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1.
Rev. Ciênc. Saúde ; 13(4): 4-10, Dezembro 2023.
Article in English | LILACS | ID: biblio-1525676

ABSTRACT

Objectives: To investigate the effect of exercise intensity on functional capacity in individuals with coronary artery disease, assess adherence to the heart rate training zone (HRTZ), and relationship between trained intensity and functional capacity. Methods: Retrospective study led with medical records of 54 outpatients with coronary artery disease in a public hospital. The prescribed intensity started at 50 ­60% of heart rate reserve, increasing monthly to 70 ­80% by the third month. Spearman's test was used to assess the correlation between improvement in distance in the incremental shuttle walk test (ISWT), exercise intensity, and rating of perceived exertion (Borg­RPE). Adherence was classified as 'below' when HRTZ was not achieved in any phase of the program, 'intermediate' when HR was within the HRTZ for one or two months, and 'above' when HR was at or higher than HRTZ two months. Improvement was tested with t-test and one-way ANOVA. Results: 51.9% of participants had an increase in ISWT of ≥70 m (p < 0.0001). In at least one month, 50.9% trained below HRTZ. Trained intensity did not go below 8.6% of the prescribed minimal threshold of HRTZ. Changes in ISWT were not significantly correlated with exercise intensity (p = 0.87) or Borg­RPE (p = 0.16). Conclusion: While a significant increase in functional capacity was found, considerable heterogeneity in changes were observed. This may, in part, be related to adherence to HRTZ with progressive exercise intensity and to the variability in exercise volume incardiovascular rehabilitation programs.


Subject(s)
Humans , Medical Records , Walk Test , Cardiac Rehabilitation , Hospitals, Public
2.
Rev. costarric. cardiol ; 25(2): 16-24, jul.-dic. 2023. graf
Article in Spanish | LILACS, SaludCR | ID: biblio-1559763

ABSTRACT

RESUMEN Las enfermedades cardiovasculares y el cáncer corresponden a la primera y segunda causa de muerte a nivel mundial, respectivamente. Comparten factores de riesgo comunes: envejecimiento, estilos de vida no saludables, entre otros; con la atenuante que los pacientes con cáncer o sobrevivientes a este, por sus tratamientos, pueden desarrollar cardiotoxici- dad. Por lo tanto, las estrategias de prevención y tratamiento en algunos de sus abordajes también son similares. Pueden considerarse enfermedades simultáneas o consecutivas, pueden coexistir en un mismo paciente, corresponde entonces un abordaje multidisciplinario, basado en evaluación del riesgo, entrenamiento físico, optimización de terapia farmacoló- gica, consejería de estilos de vida saludable, control de factores de riesgo cardiovascular, apoyo psicológico, adherencia a un estilo de vida más activo con la consecuente mejora en la capacidad cardiopulmonar y por lo tanto funcional. Este documento tiene la intención de plantear una propuesta de protocolo para la prescripción de ejercicio en paciente on- cológico o sobreviviente de cáncer para la prevención de enfermedad cardiovascular, basado en recomendaciones de los consensos internacionales.


ABSTRACT Protocol proposal for exercise prescription in cancer patients or cancer survivors for the prevention of cardiovascular disease Cardiovascular diseases and cancer correspond to the first and second causes of death worldwide. They share common risk factors: aging, unhealthy lifestyles, among others; with the attenuating circumstance that cancer patients or survivors may develop cardiotoxicity due to their treatment. Therefore, the prevention and treatment strategies in some of its approaches are also similar. Diseases can be considered simultaneous or consecutive, they can coexist in the same patient, so a multidisciplinary approach is appropriate, based on risk assessment, physical training, optimization of drug therapy, healthy lifestyle counseling, control of cardiovascular risk factors, psychological support, adherence to a more active lifestyle with the consequent improvement in cardiopulmonary and therefore functional capacity. This document intends to propose a protocol proposal for the prescription of exercise in cancer patients or cancer survivors for the prevention of cardiovascular disease, based on international consensus recommendations.


Subject(s)
Humans , Cardiovascular Diseases/therapy , Clinical Protocols , Exercise Therapy , Cardio-Oncology/education , Costa Rica , Cardiac Rehabilitation , Heart Disease Risk Factors
3.
Medicentro (Villa Clara) ; 27(3)sept. 2023.
Article in Spanish | LILACS | ID: biblio-1514485

ABSTRACT

Introducción: La rehabilitación cardiovascular integral del paciente con infarto agudo de miocardio resulta fundamental para el logro de su bienestar físico y psicológico, y su reinserción a la vida social. Objetivo: Elaborar una estrategia de intervención psicoeducativa para potenciar la rehabilitación cardiovascular integral en pacientes convalecientes de infarto agudo de miocardio, con la visión de especialistas consultados. Métodos: Se realizó un estudio observacional, descriptivo y de corte transversal en el Hospital Universitario «Dr. Celestino Hernández Robau», de Santa Clara, entre octubre de 2019 y enero de 2021. La muestra estuvo conformada por 27 pacientes que asistieron a la consulta de Cardiología, y 7 especialistas según criterios de inclusión. Las técnicas aplicadas fueron: la revisión de historia clínica, entrevistas semiestructuradas a pacientes y especialistas, la encuesta sobre el conocimiento de la enfermedad, un autorreporte vivencial y la evaluación del estilo vida. Se utilizaron estadísticos descriptivos acorde a la medición de las variables, análisis de contenido y triangulación de la información. Resultados: En los pacientes diagnosticados con estilo de vida poco saludable, predominó un conocimiento medianamente suficiente de la enfermedad; la hipertensión arterial fue el principal factor de riesgo asociado. Se elaboró la estrategia de intervención según las necesidades psicoeducativas identificadas por los pacientes con la visión de especialistas consultados. Se constató que presentan carencia de habilidades para autocontrolar las reacciones emocionales posteriores al suceso cardiovascular. Conclusiones: La estrategia elaborada fue valorada satisfactoriamente por juicio de profesionales, indicándose la posibilidad de ser aplicada en los usuarios a los que está dirigida.


Introduction: comprehensive cardiovascular rehabilitation of patients with acute myocardial infarction is essential to achieve their physical and psychological well-being, and their reintegration into social life. Objective: to develop a psychoeducational intervention strategy to enhance comprehensive cardiovascular rehabilitation in patients convalescent from acute myocardial infarction, with the vision of consulted specialists. Methods: an observational, descriptive and cross-sectional study was carried out at "Dr. Celestino Hernández Robau" University Hospital, in Santa Clara, between October 2019 and January 2021. The sample consisted of 27 patients who come to the Cardiology consultation, and 7 specialists according to inclusion criteria. Medical history review, semi-structured interviews with patients and specialists, a survey on knowledge of the disease, an experiential self-report, and a lifestyle evaluation were the techniques applied. Descriptive statistics were used according to the measurement of the variables as well as content analysis and triangulation of the information. Results: a moderately sufficient knowledge of the disease prevailed in patients diagnosed with an unhealthy lifestyle; arterial hypertension was the main associated risk factor. The intervention strategy was developed according to the psychoeducational needs identified by the patients with the vision of the consulted specialists. We verified that they have a lack of abilities to self-control their emotional reactions after the cardiovascular event. Conclusions: the elaborated strategy was satisfactorily valued by professional judgment, which indicates the possibility of being applied to the users to whom it is directed.


Subject(s)
Cardiac Rehabilitation , Patient Care , Psychosocial Intervention , Myocardial Infarction
4.
Aquichan ; 23(3): e2333, 24 jul. 2023.
Article in English, Spanish | LILACS, BDENF, COLNAL | ID: biblio-1517711

ABSTRACT

Introduction: Cardiovascular diseases represent the leading cause of death worldwide, and education interventions are an effective measure to control modifiable risk factors in patients undergoing cardiac rehabilitation; therefore, studying this phenomenon allows expanding the tools to face this situation. Objective: To determine the impact of educational interventions to foster health in patients undergoing cardiac rehabilitation. Materials and methods: A scientific literature review was conducted in the PubMed, SciELO, LILACS, EBSCO, MEDES, CUIDEN, Dialnet, ScienceDirect and CUIDATGE databases, based on the PRISMA statement proposal for systematic reviews, registered in the Prospero database (CRD42023398444). The Jadad scale was used for the methodological assessment, according to the peer approach. Results: The initial search yielded 14,849 publications, with 10 of them meeting the inclusion criteria. The mean age of the sample population was 63 years old, male gender. Telemedicine and education software design were resources to implement the interventions, finding a reduction in hospitalizations for cardiac reasons. Regarding mental health, long-term reductions in anxiety and depression were found. Conclusions: The time until the first cardiovascular hospitalization was 502 (469-535) days in the Intervention Group, against 445 (400-491) days in the Control Group. When evaluating medication adherence, it was evidenced that 94 % of the participants had improvements. Regarding cardiovascular risk stratification, both the intervention (26 %) and the control (6 %) groups shifted to the lower-risk class.


