Functional Capacity of Patients with Venous Thromboembolic Disease Six to Twelve Months after Treatment

Background: Venous thromboembolism (VTE) is among the leading causes of hospital-related disability-adjusted life years lost. We aimed to determine the prevalence and determinants of functional capacity impairment six to twelve months after an acute VTE event. Methods: This was a cross-sectional study conducted between January and April 2021 in two referral hospitals of Yaoundé, including consenting adult patients admitted to these hospitals six to twelve months ago for VTE. We excluded dead patients and those with any comorbidity or symptoms limiting physical activity. The functional outcome was assessed with the six-minute walk test. Functional capacity impairment was defined as walking distance lower than the expected value. Results: We included 27 cases in this study with a mean age of 53.2 ± 14.4 years. The prevalence of functional capacity impairment was 29.6% (95% CI: 14.8 - 48.1). Factors associated with poor functional outcome were obesity (OR: 59.5;95% CI: 4.6 - 767.2;p - 207.4;p = 0.017), massive PE (OR: 30;95% CI: 2.5 - 354;p = 0.004), and poor adherence to treatment (OR: 30.3;95% CI: 2.5 - 333.3;p = 0.004). Conclusion: Functional capacity impairment is common in the medium-term after VTE and factors associated with this poor outcome are obesity, the severity of the VTE, and poor adherence to treatment.

Effect of Health Education Program on Self-Efficacy and Functional Capacity of Patients with Coronary Artery Bypass Surgery in Khartoum State-Sudan, 2015-2019

Coronary heart disease is among the most prevalent and costly of all global health problems. Coronary artery bypass grafting (CABG) has been increasingly used since the 1960s. Coronary heart disease is a leading cause of death worldwide, including Sudan. Self-efficacy and functional capacity is a critical factor for quality of life in patients who has undergone CABG as well as for their caregivers from their families. Aim of the Study: To explore the effects of an educational program on self-efficacy and functional capacity of patients after CABG. 1) There will be no significant difference between the intervention group and control group concerning knowledge regarding Self-efficacy and functional capacity post CABG surgery. 2) The application of our educational program for the patients will enhance the patients with CABG surgery and improve knowledge about Self-efficacy and functional capacity post CABG surgery. 3) There are some socio demographic factors that affect the response to the educational program. Methods: This was a quasi-experimental, interventional and hospital-based study, including pre-test, a post-test and follow-up test, with a control group, conducted during the period from September 2014 to June 2019. Patients were recruited consecutively to the cases and control group using convenience sampling. The sample consisted of 76 patients;41 as cases and 35 as control group. The sample included those who had undergone CABG in Khartoum State. Relevant data were collected using a checklist to monitor the effect of a health education program on self-efficacy and functional capacity of the patients. Result: The results showed marked improvement in patients’ self-efficacy and functional capacity between pretest and posttest for the study group;p-value = (0.001) in the health status of cases in comparison to the control group. The indices were observed to be higher for patients who received a nursing educational program throughout the study period;p-value = (0.002).

An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Tremendous Improvement of the Functional Capacity in Patient with Chronic Heart Failure after 12-Weeks of Exercise Training Program

Cardiac rehabilitation is recommended for patients with chronic heart failure (CHF) with preserved, or reduced left ventricular ejection fraction (LVEF). A cardiac rehabilitation program generally includes physical exercise, diet counseling, educational classes on lifestyle changes, and disease management as well as psychosocial support for patients and their families. Exercise training is a core component of the comprehensive cardiac rehabilitation program and is strongly recommended in combination with pharmacological treatment to patients with CHF, due to cardiorespiratory, metabolic, and autonomic cardiac response. Exercise-based cardiac rehabilitation affects positively functional capacity, exercise tolerance, and quality of life in CHF patients. The physical inactivity rate in Arabian Peninsula countries is extremely high, and exercise training of habitually physically inactive individuals should result in marked improvements of physical capacity. We present a case that demonstrates such a significant improvement in the physical capacity of a patient with CHF and a review of literature.

