Effect of Exercise-Based Cardiac Rehabilitation on Cardiorespiratory Fitness in Adults with Congenital Heart Disease

Background:The purpose of this study was to investigate whether patients with adult congenital heart disease(ACHD)benefit from exercise-based cardiac rehabilitation(CR)short-and long-term with regard to improvement of cardiorespiratory fitness.Methods:Cardiopulmonary exercise tests(CPET)completed by ACHD patients between January 2000 and October 2019 were analysed retrospectively.Linear mixed models were performed for peak oxygen consumption(VO_(2))with patients as random effect and age,sex,disease classification,preceding surgery(≤3 months)and preceding CR(≤4 weeks for short term and>4 weeks for long term)as fixed effects.Results:1056 CPETs of 311 ACHD patients with simple(7),moderate(188)or great(116)complexity heart defects were analysed.The 59 patients who completed a CR(median age 27 yrs,38%females)increased peak VO_(2)from before to after CR by a median of 2.7(IQR–0.6 to 5.5)ml/kg/min.However,in the multivariate mixed model,peak VO_(2)was non-significantly increased short-term after CR(β0.8,95%CI–0.7 to 2.4),not maintained long-term after CR(β0.0,95%CI–1.7 to 1.6)but significantly reduced after surgery(β–5.1,95%CI–7.1 to–3.1).The 20 CR patients after surgery increased their peak VO_(2)by 6.2(IQR 3.6–9.5)ml/kg/min,while the 39 CR patients without preceding surgery increased it by 0.9(IQR–1.5 to 3.1)ml/kg/min.Conclusions:The increase in peak VO_(2)with CR was mainly due to recovery from surgical intervention.The small independent benefit from CR was not maintained long-term,highlighting the potential to improve current CR concepts in ACHD populations.

Cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy

Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.

Effect of cardiac rehabilitation care after coronary intervention on cardiac function recovery and negative mood in patients with myocardial infarction

BACKGROUND Cardiovascular disease,particularly myocardial infarction(MI)profound impact on patients'quality of life and places a substantial burden on the healthcare and economy systems.Developments in medical technology have led to the emer-gence of coronary intervention as an essential method for treating MI.AIM To assess the effects of cardiac rehabilitation care on cardiac function recovery and negative emotions in MI after coronary intervention.METHODS This study included a total of 180 patients with MI during the period from June 2022 to July 2023.Selected patients were divided into two groups:An observation group,which receiving cardiac rehabilitation care;a control group,which re-ceiving conventional care.By comparing multiple observation indicators such as cardiac function indicators,blood pressure,exercise tolerance,occurrence of adverse cardiac events,and negative emotion scores between the two groups of patients.All the data were analyzed and compared between two groups.RESULTS There were 44 males and 46 females in the observation group with an average age of 36.26±9.88 yr;there were 43 males and 47 females in the control group,with an average age of 40.87±10.5 yr.After receiving the appropriate postoperative nursing measures,the results of the observation group showed significant improvement in several indicators compared with the control group.Indicators of cardiac function,such as left ventricular end-diastolic internal diameter and left ventricular ejection fraction were significantly better in the observation group than in the control group(P<0.05).Exercise endurance assessment showed that the 6-minute walking test distance was significantly increased in the patients of the observation group(P<0.01).In addition,the incidence of adverse cardiac events was significantly lower in the observation group,and negative mood scores were significantly reduced(P<0.05).CONCLUSION Cardiac rehabilitation care after coronary intervention has a significant positive impact on functional recovery.This emphasizes the importance of cardiac rehabilitation care to improve patient recovery.

Effect of Cardiac Rehabilitation on Physical Capacity of Heart Failure Patients in Senegal

Background: Heart failure is a chronic and severe condition that often results from various heart diseases. Cardiac rehabilitation (CR) is currently a crucial component in managing this condition. The aim was to assess the effects of cardiac rehabilitation on physical capacity of heart failure patients. Methods: This was a cross-sectional study conducted from February 1, 2021, to June 30, 2023. We included all patients with heart failure who underwent cardiac rehabilitation. Data analysis was performed using SPSS software version 24.0, with a significance level set at p Results: The study included 87 heart failure patients, with a male-to-female ratio of 1.8. Mean age was 57.10 years (±11.75). Coronary artery disease was the primary cause of heart failure, accounting for 75.9% of cases. Atrial fibrillation was present in 4.7% of cases. Following cardiac rehabilitation, Left Ventricular Ejection Fraction increased from 40.15% to 49.48% (p = 0.001). Resting heart rate decreased significantly from 81.4 bpm to 68.3 bpm (p = 0.000), and the number of METS increased from 4.3 to 6.57 (+56.8%;p = 0.000). The mean distance covered in the 6-minute walk test significantly increased from 337.8 meters to 522.7 meters (p = 0.000), reflecting a gain of 183.5 meters. Moreover, the increase in the number of METS was more pronounced in females (p = 0.001), non-obese individuals (p = 0.000), non-diabetics (p = 0.001), non-sedentary individuals (p = 0.000), and non-smokers (p = 0.000). The study reported a low readmissions rate of 2.2% and a mortality rate of 1.1%. Conclusion: Our study demonstrates that cardiac rehabilitation is beneficial for black African heart failure patients, resulting in significant improvements in symptoms, physical and capacity.