Introducción: las enfermedades cardiovasculares representan la primera causa de muerte a nivel mundial, y las intervenciones educativas representan una medida eficaz para controlar factores de riesgo modificables en pacientes en rehabilitación cardiaca, por ello estudiar este fenómeno permite ampliar las herramientas frente a esta situación. Objetivo: determinar el impacto de las intervenciones educativas para fomentar la salud en pacientes en rehabilitación cardiaca. Materiales y métodos: se realizó una revisión de la literatura científica en las bases de datos Pudmed, Scielo, Lilacs, Ebsco, Medes, Cuiden, Dialnet, Science Direct y Cuidatge, basada en la propuesta de la declaración Prisma para revisiones sistemáticas, y se registró en la base Prospero (CRD42023398444). La escala Jadad se usó para la evaluación metodológica, bajo el enfoque de dos pares. Resultados: la búsqueda inicial arrojó 14 849 publicaciones, de las cuales al final 10 cumplieron los criterios de inclusión. La edad promedio de la población de la muestra fue 63 años, de sexo masculino. La telemedicina y el diseño de software para educación fueron recursos para implementar las intervenciones, encontrando disminución de las rehospitalizaciones por causas coronarias. Respecto a la salud mental, se encontró disminución de la ansiedad y depresión a largo plazo. Conclusiones: el tiempo hasta la primera rehospitalización cardiovascular fue de 502 (469-535) días en el grupo de intervención, frente a 445 (400-491) días en el grupo control. Al evaluar la adherencia a la medicación, se evidenció que el 94 % de los participantes tuvo mejoras. En cuanto a la estratificación del riesgo cardiovascular, tanto el grupo de intervención (26 %) como el grupo control (6 %) cambiaron a clase de menor riesgo.


Introdução: as doenças cardiovasculares são a principal causa de morte em todo o mundo, e as intervenções educativas representam uma medida eficaz no controle dos fatores de risco modificáveis em pacientes de reabilitação cardíaca, razão pela qual o estudo deste fenómeno permite ampliar as ferramentas perante esta situação. Objetivo: determinar o impacto das intervenções educativas na promoção da saúde em pacientes de reabilitação cardíaca. Materiais e métodos: foi realizada uma revisão da literatura científica nas bases de dados PubMed, SciELO, LILACS, EBSCO, MEDES, CUIDEN, Dialnet, ScienceDirect e CUIDATGE, baseada na proposta da declaração Prisma para revisões sistemáticas, sendo registrada na base Prospero (CRD42023398444). A escala Jadad foi utilizada para avaliação metodológica, sob a abordagem de dois pares. Resultados: a pesquisa inicial envolveu 14.849 publicações, das quais 10 cumpriram com os critérios de inclusão. A média de idade da população da amostra foi de 63 anos, do sexo masculino. Telemedicina e design de software educativo foram os recursos utilizados para implementar as intervenções, constatando-se uma diminuição nas rehospitalizações por causas coronárias. Em relação à saúde mental, verificou-se uma diminuição da ansiedade e da depressão a longo prazo. Conclusões: o tempo até a primeira rehospitalização cardiovascular foi de 502 (469-535) dias no grupo de intervenção, comparado com 445 (400-491) dias no grupo de controle. Na avaliação da adesão à medicação, 94 % dos participantes registaram melhorias. Em termos de estratificação do risco cardiovascular, tanto o grupo de intervenção (26 %) como o grupo de controle (6 %) passaram para uma classe de risco inferior.


Subject(s)
Rehabilitation Nursing , Coronary Disease , Education , Health Impact Assessment , Cardiac Rehabilitation
5.
Article in Spanish | LILACS, CUMED | ID: biblio-1536323

ABSTRACT

Introducción: Una complicación reportada en la infección por SARS-CoV-2 es la miocardiopatía. Se ha descrito que los pacientes pueden presentar un deterioro significativo de la clase funcional, que limita el desempeño en las actividades de la vida diaria, sociales, familiares y laborales. La rehabilitación cardíaca como componente integral es una alternativa de tratamiento no farmacológica en el manejo de secuelas cardiovasculares ocasionadas por SARS-CoV-2. Objetivo: Describir el impacto de la rehabilitación cardíaca integral en un caso de paciente con miocardiopatía por SARS-CoV-2. Caso clínico: Se presenta el caso de un hombre de 56 años de edad con miocardiopatía por SARS-CoV-2 quien realizó rehabilitación cardíaca integral. Conclusiones: La rehabilitación cardíaca con un componente de intervención integral multidisciplinar permitió al paciente mejorar la capacidad aeróbica, sintomatología, calidad de vida relacionada con la salud y reincorporarse a las actividades sociales, familiares y laborales(AU)


Introduction: A reported complication of SARS-CoV-2 infection is cardiomyopathy. It has been described that patients may present with significant impairment of functional class, limiting performance in activities of daily living, social, family and work. Cardiac rehabilitation as an integral component is a non-pharmacological treatment alternative in the management of cardiovascular sequelae caused by SARS-CoV-2. Objective: To describe the impact of comprehensive cardiac rehabilitation in a case of a patient with cardiomyopathy due to SARS-CoV-2. Case report: We present the case of a 56-year-old patient with SARS-CoV-2 cardiomyopathy who underwent comprehensive cardiac rehabilitation. Conclusions: Cardiac rehabilitation with a comprehensive multidisciplinary intervention component allowed the patient to improve aerobic capacity, symptomatology, health-related quality of life and reincorporation to social, family and work activities(AU)


Subject(s)
Humans , Male , Middle Aged , Quality of Life , Cardiac Rehabilitation/methods , COVID-19/epidemiology , Cardiomyopathies/complications
6.
Int. j. morphol ; 41(1): 246-256, feb. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1430523

ABSTRACT

SUMMARY: This study is to investigate the effect of home-based cardiac rehabilitation (HBCR) on quality of life, functional capacity, and readmission rates in patients with heart failure. Randomized controlled trials (RCTs) were screened from Cochrane Library, CINAHL, EMBASE, and MEDLINE. The intervention group received a standardized HBCR or a comprehensive rehabilitation strategy that included HBCR. The participants in the control group received CR at a medical center or usual care without CR intervention. The main outcome measurements included quality of life, exercise capacity, mortality and re-hospitalization. This meta-analysis included 20 RCTs, in which 16 studies compared HBCR with usual care, and 4 studies compared HBCR with center-based CR. In comparison with the usual care, HBCR improved the total quality of life score [MD=-5.85, 95 % CI (-9.76, - 1.94), P=0.003, I2=75 %]. Patients with HBCR and usual care were significantly different in VO2max [MD=1.05 mL/kg/min, 95 % CI (0.35, 1.75), P=0.003, I2=46 %]. However, VO2max of patients with HBCR was not significantly different from those with center-based CR [MD=0.08 mL/kg/min, 95 % CI (-1.29, 1.44), P=0.91, I2=0 %]. There was statistically significant difference in the 6-min Walk Distance between usual care and HBCR (for distance [MD=11.84, 95 % CI (7.41, 16.28), P<0.00001, I2=0 %]; and for feet [MD=98.93, 95 % CI (26.79, 171.08), P=0.007, I2=56 %]). However, there was no significant difference in 6-min Walk Distance between patients with HBCR and center-based CR [MD=12.45, 95 % CI (-9.81, 34.72), P=0.27, I2=0 %] , or in anxiety and depression between patients with usual care and HBCR (for anxiety, [MD=-0.25, 95 % CI (-0.56, 0.05), P=0.11, I2=0 %]; for depression, [MD=-0.18, 95 % CI (-0.51, 0.16), P=0.30, I2=0 %] . No significant difference was found in death number [RR=1.04, 95 % CI (0.55, 1.98), P=0.90, I2=0 %] or in the number of re-hospitalization [RR=0.88, 95 % CI (0.66, 1.18), P=0.40, I2=0 %] between usual care and HBCR. For patients with heart failure, compare with usual care and center-based CR, HBCR can improve the total quality of life. Compare with usual care, HBCR can improve VO2max and 6-min Walk Distance, but compare with center- based CR, there are no differences in mortality, re-hospitalization rate or incidence of anxiety and depression. Additionally, center- based CR and HBCR showed similar outcomes and medical costs.


