Self-efficacy measurement instruments for individuals with coronary artery disease: A systematic review.

INTRODUCTION: Over the past decade, there has been a heightened interest in evaluating self-efficacy among patients with coronary artery disease (CAD). A significant number of instruments have been developed and validated, yet the need remains to assess the quality of their studies and their properties. OBJECTIVES: To evaluate the measurement properties and link the content extracted from self-efficacy instrument items for individuals with CAD to the International Classification of Functioning, Disability, and Health (ICF). METHODOLOGY: The study was conducted following the Cochrane systematic review guidelines and COnsensus norms for Selection of health Measuring INstruments (COSMIN), registered under CRD42021262613. The search was carried out on MEDLINE (Ovid), Web of Science, EMBASE, and PsycINFO, including studies involving the development and validation of self-efficacy instruments for individuals with CAD, without language or date restrictions. Data extraction was performed in May 2022 and updated in January 2023 and all the steps of this review were carried out by two different collaborators and reviewed by a third when there were divergences. Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommended by COSMIN was used to determine the quality of evidence as high, moderate, low, or very low. Instrument categorization was carried out per COSMIN recommendations, according to the construct of interest and study population into three categories (A, B, or C). RESULTS: A total of 21 studies from 12 instruments were identified. The best-rated instruments received a recommendation of B, which means, additional validation studies are needed. Barnason Efficacy Expectation Scale (BEES) showed high-quality evidence for structural, construct, criterion, and internal consistency validity; Cardiac Self-Efficacy Scale (CSES) demonstrated high quality for content, structural, cross-cultural validity, and internal consistency; Self-efficacy for Appropriate Medication Use (SEAMS) achieved a high level for structural, criterion, and internal consistency validity; Cardiovascular Management Self-Efficacy Scale exhibited high-level validity for structural, criterion, construct, and internal consistency. The CSES showed content linkage with all domains of the ICF, as well as the highest number of linkages with the categories. CONCLUSIONS: Instruments with a B-level recommendation hold potential for use. More studies assessing measurement properties are needed to reinforce or improve these recommendations. The CSES stands out as the most comprehensive instrument concerning the ICF.

Effectiveness of Paced Breathing Guided by Biofeedback on Clinical and Functional Outcomes Patients with Chronic Obstructive Pulmonary Disease: An Uncontrolled Pilot Study.

To investigate the effectiveness of paced breathing guided by biofeedback on clinical and functional outcomes of patients with chronic obstructive pulmonary disease (COPD). An uncontrolled pilot study comprising a training with paced breathing guided by biofeedback (three sessions of 35 min per week) was conducted over four weeks (12 sessions). Assessments included respiratory muscle strength (using a manovacuometer), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory), dyspnea (Baseline Dyspnea Index), functionality (Timed Up and Go Test), health status (COPD Assessment Test) and health-related quality of life (Saint George's Respiratory Questionnaire). The sample consisted of nine patients with a mean age of 68.2 ± 7.8 years. After intervention, patients significantly improved in health status and health-related quality of life, assessed using the COPD Assessment Test (p < 0.001) and Saint George's Respiratory Questionnaire (p < 0.001); anxiety (p < 0.001); and depression (p = 0.001). Patients also significantly improved in dyspnea (p = 0.008), TUG (p = 0.015), CC Score (p = 0.031), and maximum inspiratory (p = 0.004) and expiratory pressures (p < 0.001). An intervention with paced breathing guided by biofeedback promoted positive results on dyspnea, anxiety, depression, health status and perceived health-related quality of life in patients with COPD. Moreover, gains in respiratory muscle strength and functional performance were observed, affecting the performance of daily activities.

Evaluation of autonomic cardiac modulation and body composition in elderly submitted to the protocol of exercise and the gametherapy: A clinical trial protocol (SPIRIT compliant).