Factors Related to Functional Capacity and Quality of Life for Elderly People in a Middle-Sized City of São Paulo, Brazil

Introduction: It is a fact that the elderly population has been increasing all around the world and also in Brazil. This has been a challenge for governments and managers in the development of public policies to promote healthy and quality aging. And one of the conditions for healthy aging is to assess the functional capacity and quality of life of elderly people. Objective: The aim of the present study was to evaluate the factors that influence the loss of functional capacity and the worsening of the quality of life of a representative sample of elderly people from a medium-sized city in the inner of São Paulo State, Brazil. Methodology: Questionnaires about activities of daily living (ADL), instrumental activities of daily living (IADL), Flanagan quality of life scale (FQOLS), sociodemographic and morbidities aspects were applied to the elderly people. In order to assess associated factors to functional capacity and quality of life, chi-square tests and logistic regression models were fitted including variables: gender, age group, marital status, income, education level, body mass index, abdominal circumference and some morbidities reported by the elderly people. The level of significance adopted for the statistical tests was 5%. Results: Elderly with age over 75 years old and not married had more risk to be dependent on ADL, while elderly with more than 75 years old, not married, income below one minimal wage, cardiovascular disease and be diabetic had more risk to be dependent by IADL. Already, people with excess of weight had smallest risk to be dependent by IADL, paradoxically. The elderly not married and with an income below a minimum wage had the worst quality of life. Conclusions: Population aging in Brazil is an evident factor, so it is hoped that this study will contribute to the greatest diligence on the issues of the elderly and related social problems.

Evaluation of the Functional Capacity of a Group of Patients Aged over 65 Years: A Cross-Sectional Study at the YaoundéCentral Hospital

Background: The functional capacity of elderly patients decreases with age due to a combination of age-related decline in physiologic functions and chronic diseases. A severe decrease leads to an inability to carry out activities of daily living leading to a loss of autonomy and increased dependence. The aim of this study was to evaluate the functional capacity of the elderly followed at the Yaoundé Central Hospital. Methods: We carried out a non-probabilistic consecutive sampling of elderly patients that consulted in Yaoundé Central Hospital during a five-month’ period. Data was taken concerning their chronic conditions, use of medication, and presence of depressive symptoms (evaluated using the Geriatric Depression Scale (GDS) questionnaire). The presence of any cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Cardiac ultrasonography and electrocardiograms were done to evaluate the cardiac morphology and physiology. Their functional capacity was assessed with the WHO Global Physical Activity Questionnaire and the six-minute walk test. A self-paced step test was equally done to estimate the maximum oxygen consumption during aerobic exercise. We carried out aunivariate, and then multivariate analyses to identify factors associated with an altered functional status. Statistical analysis was performed using the SPSS software 23.0. The threshold of significance was set at 0.05. Results: 66 participants were included (35 women) with a median age of 70 (IQR: 67 - 75) years. Among them, 39.4% were found to have an altered functional capacity, about 87.8% had at least one chronic condition and 47% had two or more. The most prevalent chronic condition was hypertension (71.2%) followed by heart failure (24.2%) and osteoarthritis (12.1%). Mild depressive symptoms were present in 1.5% of our study population. The factors associated with an altered functional capacity include age ≥ 75 years (OR = 2.9 p heart failure (OR: 3.2, p ), osteoarthritis (OR: 5.1, p ), and poor gait and balance (OR: 3.7, p ). Conclusion: There is a high prevalence of altered functional capacity among elderly patients consulting at the Yaoundé Central Hospital. Heart failure, osteoarthritis, and an increased risk of falls are associated with an altered functional capacity.

Relationship between Changes in Functional Capacity and Anthropometric, Clinical and Psychological Indicators in Cardiac Patients Participating in Cardiac Rehabilitation Program

Background: Cardiac rehabilitation (CR) is a multifaceted treatment that can increase the survival and quality of life of cardiac patients by increasing their functional capacity (FC). In this study, we aimed to investigate the FC changes of cardiac patients after the CR program in different subgroups in terms of anthropometric, clinical, and psychological indices. Materials and Methods: This is a descriptive retrospective study that has been derived from the results of a Cohort study at the Rehabilitation Research Center of the Cardiovascular Research Institute of Isfahan (Iran), from 2006 to 2017. In this study, the dependent variable is functional capacity changes based on Mets obtained in exercise testing at the beginning and end of the CR program. Independent variables included age, sex, dyslipidemia, diabetes, smoking, and Body mass index, type of intervention, depression, and EF. Results: The sample size is 1250 cardiovascular patients, of which 917 (73.5%) are male and 331 (26.5%) are female. Functional capacity after the CR program significantly increased in all age, gender, body mass index, hypertension, hyperlipidemia, diabetes, smoking, depression, EF, and type of operation performed (angioplasty or open-heart surgery) subgroups, (p < 0.001). Using multiple linear regression analysis, a significant relationship was found between Mets changes and only the variables of gender, depression, and EF. Conclusion: The results of this study show the importance of rehabilitation programs in the secondary prevention of cardiovascular disease in different subgroups and factors such as gender, level of primary depression, and EF less than 35 are the most important factors affecting functional capacity increase after CR program in heart patients.