El objetivo de este estudio fue investigar el efecto de la rehabilitación cardíaca domiciliaria (HBCR) sobre la calidad de vida, la capacidad funcional y las tasas de reingreso en pacientes con insuficiencia cardíaca. Se seleccionaron ensayos controlados aleatorios (ECA) de la Biblioteca Cochrane, CINAHL, EMBASE y MEDLINE. El grupo de intervención recibió un HBCR estandarizado o una estrategia de rehabilitación integral que incluía HBCR. Los participantes del grupo de control recibieron RC en un centro médico o atención habitual sin intervención de RC. Las principales medidas de resultado incluyeron la calidad de vida, la capacidad de ejercicio, la mortalidad y la rehospitalización. Este metanálisis incluyó 20 ECA, en los que 16 estudios compararon HBCR con la atención habitual y 4 estudios compararon que mejoró la puntuación total de calidad de vida [DM=-5,85, IC del 95 % (-9,76, -1,94), P=0,003, I2=75 %]. Los pacientes con HBCR y atención habitual fueron significativamente diferentes en el VO2máx [DM = 1,05 ml/kg/ min, IC del 95 % (0,35, 1,75), P = 0,003, I2 = 46 %]. Sin embargo, el VO2max de los pacientes con HBCR no fue significativamente diferente de aquellos con CR basada en el centro [DM = 0,08 ml/kg/min, IC del 95 % (-1,29, 1,44), P = 0,91, I2 = 0 %]. Hubo una diferencia estadísticamente significativa en la distancia de caminata de 6 minutos entre la atención habitual y HBCR (para la distancia [DM=11,84, IC del 95 % (7,41, 16,28), P<0,00001, I2=0 %]; y para los pies [DM= 98,93, IC 95 % (26,79, 171,08), P=0,007, I2=56 %]). Sin embargo, no hubo una diferencia significativa en la distancia de caminata de 6 minutos entre los pacientes con HBCR y CR basada en el cen- tro [DM = 12,45, IC del 95 % (-9,81, 34,72), P = 0,27, I2 = 0 %], o en la ansiedad y depresión entre pacientes con atención habitual y HBCR (para ansiedad, [DM=-0,25, IC del 95 % (-0,56, 0,05), P=0,11, I2=0 %]; para depresión, [DM=-0,18, 95 % IC (- 0,51, 0,16), P=0,30, I2=0 %] No se encontraron diferencias significativas en el número de muertes [RR=1,04, IC del 95 % (0,55, 1,98), P=0,90, I2=0 %] o en el número de reingresos [RR=0,88, IC 95 % (0,66, 1,18), P=0,40, I2=0 %] entre atención habitual y HBCR. Para los pacientes con insuficiencia cardíaca, en comparación con la atención habitual y la CR en un centro, la HBCR puede mejorar la calidad de vida total. En comparación con la atención habitual, la HBCR puede mejorar el VO2máx y la distancia recorrida en 6 minutos, pero en comparación con la CR basada en un centro, no hay diferencias en la mortalidad, la tasa de rehospitalización o la incidencia de ansiedad y depresión. Además, CR y HBCR basados en el centro mostraron resultados y costos médicos similares.


Subject(s)
Humans , Cardiac Rehabilitation/methods , Heart Failure/rehabilitation , Home Care Services , Patient Readmission , Quality of Life , Exercise
7.
Article in Chinese | WPRIM | ID: wpr-1007839

ABSTRACT

Cardiac rehabilitation, with exercise training as the core component, has well-known benefits for stable coronary heart disease. This therapeutic approach is gradually gaining wide application in domestic clinical practice and is currently recommended by major guidelines at home and abroad. In recent years, more progress has been made in the technical specifications and nursing practice of rehabilitation treatment for coronary heart disease. This consensus is written by experts from the Professional Committee of Cardiopulmonary Prevention and Rehabilitation of the Chinese Rehabilitation Medical Association and the Cardiovascular Rehabilitation Committee of the Chinese Medical Association, with a view to further promoting the development of physical therapy and nursing practice for stable coronary heart disease in China.


Subject(s)
Humans , Coronary Artery Disease , Consensus , Cardiac Rehabilitation , Exercise , China
8.
Acta Physiologica Sinica ; (6): 953-961, 2023.
Article in Chinese | WPRIM | ID: wpr-1007804

ABSTRACT

The study aimed to examine the effects of virtual reality (VR) technology-based phase I cardiac rehabilitation (CR) program in elderly coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Thirty-six cases of elderly CHD patients who underwent PCI in the First Affiliated Hospital of Chongqing Medical University from June 2022 to April 2023 were recruited by convenience sampling method. The patients were randomly assigned by means of random digital table method to two study groups: control group (n = 18), which received conventional nursing intervention after PCI, and experimental group (n = 18), which received a combined program of conventional nursing intervention together with CR program based on VR technology. The 6 min walk test (6MWT), Simple Physical Performance Battery (SPPB), SF-36 scale, Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale-Revised (IES-R) were tested before and after rehabilitation. Moreover, the incidence of major adverse cardiovascular events (MACE) was recorded at 3 months after PCI. After VR-based CR, the 6MWT distance and SPPB scores of patients in the experimental group were higher than those in control group (P < 0.05). The HADS scores and IES-R scores of the patients in the experimental group were lower than those in control group (P < 0.01), and the difference in SF-36 scale scores was not statistically significant between two groups (P > 0.05). The incidence of MACE was not significantly different at 3 months after PCI (P > 0.05). These results suggest that VR-based phase I CR program mitigates the degree of PCI postoperative stress, anxiety, and depression in elderly CHD patients, however, enhances the resistance to fatigue and does not increase the risk of adverse cardiac events, suggesting it is a safe intervention.


Subject(s)
Aged , Humans , Anxiety , Cardiac Rehabilitation/methods , Coronary Disease/surgery , Percutaneous Coronary Intervention/adverse effects , Virtual Reality
9.
Article in Chinese | WPRIM | ID: wpr-970460

ABSTRACT

Acute coronary syndrome (ACS),with increasing mortality year by year,has become a major public health problem in China.Exercise rehabilitation as an important part of the out-of-hospital rehabilitation for the patients with heart diseases can further reduce the mortality of patients on the basis of drug treatment.The available studies have proved that high-intensity interval training (HIIT) is more effective and efficient than moderate-intensity continuous training (MICT) such as walking and jogging on chronic cardiovascular diseases such as heart failure,stable coronary heart disease,and hypertension and has high security.According to the latest research,HIIT can reduce the platelet response,mitigate myocardial ischemia-reperfusion injury,and increase the exercise compliance of ACS patients more significantly than MICT.Moreover,it does not increase the risk of thrombotic adverse events or malignant arrhythmia.Therefore,HIIT is expected to become an important part of exercise prescription in out-of-hospital cardiac rehabilitation strategy for the patients with ACS.


Subject(s)
Humans , Cardiac Rehabilitation , High-Intensity Interval Training , Acute Coronary Syndrome , Heart Failure , Blood Platelets
10.
Rev. costarric. cardiol ; 24(2)dic. 2022.
Article in Spanish | LILACS, SaludCR | ID: biblio-1431793

ABSTRACT

Introducción: Aun son escasos los estudios que recomiendan los pacientes con fibrilación auricular en los programas de rehabilitación cardiaca. Objetivo: Evaluar los efectos del entrenamiento físico en pacientes con fibrilación auricular en régimen de rehabilitación cardiovascular. Metodología: Se realizó un estudio pre-experimental, prospectivo, tipo pretest- postest con 18 pacientes con fibrilación auricular que asistieron durante 12 semanas a las sesiones de rehabilitación cardiaca. Se evaluó el paciente al inicio y finaldel programa con ergometría con gases espirados, análisis de sangre y ecocardiograma transtorácico. Resultados: Predominaron el sexo masculino (72.2 %), el diagnóstico de miocardiopatías (33.3 %), la hipertensión arterial (100 %) y la fibrilación auricular persistente de larga duración (55.6 %). Se encontró una diferencia estadísticamente significativa para cada variable morfofuncional: índice de masa corporal (28.0±5.0 vs. 26.9±4.4, p< 0.0001), consumo de oxígeno pico (13.6±3.0 vs. 15.3±2.9, p<0.0001), consumo de oxígeno en el umbral anaerobio (9.9±2.2 vs. 10.7±2.0; p=0.007), equivalente ventilatorio para dióxido de carbono (27.7±4.7 vs. 26.6±4.7; p<0.0001), equivalente ventilatorio para el oxígeno (24.2±5.0 vs. 23.8±4.9 p=0.001), pulso de oxígeno (10.2±2.5 vs. 12.1±2.1; p< 0,0001), unidades metabólicas (3.8±0.9 vs. 4.3±0.9; p<0.0001) y fracción de eyección ventricular izquierda (55,7±8,7 vs. 58,2±7,5, p=0,003). Las variables metabólicas disminuyeron significativamente (p<0.0001). La clase funcional de Weber mejoró en 5 pacientes (27.8 %). Conclusiones: El entrenamiento físico de pacientes con fibrilación auricular durante 12 semanas de rehabilitación cardiovascular mejoró la capacidad funcional, con incrementos evolutivos de la fracción de eyección ventricular izquierda y disminución de las variables metabólicas, sin generar riesgos ni complicaciones.


