ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSEIncreased respiratory muscle endurance and peak oxygen consumption (VO2peak) induced by respiratory muscle training support the relationship between respiratory muscle function and exercise capacity in patients with heart failure. This raises the question whether exercise-training results in increased respiratory muscle function contributing to an increased exercise tolerance, a decreased perception of breathlessness, and an improved quality of life.METHODSProspective cohort analysis was completed on 24 patients with New York Heart Association (NYHA) Class III heart failure [18 men, 6 women; aged = 64 (SD 7.9) years; percent ejection fraction (%EF) = 24.0 (SD 7.8)]. Maximal sustainable ventilatory capacity (MSVC), submaximal and peak exercise responses, perception of breathlessness, and quality of life were measured before (baseline) and after (end of study) 12 weeks of exercise training.RESULTSAs a result of exercise training, VO2peak(P= .01) and MSVC (P< .001) increased, with MSVC contributing to a larger proportion of the variability for VO2peakat study completion (r2= 0.57 vs 0.42). Although stroke volume did not increase beyond exercise at 25 W and did not change with exercise training, ventilation decreased during exercise (P< .05), perception of breathing difficulty (P<.05) was reduced, and quality of life was enhanced (P= .008).CONCUSIONSDespite no increase in cardiac output and stroke volume, respiratory muscle endurance improved with exercise training, contributing to increased exercise capacity, decreased breathlessness, and decreased perception of breathlessness. Practical implications can include less frequent rest periods and fatigue, greater confidence, maintenance of independence, and enhanced quality of life.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BACKGROUNDCardiac rehabilitation (CR) is widely accepted as beneficial for patients with myocardial infarction (MI) and coronary artery bypass graft (CABG). A need exists to evaluate how different formats of delivery can best meet CR service demands.METHODS AND RESULTSCardiac patients (n = 60) were randomly assigned to either a standard 10-week (30 sessions) or a 4-week (20 sessions) multifactorial rehabilitation program. Patients underwent exercise testing using the Bruce protocol before, immediately after, and then 6 months after CR. Patients also completed the SF-36 quality of life questionnaire and the Hospital Anxiety and Depression scale at each time point. Compared with pre-CR, exercise time and metabolic equivalents attained were significantly increased, and heart rate significantly decreased both immediately (P<.05) and 6 months after CR (P<.05) in both groups, with no between-group differences. Significant improvements (P<.05) in energy, pain, and general health were reported after CR, and in energy and emotional and social well-being at 6 months after CR. No differences were seen between the groups.CONCLUSIONSCardiac rehabilitation after MI and CABG significantly improved exercise capacity and general health and well-being. No significant differences were detected between groups undergoing a 10-week or 4-week course. These preliminary data suggest that shortened courses of CR may be beneficial to cardiac patients and such courses may also facilitate more widespread use of CR.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSEThis study evaluated the theory of planned behavior (TPB) as a framework for understanding exercise adherence during phase II cardiac rehabilitation (CR).METHODSA total of 215 patients completed a baseline questionnaire that included the TPB constructs and past exercise. Exercise adherence was measured via program attendance during phase II CR.RESULTSHierarchic regression analyses indicated that attitude, subjective norm, and perceived behavioral control (PBC) explained 30% of the variance in exercise intention, with attitude, subjective norm, and PBC each making significant unique contributions to intention. Furthermore, exercise intention explained 12% of the variance in exercise adherence. Finally, the behavioral, normative, and control beliefs provided novel information concerning why patients in phase II CR hold certain attitudes, subjective norms, PBC, and exercise intentions.CONCLUSIONResults of the present study provide evidence that the TPB is a useful framework for understanding exercise intentions and adherence during phase II CR.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSELess than 50% of persons who participate in cardiac rehabilitation (CR) programs maintain an exercise regimen for as long as 6 months after completion. This study was conducted to identify factors that predict women’s exercise following completion of a CR program.METHODSIn this prospective, descriptive study, a convenience sample of 60 women were recruited at completion of a phase II CR program. Exercise was measured using a heart rate wristwatch monitor over 3 months. Predictor variables collected at the time of the subjects’ enrollment were age, body mass index, cardiac functional status, comorbidity, muscle or joint pain, motivation, mood state, social support, self-efficacy, perceived benefits or barriers, and prior exercise.RESULTSOf women, 25% did not exercise at all following completion of a CR program and only 48% of the subjects were exercising at 3 months. Different predictors were found of the various dimensions of exercise maintenance. Predictors of exercise frequency were comorbidity and instrumental social support. Instrumental social support was the only predictor of exercise persistence. Comorbidity was the only predictor of exercise intensity. The only predictor of the total amount of exercise was benefits or barriers.CONCLUSIONSInterventions aimed at increasing women’s exercise should focus on increasing their problem-solving abilities to reduce barriers to exercise and increase social support by family and friends. Because comorbidity was a significant predictor of exercise, women should be encouraged to use exercise techniques that reduce impact on muscles and joints (eg, swimming) or exercising for short periods several times a day.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSEThis study examined the relationships between physiologic function, depressive symptoms, and body image among maintenance cardiac rehabilitation participants. Physiologic function was operationalized as both functional status and functional capacity.METHODSParticipants were 72 men (mean age = 67.3 years) all of whom had experienced a traumatic cardiac event (ie, myocardial infarction, valve replacement surgery, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty), and had completed some type of physician-supervised acute cardiac rehabilitation (ie, phase I and phase II). Measures of body image (social physique anxiety and body appearance satisfaction), self-reported functional status, clinician-reported functional capacity (ie, V02and peak power), and depressive symptoms were collected.RESULTSHierarchic multiple regression analyses revealed that both functional capacity and functional status explained significant variance in social physique anxiety (R2= 0.11,P<.05 and R2= 0.18,P< .05, respectively), whereas only functional status was a significant predictor of body appearance satisfaction (R2= 0.37,P< .01). Contrary to our hypotheses, depressive symptoms were not significantly related to either psychosocial or physiologic indices of functional well-being.CONCLUSIONSBoth patient perceptions of functional status and clinical measures of functional capacity are important aspects of psychosocial well-being among cardiac patients.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID