting exercise tolerance. However, available data on the impact of static hyperinflation on exercise performance in adult cystic fibrosis is lacking. Furthermore, the relative contribution of both static and dynamic hyperinflation to exercise performance is unknown. OBJECTIVES: To determine the impact of static hyperinflation on exercise tolerance and lung dynamics in adult cystic fibrosis. METHODS: Clinical data of 107 adult patients with cystic fibrosis, including pulmonary function, lung volumes, and cardiopulmonary exercise from the Toronto Cystic Fibrosis database were collected and analyzed...
January 13, 2018: Clinical Respiratory Journal
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