Research

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22 pages, 1312 KiB

Open AccessArticle

Development of the Brazilian Version of a Pan-Canadian Behavior Change Program and Its Health and Fitness Outcomes

by Juliano Schwartz, Paul Oh, Shannon S. D. Bredin, Ryan E. Rhodes, Maira B. Perotto, Alejandro Gaytán-González and Darren E. R. Warburton

J. Clin. Med. 2022, 11(19), 5926; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195926 - 08 Oct 2022

Cited by 1 | Viewed by 1575

Abstract

Chronic diseases are a major health problem worldwide, especially in lower-income jurisdictions. Considering this scenario, the World Health Organization has recently established, as a research priority, preventive interventions for populations from lower-income countries, such as the middle-income country of Brazil. The purpose of [...] Read more.

Chronic diseases are a major health problem worldwide, especially in lower-income jurisdictions. Considering this scenario, the World Health Organization has recently established, as a research priority, preventive interventions for populations from lower-income countries, such as the middle-income country of Brazil. The purpose of this article is to describe the components of a pan-Canadian lifestyle program adapted to Brazilians and to report its health and fitness outcomes. A 12-week program called ACCELERATION was translated and culturally adapted to Brazilians. A quasi-randomized controlled trial was designed, consisting of weekly emails and educational videos addressing risk factors for chronic disease. Health and fitness measures included body composition, cardiovascular variables, aerobic fitness, and muscular strength. The Brazilian experimental group showed maintenance in heart rate, blood pressure, and VO₂max values while presenting an improvement of 3.3% in body fat percentage (p = 0.040, d = −0.325) and 5.1% in muscular strength (p = 0.039, d = 0.328). Overall, these results were similar to the Canadian intervention. Based on these findings, the Brazilian version of the program has the potential to contribute to the fight against chronic diseases in Brazil. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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14 pages, 2824 KiB

Open AccessArticle

Influence of Risk Factors on Exercise Tolerance in Patients after Myocardial Infarction—Early Cardiac Rehabilitation in Poland

by Aleksandra Bryndal, Sebastian Glowinski and Agnieszka Grochulska

J. Clin. Med. 2022, 11(19), 5597; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195597 - 23 Sep 2022

Cited by 2 | Viewed by 1370

Abstract

(1) Background: Prognosis in patients with cardiovascular diseases is significantly influenced by lifestyle and the control of risk factors. Patients after myocardial infarction require special care and promptly introduced cardiac rehabilitation. The primary aim of this study was to identify risk factors and [...] Read more.

(1) Background: Prognosis in patients with cardiovascular diseases is significantly influenced by lifestyle and the control of risk factors. Patients after myocardial infarction require special care and promptly introduced cardiac rehabilitation. The primary aim of this study was to identify risk factors and their influence on exercise tolerance before and after cardiac rehabilitation (CR) provided under the Coordinated Specialist Care Programme—Infarct (CSC-Infarct). (2) Methods: The study was carried out at the Cardiac Rehabilitation Centre of Slupsk Specialist Hospital on a group of 112 patients aged 35–87 (62.78 ± 10.09 years) after myocardial infarction (MI), participating in CSC-Infarct. An exercise test (treadmill ECG test), the 6 min walk test (6MWT), echocardiography, blood test (total cholesterol, HDL, LDL, TG), measurement of diastolic pressure ratio (DPr), waist-to-hip ratio (WHR), and BMI were performed in participants on the first and last day of CR. Rating of perceived exertion was assessed with Borg’s scale. (3) Results: The overweight variable had the strongest effect on the increased value of initial: HR rest, HR max, and HR 1 min after exercise compared to subjects with normal BMI. DPr values before and after CR were also higher in overweight patients. Scores of 6MWT were higher in smokers compared to non-smokers. The final MET value was significantly higher in non-diabetic subjects. Hyperlipidaemia was associated with a higher initial HR max and initial HR 1 min after exercise. DPr before CR was also higher. The initial and final MET values were lower in hypertensive patients. Borg’s rating of perceived exertion measured after the final exercise test was also higher in hypertensive patients. Hypertension influenced the initial and final 6MWT scores, which were significantly higher in normotensive patients. (4) Conclusions: CR within CSC-infarction in patients after myocardial infarction improves exercise tolerance. Exercise tolerance in post-MI patients with concomitant risk factors is lower compared to post-MI patients without risk factors. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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16 pages, 1226 KiB

Open AccessArticle

Physical Activity Level and Perspectives of Participants Transitioning from Onsite to Virtual Cardiac Rehabilitation during the Early COVID-19 Pandemic: A Mixed-Method Study

by Lais Manata Vanzella, Gabriela Lima de Melo Ghisi, Tracey Jacqueline Fitchett Colella, Jillian Larkin, Luiz Carlos Marques Vanderlei, Susan Marzolini, Scott Thomas and Paul Oh

J. Clin. Med. 2022, 11(16), 4838; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164838 - 18 Aug 2022

Cited by 2 | Viewed by 1637

Abstract

This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of [...] Read more.