Functional Capacity and Psychosocial Correlates of Exercise in Nigerian Patients with Hypertension

Objectives: Psychosocial factors are important determinants of cardiovascular health outcomes in rehabilitation. However, the relationship between exercise performance and individual factors remained poorly understood. This study investigated the relationship between functional capacity and psychosocial correlates of exercise in Nigerian patients with hypertension. Study Design and Setting: This quasi-experimental study recruited 120 patients with hypertension (≥140/90 ≤ 179/109 mmHg) from the Cardiac Care Unit of a Nigerian university teaching using purposive sampling technique. Functional capacity was assessed using the 6-minute walk test and maximum oxygen consumption (VO2 max) was estimated. Participants also underwent a 30-minute self-paced walking exercise. Thereafter, psychosocial correlates of exercise including exercise self-efficacy (ESE), social support (SoS), perceived exercise barrier (PEB) and socio-economic status (SES) were assessed using validated questionnaires. Descriptive and inferential statistics were used to analyze data. Alpha level was set at p < 0.05 of significance. Results: A majority of the participants demonstrated high ESE (75.0%), moderate SoS (60.9%) and low PEB (71.7%). More than half (58.4%) of the participants were in the middle SES. Male and female participants were comparable in ESE scores (p = 0.554), SoS (p = 0.362) and six-minute walk distance (6-MWD) (p = 0.194) except in body mass index (p < 0.05). The mean 6-MWD and VO2 max were 350.6 ± 54.7 m and 9.74 ± 1.5 ml/kg/min respectively. There were significant correlations between functional capacity and each of ESE (r = 0.184;p = 0.026) and SoS (r = 0.374;p = 0.021). Conclusions: Psychosocial correlates of exercise including self-efficacy and social support were significantly associated with functional capacity among Nigerian patients with mild to moderate hypertension.

Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

Background Chronic obstructive pulmonary disease （COPD） and congestive heart failure （CHF） are two chronic diseases that affect negatively the functional condition and quality of life of patients. We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients. Methods The study included 42 COPD and 39 CHF patients. In both patient groups, dyspnea was assessed using Borg scale; functional capacity by shuttle-walk and cardiopulmonary exercise test and quality of life by short form-36 （SF36）. Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score, shuttle-walk test and the majority of subgroup scores of SF36 （P〉0.05）. A statistically significant difference was observed in peak VO2 in favor of COPD group （P〈0.05）. No significant relationship was established between dyspnea score and forced expiratory volume in one second （FEV1） in COPD patients, and left ventricular ejection fraction （LVEF） in CHF patients （P〉0.05）. A significant negative correlation was observed between dyspnea score and functional capacity tests in both disease groups （P〈0.05）. On the other hand, no relationship was found between LVEF and FEV1 and quality of life and functional capacity （P〉0.05）. Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups, however, objective indicators of disease severity do not show a similar relationship. Therefore, in addition to the objective data related to the disease, we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.

Effects of combined aerobic,resistance and inspiratory training in patients with pulmonary hypertension:A systematic review

BACKGROUND Pulmonary hypertension(PH)is a serious progressive disorder of the modern world,characterized by endothelial dysfunction and impaired vasoreactivity.Patients with PH usually present exercise intolerance from the very early stages and reduced exercise capacity.Exercise training has been shown to have beneficial effects in patients with cardiovascular comorbidities.However,data regarding the effects of combined exercise training programs in patients with PH still remains limited.AIM To investigate the effects of combined exercise training programs on exercise capacity and quality of life in patients with PH.METHODS Our search included all available randomized controlled trials(RCTs)regarding combined aerobic,resistance and inspiratory training programs in patients with PH in 4 databases(Pubmed,PEDro,Embase,CINAHL)from 2012 to 2022.Five RCTs were included in the final analysis.Functional capacity,assessed by peak VO_(2)or 6-min walking test(6MWT),as well as quality of life,assessed by the SF-36 questionnaire,were set as the primary outcomes in our study.RESULTS Peak VO_(2)was measured in 4 out of the 5 RCTs while 6MWT was measured in all RCTs.Both indices of functional capacity were significantly increased in patients with PH who underwent combined exercise training compared to the controls in all of the included RCTs(P<0.05).Quality of life was measured in 4 out of 5 RCTs.Although patients improved their quality of life in each group,however,only 2 RCTs demonstrated further improvement in patients performing combined training compared to controls.CONCLUSION By this systematic review,we have demonstrated that combined aerobic,resistance and inspiratory exercise training is safe and has beneficial effects on aerobic capacity and quality of life in patients with PH.Such exercise training regimen may be part of the therapeutic strategy of the syndrome.

