ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The effects of a 12-week exercise training and cardiac education program on short-term and long-term employment and realted measures of quality of life were compared in a nonrandomized study. Eighty-three trained patients and 92 patients who received, usual physician care (usual care) after successful percutaneous transluminal coronary angioplasty (PTCA) were studied. Data, were collected from medical files and by a before-and-after PTCA questionnaire. At baseline, groups did not differ with respect to age, medical status, occupational status, level of income, presence of risk factors for coronary disease, and patient's perception of health. Of those working full time before PTCA, 11% of the patients in the trained group and 23% of the patients in the usual care group did not resume their work status after 18 months of follow-up. At 18 months after PTCA, 37% of the trained vs 52% of the usual care patients quit working (P < 0.01), even though exercise-induced angina, greater than or equal to 1 mm ST horizontal depression at comparable work loads, and rate of restenosis were similar in both groups. Sexual activity, at 3 and 18 months, was significantly more common in the trained group (P < 0.05 to 0.0001). After PTCA, 90% of patients in each group reported unlimited social and recreational life. However, poor health as perceived by the patient was reported by more patients in the usual care group (P < 0.01). Thus, post PTCA participation in a 12-week rehabilitation program, which included physical training and patient education, significantly improved the rate of return to work, quality of life, and exercise performance that usual care did not provide.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Use patterns of outpatient cardiac rehabilitation services need to be identified, not as dichotomous measures of compliance-dropout, but as measures on a compliance continuum described by different levels of attendance. The authors investigated the associations between use of outpatient cardiac rehabilitation services (defined as attendance) and age, gender, the three major modifiable cardiovascular risk factors (smoking, hypercholesterolemia, and hypertension), reasons for referral, and different third-party reimbursement systems. The study population consisted of 492 patients (337 men, mean age, 58.8 years of age; 155 women, mean age, 57.0 years of age) who were referred to a 12-week hospital-based rehabilitation program after myocardial infarction (MI) (18.5%), coronary artery bypass surgery (CABG) (37.4%), bypass surgery plus infarction (CABG+MI) (13.4%), or other reasons (30.7%). Mean overall attendance was 75%. Survival analysis using the Cox proportional hazard regression model identified Medicaid /Title 19 as the factor most strongly associated with poor attendance (relative risk, 2.54; 95% confidence intervals, 1.76 to 3.67; P=0.000). Other factors with relative risk for poor attendance ranging from 1.86 to 1.43 included age (younger than 54 years of age), female gender, and other reasons for referral. Women younger than 45 years of age who receive reimbursement from Medicaid / Title 19, with a mean attendance of 18%, appear to be a high-risk group for poor attendance. Factors associated with attendance and compliance-enhancement warrant additional investigation as adequate use is critical for the effectiveness of cardiac rehabilitation services.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Arkansas cardiologists, cardiovascular surgeons, internists, and family practitioners were surveyed to determine their beliefs about outpatient cardiac rehabilitation (OCR) programs. They answered questions pertaining to OCR services and referrals. Results revealed an incongruity between services that physicians believe are most beneficial and services that they believe are actually offered. Findings suggest a pattern of OCR underutilization and the need for improved communication between OCR staff and referring physicians. Implications for program changes are discussed.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Arm exercise testing is used clinically in patients with leg disability. Few studies have reported normal arm performance values for middle-aged subjects, however, and physicians are more familiar with treadmill exercise. A total of 36 healthy men, aged 30 to 39 years (n = 10), 40 to 49 years (n = 10), 50 to 59 years (n = 9), or 60 to 69 years (n = 7) were evaluated using an incremental arm crank test and a Bruce treadmill test. Maximum oxygen consumption (VO2max) for treadmill and arm exercise declined with age at rates, of 0.5 and 0.3 mL · kg−1· min−1· yr−1, respectively, or 10% per decade. Arm exercise VO2maxvalues (X ± SD) for the four advancing age groups (26 ± 8.3, 22 ± 5.4, 21 ± 2.7, 16 ± 2.8 mL · kg−1· min−1respectively) were 60% of the corresponding treadmill VO2maxvalues. Maximum heart rate (HR) during arm exercise was 88% of that achieved with treadmill exercise for all age groups. Arm and treadmill VO2maxwere correlated (r = 0.81, P < 0.01), and arm and treadmill test duration were moderately related (r = 0.70, P < 0.05). The 95% confidence intervals for estimating individual treadmill time from the arm test encompassed two Bruce stages, however, prohibiting an accurate estimation of treadmill performance from the arm crank results. It was concluded that arm performance should be compared directly with existing norms for arm exercise and cannot be used to estimate individual treadmill capacity.