Association between Post-Hospitalization Psychological Distress, Exercise Capacity, Physical Function and Health Status in COVID-19 Survivors.

This study aims to determine whether post-hospitalization psychological distress is associated with exercise capacity, physical function and health status in COVID-19 survivors. In this observational study, hospitalized COVID patients were included and divided into two groups according to the mental component summary subscale of the 12-item Short-Form Health Survey. Patients with a score ≤ 45 were included in the psychological distress group, and patients with a score > 45 were included in the non-psychological distress group. The main variables were exercise capacity, physical function, and health status. Patients were evaluated at discharge, 3 months, and at 6 months follow-up. Finally, a total of 60 patients were included in the study. Significant differences were found in exercise capacity, physical function, and health status (p < 0.05), with worse results in the group with psychological distress at discharge and 3 months follow-up. At 6 months after discharge, COVID patients with psychological distress exhibited worse results in exercise capacity, physical function, and health status, being significant exercise capacity and physical function (p < 0.05). It can be concluded that COVID patients with psychological distress at hospital discharge reported worse exercise capacity, physical function and health status at hospital discharge, 3 months and 6 months follow-up.

Effects of Cardiopulmonary Rehabilitation on the Muscle Function of Children with Congenital Heart Disease: A Prospective Cohort Study.

Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects' handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects' handgrip strength (kg) (p < 0.001), biceps brachii and quadriceps femoris strength (N) (p < 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis.

Cardiopulmonary Rehabilitation Improves Respiratory Muscle Function and Functional Capacity in Children with Congenital Heart Disease. A Prospective Cohort Study.

Critical surgical and medical advances have shifted the focus of congenital heart disease (CHD) patients from survival to achievement of a greater health-related quality of life (HRQoL). HRQoL is influenced, amongst other factors, by aerobic capacity and respiratory muscle strength, both of which are reduced in CHD patients. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on respiratory muscle strength and functional capacity. Fifteen CHD patients, ages 12 to 16, with reduced aerobic capacity in cardiopulmonary exercise testing (CPET) were enrolled in a CPRP involving strength and aerobic training for three months. Measurements for comparison were obtained at the start, end, and six months after the CPRP. A significant improvement of inspiratory muscle strength was evidenced (maximum inspiratory pressure 21 cm H2O, 23%, p < 0.01). The six-minute walking test showed a statistically and clinically significant rise in walked distance (48 m, p < 0.01) and a reduction in muscle fatigue (1.7 out of 10 points, p = 0.017). These results suggest CPRP could potentially improve respiratory muscle function and functional capacity, with lasting results, in children with congenital heart disease, but additional clinical trials must be conducted to confirm this finding.

Ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo / Non-randomized trial to evaluate a continuous physiotherapy program versus interval in overweight patients suffering from acute coronary síndrome

Presentamos un ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo. OBJETIVO: Detectar diferencias entre un programa de fisioterapia (PF) continuo (CONT) y uno interválico (INT) en pacientes con sobrepeso y síndrome coronario agudo, respecto a parámetros antropométricos, analíticos, frecuencia cardiaca de reposo, adherencia a la intervención, desgaste, seguridad y tolerancia. DISEÑO: Estudio multicéntrico cuasiexperimental con diseño pre-post, no aleatorizado con muestreo por conveniencia con 2 brazos de tratamiento. Emplazamiento: Centros de prevención cardiaca comunitaria (Departamentos de Salud Manises, Valencia-La Fe, Játiva-Onteniente). PARTICIPANTES: Se consideró a 339 sujetos con sobrepeso y síndrome coronario agudo que vivían en la comunidad; mayores de 18 años; sin contraindicación para realizar ejercicio físico; sin participación previa en PF. INTERVENCIONES: Se realizó un PF con entrenamiento CONT o uno con entrenamiento INT (2 meses). Cada sesión se dividió en calentamiento, esfuerzo y enfriamiento. El esfuerzo se realizó a intensidad 12-13 Borg y con frecuencia cardiaca calculada según la máxima obtenida en ergometría basal. Mediciones principales: Se analizó el índice de masa corporal, perímetro abdominal, perfil lipídico, glucemia, hemoglobina glicosilada, frecuencia cardiaca de reposo, adherencia, desgaste, seguridad y tolerancia. RESULTADOS: El grupo CONT mostró diferencias significativamente mejores en las variables índice de masa corporal, perímetro abdominal, colesterol total, colesterol LDL, triglicéridos, HbA1C, glucemia y frecuencia cardiaca de reposo, respecto al PF INT. No hubo diferencias entre grupos respecto a adherencia, desgaste, seguridad y tolerancia. CONCLUSIONES: El grupo CONT produjo mejores resultados en todas las variables excepto en el colesterol HDL. Ambos programas registraron una elevada adherencia, seguridad y tolerancia

