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Biomedical subjects

K M Newton

Publications and source records attributed to K M Newton.

26 records · Page 2Linked to original sources
PubMed1984

Exercise, education, and counseling for patients with coronary artery disease.

A multifactorial rehabilitation program that incorporates exercise, education, and counseling can assist cardiac patients to achieve and maintain an optimal state of health. The program can be started in-hospital and continued after discharge; it may be supervised or unsupervised and conducted individually or in groups. Group programs improve compliance, and inclusion of spouse and family increases the chance of success.

Behavior Therapy↗
PubMed1981

In-hospital exercise after myocardial infarction does not improve treadmill performance.

Prolonged bed rest after myocardial infarction is thought to result in deconditioning, manifested by increased heart-rate and blood-pressure responses to exercise and decreased functional capacity. We studied the effects of early, supervised exercises in preventing deconditioning after acute myocardial infarction. Eighty-four patients were randomized to a control group and 174 to an exercise group. Enrollment in the exercise program occurred an average of 4.5 days after admission (range, one to nine). Discharge from the hospital occurred an average of 10.3 days after admission in the control group and 10.4 days in the exercise group. Most patients had a low-level treadmill test on the day before hospital discharge. There were no differences between the two groups in the clinical, hemodynamic, or electrocardiographic responses to the treadmill test. Incidences of complications and deaths (one death in each group) during hospitalization were not significantly different in the two groups, although six patients (3 per cent, all in the exercise group) required cardiac surgery--four because of recurrent chest pain and two because of rupture of heart muscle. Thus, we were unable to demonstrate any significant beneficial or deleterious effects of an early, in-hospital exercise program.

Aged↗
PubMedDate not supplied

Women's responses to a mailed hormone replacement therapy workbook.

OBJECTIVE: Effectively communicating information about the complex decisions that face women at midlife, including whether to use hormone replacement therapy (HRT), is an ongoing challenge. Although numerous decision-making tools exist, few have been evaluated. The objective of this study was to examine women's use of a workbook designed to promote informed HRT decision-making. DESIGN: We developed a workbook to prepare women to discuss HRT, osteoporosis, heart disease, and breast cancer with their providers. To evaluate the workbook, women aged 45-65 years were randomly assigned to one of three groups: (1) workbook plus baseline and 6-month surveys, (2) workbook and 6-month survey, or (3) no workbook with both surveys. Results are based on the responses of 580 women in groups 1 and 2 (response rate, 84.2%). RESULTS: At 6 months, 79% of women recalled receiving the workbook, of whom 51% read all or most of it, 35% skimmed or read part of it, and 14% did not read it. The percentages of women completing self-assessments were 55% osteoporosis; 56% heart disease; 58% breast cancer; 57% advantages and disadvantages of HRT; and 52% personal preferences about HRT. As a result of the workbook, 10% made an appointment with their providers, and 12% had a discussion about HRT with their providers. Use of the workbook was not associated with menopause symptoms, attitudes about or use of HRT, hysterectomy, or provider discussions about menopause and HRT. CONCLUSION: This simple approach of using a mailed workbook holds promise as a successful mechanism to prepare women to discuss HRT and other related health issues with their providers.

Decision Making↗
PubMedDate not supplied

Comparison of aortic and brachial cuff pressures in flat supine and lateral recumbent positions.

Systolic, diastolic, and mean aortic pressures and bilateral systolic and diastolic brachial pressures were measured in supine and right and left lateral recumbent positions. There were no significant differences between aortic pressures recorded in supine and lateral positions. Brachial pressures measured in lateral positions (up arm, down arm) were corrected for hydrostatic effects. Uncorrected up-arm pressures demonstrated a mean drop of 13 to 14 mm Hg in systolic pressure and 14 to 17 mm Hg in diastolic pressure below corresponding supine pressures. Corrected up-arm pressures were within 3 mm Hg of their respective supine pressures. Hydrostatic effects are the most likely cause of the drop in up-arm pressures. Down-arm pressure findings were inconsistent. Influences including hydrostatic effects and flow changes resulting from compression of the brachial artery by the weight of the person's body on the arm may account for this inconsistency. Brachial pressures, when possible, should be taken in supine or sitting positions. When pressures are taken with the patient in the lateral recumbent position, the up arm should be used. Up-arm pressures will be predictably lower than respective supine pressures, whereas down-arm pressures are inconsistent.

Adult↗
PubMedDate not supplied

Return to work, sexual activity, and other activities after acute myocardial infarction.

OBJECTIVES: (1) To examine the effects of exercise alone and the additional benefit of a teaching-counseling program with exercise when compared with usual medical and nursing care on the rate of return to previous activities, and (2) to describe the rates of return to former activities of daily living after an acute myocardial infarction. DESIGN: Prospective randomized clinical trial. SETTING: Seven Northwestern hospitals. SAMPLE: 258 patients, 70 years of age or younger, with the diagnosis of acute myocardial infarction, admitted to coronary care units of participating hospitals. OUTCOME MEASURES: Return to work, sexual activity, driving, previous maximum level of activity, and activities out of the home. INTERVENTION: Subjects were randomly assigned to control group A, which received usual medical and nursing care; group B1, which received usual care plus exercise; or group B2, usual care plus exercise plus teaching-counseling sessions. Home exercise programs were prescribed for patients in groups B1 and B2. Those in group B2 also participated in the outpatient teaching-counseling program that consisted of eight group sessions pertaining to risk factor reduction and psychosocial adjustment to myocardial infarction. All subjects completed Activity Summary Questionnaires, a 12-item self-report paper and pencil questionnaire about the week's activity, each week, for 12 consecutive weeks, and at week 24 after hospital discharge. RESULTS: There were no significant differences between the three groups. Previously employed patients who returned to work did so by week 24. Patients who returned to their previous maximum level of activity resumed by week 24. Most patients returned to sexual activity, driving, and activities out of the house by week 12. CONCLUSIONS: The rates of return to activities were not significantly different between the three groups. Most patients were active earlier than previously reported. Over 50% of patients returned to sexual activity, driving, and outdoor activities by 3 weeks after acute myocardial infarction. These results are useful for health care professionals who counsel patients about expectations in activity resumption.

Activities of Daily Living↗