INTRODUCTION: Aging affects the cardiovascular system by impairing the amount and strength of cardiac pumping. Heart rate variability (HRV) is a safe parameter to assess variations in the cardiovascular system, providing data on sympathetic and parasympathetic activations. OBJECTIVES: Our primary aim is to investigate the cardiac autonomic modulation and body composition of active older adults participating in a physical exercise protocol and gametherapy. Our secondary aim is to assess their functional capacity, cognitive function, balance, respiratory pressures, and functional autonomy. METHOD: This randomized clinical trial will include 100 active older adults aged 60 to 80 years. The exercise group (EG) will perform 24 supervised training sessions (strength and aerobic) for 12 weeks (2 60-minutes sessions per week). The gametherapy group (GG) will exercise using gametherapy. Assessments will occur on the first week, after the 12th week, after wash out and in the end of cross over. The primary outcome will be HRV and body composition (bioimpedance). Secondary outcomes will be functional capacity (6-minute walk test), cognitive function (mini-mental state examination), risk of falls and balance (berg balance scale and timed up and go test), inspiratory and expiratory pressures (manovacuometry) and functional autonomy (functional reach test and group of Latin American development to maturity [GDLAM] protocol). DISCUSSION: This study will provide relevant information about the effects of physical training (physical exercises and gametherapy) on HRV and other variables in active older adults.

Self-efficacy instruments for individuals with coronary artery disease: a systematic review protocol.

INTRODUCTION: Self-efficacy is associated with management of diseases, psychological well-being, improved quality of life and rehabilitation adherence. Several instruments related to behaviour or specific disease (eg, coronary artery disease (CAD)) assess self-efficacy. The evaluation of cardiac self-efficacy in individuals with CAD will support healthcare professionals to improve self-efficacy via interventions; therefore, a suitable instrument is crucial. This systematic review aims to assess measurement properties, methodological quality and content of outcome measures of cardiac self-efficacy instruments for individuals with CAD. METHODS AND ANALYSIS: The study has been developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and Consensus Norms for Selection of Health Measuring Instruments (COSMIN). The following databases will be searched: MEDLINE (Ovid), Web of Science, EMBASE and PsycINFO. Studies assessing measurement properties of cardiac self-efficacy instruments for individuals with CAD will be included. No date or language restrictions will be applied to the search. Two independent authors will be responsible for assessing the eligibility of studies. Methodological quality of studies will be assessed using the COSMIN RoB Checklist, and the Grading of Recommendations, Assessment, Development and Assessment will be used to assess the quality of each study. Two authors will independently evaluate the content of instruments and link this to the International Classification of Functioning, Disability and Health. ETHICS AND DISSEMINATION: This study does not require ethics committee approval since it is based on previously published data. Evidence from this systematic review will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021262613.

Effectiveness of therapeutic exercises for improving the quality of life of patients with chronic venous insufficiency: a systematic review.

The main signs and symptoms of chronic venous insufficiency are pain, edema, varicose veins, and tissue changes; conditions that compromise functionality and quality of life. Management of the disease aims to mitigate these losses and involves a wide range of interventions, one of which is therapeutic exercise. This article presents the existing evidence on the effectiveness of therapeutic exercises for quality of life, pain, and functionality in chronic venous insufficiency. Searches were run on the databases CENTRAL, CINAHL, LILACS, MEDLINE, PEDro, SciELO, Science Direct, Scopus, and Web of Science. Four of the 2,961 results met the eligibility criteria. Only one of these studies showed benefits of exercise for improving quality of life and reducing pain. The others had low methodological quality. The existing evidence is therefore insufficient to indicate or contraindicate therapeutic exercises for improvement of quality of life, pain, and functionality in patients with chronic venous insufficiency.

The impact of peripheral arterial disease on exercise tolerance and quality of life in the elderly and the role of cardiovascular physiotherapy: review article.

The primary symptom of peripheral arterial its intermittent claudication; a condition that causes functional disabilities, compromising quality of life. This review aimed to survey the impacts of this disease on the elderly, investigating possible contributions that cardiovascular physiotherapy has to offer. Searches were run on the MEDLINE, LILACS, SciELO, Scopus, Science Direct, and PEDro databases, identifying 7,587 studies. Seven of these met the eligibility criteria and were grouped and analyzed according evidence level, recommendation grade, and methodological quality. It was observed that this disease is responsible for considerable impact on exercise tolerance and quality of life. Regarding the therapeutic approach to these outcomes, the studies reported that there were improvements in walking and quality of life, increased functional capacity, and reduced pain. With regard to the treatment modality, most research included aerobic exercises.

