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At least 19 recordsLinked to original sources
PubMed1979

Community participation in cardiac rehabilitation.

Cardiac patients are not solely responsible for their own rehabilitation. The rehabilitative process is a prolonged one, and success lies in multidisciplinary management involving the patient, the immediate family and the community. The Health Act (Act No. 63 of 1977) has various implications for the future provision of rehabilitative services in South Africa. Each member of the health team and the community has a specific role to play, either within or outside the hospital setting, thus providing ongoing rehabilitative supervision of cardiac patients.

Aftercare↗
PubMed2026

Home-Based Cardiac Rehabilitation Using a Smart Ring and Telephone Counselling: A Randomized Controlled Trial.

BACKGROUND: Home-based cardiac rehabilitation (HB-CR) is a promising alternative to center-based cardiac rehabilitation as it can address several barriers impeding CR implementation because of its enhanced accessibility. However, to date, HB-CR has not garnered adequate attention due to a lack of communication between patients and medical staff. In this study, we aimed to investigate the effectiveness of HB-CR by monitoring the pulse rate (PR) using a smart ring equipped with photoplethysmography. METHODS: Patients with cardiovascular disease were educated on structured HB-CR methods following a symptom-limited cardiopulmonary exercise test (CPET), and were instructed to wear the device during the exercise session. The recorded PR was uploaded to a website via a smartphone and monitored by medical staff. Patients were randomly assigned to one of two groups: intervention or control group. The intervention group received weekly telephone counselling and was encouraged to maintain optimal levels of physical activity. In contrast, the control group only recorded their exercise data without additional interventions. After 3 months of training, the CPET was performed. RESULTS: Among the 64 randomized patients (32 in each group), an intention-to-treat analysis showed that peak oxygen consumption increased over time in both the groups, with a significantly greater improvement in the intervention group. The group-by-time interaction for peak oxygen consumption was statistically significant (estimated mean difference, 2.0 mL/kg/min; 95% confidence interval, 0.7-3.3; P = 0.004). CONCLUSION: HB-CR using a smart device was effective in improving oxygen consumption. However, appropriate monitoring and timely counselling by medical professionals are important for improved outcomes. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0005893.

Humans↗
PubMed1976

A physiologic approach to cardiac rehabilitation.

Rehabilitation of the patient with atherosclerotic coronary heart disease is a longitudinal, comprehensive care program that ends only on the death of the patient. Although much remains to be learned about cardiac rehabilitation, there is a rational basis predicated upon causes of disability, healing of myocardial damage, energy cost of activities, a rational approach to the activity and exercise prescription, and the potential benefits from exercise to justify a concerted national rehabilitation effort. The potential benefits in terms of more rapid return to work, maintenance of the patient's psychosocial integrity, and modification of natural history of the disease make the institution of a cardiac rehabilitation program a prudent activity for a practitioner, clinic, or hospital.

Adaptation, Physiological↗
PubMed2026

Effectiveness of Multidomain Cardiac Rehabilitation After Myocardial Infarction by Patient Frailty: Prespecified Subgroup Analysis of the PIpELINe Trial.

BACKGROUND: Frailty is common among older patients surviving myocardial infarction, is associated with adverse outcomes, and is often perceived as a barrier to cardiac rehabilitation (CR). The aim of this study is to determine whether frailty influences prognosis after myocardial infarction, and whether frailty modifies the clinical benefit of multidomain CR. METHODS: We performed a prespecified subgroup analysis of the PIpELINe (Physical Activity Intervention in Elderly Patients With Myocardial Infarction) randomized clinical trial conducted in Italy, which enrolled 512 patients aged ≥65 years recovering from myocardial infarction and randomized them in a 2:1 ratio to CR or usual care. Frailty was assessed using the Fried Frailty Phenotype, and patients were categorized as nonfrail (robust) or prefrail/frail. Time-to-event outcomes were analyzed using Kaplan-Meier estimates and Cox proportional hazards models, including treatment-by-frailty interaction terms to evaluate effect modification of the multidomain CR. The primary outcome was a composite of cardiovascular death or unplanned hospitalization for cardiovascular causes within 1 year after randomization. RESULTS: Overall, 350 patients (68.4%) were classified as prefrail/frail, of whom 232 were randomized to intervention arm (66%). Frail patients were older (median age, 80 [75-85] years) and more frequently female (41.7% versus 24.7%). Compared with robust patients, prefrail/frail patients had a higher risk of the primary outcome (16 [9.9%] versus 62 [17.7%]; hazard ratio, 1.59 [95% CI, 0.89-2.82]; adjusted P=0.117). Among prefrail/frail patients, assignment to multidomain CR was associated with a lower risk of the primary outcome compared with usual care (hazard ratio, 0.57 [95% CI, 0.34-0.94]; P=0.028), with no statistically significant interaction in the treatment effect on the primary end point (P=0.57). CONCLUSIONS: Among older patients recovering from myocardial infarction, frailty is associated with worse prognosis but does not diminish the benefit of multidomain CR. These findings support the use of frailty assessment to guide rather than limit access to CR. REGISTRATION: ClinicalTrials.gov; Unique identifier: NCT04183465.

Humans↗
PubMed1978

Electronic processing of cardiac rehabilitation data.