Effects of physical training of patients with atrial fibrillation in cardiovascular rehabilitation regimen Introduction: There are still few studies that recommend patients with atrial fibrillation in cardiovascular rehabilitation programs. Objective: To evaluate the effects of physical training in patients with atrial fibrillation undergoing cardiovascular rehabilitation. Method: A pre-experimental, prospective, pretest-posttest study was carried out with 18 patients with atrial fibrillation who attended cardiac rehabilitation sessions for 12 weeks. The patient was evaluated at the beginning and end of the program with stress test with expired gases, blood test and transthoracic echocardiogram. Results: The male sex (72.2%), the diagnosis of cardiomyopathies (33.3%), arterial hypertension (100%) and longterm persistent atrial fibrillation (55.6%) predominated. A statistically significant difference was found for each morphofunctional variable: body mass index (28.0±5.0 vs. 26.9±4.4, p<0.0001), peak oxygen consumption (13.6±3.0 vs. 15.3±2.9, p<0.0001), oxygen at the anaerobic threshold (9.9±2.2 vs. 10.7±2.0; p=0.007), ventilatory equivalent for carbon dioxide (27.7±4.7 vs. 26.6±4.7; p<0.0001), ventilatory equivalent for oxygen (24.2± 5.0 vs. 23.8±4.9 p=0.001), oxygen pulse (10.2±2.5 vs. 12.1±2.1; p<0.0001), metabolic units (3.8±0.9 vs. 4.3±0.9; p<0.0001) and fraction of left ventricular ejection (55.7±8.7 vs. 58.2±7.5, p=0.003). The metabolic variables decreased significantly (p<0.0001). Weber's functional class improved in 5 patients (27.8%). Conclusions: Physical training of patients with atrial fibrillation during 12 weeks of cardiovascular rehabilitation improved functional capacity, with progressive increases in left ventricular ejection fraction and decrease in metabolic variables, without generating risks or complications.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Atrial Fibrillation/therapy , Exercise , Cuba , Cardiac Rehabilitation/methods
11.
Rev. urug. cardiol ; 37(1): e202, jun. 2022. tab
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1390039

ABSTRACT

Introducción: El ejercicio físico, integrando la rehabilitación cardíaca (RC), tiene un efecto positivo demostrado en el pronóstico de los pacientes con enfermedad cardiovascular, optimizando el rendimiento cardíaco en términos de capacidad funcional. Mediante los programas de RC se pretende obtener los máximos beneficios clínicos del ejercicio físico con un mínimo riesgo para el paciente. Objetivos: Evaluar la seguridad y eficacia de un programa de RC extrahospitalario en pacientes de todos los niveles de riesgo, monitorizando con cardiotacómetros (instrumento de pulsera que detecta frecuencia cardíaca y permite programar alarmas) a pacientes de moderado y alto riesgo, con base en la ausencia de complicaciones cardíacas graves y la mejoría funcional de los participantes. Material y métodos: Estudio de cohorte retrospectiva, sometida a un plan de RC durante 12 semanas en el período comprendido entre enero de 2014 y marzo de 2020. Se evaluaron parámetros clínicos y funcionales al inicio y al final del plan de rehabilitación, controlando la tolerancia al esfuerzo, la presión arterial y la frecuencia cardíaca mediante el uso de cardiotacómetros. Resultados: Se incluyeron 181 pacientes, con edad promedio de 58,7 ± 9,7 años, 87,8% del sexo masculino, mayoritariamente portadores de cardiopatía isquémica (90,1%). Según la clasificación de la Asociación Americana de Rehabilitación Cardiovascular y Pulmonar, 54 pacientes (29,8%) eran de alto riesgo, 29 (16,0%) de moderado riesgo y 98 (54,1%) de bajo riesgo. En más de 10.000 horas de actividad física realizadas, un paciente requirió el implante de un marcapaso definitivo por bloqueo auriculoventricular completo, sin observarse otras complicaciones graves. Se obtuvo una mejoría significativa (p = 0,001) de la capacidad funcional, que aumentó de 7,34 ± 2,68 a 10,20 ± 2,35 METs (incremento relativo individual promedio 28,1%). Conclusiones: La RC es un tratamiento seguro y efectivo en los pacientes cardiópatas, aún en aquellos de moderado y alto riesgo. El uso de cardiotacómetros permite una adecuada monitorización del ejercicio y una oportuna detección de complicaciones.


Introduction: physical exercise, integrating cardiac rehabilitation (CR), has a proven positive effect on the prognosis of patients with cardiovascular disease, optimizing cardiac performance in terms of functional capacity. CR programs aim to obtain maximum clinical benefits with minimal risks to the patient. Objectives: assess the safety and efficacy of a cardiotachometer-monitored out-of-hospital CR program in high- and moderate-risk patients, based on the absence of major cardiac complications and improvement in participant's functional capacity. Materials and methods: retrospective cohort study, submitted to a CR plan for 12 weeks in the period between January 2014 and March 2020. Clinical and functional parameters were evaluated at the beginning and at the end of the rehabilitation plan, controlling effort tolerance, blood pressure and heart rate using cardiotachometers. Results: 181 patients were included, aged 58.7 ± 9.7 years and 87.8% female, of whom 90% were carriers of ischemic heart disease. According to the classification of the American Association of Cardiovascular and Pulmonary Rehabilitation, the patients were distributed as follows: 54 (29.8%) at high risk, 29 (16.0%) at intermediate risk, and 98 (54.1%) low risk. In more than ten thousand hours of physical activity performed, one patient required implantation of a permanent pacemaker due to complete atrioventricular block. A significant improvement (p = 0.001) of the functional capacity, from 7.34 ± 2.68 to 10.2 ± 2.35 (mean relative improvement: 28.1%.) was obtained. Conclusions: the CR is a safe and effective procedure for cardiac patients, even in moderate or high-risk subjects. The use of cardiotachometers allows adequate exercise monitoring and timely detection of complications.


Introdução: o exercício físico, integrando a reabilitação cardíaca (RC), tem comprovado efeito positivo no prognóstico de pacientes com doença cardiovascular, otimizando o desempenho cardíaco em termos de capacidade funcional. Os programas de RC visam obter o máximo de benefícios clínicos com riscos mínimos para o paciente. Objetivos: avaliar a segurança e eficácia de um programa de RC fora do hospital monitorado por cardiotacômetro em pacientes de alto e moderado risco, com base na ausência de complicações cardíacas maiores e na melhora da capacidade funcional dos participantes. Materiais e métodos: trata-se de um estudo descritivo, de um plano de RC de 12 semanas, em um período entre janeiro de 2014 a março de 2020. Os parâmetros clínicos e funcionais foram avaliados no início e no final do plano de reabilitação, a tolerância ao esforço, pressão arterial e frequência cardíaca utilizando cardiotacômetros. Resultados: foram incluídos 181 pacientes, com média de idade de 58,7 ± 9,7 anos e 87,8% do sexo masculino, dos quais 90% eram portadores de cardiopatia isquêmica. De acordo com a classificação da Associação Americana de Reabilitação Cardiovascular e Pulmonar, os pacientes foram distribuídos da seguinte forma: 54 (29,8%) de alto risco, 29 (16,0%) de risco intermediário e 98 (54,1%) de baixo risco. Em mais de dez mil horas de atividade física realizada, um paciente necessitou de implante de marcapasso definitivo por bloqueio atrioventricular total. A avaliação final mostrou melhora significativa (p = 0,001) na capacidade funcional medida em METs; este passou de 7,34 ± 2,68 para 10,2 ± 2,35 (melhora relativa média: 28,1%). Conclusões: este trabalho demonstra que a RC é um tratamento seguro e eficaz para pacientes com doenças cardíacas, mesmo em indivíduos de risco moderado e alto. O uso de cardiotacômetros permite o monitoramento adequado do exercício e a detecção oportuna de complicações.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Myocardial Ischemia/rehabilitation , Exercise Therapy , Cardiac Rehabilitation/instrumentation , Heart Failure/rehabilitation , Heart Valve Diseases/rehabilitation , Outpatients , Retrospective Studies , Treatment Outcome , Ergometry , Electrocardiography , Heart Rate Determination
12.
Rev. chil. cardiol ; 41(1): 10-18, abr. 2022. tab
Article in Spanish | LILACS | ID: biblio-1388108