Repercussão da doença arterial periférica na tolerância ao exercício e na qualidade de vida de idosos e o papel da fisioterapia cardiovascular: artigo de revisão / The impact of peripheral arterial disease on exercise tolerance and quality of life in the elderly and the role of cardiovascular physiotherapy: review article

Resumo A doença arterial periférica tem como principal sintoma a claudicação intermitente, fator que resulta em incapacidade funcional, comprometendo a qualidade de vida. Esta revisão objetivou fazer um levantamento sobre os impactos ocasionado pela doença nos idosos, investigando as possíveis contribuições da fisioterapia cardiovascular. Para isso, realizou-se uma busca nas bases de dados MEDLINE, LILACS, SciELO, Scopus, Science Direct e PEDro, a qual identificou 7.587 estudos. Desses, sete atenderam aos critérios de elegibilidade, sendo então agrupados e analisados conforme o nível de evidência, grau de recomendação e qualidade metodológica. Pôde-se observar um considerável impacto da doença sobre a tolerância ao exercício e a qualidade de vida. Quanto à abordagem terapêutica desses desfechos, os estudos relataram que houve melhora na deambulação e na qualidade de vida, aumento da capacidade funcional e redução da dor. No que se refere à modalidade de tratamento, a maioria das pesquisas incluíram exercícios aeróbicos.

Abstract The primary symptom of peripheral arterial its intermittent claudication; a condition that causes functional disabilities, compromising quality of life. This review aimed to survey the impacts of this disease on the elderly, investigating possible contributions that cardiovascular physiotherapy has to offer. Searches were run on the MEDLINE, LILACS, SciELO, Scopus, Science Direct, and PEDro databases, identifying 7,587 studies. Seven of these met the eligibility criteria and were grouped and analyzed according evidence level, recommendation grade, and methodological quality. It was observed that this disease is responsible for considerable impact on exercise tolerance and quality of life. Regarding the therapeutic approach to these outcomes, the studies reported that there were improvements in walking and quality of life, increased functional capacity, and reduced pain. With regard to the treatment modality, most research included aerobic exercises.

Eficácia dos exercícios terapêuticos na qualidade de vida de pacientes com insuficiência venosa crônica: uma revisão sistemática / Effectiveness of therapeutic exercises for improving the quality of life of patients with chronic venous insufficiency: a systematic review

Resumo Os principais sinais e sintomas da insuficiência venosa crônica são dor, edema, varizes e alterações teciduais, condições que comprometem a funcionalidade e qualidade de vida. Visando amenizar esses prejuízos, o manejo da doença envolve uma ampla modalidade de intervenções; entre elas, o exercício terapêutico. Esta pesquisa apresenta as evidências existentes sobre a efetividade dos exercícios terapêuticos na qualidade de vida, dor e funcionalidade da insuficiência venosa crônica. Efetuou-se uma busca nas bases de dados CENTRAL, CINAHL, LILACS, MEDLINE, PEDro, SciELO, Science Direct, Scopus e Web of Science. Dos 2.961 resultados, quatro atenderam aos critérios de elegibilidade. Desses, apenas um estudo mostrou benefícios dos exercícios para melhora da qualidade de vida e redução da dor. Os demais apresentaram baixa qualidade metodológica. Portanto, as evidências existentes são insuficientes para indicar ou contraindicar os exercícios terapêuticos para melhoria da qualidade de vida, dor e funcionalidade em pacientes com insuficiência venosa crônica.

