WorldWideScience

Sample records for based cardiac rehabilitation

  1. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R;

    2016-01-01

    BACKGROUND: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). OBJECTIVES: The goal of this study is to update the Cochrane...

  2. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  3. Dealing with existential anxiety in exercise-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Pedersen, Birthe D; Dreyer, Pia;

    2015-01-01

    physically and psychologically challenged, the patients were encouraged to maintain an active lifestyle. Three themes were identified: anxiety regarding exercise, whereby the patients are initially insecure about how to behave with their diseased hearts; encouragement from training together, whereby...... the patients support each other in exercising; and growing confidence in the heart, whereby the patients enjoy being physically active. Conclusions In exercise-based cardiac rehabilitation, patients' insecurity with respect to their heart disease is revealed as an existential anxiety. Through peer support...... and a positive physical perception, the patients gain renewed self-efficacy, helping them to continue their lives in an active and satisfying way. Relevance to clinical practice Knowing that patients are confronted with an existential anxiety during exercise-based cardiac rehabilitation is important because...

  4. Cardiac rehabilitation

    Science.gov (United States)

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  5. Exercise-based cardiac rehabilitation in patients with heart failure

    DEFF Research Database (Denmark)

    Lewinter, Christian; Doherty, Patrick; Gale, Christopher P;

    2015-01-01

    BACKGROUND: Guidelines recommend exercise-based cardiac rehabilitation (EBCR) for patients with heart failure (HF). However, established research has not investigated the longer-term outcomes including mortality and hospitalisation in light of the contemporary management of HF. METHODS: This was ......BACKGROUND: Guidelines recommend exercise-based cardiac rehabilitation (EBCR) for patients with heart failure (HF). However, established research has not investigated the longer-term outcomes including mortality and hospitalisation in light of the contemporary management of HF. METHODS......: This was a systematic review including a meta-analysis of EBCR on all-cause mortality, hospital admission, and standardised exercise capacity using four separate exercise tests in patients with heart failure over a minimum follow-up of six months from January 1999-January 2013. Electronic searches were performed...... in their funnel plots. CONCLUSIONS: EBCR in patients with HF is associated with significant improvements in exercise capacity and hospital admission over a minimum of six months follow-up, but not in all-cause mortality....

  6. Exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, T B; Zwisler, Ann-Dorthe; Berg, S K;

    2015-01-01

    BACKGROUND: Owing to a lack of evidence, patients undergoing heart valve surgery have been offered exercise-based cardiac rehabilitation (CR) since 2009 based on recommendations for patients with ischaemic heart disease in Denmark. The aim of this study was to investigate the impact of CR...... on the costs of healthcare use and sick leave among heart valve surgery patients over 12 months post surgery. METHODS: We conducted a nationwide survey on the CR participation of all patients having undergone valve surgery between 1 January 2011 and 30 June 2011 (n=667). Among the responders (n=500, 75...... expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis....

  7. Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study.

    Science.gov (United States)

    Chung, Heewon; Ko, Hoon; Thap, Tharoeun; Jeong, Changwon; Noh, Se-Eung; Yoon, Kwon-Ha; Lee, Jinseok

    2016-01-01

    We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone's built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient's HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis. PMID:27551969

  8. Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study

    Science.gov (United States)

    Chung, Heewon; Yoon, Kwon-Ha; Lee, Jinseok

    2016-01-01

    We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone’s built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone’s built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient’s HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis. PMID:27551969

  9. Information and communication technology-based cardiac rehabilitation homecare programs

    OpenAIRE

    Karunanithi, Mohanraj

    2015-01-01

    Marlien Varnfield, Mohanraj KarunanithiAustralian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, AustraliaAbstract: Cardiac rehabilitation (CR) has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and gui...

  10. Information and communication technology-based cardiac rehabilitation homecare programs

    OpenAIRE

    Varnfield M; Karunanithi M

    2015-01-01

    Marlien Varnfield, Mohanraj KarunanithiAustralian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, AustraliaAbstract: Cardiac rehabilitation (CR) has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideli...

  11. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, Tina B; Berg, Selina K; Sibilitz, Kirstine L;

    2015-01-01

    BACKGROUND: As with ischaemic heart disease, cardiac rehabilitation (CR) is recommended for patients undergoing heart valve surgery; recommendations are based on limited evidence. The organization of CR programmes and factors associated with uptake among patients undergoing heart valve surgery have...

  12. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  13. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  14. Information and communication technology-based cardiac rehabilitation homecare programs

    Directory of Open Access Journals (Sweden)

    Varnfield M

    2015-04-01

    Full Text Available Marlien Varnfield, Mohanraj KarunanithiAustralian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, AustraliaAbstract: Cardiac rehabilitation (CR has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideline recommendations, CR utilization has been poor, particularly in women, older patients, and ethnic minority groups. To overcome some of the barriers to the traditional delivery of CR, different delivery platforms and approaches have been developed in recent years. In general, Telehealth solutions which have been used to address the delivery of CR services remotely include: 1 patient–provider contact delivered by telephone systems; 2 the Internet, with the majority of patient–provider contact for risk factor management taking place online; and 3 interventions using Smartphones as tools to deliver CR through (independently or in combination with short message service messaging, journaling applications, connected measurement devices, and remote coaching. These solutions have been shown to overcome some of the barriers in CR participation and show potential as alternative or complementary options for individuals that find traditional center-based CR programs difficult to commit to. The major benefits of remote platforms for CR delivery are the ability to deliver these interventions without ongoing face-to-face contact, which provides an opportunity to reach large numbers of people, and the convenience of selecting the timing of cardiovascular disease management sessions. Furthermore, technologies have the potential to deliver long-term follow-up, which programs delivered by health professionals cannot afford to do due to staff shortages and budget restrictions

  15. Adoption of community-based cardiac rehabilitation programs and physical activity following phase III cardiac rehabilitation in Scotland: a prospective and predictive study.

    Science.gov (United States)

    Sniehotta, Falko F; Gorski, Charlotta; Araujo-Soares, Vera

    2010-09-01

    Little is known about levels of physical activity and attendance at phase IV community-based Cardiac Rehabilitation (CR) programs following completion of exercise-focussed, hospital-based phase III CR. This study aims to test, compare and combine the predictive utility of the Common-Sense Self-Regulation Model (CS-SRM) and the extended Theory of Planned Behaviour (TPB) with action planning for two rehabilitation behaviours: physical activity and phase IV CR attendance. Individuals diagnosed with coronary heart disease (n = 103) completed baseline measures of illness perceptions, intentions, perceived behavioural control (PBC), action planning and past physical activity in the last week of a phase III CR program, and 95 participants completed follow-up measures of physical activity and attended phase IV CR (objectively confirmed) 2 months later. Only one predictor (PBC/cyclical timeline) significantly predicted levels and change of physical activity. While illness perceptions were not predictive of phase IV CR attendance, the extended TPB model showed good predictive power with action planning and intention as the most powerful predictors. Amongst participants who planned when and where to attend phase IV CR at the end of phase III rehabilitation, 65.9% subsequently attended a phase IV CR program compared to only 18.5% of those who had not made a plan. This study adds to our understanding of cardiac rehabilitation behaviour after completion of health service delivered programs. Comparing theoretical models and rehabilitation behaviours contributes to the development of behaviour theory.

  16. Behaviour change techniques in home-based cardiac rehabilitation: a systematic review

    OpenAIRE

    Heron, Neil; Kee, Frank; Donnelly, Michael; Cardwell, Christopher; Tully, Mark A; Cupples, Margaret E

    2016-01-01

    BACKGROUND: Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.AIM: To identify and describe the use of BCTs in home-based CR programmes.DESIGN AND SETTING: Randomised controlled trials o...

  17. PATIENTS OVERCOME ANXIETY AND ARE ENCOURAGED TO BE PHYSICAL ACTIVE THROUGH EXERCISE-BASED CARDIAC REHABILITATION

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.;

    other to begin exercising; and growing confidence in the heart, whereby the patients overcome anxiety and dare to be physically active. Conclusions. Exercise-based cardiac rehabilitation provides a comfort-giving setting that offers peer support and a positive physical perception leading to confidence...... interviews were performed 1-2 months later. A phenomenological hermeneutic interpretation was conducted, comprising three methodological steps: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that although physically and especially mentally...... into that the heart endures physical activity. In addition to serving as physical guidance, exercise-based cardiac rehabilitation offers valuable mental support. The patients find help to overcome an initial anxiety and move forward towards a physically active life featuring a feeling of improved health and new...

  18. A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP

    Directory of Open Access Journals (Sweden)

    Francis Rebecca

    2010-01-01

    Full Text Available Abstract Background Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT. Methods/Design We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines. Discussion The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients. Trial registration The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR with number ACTRN12609000251224.

  19. Predicting physical fitness outcomes of exercise rehabilitation: An retrospective examination of program admission data from patient records in a hospital-based early outpatient cardiac rehabilitation program

    OpenAIRE

    Fabiato, Francois Stephane

    1998-01-01

    PREDICTING PHYSICAL FITNESS OUTCOMES IN CARDIAC REHABILITATION PATIENTS by Francois S. Fabiato (ABSTRACT) Economic justification for rehabilitative services has resulted in the need for outcome based research which could quantify success or failure in individual patients and formulate baseline variables which could predict outcomes. The purpose of this study is to investigate the utilization of baseline clinical, exercise test, and psychosocial variables to pre...

  20. Development and evaluation of a treadmill-based exercise tolerance test in cardiac rehabilitation.

    Science.gov (United States)

    Dunagan, Julie; Adams, Jenny; Cheng, Dunlei; Barton, Stephanie; Bigej-Cerqua, Janet; Mims, Lisa; Molden, Jennifer; Anderson, Valerie

    2013-07-01

    Cardiac rehabilitation exercise prescriptions should be based on exercise stress tests; however, limitations in performing stress tests in this setting typically force reliance on subjective measures like the Duke Activity Status Index (DASI). We developed and evaluated a treadmill-based exercise tolerance test (ETT) to provide objective physiologic measures without requiring additional equipment or insurance charges. The ETT is stopped when the patient's Borg scale rating of perceived exertion (RPE) reaches 15 or when any sign/symptom indicates risk of an adverse event. Outcomes of the study included reasons for stopping; maximum heart rate, systolic blood pressure, and rate pressure product; and adverse events. We tested equivalence to the DASI as requiring the 95% confidence interval for the mean difference between DASI and ETT metabolic equivalents (METs) to fall within the range (-1, 1). Among 502 consecutive cardiac rehabilitation patients, one suffered a panic attack; no other adverse events occurred. Most (80%) stopped because they reached an RPE of 15; the remaining 20% were stopped on indications that continuing risked an adverse event. Mean maximum systolic blood pressure, heart rate, and rate pressure product were significantly (P pressure products remained below 36,000. The mean difference between DASI and ETT METs was -0.8 (-0.98, -0.65), indicating equivalence at our threshold. In conclusion, the ETT can be performed within cardiac rehabilitation, providing a functional capacity assessment equivalent to the DASI and objective physiologic measures for developing exercise prescriptions and measuring progress. PMID:23814381

  1. Current trends in cardiac rehabilitation

    OpenAIRE

    Dafoe, W; Huston, P

    1997-01-01

    Cardiac rehabilitation can reduce mortality and morbidity for patients with many types of cardiac disease cost-effectively, yet is generally underutilized. Rehabilitation is helpful not only for patients who have had a myocardial infarction but also for those with stable angina or congestive heart failure or those who have undergone myocardial revascularization procedures, a heart transplant or heart valve surgery. The beneficial effects of rehabilitation include a reduction in the rate of de...

  2. Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery

    OpenAIRE

    Ghashghaei, Fatemeh Esteki; Sadeghi, Masoumeh; Marandi, Seyed Mohammad; Ghashghaei, Samira Esteki

    2012-01-01

    BACKGROUND: Cardiovascular disorders are an important public health problem worldwide. They are also the leading cause of mortality and morbidity. Therefore, American Heart Association proposed cardiac rehabilitation program as an essential part of care for cardiac patients to improve functional capacity. The aim of this study was to evaluate the effectiveness of cardiac rehabilitation program on functional status and some hemodynamic responses in patients after coronary artery bypass graft (...

  3. Sexual Dysfunction before and after Cardiac Rehabilitation

    OpenAIRE

    Jörg Schumann; Zellweger, Michael J.; Marcello Di Valentino; Simone Piazzalonga; Andreas Hoffmann

    2010-01-01

    Background. The aim of this study was to assess sexual function before and after cardiac rehabilitation in relation to medical variables. Methods. Analysis of patients participating in a 12-week exercise-based outpatient cardiac rehabilitation program (OCR) between April 1999 and December 2007. Exercise capacity (ExC) and quality of life including sexual function were assessed before and after OCR. Results. Complete data were available in 896 male patients. No sexual activity at all was indic...

  4. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    Science.gov (United States)

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions. PMID:22797030

  5. Perceptions of cardiac rehabilitation patients, specialists and rehabilitation programs regarding cardiac rehabilitation wait times

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-08-01

    Full Text Available Abstract Background In 2006, the Canadian Cardiovascular Society (CCS Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR. The objectives of the current study were to: (1 describe cardiac patient perceptions of actual and ideal CR wait times, (2 describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3 investigate actual wait times and factors that CR programs perceive to affect these wait times. Methods Postal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared. Results Responses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate, and 92 CR programs (61.7% response rate. Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days, while their ideal median wait time was 28 days. Most patients (91.5% considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p  Conclusions Wait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time

  6. Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants

    Science.gov (United States)

    Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James

    2015-01-01

    Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

  7. Evaluation of exercise tolerance patients in cardiac rehabilitation D model based on 6 Minute Walk Test

    Directory of Open Access Journals (Sweden)

    Bielawa Lukasz.