Interest of Cardiac Rehabilitation in Patients with Heart Disease in a Cardiology Department in Senegal

Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality worldwide.Cardiac rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients.Physical activity,lifestyle,and psychological support are core components of a successful CR program.CR has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of participating.An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients.The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency.It is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR program.There are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or activity.In the present editorial,we present all the updated knowledge and recommendations in CR programs.

Effect of Luhong formula on the cardiac rehabilitation of patients with chronic heart failure

BACKGROUND Current treatments for chronic heart failure(CHF)are therapeutically ineffective.The optimization of treatments for this disease needs to be explored and analyzed.AIM To analyze the effect of using Luhong Formula in the cardiac rehabilitation of patients with CHF and its influence on cardiopulmonary function(CPF)and prognosis.METHODS In total,160 patients with CHF admitted between June 2022 and June 2023 were selected,including 75 receiving perindopril(control group)and 85 receiving Luhong Formula(research group).We conducted comparative analyses on the curative effects of traditional Chinese medicine(TCM)syndromes and cardiac function,CPF[oxygen consumption at the anaerobic threshold(VO2 AT)and at peak exercise(peak VO2)],echocardiographic indexes[left atrial volume index(LAVI),left ventricular muscle mass index(LVMI),left ventricular ejection fraction(LVEF)],and prognosis[major adverse cardiovascular events(MACEs)at 6 months follow-up].RESULTS The research group showed markedly higher curative effects of TCM syndromes and cardiac function than the control group.In addition,post-treatment VO2 AT,peak VO2,LVMI and LVEF in the research group were significantly higher,whereas LAVI was significantly lower,than those of the control group.Furthermore,fewer patients in the research group developed MACEs at the 6-month follow-up.CONCLUSION Luhong Formula is more therapeutically effective than perindopril for the cardiac rehabilitation of patients with CHF,specifically in enhancing CPF and prognosis.

Exploration of cardiac rehabilitation nursing for elderly patients with myocardial infarction based on individualized cardiac rehabilitation

BACKGROUND Myocardial infarction is a high-risk condition prevalent among the elderly population,often leading to adverse clinical manifestations such as reduced cardiopulmonary function,anxiety,and depression post-surgery.Consequently,cardiac rehabilitation holds immense importance in mitigating these complications.AIM To evaluate the effect of individualized cardiac rehabilitation on blood pressure variability(BPV)and baroreflex sensitivity(BRS)in elderly patients with myocardial infarction.METHODS A cohort of 74 elderly patients diagnosed with myocardial infarction and admitted to our hospital between January 2021 and January 2022 were subjected to random selection.Subsequently,all patients were divided into two groups,namely the research group(n=37)and the control group(n=37),utilizing the number table method.The control group received conventional drug treatment and nursing guidance intervention,while the study group underwent individualized cardiac rehabilitation in addition to the interventions received by the control group.All patients were continuously intervened for 12 wk,and the BPV of these two groups in the 1st wk(T0),the 4th wk(T1)and the 12th wk(T2)were compared,BRS,changes in cardiopulmonary function measures,and adverse cardiovascular events.RESULTS Of 24 h diastolic BPV,24 h systolic BPV,carbon dioxide ventilation equivalent slope of the research group were lower than those of the control group at T1 and T2,BRS,peak heart rate and systolic blood pressure product,1 min heart rate recovery were higher than those of the control group,and the incidence of adverse events in the research group was lower than that of the control group,the difference was statistically significant(P<0.05).CONCLUSION In this study,we found that after individualized cardiac rehabilitation in elderly patients with myocardial infarction,BPV and BRS can be effectively improved,cardiac function is significantly enhanced,and a better prognosis is obtained.