Experiences of Practical Nurses in Promoting the Rehabilitation of the Elderly and Their Education - A Secondary Publication

The significance of rehabilitation-promoting nursing care is emphasized in aging Finland. According to studies, rehabilitation-promoting nursing care enhances the functional capacity of the elderly. The Elderly Services Act obliges municipalities to create a plan to support the elderly population, emphasizing home care and rehabilitation measures. A large portion of graduated practical nurses will be working with the elderly, so the education of practical nurses must meet the needs of the workforce. The study aimed to produce new information on the implementation of rehabilitation- promoting nursing care in the elderly service system and on the education of rehabilitation-promoting nursing care for the elderly in vocational institutions. The research data was collected in the autumn of 2020 through individual thematic interviews with practical nurse students (n = 8). The data was analyzed using inductive content analysis. Practical nurse students’ experiences of rehabilitation-promoting nursing care for the elderly were related to nurses’ time management, organizational practices, nursing competence, nurses’ attitudes, nurses’ practices, organizational development, implementation and development of practical education, factors affecting the use of aids, and technological aspects of aids in the future. In conclusion, it can be stated that the content of education and practical work life do not align. It is essential to increase competence in rehabilitation-promoting nursing care and to develop organizational practices.

Metabolic and functional effects of exercise training in diabetic kidney transplant recipients

BACKGROUND Physical activity levels are significantly lower in kidney transplant(KT)recipients compared to the general population.The effects of exercise training in KT recipients with diabetes mellitus remain unclear,and so little is known about the role of increased exercise on cardiovascular risk and metabolic profile of KT patients.AIM To investigate the effects of a 6-mo home-based exercise training program on functional capacity,glucose levels and lipid profile of diabetic KT patients.METHODS In total,21 type II diabetic KT recipients were randomly assigned into two groups:Exercise(n=11,aged 52.9±10.1 years)and control(n=10,aged 53.01±9.5 years).All participants at baseline and the end of the study underwent biochemical tests for fasting plasma glucose levels,glycated hemoglobin and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake[(VO2)peak]estimation.The exercise group followed a 6-mo supervised home-based aerobic and progressive resistance exercise program of moderate intensity 3 times per week,while the control group continued to receive usual care.RESULTS At the end of the 6-mo study,the exercise group had significantly lower values in fasting plasma glucose by 13.4%(from 120.6±28.9 mg/dL to 104.8±21.9 mg/dL,P=0.01),glycated hemoglobin by 1.5%(from 6.7%±0.4 to 6.6%±0.4,P=0.01)and triglycerides by 8.5%(from 164.7±14.8 mg/dL to 150.8±11.6 mg/dL,P<0.05)and higher values in high-density lipoprotein by 10.2%(from 51.4±8.8 mg/dL to 57.2±8.7 mg/dL,P<0.05)and(VO_(2))_(peak)by 4.7%(from 22.7±3.3 to 23.8±4.2,P=0.02)than the control group.There were statistically significant differences between the two groups at the end of the study for fasting plasma glucose(decreased by 9.6%,P<0.05),triglycerides(decreased by 4.5%,P=0.04)and(VO_(2))_(peak)(increased by 4.4%,P=0.01).Finally,after training,there was a moderate,positive linear relationship between(VO_(2))_(peak)and glycated hemoglobin in the exercise group(r=0.408,P=0.03).CONCLUSION The results demonstrated that a 6-mo home-based mixed type exercise training program can improve the functional capacity,levels of glucose and lipid profile of diabetic KT recipients.

Orbital electronic heat capacity of hydrogenated monolayer and bilayer graphene

The tight-binding Harrison model and Green＇s function approach have been utilized in order to investigate the contribution of hybridized orbitals in the electronic density of states（DOS） and electronic heat capacity（EHC） for four hydrogenated structures, including monolayer chair-like, table-like, bilayer AA- and finally AB-stacked graphene. After hydrogenation, monolayer graphene and bilayer graphene are behave as semiconducting systems owning a wide direct band gap and this means that all orbitals have several states around the Fermi level. The energy gap in DOS and Schottky anomaly in EHC curves of these structures are compared together illustrating the maximum and minimum band gaps are appear for monolayer chair-like and bilayer AA-stacked graphane, respectively. In spite of these, our findings show that the maximum and minimum values of Schottky anomaly appear for hydrogenated bilayer AA-stacked and monolayer table-like configurations, respectively.