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Previous endurance training studies lack sufficient sample size to adequately assess changes, in total cholesterol concentrations (ΔTC) subsequent to endurance exercise training as a function of the pretraining value. Meta-analysis techniques have previously been employed in an attempt to overcome this problem, and have suggested that pretraining TC values are significant predictors of ΔTC after training. This retrospective study was designed to identify significant predictors of ΔTC after an endurance training program, after adjusting for the pretraining cholesterol concentration. Subjects included an intact population of apparently healthy men (n = 327)and women(n = 215) ranging in age from 20 to 75 years, who completed approximately 16 to 20 weeks of endurance training in a university-based adult exercise program between 1973 and 1986. The training stimulus consisted of individualized aerobic exercise (walking, walk-jog, or running) at approximately 75% to 85% maximal heart rate reserve for 30 to 50 minutes four times per week. Pre-post training TC values were 227 (±48) vs 217 (±42) and 210 (±44) vs 205 (±40) mg /dl (P < 0.03.) for the men and the women, respectively. Significant zero-order correlations (P < 0.05) were found between ΔTC and pretraining TC (r = −0.512), change in body weight (ΔBW; r = 0.265), change in percent body fat (ΔBF; r = 0.144) and change in VO2max(ΔVO2max;r = −0.263). After adjustment for the pretraining TC, age became, and ΔBW, ΔBF, and Δ2maxremained significant first-order predictors of ΔTC for the combined male and female cohort. Gender-specific regression analysis revealed differences between men and women for predictors of ΔTC. After adjustment for the pretraining TC, ΔBW (r = 0.332), ΔBF (r = 0.223), and VO2max(r = −0.201) were significant predictors of ΔTC for the men, but only age (r = 0.135) remained a predictor of ΔTC for the women. Curvilinear trend analysis failed to reveal a threshold pretraining TC concentration above which favorable changes could be expected. However, classification into the National Cholesterol Education Program (NCEP) categories (e.g., < 200; 201–239; ± 240 mg/dl) showed that individuals in the high cholesterol category had ΔTC of −9.9% and −9.2% for the men and the women, respectively (P < 0.01). These results confirm the importance of pretraining TC levels in assessing the potential for a favorable ΔTC subsequent to endurance training, and suggest that the equivocal results found in previous studies may have been due, in part, to the use of samples with normal pretraining TC, or of small samples with a wide range of pretraining TC such that the treatment effect for those with high TC may have been diluted by the rest of the sample.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The incidence of sudden death was reviewed with reference to the imposition of maximum ages of retirement on public safety officers such as firefighters and police officers. Current evidence suggests that physical activity is rarely demanded in either of these occupations. The development of a fatal heart attack while on an active duty is a rare occurrence. Public safety is unlikely to be influenced by such an event more than once in 1 million missions. Moreover, in jurisdictions in which compulsory retirement has been abolished, the proportion of officers who have chosen to remain on active service is so small as to have little influence on this risk, Any residual concerns about public safety can be addressed effectively by a thorough screening for cardiac risk factors and the introduction of appropriate corrective programs at the work site.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Seventy patients with coronary heart disease (CHD) of functional classes (FC) I, II, and III performed various routine activities such as sawing, shoveling, vacuuming, and carrying 5-kg weights, 10-kg weights, and 15-kg weights to determine the energy expenditure and response of the cardiovascular system. Some jobs were performed in comfortable postures and uncomfortable (forced) postures. Energy expenditure and hemodynamic variables in working were expressed in terms of percent of individual maximal exercise tolerance determined during a bicycle test. The same job progressively increased in relative intensity as the FC worsened. Cardiovascular energy expenditure was greater at jobs in forced postures. The data allowed the authors to individualize the recommendations for patients with CHD with respect to their routine physical activities.

ISSN:0883-9212    

出版商:OVID    

年代:1992

数据来源: OVID