Abstract The main signs and symptoms of chronic venous insufficiency are pain, edema, varicose veins, and tissue changes; conditions that compromise functionality and quality of life. Management of the disease aims to mitigate these losses and involves a wide range of interventions, one of which is therapeutic exercise. This article presents the existing evidence on the effectiveness of therapeutic exercises for quality of life, pain, and functionality in chronic venous insufficiency. Searches were run on the databases CENTRAL, CINAHL, LILACS, MEDLINE, PEDro, SciELO, Science Direct, Scopus, and Web of Science. Four of the 2,961 results met the eligibility criteria. Only one of these studies showed benefits of exercise for improving quality of life and reducing pain. The others had low methodological quality. The existing evidence is therefore insufficient to indicate or contraindicate therapeutic exercises for improvement of quality of life, pain, and functionality in patients with chronic venous insufficiency.

Effectiveness of inspiratory muscle training associated with a cardiac rehabilitation program on sympathetic activity and functional capacity in patients with heart failure: a study protocol for a randomized controlled trial.

BACKGROUND: Individuals affected by heart failure (HF) may present fatigue, dyspnea, respiratory muscle weakness, and sympathetic activity hyperstimulation of the myocardium, among other symptoms. Conducting cardiac rehabilitation (CR) programs can be associated with inspiratory muscle training. The aim of this study was to evaluate the efficacy of inspiratory muscular training (IMT) associated with a CR program on modulating myocardial sympathetic activity and maximal functional capacity, submaximal functional capacity, thickness, and mobility of the diaphragm muscle in patients with HF. METHODS: We will conduct a clinical, controlled, randomized, double-blind trial that will include sedentary men and women who are 21-60 years old and who have diagnosed systolic HF and a left ventricular ejection fraction of less than 45%. Participants will be randomly assigned to one of two groups: experimental and control. The control group will follow the conventional CR protocol, and the experimental group will follow the conventional CR protocol associated with IMT 7 days a week. The two proposed exercise protocols will have a frequency of three times a week for a period of 12 weeks. The sympathetic innervation of the cardiac muscle, the maximum and submaximal functional capacity, diaphragm mobility and thickness, and the quality of life of the participants will be evaluated before and after the intervention protocol. DISCUSSION: This clinical trial will be the first study to investigate the additional effects of IMT on CR in sympathetic hyperstimulation in the myocardium. The results of this study will contribute to developing therapeutic strategies collaborating to elucidate whether the association of IMT with CR can induce clinical benefits for patients with HF. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02600000. Registered November 9, 2015. Retrospectively registered.

Effects of daily inspiratory muscle training on respiratory muscle strength and chest wall regional volumes in haemodialysis patients: a randomised clinical trial.

Purpose: Evaluating the effects of interdialytic daily inspiratory muscle training (IMT) on respiratory muscle strength, chest wall regional volumes, diaphragmatic mobility and thickness, pulmonary function, functional capacity, and quality of life (QoL) in haemodialysis (HD) patients.Method: A randomised, and double-blind clinical trial composed of 24 chronic kidney disease patients undergoing HD. Patients were allocated into the IMT group (n = 12) or sham group (n = 12) and performed daily IMT twice per day with a load of 50% inspiratory muscle strength for the IMT group and 5 cmH2O for the sham group during 8 weeks. Respiratory muscle strength, diaphragm thickness and mobility, chest wall regional volumes, functional capacity, and QoL were measured.Results: At the end of the study, an increase in inspiratory and expiratory muscle strength was observed for both groups, but no significant difference was found between them. Changed volume distribution was also observed in the IMT group, with significantly increased inspiratory capacity in the pulmonary compartment compared to the sham group.Conclusions: Daily interdialytic IMT promoted a change in chest wall regional volumes, with an increase in the inspiratory capacity of the pulmonary rib cage. Both groups had increased inspiratory and expiratory muscle strength with daily respiratory exercise.Trial registration: www.ClinicalTrials.gov; study number: NCT02599987; name of trial registry: IMT in Patients with End-stage Renal Disease.Implications for rehabilitationMuscular impairment in chronic kidney disease patients results from a series of common alterations, affecting respiratory muscles.Patients with chronic kidney disease have low values of diaphragmatic thickness.The daily inspiratory muscle training (IMT) or breathing exercise over a period of 8 weeks provided increased respiratory muscle strength.The daily inspiratory muscle training presented a change in tri-compartment distribution of lung volume compared to the sham group, with increased inspiratory capacity of the pulmonary rib cage.