    2012-12-01

    Full Text Available Evaluation of the results of 6-minute walk test depending on gender, age, left ventricular ejection fraction, the primary disease and BMI. Patients underwent assessment of Cardiac Rehabilitation Department in Szymbark in 2012 (80 people. Duration of rehabilitation for all patients was 21 days. The test was performed at the beginning and end of the cycle. Following the 3-week cardiac rehabilitation in the model D in a group of 80 patients with a mean age of 72 years achieved a statistically significant improvement in exercise capacity, expressed in the increase in test 6MWT distance by an average of 52 meters. In the study, men received final results statistically superior to women. The largest increase in the distance gained to patients after aortic valve prosthesis. People who are obese with a body mass index BMI over 30 have an average trip distance underperform both at baseline, final, and in the resulting increase of the distance than those with a BMI under 30. Prevention of obesity, one of the modifiable risk factors for cardiovascular disease should be the goal of training during cardiac rehabilitation patient education.

  8. Understanding exercise behaviour during home-based cardiac rehabilitation: a theory of planned behaviour perspective.

    Science.gov (United States)

    Blanchard, Christopher

    2008-01-01

    Although home-based cardiac rehabilitation (CR) programs have been shown to produce significant increases in exercise capacity, obtaining patient adherence to these programs has been challenging. It is therefore critical to identify key theoretical determinants of exercise during home-based CR in order to inform the development of behavioural interventions that improve adherence. The present study examined the utility of the theory of planned behaviour (TPB) in explaining exercise behaviour during home-based CR. Seventy-six patients who were receiving 6 months of home-based CR completed a TPB questionnaire at the beginning and mid-point of the program and a physical activity scale at the mid-point and end of the program. Path analyses showed that attitude and perceived behavioural control significantly predicted intention for both time intervals (baseline to 3 months, and 3 months to 6 months), whereas subjective norm only predicted intention within the 1st 3 months. Intention significantly predicted implementation intention, which, in turn, significantly predicted exercise for both time intervals. Finally, several underlying accessible beliefs were significantly related to exercise for both time intervals. Therefore, results suggest that the TPB is a potentially useful framework for understanding exercise behaviour during home-based CR.

  9. [Cardiac rehabilitation in Germany: a successful model with promising prospects].

    Science.gov (United States)

    Korsukéwitz, C; Falk, J; Lindow, B

    2012-02-01

    Over the past 20 years the German Pension Insurance has rehabilitated nearly 800,000 patients with coronary heart disease. In particular, phase-II rehabilitation has been established as an integral part of cardiac patient care. However, the decreasing number of participants in phase-III must be seen critically. Today's cardiac rehabilitation is characterised by evidence-based treatment modules and a sophisticated quality assurance system that ensures quality orientation in all aspects, from access to rehabilitation through to aftercare. Future developments such as vocationally-oriented medical rehabilitation and the use of new technologies will further improve cardiac rehabilitation. Positive patient feedback and scientific evidence of the effectiveness of cardiac rehabilitation are further incentives to maintain this forward-looking approach. PMID:22190191

  10. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Science.gov (United States)

    2010-10-01

    ... and intensive cardiac rehabilitation program: Conditions of coverage. (a) Definitions. As used in this... 42 Public Health 2 2010-10-01 2010-10-01 false Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage. 410.49 Section 410.49 Public Health CENTERS...

  11. Cardiac Rehabilitation in Older Adults.

    Science.gov (United States)

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy. PMID:27297002

  12. Cardiac rehabilitation in New Zealand-moving forward.

    Science.gov (United States)

    Benatar, Jocelyne; Langdana, Fali; Doolan-Noble, Fiona; McLachlan, Andrew

    2016-01-01

    Modern guideline-based cardiac rehabilitation provides an evidence-based, cost effective and comprehensive approach to reduce re-infarction and mortality. It offers a multidisciplinary approach to support self-management, improves psychological and social functioning and adherence to recommended life-style changes and medications. The challenge is to broaden uptake of cardiac rehabilitation, increase participation in supervised exercise programs and ensure that healthy behaviours are maintained in the long term. Shared care planning between cardiac rehabilitation specialists and primary health providers could improve long-term adherence by ensuring continuity of care of patients who have completed a Phase 2 cardiac rehabilitation program, either facility or home based. PMID:27355170

  13. Cardiac Rehabilitation: Improving Function and Reducing Risk.

    Science.gov (United States)

    Servey, Jessica T; Stephens, Mark

    2016-07-01

    Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions aimed at lowering blood pressure and improving lipid and diabetes mellitus control, with tobacco cessation, behavioral counseling, and graded physical activity. The physical activity component typically involves 36 sessions over 12 weeks, during which patients participate in supervised exercise under cardiac monitoring. There are also intensive programs that include up to 72 sessions lasting up to 18 weeks, although these programs are not widely available. Additional components of cardiac rehabilitation include counseling on nutrition, screening for and managing depression, and assuring up-to-date immunizations. Cardiac rehabilitation is covered by Medicare and recommended for patients following myocardial infarction, bypass surgery, and stent placement, and for patients with heart failure, stable angina, and several other conditions. Despite proven benefits in mortality rates, depression, functional capacity, and medication adherence, rates of referral for cardiac rehabilitation are suboptimal. Groups less likely to be referred are older adults, women, patients who do not speak English, and persons living in areas where cardiac rehabilitation is not locally available. Additionally, primary care physicians refer patients less often than cardiologists and cardiothoracic surgeons. PMID:27386722

  14. Expanding the Limits of Evidence-Based Medicine: A Discourse Analysis of Cardiac Rehabilitation Clinical Practice Guidelines.

    Science.gov (United States)

    Wise, Meg

    Heart attacks are the leading cause of death in the United States, and cardiac rehabilitation, a form of post-MI (myocardial infarction) education, accounts for at most 20% of improved lifestyle behavior that can effectively manage symptoms, delay or prevent subsequent attacks, and lower mortality and morbidity rates. In an attempt to improve…

  15. Cardiac Rehabilitation. A Handbook for Vocational Rehabilitation Counselors.

    Science.gov (United States)

    Brammell, H. L.; And Others

    Basic information about heart disease and functional capacity assessment and its application to activity/job counseling are presented in this handbook for vocational rehabilitation counselors. Sections include the following: impact of heart disease; basic anatomy and physiology (e.g., the heart, pulmonary circulation, causes of cardiac pain, and…

  16. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey

    DEFF Research Database (Denmark)

    Bjarnason-Wehrens, Birna; McGee, Hannah; Zwisler, Ann-Dorthe;

    2010-01-01

    Cardiac rehabilitation (CR) programmes support patients to achieve professionally recommended cardiovascular prevention targets and thus good clinical status and improved quality of life and prognosis. Information on CR service delivery in Europe is sketchy....

  17. Anxious attachment and psychological distress in cardiac rehabilitation patients.

    Science.gov (United States)

    West, M; Sarah Rose, M; Brewis, C S

    1995-06-01

    This study investigated the relevance of anxious attachment to the differentiation of psychologically distressed and non-psychologically distressed cardiac patients. Attachment is a biologically based behavioral system in which proximity to a special other is sought or maintained to achieve a sense of safety and security. Anxious attachment, as the name denotes, fails to achieve the function of attachment in the sense of individuals having little or no confidence in the availability of their attachment figures. Empirically, three scales (feared loss of the attachment figure, proximity seeking and separation protest) capture the features of anxious attachment as elaborated by Bowlby. These scales were administered to 178 cardiac rehabilitation patients drawn from the cardiac rehabilitation program of the Calgary General Hospital. The results indicate that feared loss and proximity seeking differentiated psychologically distressed from non-psychologically distressed patients. The implications of this finding for the understanding of psychologically distressed cardiac patients are discussed.

  18. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Krutika Gajjar

    2012-06-01

    Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.

  19. Exercise-based cardiac rehabilitation for adults after heart valve surgery

    DEFF Research Database (Denmark)

    Lærum Sibilitz, Kristine; Berg, Selina Kikkenborg; Tang, Lars Hermann;

    2016-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The aim of this review is to assess the benefits and harms of rehabilitation programmes consisting of a physical exercise component that focuses on increasing exercise capacity, and may include a psychoeduc...

  20. Differences Between Women and Men in Phase I Cardiac Rehabilitation After Acute Myocardial Infarction: A Nationwide Population-Based Analysis.

    Science.gov (United States)

    Lin, Wen-Chih; Ho, Chung-Han; Tung, Li-Chen; Ho, Chi-Che; Chou, Willy; Wang, Chun-Hou

    2016-01-01

    Although numerous studies have investigated gender-related differences in patients who have had an acute myocardial infarction (AMI), few studies have examined the gender-related differences among inpatients receiving Phase I inpatient cardiac rehabilitation following AMI.Using data from the Taiwan National Health Insurance Research Database, this study analyzed 6713 adult patients who received inpatient cardiac rehabilitation following AMI between 2002 and 2011. The differences in comorbidity, medical service use, and prognosis between the male and female patients were analyzed to determine whether the comorbidities affecting their prognoses differed.Female patients accounted for 23.18% of the sample, had a higher average age, and exhibited severe comorbidities; furthermore, they had significantly more days of hospitalization and days in an intensive care unit than did male patients. The gender-related differences in hospital mortality rate and 30-day mortality rate were nonsignificant, but female patients exhibited a significantly higher 1-year mortality rate. Moreover, the risk for 1-year mortality was higher among female patients with moderate or severe renal disease (odds ratio: 1.94, 95% confidence interval: 1.29-2.92) than among their male counterparts. However, the 1-year mortality rate for the female patients did not increase after all risk factors were adjusted.Gender-related differences in age, comorbidity, and prognosis were confirmed in AMI patients receiving Phase I inpatient cardiac rehabilitation. In addition, gender-related differences were observed in the comorbidity risk factors affecting prognosis. However, being female did not affect the prognosis.

  1. Comparison Between Effects of Home Based Cardiac Rehabilitation Programs Versus Usual Care on the Patients’ Health Related Quality of Life After Coronary Artery Bypass Graft

    OpenAIRE

    Salavati, Mohsen; Falahinia, Gholamhossein; Vardanjani, Ali Esmaeili; Rafiei, Hossein; Moosavi, Saeid; Torkamani, Mehdi

    2015-01-01

    Background & Aim: To compare home-based cardiac rehabilitation with usual care on the patients’ Health Related Quality of Life (HRQoL) after coronary artery bypass graft in patients with coronary artery bypass graft (CABG) surgery. Methods: In a randomized controlled clinical conducted from March 2013 to June 2013, 110 patients with CABG surgery were randomly assigned into two groups. While patients in group I, were received usual care and patients in group II, in addition to the usual care w...

  2. Cardiac Rehabilitation in Patients with Heart Failure

    OpenAIRE

    Fu, Tieh-Cheng; Huang, Shu-Chun; Hsu, Chih-Chin; Wang, Chao-Hung; Wang, Jong-Shyan

    2014-01-01

    Reduced exercise capacity negatively affects the ability of patients with heart failure (HF) to perform activities required for daily life, further decreasing their independence and quality of life (QoL). Cardiac rehabilitation (CR) can effectively improve aerobic fitness and overall health status in patients with HF. Low referral rate is an important limitation that may impede successful CR, whereas the automatic referral and liaison strategies performed by some healthcare providers manifest...

  3. Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine Lærum; Berg, Selina Klikkenborg; Rasmussen, Trine Bernholdt;

    2016-01-01

    OBJECTIVE: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart ...

  4. Sexual Dysfunction before and after Cardiac Rehabilitation

    Directory of Open Access Journals (Sweden)

    Jörg Schumann

    2010-01-01

    variables. Methods. Analysis of patients participating in a 12-week exercise-based outpatient cardiac rehabilitation program (OCR between April 1999 and December 2007. Exercise capacity (ExC and quality of life including sexual function were assessed before and after OCR. Results. Complete data were available in 896 male patients. No sexual activity at all was indicated by 23.1% at baseline and 21.8% after OCR, no problems with sexual activity by 40.8% at baseline and 38.6% after OCR. Patients showed an increase in specific problems (erectile dysfunction and lack of orgasm from 18% to 23% (<.0001 during OCR. We found the following independent positive and negative predictors of sexual problems after OCR: hyperlipidemia, age, CABG, baseline ExC and improvement of ExC, subjective physical and mental capacity, and sense of affiliation. Conclusions. Sexual dysfunction is present in over half of the patients undergoing OCR with no overall improvement during OCR. Age, CABG, low exercise capacity are independent predictors of sexual dysfunction after OCR.

  5. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Rasmussen, Søren;

    2008-01-01

    BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic ...

  6. Effect of Cardiac Rehabilitation on Strength and Balance in Patients after Coronary Artery Bypass Graft

    OpenAIRE

    Nahid Nazari; Ali Akbar Hashemi-Javaheri; Amir Rashid-Lamir; Emad Alaviniya

    2014-01-01

    Background: The most common method for improving the quality of life especially in chronic heart disease is rehabilitation. For increasing the level of knowledge about effect of rehabilitation and its' impression on improving the quality of life in patients. This study evaluates effect of one month cardiac rehabilitation on lower limb strength and the static and dynamic balance of CABG patients. Materials and Methods: This study is based on clinical trial before and after rehabilitation. t...

  7. Problem-Based Learning Used in the Context of Cardiac Rehabilitation: Different Scenes and Different Roles

    Science.gov (United States)

    Hjelmfors, Lisa; Abrandt Dahlgren, Madeleine; Kärner, Anita; Tingström, Pia

    2014-01-01

    Several studies show that how patients have difficulties in changing lifestyle even though such changes are essential because they are suffering from a life-threatening disease. Coronary artery disease (CAD) patients met 13 times during a year and used problem-based learning (PBL) to improve their empowerment and self-efficacy in making lifestyle…

  8. Effect of Cardiac Rehabilitation in Patients with ICD

    DEFF Research Database (Denmark)

    Christensen, Anne Vinggaard; Zwisler, Ann-Dorthe; Svendsen, Jesper Hastrup;

    2015-01-01

    in physical component scale, mental component scale, social functioning, physical functioning, bodily pain, vitality, mental health, and QoL with men having higher scores. Among men only, significant differences were found in VO2 (rehabilitation: 20.9 mL/min/kg [standard deviation (SD) 8.1] vs 23.4 m......BACKGROUND: The COPE-ICD (Copenhagen Outpatient ProgrammE-implantable cardioverter defibrillator) trial studied comprehensive cardiac rehabilitation for patients with ICDs. The purpose of this paper was to explore: (1) gender differences in self-rated health and quality of life (QoL) at hospital...... discharge after ICD implantation, (2) gender differences in effect of cardiac rehabilitation, and (3) predictors of effect of cardiac rehabilitation. METHODS: Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation versus usual care. Gender differences in self...

