High intensity interval training vs. moderate intensity continuous training on aerobic capacity and functional capacity in patients with heart failure: a systematic review and meta-analysis.

Background: Exercise training is commonly employed as a efficacious supplementary treatment for individuals suffering from heart failure, but the optimal exercise regimen is still controversial. The objective of the review was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the exercise capacity, cardiac function, quality of life (QoL) and heart rate among patients with heart failure with reduced ejection fraction. Methods: A systematic search was performed using the following eight databases from their inception to July 5, 2023: PubMed, Web of Science, Embase, Cochrane Library, Clinical Trials, China Knowledge Network, Wan fang Data, and the China Biology Medicine databases. The meta-analysis results were presented as mean difference (MD) and 95% confidence interval (CI). The Cochrane Risk of Bias tool was used for the included studies. The Grading of Recommendations Assessment, Development, and Evaluations was used to assess the certainty of evidence. Results: Thirteen randomized controlled trials were included in the study. The results showed that HIIT had a significant positive effect on peak oxygen uptake (MD = 1.78, 95% CI for 0.80-2.76), left ventricular ejection fraction (MD = 3.13, 95% CI for 1.25-5.02), six-minute walk test (MD = 28.13, 95% CI for 14.56-41.70), and Minnesota Living with Heart Failure Questionnaire (MD = -4.45, 95% CI for -6.25 to -2.64) compared to MICT. However, there were no statistically significant differences observed in resting heart rate and peak heart rate. Conclusions: HIIT significantly improves peak oxygen uptake, left ventricular ejection fraction, six-minute walk test, and Minnesota Living with Heart Failure Questionnaire in patients with heart failure with reduced ejection fraction. Additionally, HIIT exhibits greater effectiveness in improving peak oxygen uptake among patients with lower body mass index. Systematic Review Registration: https://www.doi.org/10.37766/inplasy2023.7.0100, identifier (INPLASY2023.7.0100).

Analysis of Effect of Minimally Invasive Fourth-ventricle Hematoma Removal for Patients with Intraventricular Hemorrhage Casting and Influence of Feedback Early Rehabilitation on Postoperative Neurological Function.

Purpose: To investigate the therapy effect of minimally invasive fourth-ventricle hematoma removal (MIFHR) for patients with intraventricular hemorrhage (IVH) casting and the influence of feedback early rehabilitation on post-operative neurological function. Methods: Eighty patients with IVH casting were enrolled from January 2019 to December 2020 in this retrospective study. Forty patients receiving MIFHR with feedback early rehabilitation were divided into the observational group, while the others receiving bilateral external ventricular drainage with traditional rehabilitation were divided into the control group. Glasgow Coma Scale (GCS) and neurological function before and after operation were compared between the two groups. In addition, hematoma clearance rate three days after surgery, drainage duration, hospitalization time, motor function and activity daily living (ADL) six months after surgery, and incidence of complications were also compared. Results: No significant differences were observed in GCS score and neurological function before surgery between the two groups (both P > .05). At the same time, there were significant differences GCS score and neurological function after surgery (both P < .05). Hematoma clearance rate three days after surgery, drainage duration, hospitalization time, and incidence of complications in the observational group were lower than those in the control group (all P < .05). In contrast, motor function and ADL six months after surgery were better in the observational group (both P < .05). Conclusion: MIFHR combined with feedback early rehabilitation is conducive to the recovery of neurological function, motor function, and ADL without increasing the incidence of complications.

Combined Effect of Early Physical Exercise and Stereotactic Hematoma Evacuation in Patients with Cerebral Hemorrhage Undergoing Hemodialysis.

