ABSTRACT
Objective: To evaluate the efficacy of a cardiac rehabilitation program (CRP) in improving adherence to non-pharmacological secondary prevention in patients with acute coronary syndrome (ACS). Method: Retrospective study of patients with ACS referred to CRP in a tertiary hospital from 2018 to 2021. Pre-post differences in adherence to physical activity, Mediterranean diet, smoking, and motivation to change were analyzed. Age, sex, and baseline motivation were analyzed in predicting change in adherence. Results: 418 patients were included. At the end of the CRP, the adherence to the mediterranean diet increased (p < 0.05; d = 0.83), frequency of physical activity increased by 2.16 (p < 0.05), and motivation to change remained constant (p = 0.94). Both women and men improved their adherence to the mediterranean diet. Both sexes performed more physical activity at the end of the CRP (1.89 times more in men and 4 times more in women; p < 0.05). An association was found between initial motivation and greater changes in adherence to the mediterranean diet (p < 0.05). An inversely proportional difference was observed between age and adherence to the mediterranean diet (p < 0.05). Conclusions: The CRP, in our hospital environment, has an effect of improving adherence to the mediterranean diet and physical exercise in patients with ACS. The change in adherence to the diet increases as the motivation to change the baseline increases, and age is inversely related to the change in adherence.
Objetivo: Evaluar la eficacia de un programa de rehabilitación cardiaca (PRC) sobre la mejora de la adherencia a las medidas de prevención secundaria no farmacológicas en pacientes con síndrome coronario agudo (SCA). Método: Estudio retrospectivo con pacientes con SCA derivados a PRC en un hospital terciario de 2018 a 2021. Se analizaron diferencias pre-post de adherencia a actividad física, dieta mediterránea, tabaquismo y motivación al cambio. Se analizaron la edad, el sexo y la motivación basal en la predicción del cambio de adherencia. Resultados: Se incluyeron 418 pacientes. Al final del PRC aumentó la adherencia a la dieta mediterránea (p < 0.05; d = 0.83), la frecuencia de actividad física aumentó 2,16 (p < 0.05) y la motivación al cambio se mantuvo constante (p = 0.94). Tanto las mujeres como los hombres mejoraron la adherencia a la dieta mediterránea. Ambos sexos realizaron más ejercicio físico al final del PRC (1.89 veces más los hombres y 4 las mujeres; p < 0.05). Se encontró una asociación entre motivación inicial y mayores cambios en la adherencia a la dieta mediterránea (p < 0.05). Se observó una diferencia inversamente proporcional entre la edad y la adherencia a la dieta mediterránea (p < 0.05). Conclusiones: El PRC, en nuestro medio hospitalario, mejora la adherencia a la dieta mediterránea y al ejercicio físico en los pacientes con SCA. La adherencia a la dieta mediterránea aumenta a medida que lo hace la motivación al cambio basal, mientras que la edad está inversamente relacionada con el cambio de adherencia.
ABSTRACT
Fundamento. El objetivo de este estudio es analizar los efectos de un programa de rehabilitación cardiaca (PRC) extrahospitalario en un centro municipal deportivo sobre la capacidad funcional y la adherencia al ejercicio físico, entre otras variables, en comparación con un modelo hospitalario. Métodos. Ensayo clínico aleatorizado con dos grupos paralelos de pacientes con síndrome coronario agudo que realizaron un PRC con ejercicio físico moderado interválico coordinado con educación en hábitos saludables en un centro deportivo municipal (GE) y en un hospital terciario (GC), entre septiembre de 2019 y junio de 2020. Se analizaron variables de adherencia, antropométricas, clínicas, psicológicas, de fuerza, de prevención secundaria (dieta, tabaco) y capacidad funcional en la prueba de ergoespirometría. Resultados. Veintidós pacientes completaron el PRC (GC=10, GE=12). Se observaron mejoras significativas pre-post en GC (colesterol, test de la silla, frecuencia cardiaca en VT1 y VT2, y vatios en VT1) y en GE (colesterol HDL, triglicéridos, test de la silla, y frecuencia cardiaca y vatios en VT1). Estas mejoras fueron mayores en el GC para la frecuencia cardiaca en VT2 (11,17 vs 2,88 lpm) y en el GE para el colesterol HDL (11,0 vs 0,63 mg/dL). Conclusiones. Este estudio no ha podido determinar la eficacia de los PRC extrahospitalarios por falta de potencia (abundantes abandonos debidos al confinamiento por COVID-19). A pesar de ello, en el GE se observó mayor aumento en colesterol HDL que en el GC, aunque la frecuencia cardiaca en VT2 fue mayor en el GC (AU)
Background. This study aimed to analyze the effects of an outpa-tient cardiac rehabilitation program in a municipal sports center on functional capacity and adherence to physical activity among other variables compared to an in-hospital program.Methods. Randomized clinical trial that included two parallel groups of acute coronary syndrome patients who performed a car-diac rehabilitation program that consisted of moderate physical ex-ercise intervals along with learning healthy habits in a municipal sports center (EG) and in a tertiary hospital (CG) between Septem-ber 2019 and June 2020. We collected the following data: compli-ance, anthropometrical, clinical, psychological variables, diet and tobacco habits, strength and functional capacity from ergospirom-etry. Results. Twenty-two patients completed the cardiac rehabilitation program (EG=12, CG=10). Significant improvement was observed for cholesterol, the sit-and-stand test, cardiac frequency in VT1 and VT2, and watts in VT1 in the CG, and for HDL-cholesterol, triglycerides, the sit-and-stand test, and frequency, and watts in VT1 in the EG. Better achievement was found in the CG for cardiac frequency in VT2 (11.17 vs 2.88 bpm) and in EG for HDL-cholesterol (11.0 vs 0.63 mg/dL).Conclusions. We are unable to determine the effectiveness of the out-of-hospital cardiac rehabilitation program due to a lack of power (high number of withdrawals caused by COVID-19 lockdown). How-ever, the EG achieved higher HDL-cholesterol levels, while cardiac frequency in VT2 was higher in the CG (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Exercise Therapy/methods , Cardiac Rehabilitation/methods , Acute Coronary Syndrome/rehabilitation , Health Education , Treatment OutcomeABSTRACT