  9. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  10. Yoga based cardiac rehabilitation after coronary artery bypass surgery: One-year results on LVEF, lipid profile and psychological states – A randomized controlled study

    Science.gov (United States)

    Raghuram, Nagarathna; Parachuri, Venkateshwara Rao; Swarnagowri, M.V.; Babu, Suresh; Chaku, Ritu; Kulkarni, Ravi; Bhuyan, Bhagavan; Bhargav, Hemant; Nagendra, Hongasandra Ramarao

    2014-01-01

    Objective To compare the long term effects of yoga based cardiac rehabilitation program with only physiotherapy based program as an add-on to conventional rehabilitation after coronary artery bypass grafting (CABG) on risk factors. Methods In this single blind prospective randomized parallel two armed active control study, 1026 patients posted for CABG at Narayana Hrudayalaya Institute of Cardiac Sciences, Bengaluru (India) were screened. Of these, 250 male participants (35–65 years) who satisfied the selection criteria and consented were randomized into two groups. Within and between group comparisons were done at three points of follow up (i.e. 6th week, 6th month, and 12th month) by using Wilcoxon's signed ranks test and Mann Whitney U test respectively. Results Yoga group had significantly (p = 0.001, Mann Whitney) better improvement in LVEF than control group in those with abnormal baseline EF (<53%) after 1 year. There was a better reduction in BMI in the yoga group (p = 0.038, between groups) in those with high baseline BMI (≥23) after 12 months. Yoga group showed significant (p = 0.008, Wilcoxon's) reduction in blood glucose at one year in those with high baseline FBS ≥110 mg/dl. There was significantly better improvement in yoga than the control group in HDL (p = 0.003), LDL (p = 0.01) and VLDL (p = 0.03) in those with abnormal baseline values. There was significantly better improvement (p = 0.02, between groups) in positive affect in yoga group. Within Yoga group, there was significant decrease in perceived stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.001), and negative affect (p = 0.03) while in the control group there was reduction (p = 0.003) only in scores on anxiety. Conclusion Addition of yoga based relaxation to conventional post-CABG cardiac rehabilitation helps in better management of risk factors in those with abnormal baseline values and may help in preventing recurrence. PMID:25443601

  11. Cardiac rehabilitation services in Denmark: still room for expansion

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe O; Traeden, Ulla I; Videbaek, Jørgen;

    2005-01-01

    AIM: European cardiologists agree that cardiac rehabilitation (CR) should be offered as an integrated part of cardiac care, and CR guidelines have been published. The authors aimed to ascertain the potential for expanding CR coverage at hospitals in Denmark. METHOD: A cross-sectional questionnair...

  12. MULTIPLE FACETS OF REHABILITATION IN ELDERLY PATIENTS AFTER CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    Maura Gabriela FELEA

    2014-11-01

    Full Text Available The elderly rehabilitation program after coronary artery bypass graft (CABG encompasses endurance training performed on a cycloergometer and physical rehabilitation, the results being exceeded by adding strength and balance exercises. Early initiation of mobilization exercises can prevent problems of posture, as well as thoraco-pulmonary and scapular-humeral articulation conditions often encountered after cardiac surgery. The results of special functional training in elderly can be assessed by six minute walk perimeter and quality of life questionnaire. This article describes the extents of multiple dimensions facets of cardiac rehabilitation program, like effort capacity and psycho-social benefits, morbi-mortality and cost-effectiveness. Referral to cardiac rehabilitation for primary and secondary prevention programs remains low in developing countries. There is a need for a network intelligence schema in order to address patients’ needs and to improve health care professionals’ education.

  13. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery after Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting

    OpenAIRE

    Ali Abbasi; Mostafa Nejatian; Seyed Hesameddin Abbasi; Mehrab Marzban; Saeed Davoodi; Abbasali Karimi; Seyed Ebrahim Kassaian; Mojtaba Salarifar; Mohammad Alidoosti; Abbas Soleimani

    2008-01-01

    Background: The objective of this study was to evaluate the effect of a hospital-based cardiac rehabilitation program on heart rate recovery (HRR) in patients who received percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Methods: Two hundred forty patients, who completed 24 sessions of a cardiac rehabilitation program (phase 2) after PCI (n=62) or CABG (n=178) at the rehabilitation department of Tehran Heart Center were included in the present study. Demogra...

  14. CARDIAC REHABILITATION PROGRAM (AEROBIC) AND QUALITY OF LIFE IN CARDIAC PATIENTS

    OpenAIRE

    Majid Gorgeh; Morad Jorgeh; Farzad Nazem; Ali Yelfani

    2011-01-01

    Cardiac rehabilitation is the effective method to improve quality of life; especially in heartdisease.The purpose of this study was to determine the effect of cardiac rehabilitation programson the quality of life of patients who had undergone coronary artery bypass grafting in Iran.Six weeks after CABG 60 patients ( 46 male and 14 female) participated in an 12-week cardiacrehabilitation program that consisted of formal supervised exercise training and educationalsessions in shahid beheshti re...

  15. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation.

    Science.gov (United States)

    Corrà, Ugo; Piepoli, Massimo F; Carré, François; Heuschmann, Peter; Hoffmann, Uwe; Verschuren, Monique; Halcox, Julian; Giannuzzi, Pantaleo; Saner, Hugo; Wood, David; Piepoli, Massimo F; Corrà, Ugo; Benzer, Werner; Bjarnason-Wehrens, Birna; Dendale, Paul; Gaita, Dan; McGee, Hannah; Mendes, Miguel; Niebauer, Josef; Zwisler, Ann-Dorthe Olsen; Schmid, Jean-Paul

    2010-08-01

    Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling, exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise training as central components in all rehabilitation and preventive interventions. Many of the risk factor improvements occurring in CR can be mediated through exercise training programmes. This call-for-action paper presents the key components of a CR programme: physical activity counselling and exercise training. It summarizes current evidence-based best practice for the wide range of patient presentations of interest to the general cardiology community.

  16. MULTIPLE FACETS OF REHABILITATION IN ELDERLY PATIENTS AFTER CARDIAC SURGERY

    OpenAIRE

    Maura Gabriela FELEA; Florin MITU; Maria M. LEON

    2014-01-01

    The elderly rehabilitation program after coronary artery bypass graft (CABG) encompasses endurance training performed on a cycloergometer and physical rehabilitation, the results being exceeded by adding strength and balance exercises. Early initiation of mobilization exercises can prevent problems of posture, as well as thoraco-pulmonary and scapular-humeral articulation conditions often encountered after cardiac surgery. The results of special functional training in elderly can be assessed ...

  17. Effects of Cardiac Rehabilitation Program on Right Ventricular Function After Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2012-03-01

    Full Text Available Background: Cardiac rehabilitation has been recognized as one of the most effective strategies for managing cardiovascular indices as well as controlling the cardiovascular risk profile, in particular after coronary artery bypass graft surgery (CABG. However, the effect of this program on right ventricular function following CABG is unclear. The aim of this study was to evaluate the impact of cardiac rehabilitation on the right ventricular (RV function in a cohort of patients who underwent CABG. Methods: A total of 28 patients who underwent CABG and participated consecutively in an 8-week cardiac rehabilitation program at Tehran Heart Center were studied. The control group consisted of 39 patients who refused to attend cardiac rehabilitation and only received postoperative medical treatment after registration in the Cardiac Rehabilitation Clinic. Two-dimensional and Doppler echocardiography was performed to assess the RV function in both groups at the three time points of before surgery, at the end of surgery, and at the end of the rehabilitation program. Results: Significant increase of RV function parameters were observed in both rehabilitation group (RG and control group (CG at the end of the rehabilitation program compared with post-CABG evaluation in terms of tricuspid annular plane systolic execution (RG: 12.50 mm to 14.18 mm; CG: 13.41 mm to 14.56 mm, tricuspid annular peak systolic velocity (RG: 8.55 cm/s to 9.14 cm/s; CG: 9.03 cm/s to 9.26 cm/s, and tricuspid annular late diastolic velocity (RG: 8.93 cm/s to 9.39 cm/s; CG: 9.26 cm/s to 9.60 cm/s.The parameters of the RV function did improve in both groups, but this improvement was not associated with participation in the complete cardiac rehabilitation program. Conclusion: The RV function parameters gradually improved after CABG; this progress, however, was independent of the exercise-based cardiac rehabilitation program.

  18. ECG Monitoring in Cardiac Rehabilitation: Is It Needed?

    Science.gov (United States)

    Greenland, Philip; Pomilla, Paul V.

    1989-01-01

    Discusses the controversial use of continuous electrocardiogram (ECG) monitoring as a safety measure in cardiac rehabilitation exercise programs. Little evidence substantiates its value for all patients during exercise. In the absence of empirical evidence documenting the worth of this expensive procedure, it is recommended for use with high-risk…

  19. Best Practices for Counseling in Cardiac Rehabilitation Settings

    Science.gov (United States)

    Sheikh, Alia I.; Marotta, Sylvia A.

    2008-01-01

    Heart disease is the leading cause of death in the United States and can affect individuals of all ages, gender, ethnicity, and socioeconomic status. This article reviews the research on psychosocial interventions in cardiac rehabilitation programs and discusses the evolving set of best practices for counselors working in a new setting with people…

  20. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial)--design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Brønnum-Hansen, Henrik;

    2005-01-01

    BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CR), although evidence for this is still limited. It is not known whether evidence from before 1995 is still valid. STUDY DESIGN: The DANish Cardiac ReHABilitation (DANREHAB) trial was designed as a centrally r...

  1. A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial) - design, intervention, and population

    DEFF Research Database (Denmark)

    Zwisler, A.D.O.; Schou, O.; Soja, A.M.B.;

    2005-01-01

    Background Current guidelines broadly recommend comprehensive cardiac rehabilitation (CR), although evidence for this is still limited. It is not known whether evidence from before 1995 is still valid. Study Design The DANish Cardiac REHABilitation (DANREHAB) trial was designed as a centrally ran...

  2. [A multidisciplinary approach to cardiac rehabilitation].

    Science.gov (United States)

    Barbet, Régis; Caux, Christelle; Brysse, Lydie; Foy, Mireille; Cardon, Cindy

    2015-03-01

    The rehabilitation of a coronary patient involves numerous professionals in a global care approach. The objective is to reintroduce physical activity and put in place lifestyle changes, in order to reduce the risk factors. Therapeutic education is an essential part of this support. PMID:26040143

  3. Making an APPropriate Care Program for Indigenous Cardiac Disease: Customization of an Existing Cardiac Rehabilitation Program.

    Science.gov (United States)

    Bradford, DanaKai; Hansen, David; Karunanithi, Mohan

    2015-01-01

    Cardiovascular disease is a major health problem for all Australians and is the leading cause of death in Aboriginal and Torres Strait Islanders. In 2010, more then 50% of all heart attack deaths were due to repeated events. Cardiac rehabilitation programs have been proven to be effective in preventing the recurrence of cardiac events and readmission to hospitals. There are however, many barriers to the use of these programs. To address these barriers, CSIRO developed an IT enabled cardiac rehabilitation program delivered by mobile phone through a smartphone app and succesfully trialed it in an urban general population. If these results can be replicated in Indigenous populations, the program has the potential to significantly improve life expectancy and help close the gap in health outcomes. The challenge described in this paper is customizing the existing cardiac health program to make it culturally relevant and suitable for Indigenous Australians living in urban and remote communities. PMID:26262068

  4. Effect of Cardiac Rehabilitation on Strength and Balance in Patients after Coronary Artery Bypass Graft

    Directory of Open Access Journals (Sweden)

    Nahid Nazari

    Full Text Available Background: The most common method for improving the quality of life especially in chronic heart disease is rehabilitation. For increasing the level of knowledge about effect of rehabilitation and its' impression on improving the quality of life in patients. This study evaluates effect of one month cardiac rehabilitation on lower limb strength and the static and dynamic balance of CABG patients. Materials and Methods: This study is based on clinical trial before and after rehabilitation. the exercise protocol lasted for one month, three times per week, each session lasting 1 hour, on 30 male patients in two groups in control (N=15 and experimental group (N=15 after CABG in the centre of rehabilitation in Javad-Alaeme Heart Hospital, Mashhad. The strength of lower limb by chair standing test, the static balance by standing on one leg and dynamic balance by time up and go (TUG test, was evaluated before and after 1 month rehabilitation in training group and detraining in control group. Data were analyzed with SPSS-16 and used t-test analysis (p≤0.05.Results: The strength of lower limb (p=0.001, static balance (p=0.023 and dynamic balance (p=0.037 increased significantly after one month of cardiac rehabilitation.Conclusion: The result of this study indicates that cardiac rehabilitation after coronary artery bypass surgery causes significant increase in strength of lower limb and balance in patients, the more muscle strength is associated with an increase in ability of performing daily activities and so it causes improved quality of life.