ABSTRACT

RESUMEN INTRODUCCIÓN: Un evento cardiovascular puede reducir o alterar la capacidad funcional de las personas y, por ende, afectar el desempeño adecuado en el ámbito físico, familiar, social y laboral. La OMS ha definido la salud de los adultos mayores por su capacidad funcional y no por sus limitaciones, discapacidades o enfermedades. Por lo tanto, la calidad de vida de los adultos mayores está estrechamente relacionada con la capacidad funcional y el conjunto de condiciones que le permiten participar en su propio autocuidado, en la vida social y familiar. OBJETIVO: El objetivo de este estudio es explorar la evidencia existente en la última década acerca de las pruebas y escalas de funcionalidad usadas en población adulta mayor con enfermedad cardiovascular durante su hospitalización y que reciben tratamiento de terapia física. MÉTODOS: Se usó la metodología Scoping Review, usando los términos DeCS/MeSH: cardiac, rehabilitation, cardiovascular disease, physical therapy, elderly, inpatient, y functionality. La revisión siguió el modelo PRISMA para ordenar y sintetizar los resultados. Las bases de datos consultadas fueron: Pubmed, Scielo, Sciencedirect y Scopus, Lilacs, PeDro. RESULTADOS: 20 artículos fueron seleccionados en los cuales se identificó que las escalas de valoración funcional más utilizadas fueron: caminata de 6 minutos, escala de independencia (FIM), Percepción de salud SF -36. CONCLUCIONES: La evidencia encontrada para guiar la rehabilitación física en paciente adulto mayor muestra cambios significativos en el incremento de la capacidad funcional.


ABSTRACT: INTRODUCTION: A cardiovascular event can reduce or alter the functional capacity of people affecting the physical capacity, and the performance in family, social and work environments. The WHO has defined the health of older adults by their functional capacity and not by their limitations, disabilities or illnesses. Therefore, the quality of life of older adults is closely related to the functional capacity and the set of conditions that allow them to participate in their own self-care, in social and family life. The aim of this study was to explore the existing evidence in the last decade about the tests and scales of functionality used in older adults with cardiovascular disease receiving physical therapy during hospitalization. METHODS: The Scoping Review methodology was used. Mesh and DeCS/MeSH terms included were cardiac, rehabilitation, cardiovascular disease, physical therapy, elderly, inpatient and functionality. The review followed the PRISMA model to sort and synthesize the results. The databases consulted were: Pubmed, Scielo, Science direct and Scopus, Lilacs, PeDro. RESULTS: 20 articles were selected in which it was identified that the most used functional assessment scales were: The 6-minute walk test, the Independence scale (FIM) and the Health Perception scale (SF-36). CONCLUSION: In older patients the functional tests identified allowed to detect significant improvements in functional capacity following cardiac rehabilitation.


Subject(s)
Humans , Cardiovascular Diseases/diagnosis , Cardiac Rehabilitation/statistics & numerical data , Quality of Life , Exercise , Epidemiology, Descriptive
13.
São Paulo med. j ; 140(1): 108-114, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1357455

ABSTRACT

ABSTRACT BACKGROUND: Cardiac rehabilitation (CR) barriers are well-understood in high-resource settings. However, they are under-studied in low-resource settings, where access is even poorer and the context is significantly different, including two-tiered healthcare systems and greater socioeconomic challenges. OBJECTIVE: To investigate differences in characteristics of patients attending publicly versus privately funded CR and their barriers to adherence. DESIGN AND SETTING: Observational, cross-sectional study in public and private CR programs offered in Brazil. METHODS: Patients who had been attending CR for ≥ 3 months were recruited from one publicly and one privately funded CR program. They completed assessments regarding sociodemographic and clinical characteristics and the CR Barriers Scale. RESULTS: From the public program, 74 patients were recruited, and from the private, 100. Participants in the public program had significantly lower educational attainment (P < 0.001) and lower socioeconomic status (P < 0.001). Participants in the private program had more cognitive impairment (P = 0.015), and in the public program more anxiety (P = 0.001) and depressive symptoms (P = 0.008) than their counterparts. Total barriers among public CR participants were significantly higher than those among private CR participants (1.34 ± 0.26 versus 1.23 ± 0.15/5]; P = 0.003), as were scores on 3 out of 5 subscales, namely: comorbidities/functional status (P = 0.027), perceived need (P < 0.001) and access (P = 0.012). CONCLUSION: Publicly funded programs need to be tailored to meet their patients' requirements, through consideration of educational and psychosocial matters, and be amenable to mitigation of patient barriers relating to presence of comorbidities and poorer health status.


Subject(s)
Humans , Cardiac Rehabilitation , Brazil , Cross-Sectional Studies , Delivery of Health Care
14.
Ribeirão Preto; s.n; 2022. 71 p. tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1524395

ABSTRACT

Introdução: O direito à saúde é um dos direitos sociais constitucionalmente garantidos. A realidade brasileira ainda é excludente e também reflete as dificuldades estudadas e superadas por outros países desenvolvidos. No Brasil, menos de 20% dos pacientes que saem de uma internação hospitalar por problemas cardíacos, recebe a indicação para a reabilitação cardíaca. Uma vez inserido em um programa de reabilitação cardíaca (PRC), as maiores barreiras para sua participação estão relacionadas com as comorbidades e/ou estado funcional, necessidades percebidas e acesso. Objetivos: 1) avaliar as barreiras para participação em PRC, na perspectiva de um grupo de participantes, antes da ocorrência da pandemia da COVID-19 (Etapa 1); 2) avaliar as barreiras percebidas pelos participantes para retornarem ao PRC, durante a pandemia da COVID-19 (Etapa 2); 3) comparar as barreiras percebidas nas duas etapas; e 4) avaliar os aspectos físicos e emocionais da qualidade de vida relacionada à saúde (QVRS) dos participantes durante a pandemia da COVID-19. Método: Estudo observacional, analítico e longitudinal realizado em duas etapas com pacientes inseridos em um PCR, fases 2 ou 3, de um hospital universitário do interior paulista. Na primeira etapa, antes da pandemia, 23 participantes responderam presencialmente aos 21 itens da Escala de Barreiras para a Reabilitação Cardíaca (EBRC), usando uma escala ordinal de 1 a 5 (escore total de 21 a 105, com maiores escores indicando maiores barreiras percebidas). Na segunda etapa, realizada por telefone durante o período pandêmico, 18 desses participantes responderam novamente aos itens da EBRC, bem como aos itens dos domínios Aspectos Físicos e Aspectos Emocionais do instrumento Medical Outcomes Study (MOS): 36-Item Short Form Survey (SF-36). Resultados: Na primeira etapa foram entrevistados 23 indivíduos, dos quais três faleceram e dois não apresentaram condições físicas para participarem da segunda entrevista. Concluímos o seguimento de 18 pacientes, sendo a maioria do sexo masculino (66,7%), casada/união estável (60,9%), sem desempenhar atividade ocupacional (91,3%) e residentes da cidade de Ribeirão Preto (52,2%). A média de idade foi de 58,9 (D.P.=12,5) anos, com renda mensal familiar média de R$ 2.072,78 (D.P.=1.397,40) e baixa escolaridade (oito anos de estudo formal, em média). Ao compararmos as barreiras percebidas, antes e durante a pandemia, constatamos a diminuição na percepção dos pacientes sobre as barreiras para a participação em um PRC sendo as diferenças estatisticamente significantes para o escore total da EBRC (p<0,001), para a média total dos itens (p<0,001) e para a maioria dos itens (81%). Durante a pandemia, os participantes avaliaram melhor os aspectos emocionais (M=72,2; D.P.=34,8) do que físicos (M=40,3; D.P.=41,2) da QVRS. Conclusão: No grupo investigado, após a interrupção da participação em um PRC em decorrência da pandemia da COVID-19, os participantes consideraram as barreiras para a adesão ao programa como sendo menores do que aquelas percebidas enquanto estavam inseridos na reabilitação cardíaca. Os resultados encontrados podem ser compreendidos no contexto do isolamento social imposto aos indivíduos com doenças cardíacas e com outras doenças consideradas de risco para o agravamento da condição de saúde diante da contaminação pelo novo coronavírus


