ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundCurrent theories of human health behaviors suggest that clients' preferences for specific aspects of a health regimen are an important influence on their decisions to initiate and continue use of the regimen. Despite low rates of participation in cardiac rehabilitation programs, especially among women, little research has been done to determine patient preferences for features of cardiac rehabilitation programs. The purpose of this study was to identify and compare women's and men's preferences for specific cardiac rehabilitation program features.MethodsUsing a descriptive survey design, a convenience sample of 65 individuals (33 men and 32 women) participating in a cardiac rehabilitation program completed a self-administered survey in which they indicated both the importance of each of 17 cardiac rehabilitation program features and the extent to which they had experienced each of the features.ResultsConvenience factors (drive time, transportation, noninterference with other life activities, and ease of learning the exercises) were well-met preferences for both women and men. Men's and women's preferences were not well met for being able to discuss their progress with professionals and the ability to choose their own exercises. Men indicated that the ability to set their own goals was their greatest unmet preference. Women's preferences for not having pain and not tiring while exercising were significantly less well met than those of men.ConclusionsThese findings suggest that a cardiac rehabilitation program that is responsive to client preferences should emphasize joint goal setting with participants and discussion of progress, offer frequent encouragement from professionals, and provide a range of exercise choices. Attention to women's concerns about pain and fatigue while exercising should also be addressed in the program.

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

PurposeRehabilitation after myocardial infarction produces an increased peak oxygen uptake (˙VO2peak). This study investigates the relationship between the modifications in skeletal muscle metabolism and the modification in ˙VO2peakinduced by a standard program of physical training following a myocardial infarction.MethodsSeventeen patients (14 male, 3 female) were studied by phosphorus 31 (31P) magnetic resonance spectroscopy after the acute phase of a myocardial infarction and after 2 months of rehabilitation. Changes in calf muscle pH, phosphocreatine, and inorganic phosphates were measured at rest and during a plantar flexion-type incremental workload protocol. Calf muscle pH, phosphocreatine/(phosphocreatine + inorganic phosphates), and inorganic phosphates/phosphocreatine ratios were compared at the highest identical workload attained in both studies. The ˙VO2peak(mL/kg/min) was determined during a cycle stress test.ResultsAt the highest identical workload attained in both tests, the ratio phosphocreatine/(phosphocreatine + inorganic phosphates) was significantly higher (0.48±0.15 to 0.57±0.18: P<.001), and the ratio inorganic phosphates/phosphocreatine was lower (1.38±1.14 to 0.99±0.87: P<.01). After rehabilitation, no difference was observed for the pH at stress (6.83±0.16 to 6.91±0.14: not significant [NS]). The increase in the ˙VO2peakwas significant after rehabilitation (24±9 to 29±11 mL/kg/min: P<.001). The ˙VO2peakimprovement induced by the physical training was correlated with the increase in the phosphocreatine/(phosphocreatine+inorganic phosphates) (r=0.818, P<.001).ConclusionsThe reduction in phosphocreatine depletion indicated that the oxidative capacity of the skeletal muscle was improved during the rehabilitation. The good correlation between the indexes of skeletal muscle metabolism and ˙VO2peaksuggests the peripheral effect of training.

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

PurposeThis report analyzes the delivery of exercise conditioning services in the 1991 Pennsylvania, New Jersey, and Delaware regional survey of pulmonary rehabilitation programs.MethodsData from a questionnaire was analyzed with special consideration given to whether the program provided services for patients with only pulmonary diseases (n = 41) or with cardiac and pulmonary diseases (n = 18).ResultsAll 59 programs included exercise conditioning. Most programs (67%) used oxygen saturation and/or expired gas analysis for writing exercise prescriptions. Only pulmonary programs used 6- or 12-minute walk data. The exercise prescription was written by nonphysicians in 51% of the programs. Most pulmonary-only programs used respiratory therapists by themselves or in combination with other professionals as exercise supervisors (71%). Cardiopulmonary programs used exercise physiologists by themselves (22%) or nurses by themselves or in combination with other professionals (50%). For all programs, the standard for ratio of patients to exercise staff averaged 3.0:1. Pulmonary-only programs did slightly but significantly more continuous arterial oxygen percent saturation (SaO2) monitoring rather than spot checking. A standard determining the use of supplemental oxygen during exercise was reported by 78% of all programs. Most used supplemental oxygen after observing the SaO2level falling to <90%. Electrocardiography monitoring was done in 66% of pulmonary-only programs, but in 94% of the cardiopulmonary programs. Maintenance sessions were offered by 64% of the pulmonary-only programs and also by 78% of the cardiopulmonary programs.ConclusionThe type of rehabilitation program, either pulmonary-only or cardiopulmonary, appears to influence the exercise conditioning services used by the pulmonary patient.