  5. Effect of Cardiac Rehabilitation on Strength and Balance in Patients after Coronary Artery Bypass Graft

    Directory of Open Access Journals (Sweden)

    Nahid Nazari

    2014-01-01

    Full Text Available Background: The most common method for improving the quality of life especially in chronic heart disease is rehabilitation. For increasing the level of knowledge about effect of rehabilitation and its' impression on improving the quality of life in patients. This study evaluates effect of one month cardiac rehabilitation on lower limb strength and the static and dynamic balance of CABG patients. Materials and Methods: This study is based on clinical trial before and after rehabilitation. the exercise protocol lasted for one month, three times per week, each session lasting 1 hour, on 30 male patients in two groups in control (N=15 and experimental group (N=15 after CABG in the centre of rehabilitation in Javad-Alaeme Heart Hospital, Mashhad. The strength of lower limb by chair standing test, the static balance by standing on one leg and dynamic balance by time up and go (TUG test, was evaluated before and after 1 month rehabilitation in training group and detraining in control group. Data were analyzed with SPSS-16 and used t-test analysis (p≤0.054T. Results: The strength of lower limb (p=0.001, static balance (p=0.023 and dynamic balance (p=0.037 increased significantly after one month of cardiac rehabilitation4T. Conclusion: The result of this study indicates that cardiac rehabilitation after coronary artery bypass surgery causes significant increase in strength of lower limb and balance in patients, the more muscle strength is associated with an increase in ability of performing daily activities and so it causes improved quality of life4T.

  6. Benefit of cardiac rehabilitation programme in revascularized coronary patient

    Directory of Open Access Journals (Sweden)

    Laura Crăciun

    2009-06-01

    Full Text Available Objective: Evaluating the cardiovascular risk profile in revascularized coronary patients at 16 months after revascularization(PCI+CABG. Material and method: We evaluated the cardiovascular risk profile, compliance to the secondary preventionmeasures and reaching guideline targets in revascularized coronary patients included in EuroASpire III Romania. The patientswere divided in two groups: the selection criteria was the adherence to cardiac rehabilitation programme (CRP+/CRP-. Result:The prevelence of cardiovascular risk factors was about 76%, with an increased significance in CRP- group (p0.05, OR>1. Conclusion: At 16 months after revascularisation, the patientsstill present a high risk. The level of cardio-metabolic and hemodynamic risk are maintained the same by unreaching thetargeted values recomended by ESC prevention guideline. The patients in CPR+ group had a significant improvement ofcardiovascular risk factors. Indication but also compliance to structured cardiac rehabilitation programme after myocardialrevascularisation remains at a suboptimal level.

  7. Review of High-intensity Interval Training in Cardiac Rehabilitation.

    Science.gov (United States)

    Ito, Shigenori; Mizoguchi, Tatsuya; Saeki, Tomoaki

    2016-01-01

    For the secondary prevention of cardiovascular disease, comprehensive cardiac rehabilitation is required. This involves optimal medical therapy, education on nutrition and exercise therapy, and smoking cessation. Of these, efficient exercise therapy is a key factor. A highly effective training protocol is therefore warranted, which requires a high rate of compliance. Although moderate-intensity continuous training has been the main training regimen recommended in cardiac rehabilitation guidelines, high-intensity interval training has been reported to be more effective in the clinical and experimental setting from the standpoint of peak oxygen uptake and central and peripheral adaptations. In this review, we illustrate the scientific evidence for high-intensity interval training. We then verify this evidence and discuss its significance and the remaining issues. PMID:27580530

  8. Impact of cardiac rehabilitation on health related quality of life.

    LENUS (Irish Health Repository)

    Riaz, A

    2012-02-01

    Cardiac rehabilitation (CR) programs are recognized as integral part of the comprehensive care of patients with cardiovascular disease and are recommended as useful and effective (Class I) by the American Heart Association (AHA). In this study we used serial administration of the short form 36 (SF36) to evaluate patient\\'s response to CR in terms of improvement in Health related Quality of Life. A total of 49 patients were included in the analysis. There was a significant improvement observed after CR in the Physical Capacity Score (42.3 vs 49.9 p = 0.0005). There was no significant improvement in the Mental Capacity Score (54.8 vs 54.9 p = 0.96). We conclude that Cardiac Rehabilitation Program causes a significant improvement in the health related quality of life of patients by improving their physical health and well being but does not improve the mental capacity which is already at a healthy level before CR.

  9. Review of High-intensity Interval Training in Cardiac Rehabilitation.

    Science.gov (United States)

    Ito, Shigenori; Mizoguchi, Tatsuya; Saeki, Tomoaki

    2016-01-01

    For the secondary prevention of cardiovascular disease, comprehensive cardiac rehabilitation is required. This involves optimal medical therapy, education on nutrition and exercise therapy, and smoking cessation. Of these, efficient exercise therapy is a key factor. A highly effective training protocol is therefore warranted, which requires a high rate of compliance. Although moderate-intensity continuous training has been the main training regimen recommended in cardiac rehabilitation guidelines, high-intensity interval training has been reported to be more effective in the clinical and experimental setting from the standpoint of peak oxygen uptake and central and peripheral adaptations. In this review, we illustrate the scientific evidence for high-intensity interval training. We then verify this evidence and discuss its significance and the remaining issues.

  10. Benefit of cardiac rehabilitation programme in revascularized coronary patient

    OpenAIRE

    Laura Crăciun; Claudiu Avram; Adina Avram; Stela Iurciuc; Dan Gaiţă

    2009-01-01

    Objective: Evaluating the cardiovascular risk profile in revascularized coronary patients at 16 months after revascularization(PCI+CABG). Material and method: We evaluated the cardiovascular risk profile, compliance to the secondary preventionmeasures and reaching guideline targets in revascularized coronary patients included in EuroASpire III Romania. The patientswere divided in two groups: the selection criteria was the adherence to cardiac rehabilitation programme (CRP+/CRP-). Result:The p...

  11. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Piepoli, Massimo Francesco; Corrà, Ugo; Benzer, Werner;

    2010-01-01

    Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to card...

  12. [The role of dietitian in cardiac rehabilitation and secondary prevention].

    Science.gov (United States)

    Agostini, Susanna; Biffi, Barbara; Brazzo, Silvia; Da Vico, Letizia; Masini, Maria Luisa

    2014-03-01

    Rehabilitation and secondary prevention programs are recognized as an essential part of the overall care of patients with cardiovascular disease. They consist of multidisciplinary strategies aiming at the reduction of modifiable risk factors for cardiovascular disease. There are some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation. In 2007, the Italian Association of Dietitians (ANDID) appointed a working group of dietitians, skilled in nutrition applied in cardiovascular disease, with the aim to make an overview of the available scientific literature and to develop a Professional Position Paper on the role of Dietitian in cardiac rehabilitation and secondary prevention. The first Position Paper, developed in 2008, covered the available evidence about the dietitian professional role and contribution in the management of the topic. The working group has recently updated the contents by introducing, in agreement with the work done by ANDID, the methodology of the Nutrition Care Process and Model (NCP), a systematic problem-solving method intended to stimulate critical thinking, decision-making and address issues related to food and nutritional assistance, in order to provide a safe, effective and high quality care.

  13. Physician-Related Factors Affecting Cardiac Rehabilitation Referral

    Directory of Open Access Journals (Sweden)

    Bahieh Moradi

    2011-12-01

    Full Text Available Background: Despite the positive impact of cardiac rehabilitation (CR on quality of life and mortality, the majority of people who could benefit from this program fail to participate in it. The lack of referral from the physician is a common reason that patients give for not seeking CR. The objective of this study was to compare factors affecting CR referral by cardiologists. Methods: A cross-sectional survey of 122 cardiologists, including 89 general cardiac specialists and 33 fellows in cardiology from 11 major cardiology training centers in Iran, was done in 2010. They responded to the 14- item investigator-generated survey, examining the physician’s attitudinal and knowledge factors affecting CR referral. Results: 47.9% of the subjects reported having available CR centers but only 6.6% reported continuous medical education on the topic. 90.7% of the physicians reported that less than 15% of patients are referred to CR centers. The main factor affecting the low referral rate was limited general knowledge about CR programs (79.5% such as program attributes and benefits, methods of reimbursement. Lack of insurance coverage, unavailability of CR centers in the community and low physicians’ fee were other factors reported by the physicians. Conclusion: Cardiologists’ inadequate general knowledge of and attitude toward CR programs seem to be a potential threat for cardiac prevention and rehabilitation in some societies.

  14. Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

    OpenAIRE

    Zanettini, Renzo; Gatto, Gemma; Mori, Ileana; Pozzoni, Maria Beatrice; Pelenghi, Stefano; Martinelli, Luigi; Klugmann, Silvio

    2014-01-01

    Background Evaluation of patient outcomes following transcatheter aortic valve implantation (TAVI) has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cog...

  15. Lifestyle after Cardiac Rehabilitation: Did the Message Come across, and Was It Feasible? An Analysis of Patients’ Narratives

    DEFF Research Database (Denmark)

    Knudsen, Marie Veje; Laustsen, Sussie; Petersen, Annemette Krintel;

    2014-01-01

    Lifestyle following heart disease is considered important to prevent and reduce cardiovascular risk factors. Thus, cardiac rehabilitation is focused on potential lifestyle changes. Further insight into patients’ perspective on lifestyle after cardiac rehabilitation is needed as changing habits fo...

  16. Cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Sandra Spronk

    Full Text Available OBJECTIVE: Peripheral arterial disease (PAD often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease (CAD undergoing cardiac rehabilitation. DATA SOURCES: Best-available evidence was retrieved from literature and combined with primary data from 231 patients. METHODS: We developed a markov decision model to compare the following treatment strategies: 1. cardiac rehabilitation only; 2. ankle-brachial index (ABI if cardiac rehabilitation fails followed by diagnostic work-up and revascularization for PAD if needed; 3. ABI prior to cardiac rehabilitation followed by diagnostic work-up and revascularization for PAD if needed. Quality-adjusted-life years (QALYs, life-time costs (US $, incremental cost-effectiveness ratios (ICER, and gain in net health benefits (NHB in QALY equivalents were calculated. A threshold willingness-to-pay of $75,000 was used. RESULTS: ABI if cardiac rehabilitation fails was the most favorable strategy with an ICER of $44,251 per QALY gained and an incremental NHB compared to cardiac rehabilitation only of 0.03 QALYs (95% CI: -0.17, 0.29 at a threshold willingness-to-pay of $75,000/QALY. After sensitivity analysis, a combined cardiac and vascular rehabilitation program increased the success rate and would dominate the other two strategies with total lifetime costs of $30,246 a quality-adjusted life expectancy of 3.84 years, and an incremental NHB of 0.06 QALYs (95%CI:-0.24, 0.46 compared to current practice. The results were robust for other different input parameters. CONCLUSION: ABI measurement if cardiac rehabilitation fails followed by a diagnostic work-up and revascularization for PAD if needed are potentially cost-effective compared to cardiac rehabilitation only.

  17. "I'm No Superman": Understanding Diabetic Men, Masculinity, and Cardiac Rehabilitation.

    Science.gov (United States)

    Dale, Craig M; Angus, Jan E; Seto Nielsen, Lisa; Kramer-Kile, Marnie; Pritlove, Cheryl; Lapum, Jennifer; Price, Jennifer; Marzolini, Susan; Abramson, Beth; Oh, Paul; Clark, Alex

    2015-12-01

    Exercise-based cardiac rehabilitation (CR) programs help patients with coronary heart disease (CHD) reduce their risk of recurrent cardiac illness, disability, and death. However, men with CHD and Type 2 diabetes mellitus (T2DM) demonstrate lower attendance and completion of CR despite having a poor prognosis. Drawing on gender and masculinity theory, we report on a qualitative study of 16 Canadian diabetic men recently enrolled in CR. Major findings reflect two discursive positions men assumed to regain a sense of competency lost in illness: (a) working with the experts, or (b) rejection of biomedical knowledge. These positions underscore the varied and sometimes contradictory responses of seriously ill men to health guidance. Findings emphasize the priority given to the rehabilitation of a positive masculine identity. The analysis argues that gender, age, and employment status are powerful mechanisms of variable CR participation.

  18. Cardiac rehabilitation delivery model for low-resource settings

    Science.gov (United States)

    Grace, Sherry L; Turk-Adawi, Karam I; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L; Oldridge, Neil; Sarkar, Bidyut K; Yeo, Tee Joo; Lopez-Jimenez, Francisco; Mendis, Shanthi; Oh, Paul; Hu, Dayi; Sarrafzadegan, Nizal

    2016-01-01

    Objective Cardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries. Methods A literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not. Results Available data on cost of CR delivery in low-resource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by non-physician healthcare workers, in non-clinical settings. Conclusions Advocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed. PMID:27181874

  19. Cardiovascular prevention and rehabilitation in the elderly: evidence for cardiac rehabilitation after myocardial infarction or chronic heart failure.