Introduction: Health care is one of the social rights constitutionally guaranteed. The Brazilian reality is still exclusionary and also reflects the difficulties studied and overcome by other developed countries. In Brazil, less than 20% of the patients that leave hospitalization due to cardiac problems receive a referral to cardiac rehabilitation. Once inserted in a cardiac rehabilitation program (CRP), the biggest barriers to patients' participation are related to comorbidities and/or functional status, perceived needs and access. Objectives: 1) assess barriers to participation in CRP, from the perspective of a group of participants, before the occurrence of the COVID-19 pandemic (Step 1); 2) assess the barriers perceived by the participants to return to the CRP, during the COVID-19 pandemic (Step 2); 3) compare the perceived barriers in the two phases; e 4) assess the physical and emotional aspects of the participants' health-related quality of life (HRQoL) during the COVID-19 pandemic. Method: Observational, analytical and longitudinal study carried out in two stages with patients enrolled in a CRP, phase 2 or 3, at a university hospital in the countryside of São Paulo. In the first step, before the pandemic, 23 participants responded face-to-face to the 21 items of the Cardiac Rehabilitation Barriers Scale (CRBS), using an ordinal scale from 1 to 5 (total score ranging from 21 to 105, with higher scores indicating greater perceived barriers). In the second step, carried out by telephone during the pandemic period, 18 of those participants responded again to the CRBS items, as well as to the items in the Physical Aspects and Emotional Aspects domains of the Medical Outcomes Study (MOS): 36-Item Short Form Survey (SF -36). Results: In the first step, 23 individuals were interviewed, of which three died and two were not physically able to participate in the second interview. We concluded the follow-up of 18 patients, most of them male (66.7%), married/in a stable relationship (60.9%), with no occupational activity (91.3%) and residents of the city of Ribeirão Preto (52.2%). The mean age was 58.9 (SD=12.5) years, with an average monthly family income of BRL 2,072.78 (SD=1,397.40) and low schooling (eight years of formal schooling, on average). When comparing perceived barriers, before and during the pandemic, we found a decrease in patients' perception of barriers to participation in a CRP, with statistically significant differences for the total CRBS score (p<0.001), for the total average of the items (p<0.001) and for 81% of the items. During the pandemic, participants better rated the emotional (M=72.2; SPD=34.8) than physical (M=40.3; SD=41.2) aspects of HRQoL. Conclusion: In the investigated group, after the interruption of participation in a CRP due to the COVID-19 pandemic, the participants considered the barriers to adherence to the program to be lower than those perceived while they were in cardiac rehabilitation. The results found can be understood in the context of the social isolation imposed on individuals with heart disease and other diseases considered to be at risk for the worsening of their health condition in the face of contamination by the new coronavirus


Subject(s)
Humans , Middle Aged , Pandemics , Cardiac Rehabilitation , COVID-19 , Health Services Accessibility
15.
Article in Spanish | LILACS | ID: biblio-1384323

ABSTRACT

RESUMEN: El objetivo de esta revisión fue conocer la influencia del entrenamiento muscular inspiratorio (EMI) sobre la capacidad aeróbica y la fuerza muscular inspiratoria (FMI) en pacientes con insuficiencia cardíaca (IC). Realizamos una revisión de revisiones sistemáticas en PubMed y Web of Science hasta agosto de 2019. Se identificaron un total de 2053 artículos, de los cuales 4 se seleccionaron para esta revisión. Se utilizó la herramienta 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2) para evaluar la calidad de los estudios. En los estudios incluidos se examinaron un total de 10 intervenciones diferentes con 250 pacientes (rango edad media= 53-76 años). Todos los estudios presentaron nivel de confianza alto (AMSTAR-2). El EMI presentó mejoras significativas sobre la capacidad aeróbica (test de la marcha de 6 minutos: 46.66-71.04 metros; p<0.05 y VO2pico: 2.59-2.65 mL/kg-1/min-1; p<0.01) y la FMI (presión inspiratoria máxima: 16.57-23.36 cmH2O, p<0.05) en comparación al grupo control. Programas de intervención de EMI con una duración de 12 semanas reportaron mayores mejorías sobre la capacidad aeróbica y la FMI en comparación a programas de intervención de menor duración. El EMI es un tratamiento importante y necesario en la rehabilitación cardíaca de pacientes con IC. Son necesarios más estudios que analicen los efectos de diferentes rangos en las características del EMI.


ABSTRACT: The aim of this review was to understand the influence of inspiratory muscle training (IMT) on aerobic capacity and inspiratory muscle strength (IMS) in patients with heart failure (HF). We conducted a review of systematic reviews in PubMed and Web of Science up to August 2019. A total of 2053 articles were identified, of which 4 were selected for this review. The 'Assessment of Multiple Systematic Reviews 2' (AMSTAR-2) tool was used to assess the quality of the studies. In the included studies, a total of 10 different interventions with 250 patients (mean age range = 53-76 years) were examined. All the studies presented high confidence level (AMSTAR-2). IMT showed significant improvements in aerobic capacity (6-minute walk test: 46.66-71.04 meters; p<0.05 and VO2peak: 2.59-2.65 mL/kg-1/min-1; p<0.01) and IMS (maximal inspiratory pressure: 16.57-23.36 cmH2O, p<0.05) in this population compared to the control group and IMF in this population. IMT intervention programs lasting 12 weeks reported greater improvements in aerobic capacity and IMS compared to shorter intervention programs. IMT is an important and necessary treatment in cardiac rehabilitation of patients with HF. More studies are needed to analyze the effects of different ranges of the IMT characteristics.


Subject(s)
Humans , Breathing Exercises/methods , Mentoring/methods , Heart Failure/complications , Speed Meters , Muscle Strength , Cardiac Rehabilitation
16.
Rev. Investig. Salud. Univ. Boyacá ; 9(2): 173-193, 20220000. tab, ilust
Article in Spanish | LILACS, COLNAL | ID: biblio-1445040

ABSTRACT

Introducción: A diario, los profesionales de la salud se enfrentan a importantes retos diagnósticos cuando atienden a sus pacientes, por lo que se apoyan en exámenes paraclínicos que complementan su ejercicio semiológico, porque les permiten confirmar o descartar una enfermedad. Objetivo: Explicar a los especialistas en rehabilitación cardiopulmonar los conceptos requeridos para interpretar de forma crítica los resultados de las pruebas diagnósticas. Materiales y métodos: Revisión narrativa de la literatura, que expone conceptos actualizados, ejemplos y gráficas con enfoque académico y didáctico. Resultado: Se realizó la actualización y explicación de los conceptos de sensibilidad, especificidad, valores predictivos positivo y negativo y los likelihood ratio positivo y negativo y su interpretación en el normograma de Fagan, a través de ejemplos del día a día del especialista. Conclusión: Comprender los conceptos que acompañan la evaluación de pruebas diagnósticas ayuda a que los especialistas en rehabilitación cardiopulmonar analicen críticamente los resultados de las ayudas paraclínicas funcionales y estructurales que acompañan a sus pacientes y, de esta manera, puedan caracterizar bien el diagnóstico y seguimiento de las personas


Introduction: Health professionals face important diagnostic challenges daily when they care for their patients, which is why they rely on paraclinical tests that complement their semiological exercise by confirming or ruling out a disease. Objective: Explain to cardiopulmonary rehabilitation specialists, the concepts necessary to critically interpret the results of diagnostic tests. Materials and methods: narrative review of the literature was carried out, which exposes updated concepts, examples, and graphs with an academic and didactic approach.Result: The concepts of sensitivity, specificity, positive and negative predictive values and the positive and negative Likelihood Ratio and their interpretation in the Fagan normogram were updated and explained, through examples of the specialists day-to-day. Conclusion: understanding the concepts that accompany the evaluation of diagnostic tests help car-diopulmonary rehabilitation specialists to critically analyze the results of the functional and structural paraclinical aids that accompany their patients, and thus be able to properly characterize the diagno-sis and follow-up. of people