BACKGROUND: This study aimed to analyze the effects of an outpatient cardiac rehabilitation program in a municipal sports center on functional capacity and adherence to physical exercise - among other variables - compared to an in-hospital program. METHODS: Randomized clinical trial that included two parallel groups of acute coronary syndrome patients who performed a cardiac rehabilitation program that consisted of moderate physical exercise intervals along with learning healthy habits in a municipal sports center (experimental group) and in a tertiary hospital (control group) between September 2019 and June 2020. We collected the following data: compliance, anthropometrical, clinical, psychological variables, diet and tobacco habits, strength and functional capacity from ergospirometry. RESULTS: Twenty-two patients completed the cardiac rehabilitation program (experimental group=12, control group=10). Significant improvement was observed for cholesterol, the sit-and-stand test, cardiac frequency in VT1 and VT2, and watts in VT1 in the control group, and for HDL-cholesterol, triglycerides, the sit-and-stand test, and frequency, and watts in VT1 in the experimental group. Better achievement was found in the control group for cardiac frequency in VT2 (11.17 vs 2.88 bpm) and in EG for HDL-cholesterol (11.0 vs 0.63 mg/dL). CONCLUSIONS: We are unable to determine the effectiveness of the out-of-hospital cardiac rehabilitation program due to a lack of power (high number of withdrawals caused by COVID-19 lockdown). However, the experimented group achieved higher HDL-cholesterol levels, while cardiac frequency in VT2 was higher in the control group.
Subject(s)
Cardiac Rehabilitation , Sports , Humans , Exercise , Exercise Therapy , Cholesterol , HospitalsABSTRACT
Cognitive multisensory rehabilitation (CMR) -a therapeutic approach to help recover movement using neurocognitive exercises- activates patient's perceptive and cognitive processes, key for motor learning. The aim of this systematic review was to assess the effectiveness of CMR on motor function and quality of life and compare the findings with other rehabilitation approaches or no-intervention in neurological and trauma adult and pediatric patients. We carried out a systematic review of randomized controlled clinical trials, pilot studies, and case series in PubMed, PEDro, Cochrane Library, and the CINHAL Complete database published between 2012 and 2021. Ten studies met the eligibility criteria. CMR provides similar or superior benefits compared to other types of approaches for the restoration of upper limb function, gait, balance, and quality of life in neurological and trauma patients. Further research with larger samples and higher methodological quality need to be developed to de-termine its long-term effectiveness.
Subject(s)
Exercise Therapy , Quality of Life , Humans , Child , Exercise , CognitionABSTRACT
La rehabilitación cognitiva multisensorial (RCM) es un tratamiento para la recuperación del movimiento a través de ejercicios neurocognitivos que activan los procesos perceptivos y cognitivos del paciente fundamentales para el aprendizaje motor. El objetivo de la revisión fue evaluar la eficacia de la RCM sobre funcionalidad y calidad de vida en pacientes adultos y pediátricos en comparación con otras intervenciones o la no intervención. Se realizó una revisión sistemática de ensayos clínicos controlados aleatorizados, estudios piloto y series de casos, publicados entre 2012 y 2021 en las bases de datos PubMed, PEDro, Cochrane Library y CINHAL Complete. Diez estudios cumplieron los criterios de elegibilidad. La RCM muestra beneficios similares o superiores a otras intervenciones sobre la funcionalidad del miembro superior, la marcha, el equilibrio y la calidad de vida en pacientes neurológicos y traumatológicos. Se necesitan más estudios con mayores muestras y calidad para valorar los efectos a largo plazo.(AU)
Cognitive multisensory rehabilitation (CMR) a thera-peutic approach to help recover movement using neurocog-nitive exercises activates patients perceptive and cognitiveprocesses, key for motor learning. The aim of this system-atic review was to assess the effectiveness of CMR on mo-tor function and quality of life and compare the findingswith other rehabilitation approaches or no-intervention inneurological and trauma adult and pediatric patients. Wecarried out a systematic review of randomized controlledclinical trials, pilot studies, and case series in PubMed, PE-Dro, Cochrane Library, and the CINHAL Complete databasepublished between 2012 and 2021. Ten studies met the eli-gibility criteria. CMR provides similar or superior benefitscompared to other types of approaches for the restoration ofupper limb function, gait, balance, and quality of life in neu-rological and trauma patients. Further research with largersamples and higher methodological quality need to be devel-oped to determine its long-term effectiveness.(AU)
