摘要:

Purpose.There is increasing interest in the use of performance tests to assess physical function among patients with debilitating diseases. The purpose of this study was to describe the measurement properties of a performance test battery used in the Reconditioning Exercise and Chronic Obstructive Pulmonary Disease Trial and to explore how well-selected physiologic and psychosocial measures explained test performance.Methods.To assess test-retest reliability of the performance tests, older patients with chronic obstructive pulmonary disease (n= 30) completed, on two different occasions, a 6-minute walk for distance, a timed stair climb, and a timed elevated-arm task. In addition, stepwise regression analyses were conducted on a larger sample (n= 209) to examine how effective conceptually relevant physiologic and psychosocial variables were at explaining variation in task performance.Results.Results showed that all three performance tasks had good test-retest reliability (all coefficients > 0.80) and shared variance in expected directions with VO2peak, forced expiratory volume in 1 second (FEV1), and self-reported disability. Regression analyses suggest that VO2peak, FEV1, self-efficacy, and self-reported disability are important variables to consider in attempts to understand performance-related disability in patients with chronic obstructive pulmonary disease (COPD).Conclusions.The physical performance test battery appears to be a reliable means of assessing physical functioning in older patients with COPD. Furthermore, findings support the important role that VO2peakplays in task performance and suggest that patients' perceptions should be given careful consideration when attempting to understand physical decline in clinical settings.

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background.Studies have shown that digoxin binds to the working muscles during an acute bout of exercise, with a concomitant decrease in serum digoxin concentration. This study investigated the effects of 16 weeks of endurance exercise training on the pharmacokinetics of digoxin in old and young adults.Methods.Twelve subjects, aged 68.5 ± 4.5 years, and six subjects, aged 30.3 ± 3.8 years, completed the study. All subjects were healthy, sedentary, and taking no cardiovascular medications. After initial testing and maximum oxygen consumption (VO2max) measurements, subjects were hospitalized for 28 hours for renal function testing and digoxin clearance studies and then randomly assigned to an exercise (EG) or control (CG) group. The EG completed 16 weeks (three 1-hour bouts/week) of aerobic training at 75% to 85% of maximum capacity. The CG did not exercise. All tests were repeated at the end of the 16-week study period.Results.In the older EG subjects, VO2maxincreased by 3.4 ml/kg/min, or approximately 16% (P= 0.0002). VO2maxincreased in the younger EG subjects by 1.1 ml/kg/min, but the increase was not significant (P> 0.05). There were no significant changes in body composition, renal function, or time of onset, peak concentration, or elimination phase half-life of digoxin in either the old or young exercise or control groups (P> 0.05 for all variables).Conclusion.Although 16 weeks of endurance exercise training improves cardiorespiratory fitness, the pharmacokinetics of digoxin are neither improved nor adversely affected in healthy old and young adults.

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Obesity is an independent risk factor for the development of coronary artery disease (CAD). Obesity also increases risk for CAD indirectly through its association with insulin resistance, hyperlipidemia, and hypertension. An increased accumulation of fat in the intraabdominal cavity, termed visceral adiposity, is highly correlated with an adverse coronary risk profile. In patients at risk for coronary artery disease, the treatment of obesity results in an improved coronary risk profile. The prevalence of obesity is extremely high in coronary populations, yet the effect of weight loss on cardiovascular outcomes in CAD patients has received relatively little attention. Observational studies in the cardiac rehabilitation setting showed that patients who lose weight and exercise show an improvement in coronary risk profile. Further research is needed to better define the clinical effectiveness of weight loss programs and their benefits in coronary patients.

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Methods:This article incorporates known findings from the psychological literature regarding health behaviors and adjustment to cardiac illness with identified psychosocial needs of implantable cardioverter defibrillator (ICD) patients. An emphasis is placed on healthcare providers' unique ability to facilitate adjustment during routine patient contacts.Results:Seven principles of supportive communication are presented to enhance healthcare providers' awareness of the psychosocial needs of ICD patients. A table of "quotes" representing each principle is provided to show how each form of supportive communication may be delivered to optimize health outcomes for ICD patients.Conclusions:Brief, routine communication between healthcare providers and ICD patients about psychosocial issues can facilitate patient adjustment. Although not sufficient to meet the needs of all ICD patients, supportive communication bolsters problem-solving and coping strategies of most ICD patients. For patients with more severe psychological adjustment difficulties, supportive communication may lead to better identification of patients who would benefit from referrals to mental health professionals.

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Background:Optimal cardiac rehabilitation (CR) program length and the time course of changes in relevant outcomes are unknown. The purpose of this study was to assess changes in coronary risk factors and health-related quality of life (HRQoL) after 3 months and 6 months of cardiac rehabilitation.Methods:This is an observational study of a cohort of 126 consecutive cardiac rehabilitation patients who completed baseline, 3-month, and 6-month evaluations of coronary risk factors and HRQoL. The coronary risk factors included lipid profile, blood pressure, body mass index (BMI), and physical activity level. HRQoL was assessed using the Short Form-36 questionnaire (SF-36) comprising eight health concepts and two component scales (physical [PCS] and mental [MCS]).Results:There was significant improvement in all coronary risk factors and HRQoL measures, except BMI, over the 6-month period (P< 0.001). Significant changes in blood pressure, physical activity, PCS, and high-density lipoprotein cholesterol (HDL-C) were apparent at 3 months, and no additional significant changes in these variables occurred between 3 and 6 months. For total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and MCS, significant change was achieved between 3 and 6 months but not between baseline and 3 months.Conclusions:Secondary prevention and HRQoL outcomes improved at variable rates. Physical activity and physical function peaked at 3 months and were maintained at program completion. Significant improvements occurred in mental health recovery beyond the traditional 12-week CR program length. Outcomes furthest from normative values showed the most rapid improvement. Optimal duration of participation may vary according to the outcome of interest.

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2000

数据来源: OVID