Depressive symptoms and their associated factors in heart failure patients

Objectives:Depressive symptoms are common in heart failure(HF)patients and they may exacerbate the progression of HF.Thus,identifying associations with depressive symptoms is essential to develop effective interventions to alleviate patients’depressive symptoms.Therefore,this study aimed to explore the factors related to HF patients’depressive symptoms.Methods:Potential hospitalized patients were recruited from a university-affiliated hospital by convenience sampling.This study included 321 HF patients who had completed information about depressive symptoms,functional capacity,social support,dispositional optimism,self-care confidence,and health literacy.Descriptive statistics were used to characterize the sample.Independent group t-tests and one-way analysis of variance were used to assess the difference in depressive symptoms score in demographic and clinical characteristics,while Pearson’s correlation was used to assess the associations among continuous variables.Results:The scores for functional capacity,social support,dispositional optimism,self-care confidence,and health literacy were negatively associated with the score for depressive symptoms.The interaction effect between the functional capacity and the dispositional optimism on depressive symptoms was significant.Conclusions:Interventions targeted improving the above-mentioned factors may be beneficial to reduce depressive symptoms in HF patients.

Pressure-induced phase transition in silicon nitride material

The equilibrium crystal structures,lattice parameters,elastic constants,and elastic moduli of the polymorphs α-,β-,and γ-Si3N4,have been calculated by first-principles method.β-Si3N4 is ductile in nature and has an ionic bonding.γSi3N4 is found to be a brittle material and has covalent chemical bonds,especially at high pressures.The phase boundary of the β→γ transition is obtained and a positive slope is found.This indicates that at higher temperatures it requires higher pressures to synthesize γ-Si3N4.On the other hand,the α→γ phase boundary can be described as P = 14.37198＋ 3.27 × 10？3T-7.83911 × 10？7T2-3.13552 × 10？10T3.The phase transition from α-to γ-Si3N4 occurs at 16.1 GPa and 1700 K.Then,the dependencies of bulk modulus,heat capacity,and thermal expansion on the pressure P are obtained in the ranges of 0 GPa-30 GPa and 0 K-2000 K.Significant features in these properties are observed at high temperatures.It turns out that the thermal expansion of γ-Si3N4 is larger than that of α-Si3N4 over wide pressure and temperature ranges.The evolutions of the heat capacity with temperature for the Si3N4 polymorphs are close to each other,which are important for possible applications of Si3N4.

Are flexibility and muscle-strengthening activities associated with functional limitation?

This retrospective cohort study examined the relationship between self-reported participation in flexibility and muscular strengthening activities and the development of functional limitation(i.e.,once an individual has difficulty with or becomes unable to perform activities of daily living).Data were obtained from 1318 adults(mean age 49.59.7 years;98.7%Caucasian;14.9%female)enrolled in the Aerobics Center Longitudinal Study from 1979 to 2004 and free of functional limitation at baseline.Mail-back health surveys were used to prospectively determine incident functional limitation.Participation in muscle-strengthening and flexibility activities was assessed via self-report.Adjusted logistic regression analyses were used to determine the odds ratios(OR)and corresponding 95%confidence intervals for developing functional limitation during follow-up based on participation in general and specific categories of flexibility(‘Stretching’,‘Calisthenics’,or‘Exercise Class’)and musclestrengthening activities(‘Calisthenics’,‘Free Weights’,‘Weight Training Machines’,or‘Other’).Overall,42.6%of the sample reported incident functional limitation.After adjusting for potential confounders(e.g.,age,sex,cardiometabolic risk factors),those who reported performing muscle-strengthening activities in general(n=685)were at lower risk of developing functional limitation[OR=0.79(0.63–1.00)].In addition,the specific flexibility activities of stretching(n=491)and calisthenics(n=122)were associated with 24%and 38%decreased odds of incident functional limitation,respectively.General muscle-strengthening,stretching,and calisthenics activities are prospectively associated with decreased risk of incident functional limitation in generally healthy,middleaged and older adults.Thus,both public health and rehabilitation programs should highlight the importance of flexibility and muscle-strengthening activities during adulthood to help preserve functional capacity.