This mixed-method study aimed to compare physical activity (PA) patterns of a cross-over cardiac rehabilitation (CR) cohort with a center-based CR cohort and to explore barriers and facilitators of participants transitioning and engaging in virtual CR. It included the retrospective self-reported PA of a cross-over CR cohort (n = 75) and a matched center-based CR cohort (n = 75). Some of the participants included in the cross-over cohort (n = 12) attended semi-structured focus group sessions and results were interpreted in the context of the PRECEDE-PROCEED model. Differences between groups were not observed (p > 0.05). The center-based CR cohort increased exercise frequency (p = 0.002), duration (p = 0.007), and MET/minutes (p = 0.007) over time. The cross-over cohort increased exercise duration (p = 0.04) with no significant change in any other parameters. Analysis from focus groups revealed six overarching themes classified under predisposing factors (knowledge), enabling factors (external support, COVID-19 restrictions, mental health, personal reasons/preferences), and reinforcing factors (recommendations). These findings suggest an improvement of the PA levels of center-based CR cohort participants pre-pandemic and mitigated improvement in those who transitioned to a virtual CR early in the pandemic. Improving patients’ exercise-related knowledge, provider endorsements, and the implementation of group videoconferencing sessions could help overcome barriers to participation in virtual CR. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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8 pages, 719 KiB

Open AccessArticle

A Comparison of Barrier Factors between Hospitals with and without Cardiac Rehabilitation Programs in Korea: A Nation-Wide Survey Research

by Chul Kim, Jidong Sung, Jae-Young Han, Sungju Jee, Jang Woo Lee, Jong Hwa Lee, Won-Seok Kim, Heui Je Bang, Sora Baek, Kyung-Lim Joa, Ae Ryoung Kim, So Young Lee, Jihee Kim, Chung Reen Kim and Oh Pum Kwon

J. Clin. Med. 2022, 11(9), 2560; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11092560 - 02 May 2022

Cited by 3 | Viewed by 1348

Abstract

The percentage of patients undergoing cardiac rehabilitation programs (CRP) is very low (30–40%), and hospitals providing CRP are either insufficient or lacking, even in countries with advanced medical care; therefore, this study aims to investigate the barriers, as well as compare the differences [...] Read more.

The percentage of patients undergoing cardiac rehabilitation programs (CRP) is very low (30–40%), and hospitals providing CRP are either insufficient or lacking, even in countries with advanced medical care; therefore, this study aims to investigate the barriers, as well as compare the differences between hospitals, with or without CRP. We conducted a survey, in which the questionnaire was distributed through post or email to 607 specialists who work at 164 hospitals performing percutaneous coronary interventions (PCI). The results were as follows: (1) of the 164 hospitals, 132 responded (response rate: 80.5%). While all 47 hospitals with CRP responded (100%), from among the 117 hospitals without CRP, 85 responded (72.7%). (2) Of the 607 specialists, 227 responded (response rate: 36.9%). The response rates according to specialties were as follows: cardiologists (28.9%), cardiac surgeons (24.5%), and physiatrists (64.1%). (3) While the specialists at hospitals with CRP identified patient referral, transportation, and cost as the major barriers, for those at hospitals without CRP, all items were considered barriers, especially the items related to equipment, space, workforce, and budget as being more serious barriers. Therefore, in order to actively promote CRP, it is suggested that governments consider the customized support system according to the performance of CRPs. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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9 pages, 1522 KiB

Open AccessArticle

Association between Right Ventricular Function and Exercise Capacity in Patients with Chronic Heart Failure

by Kazumasa Ohara, Teruhiko Imamura, Hiroyuki Ihori, Kenichi Chatani, Makoto Nonomura, Tomoki Kameyama and Hiroshi Inoue

J. Clin. Med. 2022, 11(4), 1066; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11041066 - 18 Feb 2022

Cited by 3 | Viewed by 1278

Abstract

Background: The association between right ventricular function and exercise capacity in patients with chronic heart failure remains uncertain. Several studies very recently mentioned the association between right ventricular reserve and exercise capacity, whereas the implication of tricuspid annular plane systolic excursion (TAPSE) remains [...] Read more.