Comprehensive and personalized approach is a critical area for developing remote cardiac rehabilitation programs

In the evolving landscape of cardiac rehabilitation(CR),adopting digital technologies,including synchronous/real-time digital interventions and smart applications,has emerged as a transformative approach.These technologies offer realtime health data access,continuous vital sign monitoring,and personalized educational enhanced patient self-management and engagement.Despite their potential benefits,challenges and limitations exist,necessitating careful consideration.Synchronous/real-time digital CR involves remote,two-way audiovisual communication,addressing issues of accessibility and promoting home-based interventions.Smart applications extend beyond traditional healthcare,providing real-time health data and fostering patient empowerment.Wearable devices and mobile apps enable continuous monitoring,tracking of rehabilitation outcomes,and facilitate lifestyle modifications crucial for cardiac health maintenance.As digital CR progresses,ensuring patient access,equitable implementation,and addressing the digital divide becomes paramount.Artificial intelligence holds promise in the early detection of cardiac events and tailoring patient-specific CR programs.However,challenges such as digital literacy,data privacy,and security must be addressed to ensure inclusive implementation.Moreover,the shift toward digital CR raises concerns about cost,safety,and potential depersonalization of therapeutic relationships.A transformative shift towards technologically enabled CR necessitates further research,focusing not only on technological advancements but also on customization to meet diverse patient needs.Overcoming challenges related to cost,safety,data security,and potential depersonalization is crucial for the widespread adoption of digital CR.Future studies should explore integrating moral values into digital therapeutic relationships and ensure that digital CR is accessible,equitable,and seamlessly integrated into routine cardiac care.Theoretical frameworks that accommodate the dynamic quality of real-time monitoring and feedback feature of digital CR interventions should be considered to guide intervention development.

Application Effect of Blended Education Strategy Based on the Learning Pass Platform in Phase III Cardiac Rehabilitation of Patients with Coronary Artery Disease

Objective:To explore the application effect of the blended education strategy based on the Learning Pass platform in the phase III cardiac rehabilitation of patients with coronary artery disease.Methods:90 patients diagnosed with coronary artery disease in the Department of Cardiology of our hospital from January 2019 to January 2021 were selected and divided into the control group and the experimental group according to the method of randomized numerical table,with 45 cases in each group.Both the experimental group and the control group received pre-discharge cardiac rehabilitation education by conventional means.The control group received education and supervision information via WeChat after discharge,while the experimental group joined the Learning Pass platform to receive online and offline hybrid education and supervision,with online as the mainstay and offline as a supplement.The disease cognitive level,self-management skills,quality of life,medication adherence,and emotional status of the two groups were compared.Results:The disease cognitive levels in the experimental group were significantly higher than those of the control group(P<0.05);the scores of the experimental group in terms of quality of life,self-management skills,and medication adherence were significantly higher than those of the control group(P<0.05);and the scores of anxiety and depression in the experimental group were significantly lower than those of the control group(P<0.05).Conclusion:The blended education strategy based on the Learning Pass platform has a significant application effect in phase III cardiac rehabilitation of patients with coronary artery disease.It can improve patients’disease cognitive level,self-management skills,and quality of life,and provide a basis for improving patients’prognosis.

Prevalence of posttraumatic stress disorder following acute coronary syndrome and clinical characteristics of patients referred to cardiac rehabilitation

BACKGROUND Studies have demonstrated that patients who have experienced acute coronary syndrome(ACS)have an increased risk of developing posttraumatic stress disorder(PTSD)and experiencing worse survival outcomes than those who do not develop PTSD.Nevertheless,the prevalence rates of PTSD following ACS vary widely across studies,and it is noteworthy that in most cases,the diagnosis of PTSD was based on self-report symptom questionnaires,rather than being established by psychiatrists.Additionally,the individual characteristics of patients who develop PTSD after ACS can differ widely,making it difficult to identify any consistent patterns or predictors of the disorder.AIM To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation(CR)after ACS,as well as their characteristics in comparison to a control group.METHODS The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia,the Special Hospital for Medical Rehabilitation Krapinske Toplice.Patient recruitment for the study took place over the course of one year,from January 1,2022,to December 31,2022,with a total of 504 participants.The expected average follow-up period for patients included in the study is about 18 mo,and currently ongoing.Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview,a group of patients with a PTSD diagnosis was identified.From the participants who do not have a PTSD diagnosis,patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups.RESULTS A total of 507 patients who were enrolled in the CR program were approached to participate in the study.Three patients declined to participate in the study.The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients.Out of the total sample of 504 patients,74.2%were men(n=374)and 25.8%were women(n=130).The mean age of all participants was 56.7 years(55.8 for men and 59.1 for women).Among the 504 participants who completed the screening questionnaire,80 met the cutoff criteria for the PTSD and qualified for further evaluation(15.9%).All 80 patients agreed to a psychiatric interview.Among them,51 patients(10.1%)were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria.Among the variables analyzed,there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups.Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group(P=0.035).CONCLUSION The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment.Furthermore,the data suggest that these patients may exhibit reduced physical activity levels,which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population.Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.