We present a non-randomised trial to evaluate a continuous physiotherapy program versus a periodic one in overweight patients suffering from acute coronary syndrome. AIM: To detect differences between a continuous (CONT) physiotherapy program (PF) and a periodic (INT) physiotherapy program in overweight patients with acute coronary syndrome on anthropometric parameters, analytical parameters, heart rate, adherence, drop-outs, safety and tolerance. DESIGN: A multicentre, non-randomised two-armed quasi-experimental study with pre-post design. LOCATION: Community cardiac prevention centres (Manises, Valencia-LaFe, Játiva-Onteniente Health Department). PARTICIPANTS: The study included a total of 339 overweight participants with acute coronary syndrome; living in the community; aged more than 18; no contraindication for physical exercise; no previous participation in a PF. INTERVENTIONS: Participants were assigned to a CONT training or an INT training (2 months). Each session was divided in warm-up, endurance, and cool-down. Endurance was performed at 12-13 Borg intensity and with heat rate calculated, with maximum heat rate obtained in the baseline ergometry. MAIN MEASUREMENTS: Body mass index, waist circumference, lipid profile, blood glucose, glycosylated haemoglobin, resting heat rate, adherence, drop-outs, safety, and tolerance were assessed. RESULTS: The CONT group showed significantly better differences in body mass index, waist circumference, total cholesterol, triglycerides, blood glucose, glycosylated haemoglobin and resting heat rate. No differences were observed in adherence, drop-outs, safety, and tolerance. CONCLUSIONS: The CONT group obtained better results in all variables except for HDL cholesterol. Both programs offered a high adherence, safety, and tolerance

[Non-randomized trial to evaluate a continuous physiotherapy program versus interval in overweight patients suffering from acute coronary syndrome]. / Ensayo no aleatorizado de un programa de fisioterapia continuo frente a interválico para pacientes con sobrepeso y síndrome coronario agudo.

We present a non-randomised trial to evaluate a continuous physiotherapy program versus a periodic one in overweight patients suffering from acute coronary syndrome. AIM: To detect differences between a continuous (CONT) physiotherapy program (PF) and a periodic (INT) physiotherapy program in overweight patients with acute coronary syndrome on anthropometric parameters, analytical parameters, heart rate, adherence, drop-outs, safety and tolerance. DESIGN: A multicentre, non-randomised two-armed quasi-experimental study with pre-post design. LOCATION: Community cardiac prevention centres (Manises, Valencia-LaFe, Játiva-Onteniente Health Department). PARTICIPANTS: The study included a total of 339 overweight participants with acute coronary syndrome; living in the community; aged more than 18; no contraindication for physical exercise; no previous participation in a PF. INTERVENTIONS: Participants were assigned to a CONT training or an INT training (2 months). Each session was divided in warm-up, endurance, and cool-down. Endurance was performed at 12-13 Borg intensity and with heat rate calculated, with maximum heat rate obtained in the baseline ergometry. MAIN MEASUREMENTS: Body mass index, waist circumference, lipid profile, blood glucose, glycosylated haemoglobin, resting heat rate, adherence, drop-outs, safety, and tolerance were assessed. RESULTS: The CONT group showed significantly better differences in body mass index, waist circumference, total cholesterol, triglycerides, blood glucose, glycosylated haemoglobin and resting heat rate. No differences were observed in adherence, drop-outs, safety, and tolerance. CONCLUSIONS: The CONT group obtained better results in all variables except for HDL cholesterol. Both programs offered a high adherence, safety, and tolerance.

[Descriptive and comparative study of cardiovascular risk factors and physical activity in patients with acute coronary syndrome]. / Estudio descriptivo y comparativo de factores de riesgo cardiovascular y actividad física en pacientes con síndrome coronario agudo.

AIM: To analyse several cardiovascular risk factors by means of the physical activity performed by patients with acute coronary syndrome (ACS). DESIGN: Cross-sectional study. LOCATION: Cardiovascular prevention service (Health Department, Valencia, Spain). PARTICIPANTS: The study included 401 individuals with acute coronary syndrome and discharged from hospital 2-3months before the assessment. The inclusion criteria included age between 30 and 80years-old, no contraindication for physical activity, and no previous participation in cardiac rehabilitation programmes. MAIN MEASUREMENTS: Metabolic equivalent MET (Kcal/Kg) was calculated, based on the type of activity, frequency, duration and intensity. Participants were divided into two groups: sedentary group (<10METs/week) and physically active group (≥10METs/week). Several variables associated with cardiovascular risk factors were assessed: body mass index (BMI), waist circumference, lipid profile, blood glucose, and arterial pressure. RESULTS: The mean consumption was 8.24±12.5METs/week. Prevalent factors were overweight (77.05%), and dyslipidaemia (64.3%), whilst 64.8% were sedentary. The physically active group showed differences when compared to sedentary group in triglycerides (146.53±72.8 vs. 166.94±104.8mg/dL; 95%CI; P=.031), and BMI (27.65±3.86 vs. 28.50±4.38kg/m2; 95%CI; P=.045). CONCLUSION: Physical activity was performed by a limited number of patients with ACS, with a prevalence of overweight and dyslipidaemia. Being physically active improved triglycerides levels and BMI. Therefore, health promotion from Primary Care and encouraging physical activity amongst patients with ACS is crucial.