    Science.gov (United States)

    Fattirolli, Francesco; Pratesi, Alessandra

    2016-01-01

    Cardiac rehabilitation in the elderly today often represents a utopia. The international scientific literature takes little into account this type of prescription for old people, although they represent a large and growing proportion of cardiac patients, with acute coronary syndrome or heart failure, which we have to manage in everyday life. Furthermore, interventions of health education, clinical follow up, rehospitalisation prevention and prescription of tailored exercise, are sometimes more necessary in this kind of patients, given the presence of multimorbidity, functional dependence, frailty, sarcopenia, social neglect. Most of the data on the feasibility, safety and efficacy of cardiac rehabilitation are favourable, but they are few and apparently not strong enough to convince the medical community. Therefore is necessary to join efforts to identify the geriatric patient's peculiarities and plan a suitable program of cardiac rehabilitation, which takes into account the multi-dimensionality and complexity of typical problems of the elderly, for which the classical cardiac outcomes can be limited. PMID:27374045

  20. Effects of a brief intervention on retention of patients in a cardiac rehabilitation program.

    Science.gov (United States)

    McGrady, Angele; Burkes, Robert; Badenhop, Dalynn; McGinnis, Ron

    2014-12-01

    This intervention assessed the effects of a brief intervention on dropout rate in a cardiac rehabilitation program. One hundred thirty five patients were recruited from a cardiac rehabilitation program and randomized to either a control or intervention group. The intervention group participated in four sessions of motivational interviewing and stress management-relaxation in addition to standard cardiac rehabilitation. The control group underwent cardiac rehabilitation alone. Patients who completed the intervention completed an average of 30 sessions while those who dropped out of the intervention completed about six (p Anxiety and depression measured at baseline were the primary predictors of dropout. Patients in both the intervention and controls groups who completed cardiac rehabilitation improved the distance walked, quality of life and decreased anxiety. PMID:25150038

  1. Bandura's self-efficacy theory: a guide for cardiac rehabilitation nursing practice.

    Science.gov (United States)

    Jeng, C; Braun, L T

    1994-12-01

    To help patients achieve the greatest benefit from cardiac rehabilitation programs, nurses must assist them to modify unhealthy behaviors. Many cardiac rehabilitation programs, however, lack a theoretical foundation; therefore, interventions are usually executed without accounting for the complexities of human behavior, and little consideration is given to the difficulties encountered in altering unhealthy behavior patterns. Bandura's self-efficacy theory is considered a suitable model for cardiac rehabilitation because it provides a systematic direction which allows one to interpret, modify, and predict patients' behaviors. This article describes the development of and conceptual framework for Bandura's theory, how it provides a basis for measurement of self-efficacy, and how it may be applied to the study of cardiac rehabilitation. Finally, some research issues, which are related to applications of self-efficacy theory in cardiac rehabilitation are discussed. PMID:7722281

  2. Extended cardiac rehabilitation for socially vulnerable patients improves attendance and outcome

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Meillier, Lucette Kirsten; Larsen, Mogens Lytken

    2013-01-01

    Patients living alone or having a low socioeconomic status are likely to quit cardiac rehabilitation. We aimed to compare patients being offered extended rehabilitation (ERP) with those being offered standard rehabilitation (SRP) as concerns 1) attendance rates and 2) achievement of treatment goals...

  3. Predicting non-return to work in patients attending cardiac rehabilitation

    DEFF Research Database (Denmark)

    Samkange-Zeeb, Florence; Altenhöner, Thomas; Berg, Gabriele;

    2006-01-01

    Return to work (RTW) is the primary goal in the rehabilitation of patients suffering from coronary heart diseases. However, in spite of expensive rehabilitative efforts, many patients do not resume work following cardiac rehabilitation. To increase cost-effectiveness, predictive tests for non-RTW...

  4. A self-regulation lifestyle program for post-cardiac rehabilitation patients has long-term effects on exercise adherence.

    Science.gov (United States)

    Janssen, Veronica; De Gucht, Veronique; van Exel, Henk; Maes, Stan

    2014-04-01

    As maintenance of lifestyle change and risk factor modification following completion of cardiac rehabilitation has been shown to be notoriously difficult, we developed a brief self-regulation lifestyle program for post-cardiac rehabilitation patients. Randomized-controlled trial. Following completion of cardiac rehabilitation 210 patients were randomized to receive either a lifestyle maintenance program (n = 112) or standard care (n = 98). The program was based on self-regulation principles and consisted of a motivational interview, 7 group sessions and home assignments. Risk factors and health behaviors were assessed at baseline (end of cardiac rehabilitation), and 6 and 15 months thereafter. ANCOVAs showed a significant effect of the lifestyle program on exercise behavior at 15-month follow-up. Mediation analysis demonstrated that the treatment effect on exercise behavior could be explained by self-regulation skills. Chi squared tests showed that patients in the intervention group had significantly fewer uncontrolled risk factors as compared to the control group. Finally, the lifestyle intervention program was associated with a 12 % reduction in self-reported cardiac hospital admission rates. This trial indicates that a relatively brief, theory-based lifestyle program is capable of inciting and maintaining improvements in exercise adherence. It is suggested that patients may need ongoing attention and guidance, for example in the form of (internet-based) booster sessions, as long-term consolidation of changes is arduous. PMID:23334387

  5. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery after Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Ali Abbasi

    2008-07-01

    Full Text Available Background: The objective of this study was to evaluate the effect of a hospital-based cardiac rehabilitation program on heart rate recovery (HRR in patients who received percutaneous coronary intervention (PCI or coronary artery bypass grafting (CABG. Methods: Two hundred forty patients, who completed 24 sessions of a cardiac rehabilitation program (phase 2 after PCI (n=62 or CABG (n=178 at the rehabilitation department of Tehran Heart Center were included in the present study. Demographic and clinical characteristics and exercise capacity at baseline and at follow-up were compared between the two groups. The main outcome measurements were: Resting heart rate, peak heart rate, and HRR.Results: All the patients showed significant improvements in heart rate parameters from the baseline to the last sessions. The profile of atherosclerotic risk factors (except for diabetes mellitus was similar between the PCI and CABG subjects. After eight weeks of cardiac rehabilitation, HRR increased averagely about 17 and 21 bpm among the CABG and PCI patients, respectively (p=0.019. Conclusion: The results of the present study were indicative of an increase in HRR over 1 minute in patients irrespective of their initial revascularization modality (i.e. PCI or CABG after the completion of cardiac rehabilitation. Be that as it may, the PCI patients achieved greater improvement in HRR by comparison with the CABG patients.

  6. Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

    Institute of Scientific and Technical Information of China (English)

    Renzo Zanettini; Gemma Gatto; Ileana Mori; Maria Beatrice Pozzoni; Stefano Pelenghi; Luigi Martinelli; Silvio Klugmann

    2014-01-01

    Background Evaluation of patient outcomes following transcatheter aortic valve implantation (TAVI) has usually been based on sur-vival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lack-ing. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional as-sessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic ac-tivities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be trans-ferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at dis-charge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days (range:192–738 days), five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients re-ferred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.

  7. The impact of professional status on the effects of and adherence to the outpatient followed by home-based telemonitored cardiac rehabilitation in patients referred by a social insurance institution

    Directory of Open Access Journals (Sweden)

    Dominika Szalewska

    2015-08-01

    Full Text Available Objectives: Legislators and policymakers have expressed strong interest in intervention programs to reduce dependence on social disability benefits. Hybrid: ambulatory followed by home-based cardiac telerehabilitation – hybrid cardiac rehabilitation (HCR seems to be a novel alternative for standard cardiac rehabilitation for patients with cardiovascular diseases (CVD as a form of pension prevention paid by the Social Insurance Institution (SII. The kind of professional status may bias the motivation to return to work after HCR. The aim of our study was to evaluate whether the professional status can affect the effects of HCR. Material and Methods: One hundred fifty-two patients with CVD referred by the SII for a 5-week HCR were qualified for the study. Patients (87.7% males, aged 57.31±5.61 years, were divided into 2 subgroups: W white-collar employees (N = 22 and B blue-collar employees (N = 130. To evaluate functional capacity, an exercise test on a treadmill was used. Results: The number of days of absence in the cardiac rehabilitation program did not differ between the groups (mean ± standard deviation – B: 1.09±3.10 days, W: 1.95±3.64 days. There were significant improvements (p < 0.05 in measured variables after HCR in both (W and B groups (max workload: 8.21±2.88 METs (measured in metabolic equivalents vs. 9.6±2.49 METs, 7.76±2.51 METs vs. 8.73±2.7 METs, resting heart rate (RHR: 77±16.22 bpm vs. 69.94±12.93 bpm, 79.59±14 bpm vs. 75.24±11.87 bpm; double product, i.e., product of heart rate and systolic BP (DP rest 10 815.22±2968.24 vs. 9242.94±1923.08, 10 927.62±2508.47 vs. 9929.7±2304.94. In group B, a decrease in systolic blood pressure (BP syst. – 137.03±17.14 mm Hg vs. 131.82±21.13 mm Hg, heart rate recovery in the 1st minute after the end of peak exercise (HRR1 (99.38±19.25 vs. 93.9±19.48 and New York Heart Association (NYHA class (1.22±0.53 vs. 1.11±0.36 was observed. In group W, a decrease in diastolic

  8. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Carré, François; Heuschmann, Peter; hoffmann, Thomas;

    2010-01-01

    , exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise...... of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction...... and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention...

  9. [Participation in cardiac rehabilitation after coronary bypass surgery: good news, bad news].

    Science.gov (United States)

    Henkin, Yaakov

    2012-09-01

    Cardiac rehabilitation programs have the potential to decrease morbidity and mortality and increase quality of life after acute coronary events and coronary bypass surgery (CABG). Unfortunately, the proportion of eligible patients that participate in cardiac rehabilitation remains low, despite coverage of such programs by the Israeli National Health Insurance. A low participation rate is especially prominent in women, elderly, minorities and low socioeconomic classes. In this edition of Harefuah, Gendler et at conducted an interventional study aimed at increasing the participation of patients in cardiac rehabilitation programs after CABG in 5 cardiothoracic wards across Israel. They interviewed 489 patients in the intervention arm and 472 patients in the control arm before surgery and a year later. The intervention included dissemination of information on cardiac rehabilitation to the medical staff and patients. Following the intervention, cardiac rehabilitation increased almost twofold in veteran-Israeli males and females. Although it increased significantly in USSR-born male immigrants, their absolute rate of participation remained low (13.6%). No USSR-born female participated in rehabilitation, either before or after the intervention. The good news is that a simple, inexpensive intervention can increase participation in cardiac rehabilitation after CABG surgery. The bad news is that this potentially lifesaving activity remains unattended by most USSR-born immigrants, and particularly by females. Additional research is required to explore the cultural, social and economic barriers of this phenomenon. PMID:23367745

  10. Participation in Society in Patients With Coronary Artery Disease Before and After Cardiac Rehabilitation

    NARCIS (Netherlands)

    ter Hoeve, Nienke; van Geffen, Myrna E.; Post, Marcel W.; Stam, Henk J.; Sunamura, Madoka; van Domburg, Ron T.; van den Berg-Emons, Rita J.

    2015-01-01

    Objectives: To assess changes in participation in society (frequency, restrictions, satisfaction) during and after cardiac rehabilitation (CR) and to assess associations between participation and heath-related quality of life (HRQOL). Design: Prospective cohort study. Setting: Outpatient CR center.

  11. Heart shaking transitions - A phenomenological-hermeneutic study of patients´ experiences in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.;

    angina pectoris or non-St-elevation myocardial infarction experience their life situation. Methods. Within a phenomenological-hermeneutic frame a qualitative design was chosen. Introductory field observations were made. Focus group interviews and individual interviews were conducted with 11 patients...... enrolled in the cardiac rehabilitation programme. The data underwent interpretation consisting of three phases: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that the patients go through a Heart Shaking Journey in Cardiac Rehabilitation. Three...

  12. Cost and effectiveness assessment of cardiac rehabilitation for dialysis patients following coronary bypass

    OpenAIRE

    Huang, Yijian; Zhang, Rebecca; Culler, Steven; Kutner, Nancy

    2008-01-01

    Dialysis patients have a high risk of cardiovascular disease. In the general population, cardiac rehabilitation is recommended as a standard component of care and is covered by Medicare for patients who have undergone coronary artery bypass grafting (CABG). Previous investigation demonstrated survival benefit of cardiac rehabilitation in dialysis patients. This study investigated its impact on Medicare expenditure and its cost effectiveness. A cohort of 4,324 end-stage renal disease (ESRD) pa...

  13. Effects of Cardiac Rehabilitation Program on Right Ventricular Function after Coronary Artery Bypass Graft Surgery

    OpenAIRE

    Akram Sardari; Seyed Kianoosh Hosseini; Ali Taherian; Arezoo Zoroufian; Mehrdad Sheikhvatan

    2012-01-01

    Background: Cardiac rehabilitation has been recognized as one of the most effective strategies for managing cardiovascular indices as well as controlling the cardiovascular risk profile, in particular after coronary artery bypass graft surgery (CABG). However, the effect of this program on right ventricular function following CABG is unclear. The aim of this study was to evaluate the impact of cardiac rehabilitation on the right ventricular (RV) function in a cohort of patients who underwent ...

  14. The Effect of a Self Exercise Program in Cardiac Rehabilitation for Patients with Coronary Artery Disease

    OpenAIRE

    Kim, Chul; Youn, Jo Eun; Choi, Hee Eun

    2011-01-01

    Objective To investigate the effect of self exercise in cardiac rehabilitation on cardiopulmonary exercise capacity for selected patients with coronary artery disease. Method The subjects of this study were patients who received percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery and who participated in a cardiac rehabilitation program. The supervised exercise group participated in 6-8 weeks of aerobic exercise training with telemetry ECG monitoring in hosp...

  15. Cardiac rehabilitation for patients after coronary artery bypass graft surgery Nursing Interventions

    OpenAIRE

    Tsaloglidou A.; Lavdaniti M.; Ioannidis T.

    2010-01-01

    Purpose: To describe the way by which the rehabilitation of the patients that have undergone cardiac surgery is performed, to present the content of the cardiac rehabilitation programs and to determine the nursing role in the whole process. Methodology: Literature review of the relevant articles in the databases pubmed and scopus. Results: The patients with coronary heart disease usually face a lot of problems in their everyday life. Coronary artery bypass graft surgery (CABG) is commonly per...

  16. Cardiac rehabilitation patient's perspectives on the recovery following heart valve surgery: a narrative analysis

    DEFF Research Database (Denmark)

    Hansen, Tina Birgitte; Zwisler, Ann Dorthe Olsen; Berg, Selina Kikkenborg;

    2016-01-01

    AIMS: To explore the structure and content of narratives about the recovery process among patients undergoing heart valve surgery participating in cardiac rehabilitation. BACKGROUND: Several studies with short-term follow-up have shown that recovering from cardiac surgery can be challenging, but ...... benefit from more extensive medical follow-up immediately after discharge, individual psychological assessment and individualized, realistic information about the recovery trajectory.......AIMS: To explore the structure and content of narratives about the recovery process among patients undergoing heart valve surgery participating in cardiac rehabilitation. BACKGROUND: Several studies with short-term follow-up have shown that recovering from cardiac surgery can be challenging......, but evidence on the long-term recovery process is very limited, especially following heart valve surgery. Furthermore, few studies have explored the recovery process among cardiac rehabilitation participants. DESIGN: A qualitative study with serial interviews analysed using narrative methods. METHODS: We...