Introdução: Diariamente, os profissionais da saúde enfrentam desafios diagnósticos, recorrendo a exames que complementem a sua prática semiológica, permitindo-lhes confirmar ou excluir uma doença. Objetivo: Explicar aos especialistas em reabilitação cardiopulmonar os conceitos necessários para interpretar criticamente os resultados dos testes de diagnóstico. Materiais e métodos: Revisão narrativa da literatura, fornecendo conceitos atualizados, exemplos e gráficas com uma abordagem académica e didática. Resultado: Os conceitos de sensibilidade, especificidade, valores preditivos positivos e negativos e razões de verossimilhança positivas e negativas e a sua interpretação no normograma de Fagan foram atualizados e explicados com exemplos do trabalho diário do especialista. Conclusão: A compreensão dos conceitos que acompanham a avaliação dos testes de diagnóstico ajuda aos especialistas em reabilitação cardiopulmonar na analise critica dos resultados das ajudas clínicas funcionais e estruturais dos pacientes e, desta forma, caracterizar bem o diagnóstico e o acompanhamento dos indivíduos


Subject(s)
Cardiac Rehabilitation , Physical and Rehabilitation Medicine , Epidemiology , Predictive Value of Tests , Sensitivity and Specificity , Diagnostic Tests, Routine
17.
Rev. costarric. cardiol ; 23(2)dic. 2021.
Article in Spanish | LILACS, SaludCR | ID: biblio-1389039

ABSTRACT

Resumen A pesar de la amplia evidencia científica de los beneficios de la Rehabilitación Cardiaca (RC) a nivel mundial, la investigación en Costa Rica en esta área continúa siendo escasa. Objetivo: Presentar la evidencia científica de las investigaciones realizadas por programas de RC en Costa Rica. Metodología: se realizó una búsqueda de artículos en las bases de datos "PUBMED""ScienceDirect""SportDiscus" y "Google Académico", utilizando las palabras claves: "Rehabilitación cardiaca en Costa Rica", "Cardiac Rehabilitation AND Costa Rica". Los estudios incluidos fueron publicaciones en revistas indexadas entre los años 2000 a octubre de 2021. Resultados: Se encontraron 14 publicaciones en revistas indexadas, ocho publicaciones en revistas costarricenses y seis internacionales. Los principales resultados de las investigaciones fueron que el VO2máx aumentó entre 19 % a 30 %. La capacidad funcional mejoró entre 31 % a 34 %, la presión arterial sistólica disminuyó entre 4 mmHg y 7,8 mmHg y la presión arterial diastólica se redujo entre 1,2 y 2 mmHg. También, se reportó mejorías en IMC, colesterol total, HDL-C y disminuciones en triglicéridos. Los niveles de estrés percibido disminuyeron el 50 % y los estados de ánimo tuvieron reducciones en la fatiga 58 %, la tensión en 60 % y el vigor aumentó 31 % después de una o varias semanas de RC. Asimismo, la calidad de vida de los pacientes mejoró. Conclusión: Los programas de RC en Costa Rica lograron aumentar el VO2máx, la capacidad funcional, disminuir la presión arterial y mejorar los factores de riesgo coronario de los pacientes con ECV. Además, la RC contribuye psicológicamente, puesto que disminuye el estrés, mejora los estados de ánimo y la calidad de vida de los pacientes cardiacos.


Abstract Despite the extensive scientific evidence regarding the health benefits of Cardiac Rehabilitation (CR) worldwide, research in Costa Rica in this area is still lacking. Objective: To present the scientific evidence of CR research made in Costa Rica. Methods: This systematic review searched articles in electronic databases: "PUBMED" "ScienceDirect" "SportDiscus" y "Google Scholar", using keywords: "Rehabilitación cardiaca en Costa Rica", "Cardiac Rehabilitation AND Costa Rica", The studies included were from years 2000 to October 2021 and publications on indexed journals. Results: A total of 14 publications were found in indexed journals, 8 in Costa Rican journals and 6 on international journals. The main results from these publications were that VO2max increased between 19% to 30%. functional capacity improved 31% to 34%, systolic blood pressure decreased 4 mmHg to 7.8 mmHg and diastolic blood pressure reduced 1.2 to 2 mmHg. Improvements in BMI, total cholesterol, HDL-C and reductions in triglycerides were also found. Perceived stress decreased by 50% and mood states of fatigue reduced 58%, tension 60% and vigor increased 31% after one or several weeks. Conclusión: CR programs in Costa Rica reported improvements in VO2max, functional capacity, reductions in blood pressure, and improvements in coronary risk factors from patients with cardiovascular disease. Furthermore, CR contributes to improving psychological outcomes by reducing stress, improvement of mood states and quality of life in cardiac patients.


Subject(s)
Humans , Evidence-Based Medicine , Exercise Therapy/methods , Cardiac Rehabilitation/methods , Quality of Life , Functional Residual Capacity , Costa Rica
18.
Rev. costarric. cardiol ; 23(2)dic. 2021.
Article in Spanish | LILACS, SaludCR | ID: biblio-1389041

ABSTRACT

Resumen Introducción y objetivos: Los programas de rehabilitación cardiaca (RHC) son considerados como los más eficaces entre las intervenciones de prevención secundaria. El cual su función es mejorar la sobrevida como así también, la calidad de vida de estos enfermos. El objetivo fundamental de este trabajo es analizar el impacto de un Programa de Rehabilitación Cardiaca en pacientes portadores de cardiopatía isquémica con respecto a parámetros bioquímicos, antropométricos y funcionales. Pacientes y métodos: Fue un estudio observacional retrospectivo, unicéntrico, con seguimiento de 3 años. Se incluyo un total de 228 pacientes. Con criterios de inclusión: >18 años, con EAC y al menos una comorbilidad de riesgo cardiovascular que completaran el PRC. Se excluyó enfermedad valvular sin cardiopatía isquémica preexistente, infarto agudo al miocardio reciente, ángor inestable, obstrucción del tracto de salida del ventrículo izquierdo, y los que no cumplieron el PRC. Resultados: De los 228 pacientes que se incluyeron el PRC del HSVP el 70,7% eran hombres y el 29,3% eran mujeres con diagnóstico de cardiopatía isquémica. El promedio de edad era de 60.2 +- 11.4 años en total entre hombres y mujeres. El peso de los pacientes masculinos previo al ingreso del PRC fue de 77,7 kg +-13,2 kg, y las mujeres 69,7 kg +- 13,1 kg. Al final del fue de 75,5 kg +-13,1 kg y el de las mujeres era de 68,3 +- 13,1 kg. En la caminata de 6 minutos el promedio de mujeres al inicio fue de 390,0 mts y el de los hombres de 386,6, y la segunda vez posterior a la rehabilitación en hombres fue de 595,8 +- 107,2 y el de las mujeres fue de 549+-102,4. Los niveles de PCR de los hombres al inicio del programa fue de 1,2 +-2,4 mg/dL y el de las mujeres fue de 1,5 +- 1,9 mg/dL al finalizar los hombres tuvieron un promedio de 1,8+-3,0 Conclusiones: Los PRC dependen de la participación de profesionales de la salud que trabajen en equipo para alcanzar resultados finales, los cuales están basados no solo en el ejercicio sino también en el cambio de estilo de vida del paciente, por lo tanto, necesita de servicios asociados como fisioterapia, nutrición, psicología.