Background: The association between right ventricular function and exercise capacity in patients with chronic heart failure remains uncertain. Several studies very recently mentioned the association between right ventricular reserve and exercise capacity, whereas the implication of tricuspid annular plane systolic excursion (TAPSE) remains uninvestigated. We aimed to assess the impact of TAPSE on exercise capacity in cardiac rehabilitation candidates. Methods: Data from patients with chronic heart failure who received cardiopulmonary exercise tests and transthoracic echocardiography prior to cardiac rehabilitation were retrospectively collected, and their association was investigated. Results: A total of 169 patients with chronic heart failure (70.3 ± 11.7 years old, 74.6% men) were included. Tertiled tricuspid annular plane systolic excursion significantly stratified anaerobic threshold (10.2 ± 2.2, 11.4 ± 2.2, and 12.2 ± 2.8 mm; p < 0.01) and peak oxygen consumption (15.9 ± 4.5, 18.3 ± 5.3, and 19.8 ± 5.6 mm; p < 0.01). In the multivariate logistic regression analyses, TAPSE was an independent factor associated with anaerobic threshold and peak oxygen consumption (p < 0.05 for both). Conclusions: Right ventricular impairment was associated with reduced exercise capacity in patients with chronic heart failure. Such knowledge would be useful to estimate patients’ exercise capacity and prescribe cardiac rehabilitation. Its longitudinal association and clinical implication need further studies. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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Review

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12 pages, 294 KiB

Open AccessReview

Linking Heart Health and Mental Wellbeing: Centering Indigenous Perspectives from across Canada

by Shannon N. Field, Rosalin M. Miles and Darren E. R. Warburton

J. Clin. Med. 2022, 11(21), 6485; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11216485 - 01 Nov 2022

Viewed by 2492

Abstract

Indigenous peoples have thrived since time immemorial across North America; however, over the past three to four generations there has been a marked increase in health disparities amongst Indigenous peoples versus the general population. Heart disease and mental health issues have been well [...] Read more.

Indigenous peoples have thrived since time immemorial across North America; however, over the past three to four generations there has been a marked increase in health disparities amongst Indigenous peoples versus the general population. Heart disease and mental health issues have been well documented and appear to be interrelated within Indigenous peoples across Canada. However, Western medicine has yet to clearly identify the reasons for the increased prevalence of heart disease and mental health issues and their relationship. In this narrative review, we discuss how Indigenous perspectives of health and wholistic wellness may provide greater insight into the connection between heart disease and mental wellbeing within Indigenous peoples and communities across Canada. We argue that colonization (and its institutions, such as the Indian Residential School system) and a failure to include or acknowledge traditional Indigenous health and wellness practices and beliefs within Western medicine have accelerated these health disparities within Indigenous peoples. We summarize some of the many Indigenous cultural perspectives and wholistic approaches to heart health and mental wellbeing. Lastly, we provide recommendations that support and wholistic perspective and Indigenous peoples on their journey of heart health and mental wellbeing. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

19 pages, 1762 KiB

Open AccessReview

The Link between Stroke Risk and Orodental Status—A Comprehensive Review

by Shahriar Shahi, Mehdi Farhoudi, Solmaz Maleki Dizaj, Simin Sharifi, Saeed Sadigh-Eteghad, Khang Wen Goh, Long Chiau Ming, Jagjit Singh Dhaliwal and Sara Salatin

J. Clin. Med. 2022, 11(19), 5854; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195854 - 02 Oct 2022

Cited by 2 | Viewed by 2853

Abstract

One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person’s general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. [...] Read more.

One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person’s general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors’ best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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11 pages, 420 KiB

Open AccessReview

Exercise Testing in Aortic Stenosis: Safety, Tolerability, Clinical Benefits and Prognostic Value

by Sahrai Saeed and John B. Chambers

J. Clin. Med. 2022, 11(17), 4983; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11174983 - 25 Aug 2022

Cited by 2 | Viewed by 1403

Abstract

Background: Routine exercise testing in asymptomatic patients with valvular heart disease (VHD) better classifies the hemodynamic severity of valve stenosis or regurgitation, and describes the symptomatic status and functional capacity of the patient. This is crucial for planned surveillance and optimal timing of [...] Read more.

Background: Routine exercise testing in asymptomatic patients with valvular heart disease (VHD) better classifies the hemodynamic severity of valve stenosis or regurgitation, and describes the symptomatic status and functional capacity of the patient. This is crucial for planned surveillance and optimal timing of surgery, particularly for aortic stenosis (AS), because once symptoms occur, there is a sharp increase in the risk of sudden death unless valve intervention is performed. Purpose: To conduct a focused clinical review on the benefits of exercise testing in patients with AS. Methods: The electronic database PubMed was systematically searched for relevant retrospective and prospective cohort studies reporting on the safety, feasibility and tolerability of exercise testing in VHD, with a special focus on AS. Results and conclusions: In patients with significant AS, exercise testing is safe, feasible and reveals symptoms in a significant proportion of patients. In addition, serial testing has incremental prognostic value over a baseline test alone. Exercise testing in patients with AS is underused and should be performed routinely to refine the hemodynamic severity of AS. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation—Part II)

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