  17. Experience of Spiritual Care in Cardiac Rehabilitation: An Interpretative Phenomenological Analysis.

    Science.gov (United States)

    Hosseini, Mohammadali; Davidson, Patricia M; Khoshknab, Masoud Fallahi; Nasrabadi, Alireza Nikbakht

    2015-06-01

    The aim of the study was to explore the experience of spiritual care among a cardiac rehabilitation team. Spiritual care is an important dimension of providing comprehensive care, and understanding the views of health professionals is pivotal to making recommendations for caring. This study used an interpretive phenomenological approach. Semi-structured interviews were undertaken with 13 cardiac rehabilitation professionals. Seven persons participated in individual interviews and six in focus group discussions. Data were analyzed using Smith and Osborn's interpretative phenomenological analysis method. Study data were categorized into more than 150 initial themes, 12 clustered and four superordinate themes, included: 'Helping patients to obtain a meaningful sense of being', 'Providing religious/spiritual focused care', 'holistic approach to rehabilitation is needed' and 'spirituality as a neglected aspect of rehabilitation'. Participants described that they did not have sufficient training in providing spiritual care. Nurses' awareness of spiritual care meaning among a cardiac rehabilitation team is helping to respond to rehabilitation care in a holistic approach. Helping patients to get a meaningful sense of being is an important part of assisting in recovery and adjustment following an acute cardiac event. Providing clear guidelines and support for providing spiritual care in cardiac rehabilitation is required.

  18. Cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease

    NARCIS (Netherlands)

    S. Spronk (Sandra); J.L.H.R. Bosch (Ruud); C. Ryjewski (Connie); J. Rosenblum (Judy); G.C. Kaandorp (Guido); J.V. White (John); M.G.M. Hunink (Myriam)

    2008-01-01

    textabstractObjective: Peripheral arterial disease (PAD) often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease (

  19. Evolving Role of Exercise Testing in Contemporary Cardiac Rehabilitation.

    Science.gov (United States)

    Reeves, Gordon R; Gupta, Shuchita; Forman, Daniel E

    2016-01-01

    Symptom-limited (maximal) exercise testing before cardiac rehabilitation (CR) was once an unambiguous standard of care. In particular, it served as an important screen for residual ischemia and instability before initiating a progressive exercise training regimen. However, improved revascularization and therapy for coronary heart disease has led many clinicians to downplay this application of exercise testing, especially because such testing is also a potential encumbrance to CR enrollment (delaying ease and efficiency of enrollment after procedures and hospitalizations) and patient burden (eg, added costs, logistic hassle, and anxiety). Nonetheless, exercise testing has enduring value for CR, especially because it reveals dynamic physiological responses as well as ischemia, arrhythmias, and symptoms pertinent to exercise prescription and training and to overall stability and prognosis. Moreover, as indications for CR have expanded, the value of exercise testing and functional assessment is more relevant than ever in the growing population of eligible patients, including those with heart failure, valvular heart disease, and posttransplantation, especially as current patients also tend to be more clinically complex, with advanced ages, multimorbidity, frailty, and obesity. This review focuses on the appropriate use of exercise testing in the CR setting. Graded exercise tests, cardiopulmonary exercise tests, submaximal walking tests, and other functional assessments (strength, frailty) for CR are discussed. PMID:27120040

  20. Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Pedersen, Preben Ulrich; Zwisler, Ann-Dorthe;

    2015-01-01

    Aims:The aim of this randomised clinical trial was to assess a comprehensive cardiac rehabilitation intervention including exercise training and psycho-education vs 'treatment as usual' in patients treated with an implantable cardioverter defibrillator (ICD).Methods:In this study 196 patients...... with first time ICD implantation (mean age 57.2 (standard deviation (SD)=13.2); 79% men) were randomised (1:1) to comprehensive cardiac rehabilitation vs 'treatment as usual'. Altogether 144 participants completed the 12 month follow-up. The intervention consisted of twelve weeks of exercise training and one...... rehabilitation significantly increased VO2 uptake after exercise training to 23.0 (95% confidence interval (CI) 20.9-22.7) vs 20.8 (95% CI 18.9-22.7) ml/min/kg in the control group (p=0.004 (multiplicity p=0.015)). Comprehensive cardiac rehabilitation significantly increased general health; at three months (mean...

  1. Effect of a cardiac rehabilitation program on exercise oscillatory ventilation in Japanese patients with heart failure.

    Science.gov (United States)

    Yamauchi, Fumitake; Adachi, Hitoshi; Tomono, Jun-Ichi; Toyoda, Shigeru; Iwamatsu, Koichi; Sakuma, Masashi; Nakajima, Toshiaki; Oshima, Shigeru; Inoue, Teruo

    2016-10-01

    Although exercise oscillatory ventilation has emerged as a potent independent risk factor for adverse prognosis in heart failure, it is not well known whether cardiac rehabilitation can improve oscillatory ventilation. In this study, we investigated the magnitude of oscillations in ventilation before and after cardiac rehabilitation in chronic heart failure patients with exercise oscillatory ventilation. Cardiac rehabilitation (5-month program) was performed in 26 patients with chronic heart failure who showed an oscillatory ventilation pattern during cardiopulmonary exercise testing (CPX). After the 5-month rehabilitation program was completed, the patients again underwent CPX. To determine the magnitude of oscillations in ventilation, the amplitude and cycle length of the oscillations were calculated and compared with several other parameters, including biomarkers that have established prognostic value in heart failure. At baseline before cardiac rehabilitation, both oscillation amplitude (R = 0.625, P rehabilitation decreased oscillation amplitude (P rehabilitation program improves exercise oscillatory ventilation in chronic heart failure patients by reducing the oscillation amplitude. This effect is associated with a reduction of plasma BNP levels, potentially contributing to an improvement of heart failure.

  2. Does Cardiac Rehabilitation After an Acute Cardiac Syndrome Lead to Changes in Physical Activity Habits? Systematic Review

    NARCIS (Netherlands)

    ter Hoeve, Nienke; Huisstede, Bionka M. A.; Stam, Henk J.; van Domburg, Ron T.; Sunamura, Madoka; van den Berg-Emons, Rita J. G.

    2015-01-01

    Background. Optimal physical activity levels have health benefits for patients with acute coronary syndrome (ACS) and are an important goal of cardiac rehabilitation (CR). Purpose. The purpose of this study was to systematically review literature regarding short-term effects (= 6 months after comple

  3. Is Cardiac Rehabilitation Exercise Feasible for People with Mild Cognitive Impairment?

    Science.gov (United States)

    Intzandt, Brittany; Black, Sandra E.; Lanctôt, Krista L.; Herrmann, Nathan; Oh, Paul; Middleton, Laura E.

    2015-01-01

    Background Exercise is a promising strategy to prevent dementia, but no clinically supervised exercise program is widely available to people with mild cognitive impairment (MCI). The objective was to survey health professionals to assess the feasibility of using cardiac rehabilitation exercise programs for MCI populations. Methods We distributed surveys to: 1) health professionals working in cardiac rehabilitation exercise programs (36/72 responded); and 2) physicians who treat MCI (22/32 responded). Questions addressed clinician and clinic characteristics and feasibility of referring and accommodating people with MCI. Results Most cardiac rehabilitation exercise programs currently treat people with MCI (61.1%). Nearly all were willing and able to accept people with MCI and comorbid vascular risk (91.7%), though only a minority could accept MCI without vascular risk (16.7%). Although most physicians recommend exercise to people with MCI (63.6%), few referred patients with MCI to programs or people to guide exercise (27.3%). However, all physicians (100%) would refer patients with MCI to a cardiac rehabilitation exercise program. Conclusions Our study supports cardiac rehabilitation exercise programs as a feasible model of exercise for patients with MCI with vascular risk. Patients with and without vascular risk could likely be accommodated if program mandates were expanded. PMID:26180562

  4. Learning and coping strategies versus standard education in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Tayyari Dehbarez, Nasrin; Lynggaard, Vibeke; May, Ole;

    2015-01-01

    disease and heart failure. Methods The study was conducted alongside a randomised controlled trial with 825 patients who were allocated to LC or standard rehabilitation and followed for 5 months. The LC approach was identical to the standard approach in terms of physical training and education......, but with the addition of individual interviews and weekly team evaluations by professionals. A societal cost perspective including the cost of intervention, health care, informal time and productivity loss was applied. Cost was based on a micro-costing approach for the intervention and national administrative...... registries for other cost categories. Quality adjusted life years (QALY) were based on SF-6D measurements at baseline, after intervention and follow-up using British preference weights. Multiple imputation was used to handle non-response on the SF-6D. Conventional cost effectiveness methodology was employed...

  5. The Impacts of Cardiac Rehabilitation Program on Echocardiographic Parameters in Coronary Artery Disease Patients with Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2013-01-01

    Full Text Available Introduction. The accurate impact of exercise on coronary artery disease (CAD patients with left ventricular dysfunction is still debatable. We studied the effects of cardiac rehabilitation (CR on echocardiography parameters in CAD patients with ventricular dysfunction. Methods. Patients with CAD who had ventricular dysfunction were included into an exercise-based rehabilitation program and received rehabilitation for eight weeks. All subjects underwent echocardiography before and at the end of the rehabilitation program. The echocardiography parameters, including left ventricular ejection fraction (LVEF, LV end-diastolic (LVEDD and end-systolic diameters (LVESD, and peak exercise capacity measured in metabolic equivalents (METs, were assessed. Results. Seventy patients (mean age = 57.5 ± 10.2 years, 77.1% males were included into the study. At the end of rehabilitation period, the LVEF increased from 45.14 ± 5.77% to 50.44 ± 8.70% (P<0.001, and the peak exercise capacity increased from 8.00 ± 2.56 to 10.08 ± 3.00 METs (P<0.001. There was no significant change in LVEDD (54.63 ± 12.96 to 53.86 ± 8.95 mm, P=0.529 or in LVESD (38.91 ± 10.83 to 38.09 ± 9.04 mm, P=0.378 after rehabilitation. Conclusion. Exercise training in postmyocardial infarction patients with ventricular dysfunction could have beneficial effects on cardiac function without adversely affecting LV remodeling or causing serious cardiac complications.

  6. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    OpenAIRE

    Akram Sardari; Mostafa Nejatian; Mehrdad Sheikhvatan

    2010-01-01

    Background: Systolic blood pressure recovery (rSBP) is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD). This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR) in a population-based sample of patients undergoing coronary artery bypass grafting (CABG).Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent sta...

  7. Assessing Physical Activity as a Core Component in Cardiac Rehabilitation: A POSITION STATEMENT OF THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

    Science.gov (United States)

    Kaminsky, Leonard A; Brubaker, Peter H; Guazzi, Marco; Lavie, Carl J; Montoye, Alexander H K; Sanderson, Bonnie K; Savage, Patrick D

    2016-01-01

    Physical inactivity is a well-established major risk factor for cardiovascular disease. As such, physical activity counseling is 1 of the 10 core components of cardiac rehabilitation/secondary prevention programs recommended by the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). In addition, the ability to perform a physical activity assessment and report outcomes is 1 of the 10 core competencies of cardiac rehabilitation/secondary prevention professionals published by the AACVPR. Unfortunately, standardized procedures for physical activity assessment of cardiac rehabilitation patients have not been developed and published. Thus, the objective of this AACVPR statement is to provide an overview of physical activity assessment concepts and procedures and to provide a recommended approach for performing a standardized assessment of physical activity in all comprehensive cardiac rehabilitation programs following the core components recommendations. PMID:27307067

  8. Type D patients report poorer health status prior to and after cardiac rehabilitation compared to non-type D patients

    DEFF Research Database (Denmark)

    Pelle, Aline J; Erdman, Ruud A M; van Domburg, Ron T;

    2008-01-01

    Type D personality is an emerging risk factor in coronary artery disease (CAD). Cardiac rehabilitation (CR) improves outcomes, but little is known about the effects of CR on Type D patients.......Type D personality is an emerging risk factor in coronary artery disease (CAD). Cardiac rehabilitation (CR) improves outcomes, but little is known about the effects of CR on Type D patients....

  9. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    OpenAIRE

    Claudiu Avram; Adina Avram; L.aura Crăciun; Stela Iurciuc; Lucian Hoble; Alexandra Rusu; Bogdan Almăjan-Guţă; Silvia Mancaş

    2010-01-01

    The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Grou...

  10. Enhancing Behavioral Change with Motivational Interviewing: a case study in a Cardiac Rehabilitation Unit

    OpenAIRE

    Giada ePietrabissa; Martina eCeccarini; Maria eBorrello; Gian Mauro eManzoni; Annamaria eTiton; Ferruccio eNibbio; Mariella eMontano; Gianandrea eBertone; Luca eGondoni; Gianluca eCastelnuovo

    2015-01-01

    Background: psychological interventions in Cardiac Rehabilitation (CR) programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients’ adherence to therapy. To this aim, Motivational Interviewing (MI) has shown promising results in improving motivation to change and individuals’ confidence in their ability to do so. Objective: the purpose of this article is to integrate theory with practice by de...

  11. Enhancing behavioral change with motivational interviewing: a case study in a Cardiac Rehabilitation Unit

    OpenAIRE

    Pietrabissa, Giada; Ceccarini, Martina; Borrello, Maria; Manzoni, Gian Mauro; Titon, Annamaria; Nibbio, Ferruccio; Montano, Mariella; Bertone, Gianandrea; Gondoni, Luca; Castelnuovo, Gianluca

    2015-01-01

    Background: Psychological interventions in cardiac rehabilitation programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients’ adherence to therapy. To this aim, motivational interviewing (MI) has shown promising results in improving motivation to change and individuals’ confidence in their ability to do so. Objective: The purpose of this article is to integrate theory with practice by desc...