Abstract Effect of the Cardiac Rehabilitation Program of the Hospital San Vicente Paúl on biochemical, anthropometric and functional parameters in patients with ischemic heart disease from January 1, 2014 to December 31, 2015 Introduction and objectives: Cardiac Rehabilitation Programs, are considered the most effective programs among secondary prevention interventions. The function is to improve survival as well as the quality of life of these patients. The main objective of this work is to analyze the impact of Cardiac Rehabilitation Program in patients with ischemic heart disease with the respect biochemical, anthropometric and functional parameters. Patients and method: A observational, retrospective single-center, study with a 3-year-follow up. A total of 228 patients were included, witch 70.7% were men with an average of 60.2+-11.4 years. The inclusion criteria were: > 18 years with CAD and at least one cardiovascular risk comorbidity and completed the Cardiac Rehabilitation Program. Valvular disease without pre-existing ischemic heart disease, recent acute myocardial infarction, unstable angina, left ventricular outflow tract obstruction, and those who did not went to the Program. Results: The 228 patients who were included in the HSVP CRP, 70.7% were men and 29.3% were women with a diagnosis of ischemic heart disease. The average age was 60.2 + - 11.4 years in total between men and women. The weight of male patients prior to admission to the CRP was 77.7 kg + -13.2 kg, and women 69.7 kg + -13.1 kg. At the end of the program, the weight of the men was 75.5 kg + -13.1 kg and that of the women was 68.3 + - 13.1 kg. The total waist circumference at the start of the program was 100.1 ± 11.4 cm. In women the average was 98.4 + - 12.7cm, that of men was 101.1 + - 10.8 cm. At the end of the program, the total average of men and women was 96.7 + - 11.0, the average of women at the end of the program was 96.2 + - 12.6 cm and of men was 96. 9 + - 10. In the 6-minute walk, the average of women at the beginning was 390.0 meters and that of men was 386.6, and the second time after rehabilitation in men was 595.8 + - 107.2 and the of women it was 549 + -102.4. In men, the previous total cholesterol was 154.8 + -39.7 mg / dL and that of women was 162.0 + -40.2 mg / dL and at the end of the program the value of men was 161 .6 + -46.0 mg / dL and 170.8 + -41.8 mg / dL for women. The CRP levels of the men at the beginning of the program was 1.2 + -2.4 mg / dL and that of the women was 1.5 + - 1.9 mg / dL at the end of the program, the men had an average of 1.8 + -3.0. Conclusion: The Cardiac Rehabilitation Program depends on the partipation of health professionals care who work as a team to achieve final results, witch are based not only on exercise but also on the change in the patient's lifestyle, therefore, they need associated services such as physiotherapy, nutrition, psychology.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Myocardial Ischemia/rehabilitation , Cardiac Rehabilitation/statistics & numerical data , Biochemical Phenomena , Body Weights and Measures , Costa Rica , Age and Sex Distribution , Exercise Therapy/statistics & numerical data , Life Style
19.
Rev. colomb. cardiol ; 28(5): 502-509, sep.-oct. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1357220

ABSTRACT

Resumen Introducción: La insuficiencia cardiaca es un estado fisiopatológico y clínico en el cual el corazón es incapaz de aportar sangre de acuerdo con los requerimientos metabólicos periféricos, repercutiendo directamente sobre la capacidad aeróbica. La rehabilitación cardiaca durante 12 semanas tiene beneficios claros principalmente sobre la capacidad aeróbica, pero son pocos los estudios que detallan dichos cambios en el transcurso del proceso de intervención. Objetivo: Determinar los cambios en la capacidad aeróbica y algunas variables fisiológicas en pacientes con insuficiencia cardiaca, a las 6 y 12 semanas de su rehabilitación cardiaca. Método: Estudio de tipo descriptivo longitudinal. La muestra se constituyó por 23 pacientes vinculados a un programa de rehabilitación cardiaca, donde realizaron prueba de esfuerzo en tres momentos (inicio y semanas 6 y 12). Las variables cuantitativas se compararon en tres momentos utilizando la prueba de medidas repetidas hasta tres colas, teniendo en cuenta la homogeneidad y la igualdad de varianzas. La significación estadística fue de 0.05. Resultados: El consumo de oxígeno mostró un aumento de 3,6 ml/kg/min durante la rehabilitación, encontrando diferencias estadísticamente significativas en los tres momentos de medición, pero se evidenció un mayor incremento entre las semanas 1 y 6 (p = 0.00), cuando se registró un cambio de 2,2 ml/kg/min. La medición de la presión arterial sistólica/diastólica inicial y final mostró una disminución (p < 0.05). Conclusiones: En pacientes con insuficiencia cardiaca, el consumo de oxígeno obtuvo un incremento progresivo a lo largo de las 12 semanas de rehabilitación cardiaca, observándose su mayor incremento en las primeras 6 semanas de intervención.


Abstract Introduction: Heart failure is a pathological and clinical state in which the heart is unable to provide blood according to peripheral metabolic requirements having a direct impact on aerobic capacity. Cardiac rehabilitation for 12 weeks has clear benefits mainly on aerobic capacity, but few studies detail such changes over the course of the intervention process. Objective: To determine changes in aerobic capacity and some physiological variables in patients with cardiac insufficiency, at 6 and 12 weeks after cardiac rehabilitation. Method: Longitudinal descriptive type study. The sample was made up of 23 patients linked to a cardiac rehabilitation program, where they performed stress testing at three times (start, weeks 6 and 12). Quantitative variables were compared in 3 moments using the repeated measurement test up to 3 tails, taking into account the homogeneity and equality of variances. The statistical significance was 0.05. Results: Oxygen consumption showed an increase of 3.6 ml/kg/min during rehabilitation, finding statistically significant differences in the three measurement moments but there was a greater increase between week 1 and 6 (p = 0.00) where a change of 2.2 ml/kg/min was recorded. Measurement of initial and final systolic/diastolic blood pressure showed a decrease (p < 0.05). Conclusions: In patients with heart failure, oxygen consumption achieved a progressive increase over 12 weeks of cardiac rehabilitation, with its largest increase seen in the first 6 weeks of intervention.


Subject(s)
Humans , Heart Failure , Exercise Tolerance , Exercise Therapy , Cardiac Rehabilitation
20.
Rev. baiana saúde pública ; 45(2): 144-159, 20211010.
Article in Portuguese | LILACS | ID: biblio-1379681

ABSTRACT

Chagas disease (CD) is a severe health problem in countries of Latin America, including Brazil, and is characterised as an acute and chronic infection. CD can affect several organs and cellular tissues, in particular the heart, which can lead to sudden death. This work aimed to review the literature regarding cardiac autonomic function assessed by Heart Rate Variability (HRV) in CD in adult individuals. The search was carried out using the electronic databases PubMed, SciELO, and Web of Science between January 2013 and October 2020. A total of 19 articles were found, of which 14 were included in this review. HRV was demonstrated at baseline conditions, physical exercise, and cardiac rehabilitation. Quantifying CD progression assessed by HRV is an effective method to detect changes in the cardiac autonomic nervous system, even in asymptomatic individuals. Physical exercise can improve autonomic function in CD. Further clinical studies are needed to assess the anatomical-functional, metabolic, and immunological parameters associated with CD evaluated by HRV.


A doença de Chagas (DC) é um grave problema de saúde em países da América Latina, incluindo o Brasil, sendo caracterizada como infecção aguda e crônica. A DC pode afetar vários órgãos e tecidos celulares, em particular o coração, podendo levar à morte súbita. O objetivo deste trabalho foi revisar a literatura relacionada à função autonômica cardíaca avaliada pela Variabilidade da Frequência Cardíaca (VFC) na DC em indivíduos adultos. A busca foi realizada nas bases de dados eletrônicas PubMed, SciELO e Web of Science entre o período de janeiro de 2013 a outubro de 2020. Foram encontrados 19 artigos, dos quais 14 foram incluídos nesta revisão. A VFC foi demonstrada em condições basais, exercícios físicos e reabilitação cardíaca. Quantificar a progressão da DC avaliada pela VFC é um método eficaz para detectar alterações no sistema nervoso autônomo cardíaco, mesmo em indivíduos assintomáticos. O exercício físico pode melhorar a função autonômica na DC. Mais estudos clínicos são necessários para avaliar os parâmetros anátomo-funcionais, metabólicos e imunológicos associados à DC e avaliados pela VFC.


La enfermedad de Chagas (EC) es un grave problema de salud que enfrenta los países de América Latina y se caracteriza por ser una infección aguda y crónica. La EC puede afectar varios órganos y tejidos celulares, en particular el corazón, y puede provocar la muerte súbita. El objetivo de este estudio fue revisar la literatura que relaciona la función autónoma cardíaca evaluada por la Variabilidad de la Frecuencia Cardíaca (VFC) en la EC en individuos adultos. La búsqueda se realizó en las bases de datos electrónicas PubMed, SciELO y Web of Science desde enero de 2013 hasta octubre de 2020. Se encontraron 19 artículos, de los cuales 14 fueron incluidos en esta revisión. La VFC se ha demostrado en condiciones basales, ejercicio físico y rehabilitación cardíaca. La cuantificación de la progresión de la EC evaluada por la VFC es un método eficaz para detectar cambios en el sistema nervioso autónomo cardíaco, incluso en individuos asintomáticos. El ejercicio físico puede mejorar la función autónoma en la EC. Se necesitan más estudios clínicos para evaluar los parámetros anatómico-funcionales, metabólicos e inmunológicos asociados con la EC y evaluados por la VFC.


Subject(s)
Chagas Disease , Death, Sudden , Cardiac Rehabilitation , Persistent Infection , Heart Rate
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