Application Analysis of Cardiac Rehabilitation Nursing in Patients with Acute Myocardial Infarction

Objective: Application analysis of cardiac rehabilitation in patients with acute myocardial infarction. Methods: A total of 102 patients with acute myocardial infarction admitted to our hospital from January 2020 to January 2022 were retrospectively selected as the observation objects. According to the nursing measures taken, they were divided into a control group and an observation group, with 51 cases in each group. A total of 51 patients in the control group received routine nursing, while 51 patients in the observation group were guided to actively participate in the cardiac rehabilitation nursing plan. The hospitalization conditions and effects of the two groups were compared. Results: The cardiac function index, bed time, hospitalization time, anxiety score and depression score of the observation group were significantly better than those of the control group, and the differences were statistically significant (P Conclusion: The application of cardiac rehabilitation nursing in patients with acute myocardial infarction has a good effect. The patients’ cardiac function recovers faster, they feel more comfortable, and they also reduce the time of hospitalization and bed rest, which is conducive to improving the psychological and anxiety state of patients and improving the quality of life.

Bibliometric and Visualized Analysis of Cardiac Rehabilitation Research for Coronary Heart Disease Patients

Objective: This study visualizes and analyzes the current status, hotspots, and frontiers of cardiac rehabilitation for patients with Coronary Heart Disease (CHD) over the past decade (2012.01-2022.12), and explores the future development trend and research direction of the CR for CHD patients in China. Methods: Relevant literature was searched, screened and downloaded from the Web of Science (WOS) database, and bibliometric and visualization analyses were performed using CiteSpace VI software. Results: Through the search and screening of related literature, 2443 English articles were finally included. Among them, most of the Chinese publishers were mainly universities and had less connection with each other, while the foreign publishers were mainly universities and medical institutions in the United States and Europe, and had close connection with each other. The research content of Chinese scholars mainly focuses on the assessment of patients’ life and psychological status, as well as the assessment of cardiac function. Foreign research focuses on physical training assessment, disease perception, etc. Conclusion: Through visualizing relevant research with CiteSpace VI software in the form of a knowledge map, the research frontiers and trends in the field of cardiac rehabilitation for coronary heart disease patients in China and abroad can be discovered more intuitively. Compared with foreign research, the development of cardiac rehabilitation for coronary heart disease patients in China is relatively slow and insufficient, and institutions lack cooperation. In the future, China should accelerate the connection between regions in the field of cardiac rehabilitation and develop a cardiac rehabilitation model suitable for coronary heart disease patients in China with its own characteristics.

Quo vadis cardiac rehabilitation;the role of comprehensive cardiac rehabilitation in modern cardiology

In accordance with the guidelines established by prominent European and global cardiology associations,comprehensive cardiac rehabilitation(CR)stands as an officially endorsed and highly recommended therapeutic approach(class I recommendations;level of evidence A)for a diverse spectrum of cardiac patients.Nevertheless,it is a cause for concern to observe that fewer than 50%of eligible patients are being effectively referred for CR,whether in an outpatient or in-patient setting.Concurrently,studies reveal that a substantial proportion of individuals with atherosclerotic cardiovascular disease maintain unhealthy lifestyles and exhibit suboptimal management of modifiable cardiovascular risk factors,including hypertension,lipid levels,and diabetes.Beyond the conven-tional patient profile encompassing those recovering from acute coronary syndrome with or without percutaneous coronary intervention,as well as patients who have undergone coronary or valvular surgery,contemporary CR now emphasizes specialized subgroups of patients.These include frail elderly patients,the female population with its unique considerations,individuals burdened by multiple cardiovascular comorbidities,those who have developed psychological consequences due to a cardiac illness and particularly those grappling with chronic heart failure.This editorial seeks to offer a state-of-the-art assessment of the significance and role of comprehensive CR within modern cardiology.