With the incidence of ischaemic heart disease at epidemic levels and rising, techniques for detecting, predicting, and rehabilitating the condition of cardiac dysfunction are constantly under development. One technique, that of exercise stress testing, has been used in recent decades in the prediction, detection, and rehabilitation of cardiopulmonary disease. However, ergometric studies in this regard have been hampered by the tedium of physiologic data collection and analysis. With the advent of automated digital and analogue computation procedures and equipment, such data can be both operated on real-time for immediate display or stored for post-exercise and patient-history studies. Such automated data manipulation provides an systematic and comprehensive testing of each patient and permits a much greater case-load. In addition, special computer programs can compile and index specific parameters from a large sample size to facilitate statistical surveys of selected patient populations. The results of such statistical analyses can, if desired, be automatically printed out in a graphical form.

Computers↗
PubMedDate not supplied

Cardiac rehabilitation: a patient education program.

Hospitalized cardiac patients were given an education program that covered, in five 45-minute discussion sessions, anatomy and physiology, dietary management, appropriate activity programs, the adjustment process, risk factors, and signs and symptoms of complications of therapy. A sample of 36 patients was given pre- and posttests and followed at six weeks and three months postdischarge. Significant (p less than .05) increases in knowledge were found among study subjects which resulted in improved conditions for the subjects.

Adolescent↗
PubMed2026

Nurse-Led Home-Based Mobile Health Cardiac Rehabilitation Program for Patients With Chronic Heart Failure: A Randomized Controlled Trial.

This 12-week randomized controlled trial evaluated a nurse-led mHealth intervention for patients with chronic heart failure, conceptually informed by Riegel's middle-range theory of self-care of chronic illness. The program integrated wearable activity tracking with weekly nurse-led behavioral coaching, reflecting the core self-care processes of monitoring, maintenance, and management. Compared with usual care, the intervention significantly improved daily step count, 6-minute walk distance, metabolic equivalents, and left ventricular ejection fraction. Findings highlight the effectiveness of theory-informed, nurse-delivered mHealth strategies in enhancing physical activity and cardiopulmonary function, while underscoring the critical role of advanced practice nurses in home-based chronic disease management.

Aged↗
PubMedDate not supplied

Brief sexual counseling during cardiac rehabilitation.

Advances in the understanding and treatment of myocardial infarction have appeared over the past decade. One intervention technique receiving increasing emphasis is the development of multidisciplinary "rehabilitation teams" whose chief aim is to assist individuals in returning to former levels of medical and psychosocial functioning. Within the team approach, the mental health specialist clearly plays a significant role. Counselors can provide support and reassurance in the midst of the medical crisis and help to minimize stress related to rearrangements in family roles and routines. In this instance, brief sex counseling as part of an ongoing rehabilitation program serves to clarify misconceptions, reduce fears, and facilitate return to sexual activities after infarction. It is important to remember, however, that an accurate physiologic evaluation provides the foundation on which to base counseling efforts. Without adequate medical information, no amount of counseling expertise will succeed. Certainly the final decision to resume sexual behavior remains with the individual couple. The counselor's primary task is to emphasize that the myth of total abstinence is not applicable for most cardiac patients. In reality, it is possible and even highly beneficial for patient and spouse to return to their normal sexual relationship.

Counseling↗
PubMed1976

[Preliminary psychological survey in the study of cardiac rehabilitation through controlled physical activity].

The authors carried out an enquiry in 32 patients as part of a more extensive study which permitted them to show the necessity of early physical rehabilitation after myocardial infarction which should be gradual and as prolonged as possible under permanent medical control. Subjects under training usually adhere enthusiastically to this program of progressively complete and rapid social reinsertion, by the development of new relationships, whether personal, familial or professional.

Adult↗
PubMed1979

The family and cardiac rehabilitation.

Family resources and needs are often overlooked in planning for rehabilitation of the individual following myocardial infarction. The acute ischemic event presents a massive disruption in the psychodynamic balance of the family, but it can provide an unparalleled opportunity for increased awareness and growth for all members of the family. An integrated program of emotional support, education, and physical activity is recommended to facilitate restoration of the individual's self-esteem. Formal family counseling provides a forum for resolution of fears and misconceptions and permits redefinition of roles within the family.

Adaptation, Psychological↗
PubMed1979

Moderate exercise and high-density lipoprotein-cholesterol. Observations during a cardiac rehabilitation program.

The effects of a 13-week moderate exercise program on fasting plasma insulin, lipids, and lipoprotein cholesterol concentrations were studied in 32 sedentary, middle-aged men with coronary artery disease. The preponderant component of the exercise program was walking or slow jogging. There was no significant change in the systolic blood pressure and pulse rate product response to a standard exercise load. The high-density lipoprotein-cholesterol (HDL-C) level increased, and the fasting plasma insulin concentration decreased. There were no significant changes in plasma triglycerides or low-density lipoprotein cholesterol levels. In sedentary subjects with coronary artery disease, a modest increase in activity can result in an increase in the HDL-C level and a decrease in the plasma insulin concentration. These changes occurred in the absence of variations in diet, smoking habits, adiposity, or plasma triglyceride concentrations and did not require a cardiovascular training effect.

Adult↗