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundEpidemiologic evidence suggests that 8,368 kJ or 2000 kcal per week of moderate physical activity, including walking and stair climbing, can reduce risk of coronary heart disease (CHD). The goal of this study was to assess the effects of this amount of these two activities on physical fitness and risk factors for CHD.MethodsTwenty-two healthy, slightly overweight, sedentary, normotensive, normolipemic men, age 22 to 44 years, were randomly assigned to an exercise or control group for 12 weeks followed by a 4-week washout period. The subjects then were crossed-over to the alternate group for an additional 12-week period. Exercise consisted of 5 days per week of supervised treadmill exercise plus stair climbing. Treadmill exercise consisted of walking for 45 minutes at 5.15 km per hour at 2% grade for a total of 19.3 km per week. Subjects also climbed 10 floors of stairs at a time at their own pace without prescribed target heart rates for a total of 50 floors per week. The estimated total weekly energy cost of the treadmill walking plus stair climbing was 8,368 kJ or 2,000 kcal. Mean observed heart rates were 55% and 82% of maximal heart rate during treadmill walking and stair climbing, respectively. Data from the two exercise periods and two control periods were pooled and compared by analysis of variance.ResultsSixteen subjects completed all phases of the study. Maximal oxygen uptake (˙VO2max) by the Bruce treadmill exercise protocol with metabolic gas measurements was below average for age at baseline, and was not significantly affected by 12 weeks of training. No significant changes were noted between groups in body weight or percent body fat (hydrostatic weighing), although there was a trend for loss of weight and fat with exercise training. Mean systolic blood pressure (119 mm Hg) was unchanged in both groups. However, diastolic blood pressure (72 mm Hg and 78 mm Hg for the treatment and control groups, respectively) showed and unexpected 6 mm Hg increase during the exercise period and a 5 mm Hg decline during the control period. Mean plasma lipid and lipoprotein levels were unaffected by training, except for a 16% reduction in triglycerides (P <.05). However, a 28% increase in plasma high density lipoprotein (HDL)-cholesterol (P <.01) was noted during the initial 12-week training period, which regressed during the washout period, and was not replicated during the second 12-week exercise period.ConclusionsTwelve weeks of walking and stair climbing at a moderate pace and intensity at an energy cost of about 2,000 kcal per week failed to improve physical fitness or risk factors for CHD. A reduction in physical activities other than the prescribed exercise program, as reported by a physical activity recall questionnaire, probably contributed to an absence of an exercise response. A longer and/or a more intense activity program is apparently required to improve these modalities.

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundPatients with atrial fibrillation (AF) referred for exercise rehabilitation exemplify the problem inherent in reliance on pulse rate to prescribe and monitor training intensity.MethodsExercise training was accomplished by specifying a training walking pace based on 60% to 80% of the peak oxygen intake (˙VO2max), as determined by the analysis of expired air (Horizon metabolic cart), and/or the ventilatory threshold (VT), together with a perceived exertion of 12 to 14 on the original Borg scale of perceived exertion.ResultsAt the end of 1 year, a significant training effect was demonstrated (˙VO2maxaverage increase 15%, 14.8 ± 3.6 mL/kg/min to 17.0 ± 3.6 mL/kg/min, P <.02; ˙VO2at VT, average increase 14%, 11.2 ± 2.2 to 12.8 ± 2.6 mL/kg/min, P <.01; peak power output increase 21%, 92.5 ± 29.3 Watts to 112 ± 3.7 Watts, P <.05) in a group of 20 patients (13 men, 7 women) with chronic atrial fibrillation.ConclusionsPatients with chronic atrial filbrillation can achieve significant functional gains from an exercise rehabilitation program.

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1996

数据来源: OVID