Cardiac Rehabilitation in the Elderly

Introduction: The purpose of cardiac rehabilitation is to improve the effects of aging and maintain a good quality of life for older individuals. This study aims to assess how cardiac rehabilitation affects the autonomy and quality of life of older adults. Patients and Method: This was a longitudinal, descriptive and comparative before-and-after cardiovascular rehabilitation study conducted over a two-year period from January 2019 to December 2021. This study was conducted at four cardiac rehabilitation units in Dakar: the Aristide Le Dantec Hospital (HALD), National Dalal Jamm Hospital, and the General Idrissa Pouye Hospital (HOGIP). We compared the degree of autonomy, dependence and quality of life of subjects aged over 65 before and after the cardiac rehabilitation program using the Katz index, the Lowton index and the SF12 quality-of-life questionnaire. Results: Over a two-year period, a total of 345 patients had benefited from a complete cardiovascular rehabilitation program in the four cardiovascular rehabilitation units in Dakar, and 86 patients, or 24.92% of the population, were at least 65 years old. The patients were predominantly male (sex ratio M/F = 4.73). The mean age was 70.35 ± 4.55 years for men and 69.27 ± 4.59 years for women. The main pathology motivating cardiac rehabilitation was ischemic heart disease, which was found in 73 patients (84.88%). Initial assessment revealed exertional dyspnea in 35 patients (40.69%), followed by residual exertional angina in 21 patients (4.41%). Mean functional capacity increased from 5.81 ± 2.38 Mets in pre-cardiac rehabilitation to 8.68 ± 2.28 Mets in post-cardiac rehabilitation (p < 0.001). The mean distance covered in the 6-minute walk test increased from 330.42 ± 170.50 m in pre-cardiac rehabilitation to 524 ± 98.54 m in post-cardiac rehabilitation (p = 0.119). The Lowton dependency index in pre-cardiac rehabilitation was 44.18% versus 36.04% in post-cardiac rehabilitation (p = 0.0156). The mental quality of life score was 42.15 ± 10.27 in pre-cardiac rehabilitation versus 52.94 ± 10.86 in post-cardiac rehabilitation (p Conclusion: This study demonstrates the effectiveness of the cardiac rehabilitation program in elderly subjects. In fact, this well-managed, well-structured and well-supervised program enables this population to regain their autonomy, improve their quality of life and functional capacities, and consequently their prognosis.

Application Effect of Blended Education Strategy Based on the Learning Pass Platform in Phase III Cardiac Rehabilitation of Patients with Coronary Artery Disease

Objective:To explore the application effect of the blended education strategy based on the Learning Pass platform in the phase III cardiac rehabilitation of patients with coronary artery disease.Methods:90 patients diagnosed with coronary artery disease in the Department of Cardiology of our hospital from January 2019 to January 2021 were selected and divided into the control group and the experimental group according to the method of randomized numerical table,with 45 cases in each group.Both the experimental group and the control group received pre-discharge cardiac rehabilitation education by conventional means.The control group received education and supervision information via WeChat after discharge,while the experimental group joined the Learning Pass platform to receive online and offline hybrid education and supervision,with online as the mainstay and offline as a supplement.The disease cognitive level,self-management skills,quality of life,medication adherence,and emotional status of the two groups were compared.Results:The disease cognitive levels in the experimental group were significantly higher than those of the control group(P<0.05);the scores of the experimental group in terms of quality of life,self-management skills,and medication adherence were significantly higher than those of the control group(P<0.05);and the scores of anxiety and depression in the experimental group were significantly lower than those of the control group(P<0.05).Conclusion:The blended education strategy based on the Learning Pass platform has a significant application effect in phase III cardiac rehabilitation of patients with coronary artery disease.It can improve patients’disease cognitive level,self-management skills,and quality of life,and provide a basis for improving patients’prognosis.

Phase Ⅰ of cardiac rehabilitation:A new challenge for evidence based physiotherapy

Cardiac rehabilitation protocols applied during the inhospital phase(phaseⅠ)are subjective and their results are contested when evaluated considering what should be the three basic principles of exercise prescription:specificity,overload and reversibility.In this review,we focus on the problems associated with the models of exercise prescription applied at this early stage in-hospital and adopted today,especially the lack of clinical studies demonstrating its effectiveness.Moreover,we present the concept of"periodization"as a useful tool in the search for better results.

Predictors of adherence to home-based cardiac rehabilitation program among coronary artery disease outpatients in China

Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.

Cardiac rehabilitation and exercise therapy in the elderly： Should we invest in the aged？

Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.