  12. Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Blake Catherine

    2009-02-01

    Full Text Available Abstract Background Coronary Heart Disease and Cerebrovascular Disease share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity and diabetes mellitus. Lifestyle interventions and pharmacological therapy are recognised as the cornerstones of secondary prevention. Cochrane review has proven the benefits of programmes incorporating exercise and lifestyle counselling in the cardiac disease population. A Cochrane review highlighted as priority, the need to establish feasibility and efficacy of exercise based interventions for Cerebrovascular Disease. Methods A single blind randomised controlled trial is proposed to examine a primary care cardiac rehabilitation programme for adults post transient ischemic attack (TIA and stroke in effecting a positive change in the primary outcome measures of cardiac risk scores derived from Blood Pressure, lipid profile, smoking and diabetic status and lifestyle factors of habitual smoking, exercise and healthy eating participation. Secondary outcomes of interest include health related quality of life as measured by the Hospital Anxiety and Depression Scale, the Stroke Specific Quality of Life scale and WONCA COOP Functional Health Status charts and cardiovascular fitness as measured by a sub-maximal fitness test. A total of 144 patients, over 18 years of age with confirmed diagnosis of ischaemic stroke or TIA, will be recruited from Dublin community stroke services and two tertiary T.I.A clinics. Exclusion criteria will include oxygen dependence, unstable cardiac conditions, uncontrolled diabetes, major medical conditions, claudication, febrile illness, pregnancy or cognitive impairment. Participants will be block-statified, randomly allocated to one of two groups using a pre-prepared computer generated randomisation schedule. Both groups will receive a two hour education class on risk reduction post stroke. The

  13. Cardiac rehabilitation for patients after coronary artery bypass graft surgery Nursing Interventions

    Directory of Open Access Journals (Sweden)

    Tsaloglidou A.

    2010-07-01

    Full Text Available Purpose: To describe the way by which the rehabilitation of the patients that have undergone cardiac surgery is performed, to present the content of the cardiac rehabilitation programs and to determine the nursing role in the whole process. Methodology: Literature review of the relevant articles in the databases pubmed and scopus. Results: The patients with coronary heart disease usually face a lot of problems in their everyday life. Coronary artery bypass graft surgery (CABG is commonly performed to improve the quality of patients’ life and to extend their survival. Ιn order for the positive results of the surgery to be maintained and the quality of patients’ life to be improved, it is essential that the patients participate after the surgery in programs of cardiac rehabilitation. The cardiac rehabilitation programs are usually consisted of four phases and they involve a variety of interventions including exercise training, suitable drug therapy, psychological input, risk factor education, as well as teaching for the rules of a healthy diet. Conclusions: Nurses and other health care professionals have to inform the patients of the existing rehabilitation programs and instruct to participate in them as well as to return in the daily life activities.

  14. Analysis of steps adapted protocol in cardiac rehabilitation in the hospital phase

    Directory of Open Access Journals (Sweden)

    Eliane Roseli Winkelmann

    2015-02-01

    Full Text Available Objective: To analyze a cardiac rehabilitation adapted protocol in physical therapy during the postoperative hospital phase of cardiac surgery in a service of high complexity, in aspects regarded to complications and mortality prevalence and hospitalization days. Methods: This is an observational cross-sectional, retrospective and analytical study performed by investigating 99 patients who underwent cardiac surgery for coronary artery bypass graft, heart valve replacement or a combination of both. Step program adapted for rehabilitation after cardiac surgery was analyzed under the command of the physiotherapy professional team. Results: In average, a patient stays for two days in the Intensive Care Unit and three to four days in the hospital room, totalizing six days of hospitalization. Fatalities occurred in a higher percentage during hospitalization (5.1% and up to two years period (8.6% when compared to 30 days after hospital discharge (1.1%. Among the postoperative complications, the hemodynamic (63.4% and respiratory (42.6% were the most prevalent. 36-42% of complications occurred between the immediate postoperative period and the second postoperative day. The hospital discharge started from the fifth postoperative day. We can observe that in each following day, the patients are evolving in achieving the Steps, where Step 3 was the most used during the rehabilitation phase I. Conclusion: This evolution program by steps can to guide the physical rehabilitation at the hospital in patients after cardiac surgery.

  15. Cardiac rehabilitation: impact of graded exercise in the recovery period following myocardial infarction

    Directory of Open Access Journals (Sweden)

    White S

    2013-07-01

    Full Text Available Simon WhiteSchool of Pharmacy, Keele University, Staffordshire, UKAbstract: This paper reviews the impact of graded exercise undertaken as part of a cardiac rehabilitation (CR program in the recovery period following a myocardial infarction, focusing on how CR may be best provided and the evidence-base relating to exercise-based CR. Essential components of CR are considered here to include education about healthy behavior, lifestyle modification where necessary (especially in relation to smoking, diet, and physical exercise, medical risk factor management, use of cardioprotective medicines and implantable devices, and psychosocial health management. It is argued that the totality of the evidence continues to demonstrate benefits of exercise-based CR in terms of mortality and morbidity, despite the debate about the magnitude of that benefit. However, given the wide variance in the quality and nature of CR service provision, there is no guarantee that patients eligible for CR will benefit fully. In line with national and international standards, CR should be tailored to the patient's individual needs, but structured exercise is recommended for most patients. Exercise sessions, whether based in hospital, in the community, or at home, should be designed to vary the frequency, intensity, duration, and type of exercise. They must include an initial warm-up period, before a conditioning period, and finish with a cool-down period. Patients should be taught to self-monitor so that they can exercise safely on their own. In designing interventions to support patients to change health behavior, health professionals should recognize that patients may only make lifestyle modifications to aspects of lifestyle perceived as causes of their cardiovascular disease and so, for example, may not do the recommended amount of exercise if they do not perceive lack of exercise to be a cause of their cardiovascular disease.Keywords: cardiovascular disease, public health

  16. Experience of cardiac rehabilitation after coronary artery surgery: effects on health and risk factors

    OpenAIRE

    Lindsay, G.; Hanlon, W.P; Smith, L.N.; Belcher, P.R.

    2003-01-01

    Objective:Cardiac rehabilitation (CR) programs are provided to support the recovery process following acute myocardial infarction and coronary artery bypass grafting (CABG). Attendance varies. We related attendance following CABG to severity of cardiac symptoms, general health status (Short Form-36) and prevalence of modifiable coronary artery disease (CAD) risk factors. METHODS: 209 patients due to undergo CABG were recruited and assessed preoperatively as well as at a mean of 16.4 months po...

  17. Testing a Longitudinal Integrated Self-Efficacy and Self-Determination Theory Model for Physical Activity Post-Cardiac Rehabilitation.

    Science.gov (United States)

    Sweet, Shane N; Fortier, Michelle S; Strachan, Shaelyn M; Blanchard, Chris M; Boulay, Pierre

    2014-01-13

    Self-determination theory and self-efficacy theory are prominent theories in the physical activity literature, and studies have begun integrating their concepts. Sweet, Fortier, Strachan and Blanchard (2012) have integrated these two theories in a cross-sectional study. Therefore, this study sought to test a longitudinal integrated model to predict physical activity at the end of a 4-month cardiac rehabilitation program based on theory, research and Sweet et al.'s cross-sectional model. Participants from two cardiac rehabilitation programs (N=109) answered validated self-report questionnaires at baseline, two and four months. Data were analyzed using Amos to assess the path analysis and model fit. Prior to integration, perceived competence and self-efficacy were combined, and labeled as confidence. After controlling for 2-month physical activity and cardiac rehabilitation site, no motivational variables significantly predicted residual change in 4-month physical activity. Although confidence at two months did not predict residual change in 4-month physical activity, it had a strong positive relationship with 2-month physical activity (β=0.30, Pself-determination and self-efficacy theory were still partially supported. Because the model had good fit, this study demonstrated that theoretical integration is feasible.

  18. Testing a longitudinal integrated self-efficacy and self-determination theory model for physical activity post-cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Shane N. Sweet

    2014-01-01

    Full Text Available Self-determination theory and self-efficacy theory are prominent theories in the physical activity literature, and studies have begun integrating their concepts. Sweet, Fortier, Strachan and Blanchard (2012 have integrated these two theories in a cross-sectional study. Therefore, this study sought to test a longitudinal integrated model to predict physical activity at the end of a 4-month cardiac rehabilitation program based on theory, research and Sweet et al.’s cross-sectional model. Participants from two cardiac rehabilitation programs (N=109 answered validated self-report questionnaires at baseline, two and four months. Data were analyzed using Amos to assess the path analysis and model fit. Prior to integration, perceived competence and self-efficacy were combined, and labeled as confidence. After controlling for 2-month physical activity and cardiac rehabilitation site, no motivational variables significantly predicted residual change in 4-month physical activity. Although confidence at two months did not predict residual change in 4-month physical activity, it had a strong positive relationship with 2-month physical activity (β=0.30, P<0.001. The overall model retained good fit indices. In conclusion, results diverged from theoretical predictions of physical activity, but self-determination and self-efficacy theory were still partially supported. Because the model had good fit, this study demonstrated that theoretical integration is feasible.

  19. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Corrà, Ugo; Piepoli, Massimo F; Carré, François;

    2010-01-01

    , exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise......Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption...

  20. Effects of home-based exercise rehabilitation on quality of life after coronary artery bypass graft and PCI early post-discharge

    OpenAIRE

    Shadi Moafi; Vahid Zolaktaf; Katayun Rabiei; Mohamad Hashemi; Hamed Tarmah

    2011-01-01

    Background: The barriers to participation in cardiac rehabilitation programs are individual and economic problems and limited availability and access of rehabilitation services. Because of the important role of rehabilitation, home based exercise rehabilitation is a new approach to participate in such programs. The purpose of this study was to evaluate the effects of home-based rehabilitation on quality of life (QoL) in patients with coronary artery disease after coronary artery bypass graft ...

  1. Effect of Long-Term Physical Activity Practice after Cardiac Rehabilitation on Some Risk Factors

    Science.gov (United States)

    Freyssin, Celine, Jr.; Blanc, Philippe; Verkindt, Chantal; Maunier, Sebastien; Prieur, Fabrice

    2011-01-01

    The objective of this study was to evaluate the effects of long-term physical activity practice after a cardiac rehabilitation program on weight, physical capacity and arterial compliance. The Dijon Physical Activity Score was used to identify two groups: sedentary and active. Weight, distance at the 6-min walk test and the small artery elasticity…

  2. Older Adults in Cardiac Rehabilitation: A New Strategy for Enhancing Physical Function.

    Science.gov (United States)

    Rejeski, W. Jack; Foy, Capri Gabrielle; Brawley, Lawrence R.; Brubaker, Peter H.; Focht, Brian C.; Norris, James L., III; Smith, Marci L.

    2002-01-01

    Contrasted the effect of a group-mediated cognitive- behavioral intervention (GMCB) versus traditional cardiac rehabilitation (CRP) upon changes in objective and self-reported physical function of older adults after 3 months of exercise therapy. Both groups improved significantly. Adults with lower function at the outset of the intervention…

  3. Change in self-efficacy during cardiac rehabilitation and the role of perceived overprotectiveness

    NARCIS (Netherlands)

    Berkhuysen, MA; Nieuwland, W; Buunk, BP; Sanderman, R; Rispens, P

    1999-01-01

    Self-efficacy (SE) is an important outcome following cardiac rehabilitation (CR) when claiming benefits to patients and improving existing programs. This study evaluated change in SE during 6 weeks of multidisciplinary CR with either a high or low-frequency exercise training program. The role of ove

  4. The Walk to Save: Benefits of Inpatient Cardiac Rehabilitation.

    Science.gov (United States)

    Rion, Joann H; Kautz, Donald D

    2016-01-01

    Hospital immobilization after a cardiac event can cause complications. The pathophysiology of complications, research concerning benefits of early ambulation, and recommendations from the American College of Sports Medicine are discussed. PMID:27522842

  5. Using a Combined Platform of Swarm Intelligence Algorithms and GIS to Provide Land Suitability Maps for Locating Cardiac Rehabilitation Defibrillators

    OpenAIRE

    KAFFASH-CHARANDABI, Neda; SADEGHI-NIARAKI, Abolghasem; Park, Dong-Kyun

    2015-01-01

    Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identi-fied and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and...

  6. [ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): temporary report of the first prospective, longitudinal registry of the cardiac rehabilitation network GICR/IACPR].

    Science.gov (United States)

    Griffo, Raffaele; Temporelli, Pier Luigi; Fattirolli, Francesco; Ambrosetti, Marco; Tramarin, Roberto; Vestri, Anna Rita; De Feo, Stefania; Tavazzi, Luigi

    2012-06-01

    The Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS) was a multicenter, prospective, longitudinal survey carried out by the Italian Association on Cardiovascular Prevention and Rehabilitation (GICR/IACPR) in patients on completion of a CR program after coronary artery by pass grafting (CABG) and percutaneous coronary intervention (PCI). The aim was to evaluate in the short and medium-term: i) the cardioprotective drug prescription, modification and adherence; ii) the achievement and maintenance of recommended lifestyle targets and risk factor control and their association with cardiovascular events; iii) the predictors of non-adherence to therapy and lifestyle recommendations. The ICAROS results offers a portrait of the "real world" of clinical practice concerning patients after CABG and PCI, and stresses the need to improve secondary prevention care after the index event: many patients after revascularization leave the acute wards without an optimal prescription of preventive medication but the prescription of cardiopreventive drugs and risk factors control is excellent after completion of a CR program. Following CR, the maintenance of evidence-based drugs and lifestyle adherence at one year is fairly good as far as the target goals of secondary prevention are concerned, but to investigate the influence of CR on long-term outcome longer-term studies are required. Last, but not least, ICAROS shows that some characteristics (PCI as index event, living alone, poor eating habits or smoking in young age, and old age, in particular with comorbidities) may identify patients with poor behavioral modification in the medium-term follow-up and in these patients further support may be warranted. In conclusion, participation in CR results in excellent treatment after revascularization, as well as a good lifestyle and medication adherence at 1 year and provides further confirmation of the the benefit of secondary

  7. Changes in the Cardiopulmonary Response to Exercise after Cardiac Transplantation in Patients Enrolled in an Early Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Lizanne M Bussières

    1997-01-01

    Full Text Available OBJECTIVE: To evaluate the changes in the cardiopulmonary response to exercise in the first year after cardiac transplantation in patients enrolled in a rehabilitation program in the first three months post-transplantation.