Objective: This study investigated the combined effect of stereotactic hematoma evacuation and early postoperative physical function exercise in hemodialysis patients with cerebral hemorrhage. Methods: A retrospective study was conducted, including a total of 78 hemodialysis patients with cerebral hemorrhage treated at our hospital between January 2021 and June 2022. The patients were equally allocated to two groups based on different postoperative rehabilitation methods. The control group underwent stereotactic hematoma evacuation, while the study group received additional early postoperative physical function exercise in addition to the intervention provided to the control group. The operative conditions of both groups were recorded, and comparisons were made concerning neural function, limb function, daily activity ability, and complications. Results: There were no significant differences between the two groups regarding operation time, intraoperative blood loss, and hematoma removal rate (P > .05). However, the study group demonstrated a significantly shorter hospital stay (12.98 ± 2.01 days) compared to the control group (15.02 ± 2.07 days), P < .05. Post-treatment, the study group exhibited substantially lower neurological function scores (NIHSS score) (6.37 ± 1.02) compared to the control group (10.03 ± 1.09), P < .05. Additionally, the study group showed significantly higher limb function scores (P < .05) and daily activity ability scores (P < .05) compared to the control group. Moreover, the incidence of complications in the study group was significantly lower than that in the control group (P < .05). Conclusions: Early postoperative physical function exercise following stereotactic hematoma evacuation showed beneficial effects in hemodialysis patients with cerebral hemorrhage. It effectively reduced operation time, restored nerve and limb function, improved daily activity ability, and reduced the incidence of related complications. These approaches hold crucial clinical significance.

The Effects of High-Intensity Interval Training on Exercise Capacity and Prognosis in Heart Failure and Coronary Artery Disease: A Systematic Review and Meta-Analysis.

Objective: The purpose of this study is to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on exercise capacity and several prognostic markers in patients with coronary artery disease (CAD) and heart failure (HF). Methods: This systematic review is registered on the INPLASY website (number: INPLASY202080112). We conducted a comprehensive search in eight databases of literature before September 13, 2019. Trials comparing HIIT and MICT in participants with CAD or HF aged 52-78 years were included. Exercise capacity (peak oxygen consumption (peak VO2)) and prognostic markers, such as the anaerobic threshold (AT), minute ventilation/carbon dioxide production (VE/VCO2) slope, left ventricular ejection fraction (LVEF), and prognostic value of the predicted VO2 max per cent (the predicted VO2 peak (%)) were examined. Results: A total of 15 studies were included comprising 664 patients, 50% of which were male, with an average age of 60.3 ± 13.2 years. For patients with CAD, HIIT significantly improved peak VO2 values (95% CI 0.7 to 2.11) compared with MICT, but peak VO2 values in patients with HF did not seem to change. For training lasting less than eight weeks, HIIT significantly improved peak VO2 values (95% CI 0.70 to 2.10), while HIIT lasting 12 weeks or longer resulted in a modestly increased peak VO2 value (95% CI 0.31 to 5.31). High-intensity interval training significantly increased the AT when compared with MICT (95% CI 0.50 to 1.48). High-intensity interval training also caused a moderate increase in LVEF (95% CI 0.55 to 5.71) but did not have a significant effect on the VE/VCO2 slope (95% CI -2.32 to 0.98) or the predicted VO2 peak (95% CI -2.54 to 9.59) compared with MICT. Conclusions: High-intensity interval training is an effective therapy for improving peak VO2 values in patients with CAD. High-intensity interval training in the early stage (eight weeks or fewer) is superior to MICT. Finally, HIIT significantly improved prognostic markers, including the AT and LVEF in patients with CAD and HF.

[Effects of tongue acupuncture combined with rehabilitation training group of dysarthria on speech function in post-stroke dysarthria patients].

OBJECTIVE: To observe the effects of tongue and nape acupuncture combined with rehabilitation training group of dysarthria on speech function in post-stroke dysarthria patients, and to explore the treatment of dysarthria. METHODS: Eighty patients with dysarthria were randomly divided into an observation group (40 cases) and a control group (40 cases). The patients in the two groups were treated with conventional treatment. The patients in the control group were treated with the acupuncture combined with rehabilitation training group of dysarthria; the patients in the observation group were treated with the control group treatment and tongue acupuncture, once a day, 6 days per week for 2 weeks. The patients were evaluated with general dysarthria scale and dysarthria checklist of Chinese Rehabilitation Study Center before and after 2-week treatment. RESULTS: After treatment, the total score and each item score of general dysarthria scale were reduced (all P<0.05); all the score in the observation group was lower than those in the control group (all P<0.05), except the score of jaw which had no significant difference between the two groups. After treatment, the dysarthria checklist of Chinese Rehabilitation Study Center in the observation group was superior to that in the control group (P<0.05). The total effective rate was 85.0% (34/40) in the observation group, which was higher than 67.5% (27/40) in the control group (P<0.05). CONCLUSION: Tongue acupuncture, nape acupuncture and rehabilitation training group of dysarthria could effectively improve the speech function of post-stroke dysarthria patients.