  8. Participation in society in patients with coronary artery disease before and after cardiac rehabilitation frequency, experienced restrictions and satisfaction

    NARCIS (Netherlands)

    ter Hoeve, Nienke; Van Geffen, M.E.; Post, MWM; Stam, H.J.; Sunamura, M.; van Domburg, R.T.; Van Den Berg-Emons, Rita

    2015-01-01

    Objectives: To assess changes in participation in society (frequency, restrictions, satisfaction) during and after cardiac rehabilitation (CR) and to assess associations between participation and heath-related quality of life (HRQOL). Design: Prospective cohort study. Setting: Outpatient CR center.

  9. Are patients undergoing treatment of hyperlipidaemia with statins the best candidates for early cardiac rehabilitation?

    OpenAIRE

    Celiński, Rafał; Grzywa-Celińska, Anna; Myśliński, Wojciech; Dybała, Andrzej; Mosiewicz, Jerzy

    2011-01-01

    The role of statins in the primary and secondary prevention of cardiovascular events is well known. An important adverse event associated with statin treatment is myopathy; intensive physical effort in patients treated with statins increases the risk of muscle injury/myopathy. In this article we discuss the benefits and risks associated with statin treatment in patients undergoing cardiac rehabilitation after acute coronary syndromes and/or coronary revascularization procedures. In our opinio...

  10. Reduction of cardiovascular event rate: different effects of cardiac rehabilitation in CABG and PCI patients

    OpenAIRE

    Hansen, D.; DENDALE, PAUL; Leenders, M; Berger, J.; Raskin, A.; Vaes, J.; Meeusen, R.

    2009-01-01

    Objective - In coronary artery disease, the implementation of a cardiac rehabilitation (CR) programme favourably affects cardiovascular prognosis. However, it remains uncertain whether patients benefit to a similar extent from CR after coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI). In this study, we have assessed whether CR is equally effective for suppressing the two-year cardiovascular event incidence after CABG or PCI. Methods and results - 194 PCI...

  11. Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine

    OpenAIRE

    Monica Lamberti; Gennaro Ratti; Donato Gerardi; Cristina Capogrosso; Gianfranco Ricciardi; Cosimo Fulgione; Salvatore Latte; Paolo Tammaro; Gregorio Covino; Albert Nienhaus; Elpidio Maria Grazillo; Mario Mallardo; Paolo Capogrosso

    2016-01-01

    Objectives: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). Material and Methods: We evaluated 204 patients with recent ACS. They were divided into 4 g...

  12. Analysis of agreement between cardiac risk stratification protocols applied to participants of a center for cardiac rehabilitation

    Science.gov (United States)

    Santos, Ana A. S.; Silva, Anne K. F.; Vanderlei, Franciele M.; Christofaro, Diego G. D.; Gonçalves, Aline F. L.; Vanderlei, Luiz C. M.

    2016-01-01

    ABSTRACT Background Cardiac risk stratification is related to the risk of the occurrence of events induced by exercise. Despite the existence of several protocols to calculate risk stratification, studies indicating that there is similarity between these protocols are still unknown. Objective To evaluate the agreement between the existing protocols on cardiac risk rating in cardiac patients. Method The records of 50 patients from a cardiac rehabilitation program were analyzed, from which the following information was extracted: age, sex, weight, height, clinical diagnosis, medical history, risk factors, associated diseases, and the results from the most recent laboratory and complementary tests performed. This information was used for risk stratification of the patients in the protocols of the American College of Sports Medicine, the Brazilian Society of Cardiology, the American Heart Association, the protocol designed by Frederic J. Pashkow, the American Association of Cardiovascular and Pulmonary Rehabilitation, the Société Française de Cardiologie, and the Sociedad Española de Cardiología. Descriptive statistics were used to characterize the sample and the analysis of agreement between the protocols was calculated using the Kappa coefficient. Differences were considered with a significance level of 5%. Results Of the 21 analyses of agreement, 12 were considered significant between the protocols used for risk classification, with nine classified as moderate and three as low. No agreements were classified as excellent. Different proportions were observed in each risk category, with significant differences between the protocols for all risk categories. Conclusion The agreements between the protocols were considered low and moderate and the risk proportions differed between protocols. PMID:27556385

  13. Clinical effects and implications of cardiac rehabilitation for implantable cardioverter defibrillator patients

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Moons, Philip; Christensen, Anne Vingaard;

    2015-01-01

    BACKGROUND:: The Copenhagen Outpatient ProgrammE-Implantable Cardioverter Defibrillator trial was a randomized clinical trial that compared a complex rehabilitation intervention including exercise training and psychoeducational interventions with usual care. A significant difference between...... rehabilitation and usual care was found in physical capacity and general and mental health. However, the clinical effect sizes of these findings were not investigated, and the findings from the quantitative and qualitative analyses were not triangulated to address the issue of whether the qualitative results......-time implantable cardioverter defibrillator implantation were randomized (1:1) to comprehensive cardiac rehabilitation (12 weeks of exercise training and 1 year of psychoeducational follow-up) versus treatment as usual. Two primary outcomes, perceived health (Short Form-36) and peak oxygen uptake, were used. Cohen...

  14. How Important Are Social Support, Expectations and Coping Patterns during Cardiac Rehabilitation

    Directory of Open Access Journals (Sweden)

    Maria J. C. Blikman

    2014-01-01

    Full Text Available Purpose. To investigate the predictive role of relevant social and psychosocial determinants on emotional distress among patients after cardiac rehabilitation. Methods. A longitudinal prospective study examined short-term (6 months and long-term (2 years impact of predictors on anxiety and depression complaints in 183 patients with 6-months follow-up data attending a four-week rehabilitation stay at the Krokeide Centre in Bergen, Norway. The patients mainly suffered from coronary heart disease. Emotional distress, coping, social support, socioeconomic status, and negative expectations were measured by means of internationally validated questionnaires. A composite score of anxiety and depression complaints was used as the outcome measure in the study. Results. This study revealed that task-oriented coping improved emotional status in long-term followup, and negative expectations were associated with emotional distress in short-term followup. A higher socioeconomic status and more social support predicted improved emotional status in short- as well as long-term followup. Conclusions. Fewer negative expectations and functional coping along with social support are important factors for the prevention of emotional distress after cardiac disease. Such elements should be addressed and encouraged in patients during cardiac rehabilitation.

  15. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  16. Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Jamnik Veronica

    2011-09-01

    Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

  17. The Effects of Exercise Cardiac Rehabilitation on Anxiety, Depression and Quality of Life in Coronary Artery Bypass Grafting Patients

    OpenAIRE

    A. Yalfani; F. Nazem; R. Safiarian; M. Jargeh

    2012-01-01

    Introduction & Objective: Despite advancement in technology such as coronary artery bypasses grafting (CABG) prevalence of anxiety and depression remain high after cardiac events, which have been found to influence recovery process, recurrent cardiac events and patients’ quality of life. Cardiac Rehabilitation (CR) as part of secondary prevention aims to improve patients’ physical, psychological and quality of life (QoL) status. As there is lack of study in this area in Iran, the present stud...

  18. Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Knapik Grant

    2003-04-01

    Full Text Available Abstract Background Currently, there are a lack of investigations that have examined the effect of participating in a comprehensive cardiac rehabilitation program on quality of life and physiological measures in women of different ages. The purpose of this investigation was to examine the effect of participating in a comprehensive cardiac rehabilitation program on quality of life, exercise tolerance, blood pressure and lipids in women between 33 and 82 years of age. Methods The 126 women participated in a 14-week cardiac rehabilitation program that consisted of 7 weeks of formal supervised exercise training and 7 weeks of unsupervised exercise and lifestyle modification. Physiologic and quality of life outcome measures obtained at the outset and after 14 weeks included: 1 exercise treadmill time; 2 resting and peak systolic and diastolic blood pressure; 3 total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol and Triglycerides; 4 Cardiac Quality of Life Index questionnaire. Results Significant improvements were found in the following quality of life measures after participating in the cardiac rehabilitation program: physical well being, psychosocial, worry, nutrition and symptoms. No significant differences were seen for any QOL variable between the different age groups. Significant improvements were seen in exercise tolerance (+21% and high density lipoprotein (+5%. Conclusion Cardiac rehabilitation may play an important role in improving quality of life, exercise tolerance and high density lipoprotein cholesterol levels in younger and older women with underlying cardiovascular disease.

  19. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery in Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Leila Mahdavi Anari

    2015-12-01

    Full Text Available Background: It has been suggested that the autonomic system function and the metabolic syndrome can significantly affect patients' survival. The aim of the current study was to investigate the impact of the cardiac rehabilitation program on the autonomic system balance in patients with coronary artery disease.Methods: Patients with a previous diagnosis of coronary artery disease who were referred to the Cardiovascular Rehabilitation Center of Afshar Hospital (Yazd, Iran between March and November 2011 were enrolled. All the patients participated in rehabilitation sessions 3 times a week for 12 weeks. Heart rate recovery (HRR was measured as an indicator of the autonomic system balance. In order to calculate HRR, the maximum heart rate during the exercise test was recorded. At the end of the exercise test, the patients were asked to sit down without having a cooldown period and their heart rate was recorded again after 1 minute. The difference between these 2 measurements was considered as HRR.Results: A total of 108 patients, including 86 (79.6% men and 22 (20.4% women, completed the rehabilitation course. The mean age of the study participants was 58.25 ± 9.83 years. A statistically significant improvement was observed in HRR (p value = 0.040. Significant declines were also observed in the patients' waist circumference (p value < 0.001 and systolic and diastolic blood pressures (p value = 0.018 and 0.003, respectively. A decreasing trend was observed in the patients' body mass index, but it failed to reach statistical significance (p value = 0.063. No statistically meaningful changes were noted in fasting blood glucose (p value = 0.171, high-density lipoprotein (p value = 0.070, or triglyceride concentrations (p value = 0.149. Conclusion: The cardiac rehabilitation program may help to improve HRR and several components of the metabolic syndrome in patients with coronary heart disease.

  20. Utilization of the internet to deliver cardiac rehabilitation at a distance: a pilot study.

    Science.gov (United States)

    Zutz, Amber; Ignaszewski, Andrew; Bates, Joanna; Lear, Scott A

    2007-06-01

    Less than 25% of eligible patients attend cardiac rehabilitation programs (CRP), with geographical proximity being a predominant barrier. Therefore, we undertook a pilot study to assess the feasibility and safety of using the Internet as a medium for delivery of an interactive "virtual" CRP (vCRP) to patients at a distance. Fifteen patients on the waiting list for a local hospital-based CRP were randomized to either an Internet-based vCRP or observational control. The vCRP consisted of on-line intake forms, one-on-one chat sessions with a nurse, dietitian, and exercise specialist, downloadable exercise heart rate monitoring, education and data monitoring of blood pressure, weight, and glucose. Participants were assessed for exercise capacity, risk factors, and lifestyle behaviors at baseline and at 12 weeks. Those in the vCRP logged onto the Internet-based CRP an average of 4.2 times per week. There were no adverse events in the vCRP participants. The vCRP group significantly improved their HDL-C, triglycerides, total cholesterol:HDL-C ratio, exercise capacity as assessed in metabolic equivalents, weekly physical activity, and exercise specific self-efficacy (p < 0.05). There were no significant improvements in the control group. Improvements in the vCRP group were similar to historical controls in a standard CRP. Feedback from exit interviews of the vCRP participants was unanimously positive. This Internet-based CRP resulted in clinically significant improvements in risk factors and exercise capacity similar to that of a standard CRP. The high user acceptance indicated that this program may have the potential to effectively manage patients who do not have access to traditional hospital-based CRP.

  1. Tai Chi Chuan for Cardiac Rehabilitation in Patients with Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Rosane Maria Nery

    2014-07-01

    Full Text Available Background: Several studies have shown that Tai Chi Chuan can improve cardiac function in patients with heart disease. Objective: To conduct a systematic review of the literature to assess the effects of Tai Chi Chuan on cardiac rehabilitation for patients with coronary artery disease. Methods: We performed a search for studies published in English, Portuguese and Spanish in the following databases: MEDLINE, EMBASE, LILACS and Cochrane Register of Controlled Trials. Data were extracted in a standardized manner by three independent investigators, who were responsible for assessing the methodological quality of the manuscripts. Results: The initial search found 201 studies that, after review of titles and abstracts, resulted in a selection of 12 manuscripts. They were fully analyzed and of these, nine were excluded. As a final result, three randomized controlled trials remained. The studies analyzed in this systematic review included patients with a confirmed diagnosis of coronary artery disease, all were clinically stable and able to exercise. The three experiments had a control group that practiced structured exercise training or received counseling for exercise. Follow-up ranged from 2 to 12 months. Conclusion: Preliminary evidence suggests that Tai Chi Chuan can be an unconventional form of cardiac rehabilitation, being an adjunctive therapy in the treatment of patients with stable coronary artery disease. However, the methodological quality of the included articles and the small sample sizes clearly indicate that new randomized controlled trials are needed in this regard.

  2. Are there meaningful longitudinal changes in health related quality of life--SF36, in cardiac rehabilitation patients?

    LENUS (Irish Health Repository)

    McKee, Gabrielle

    2012-02-01

    BACKGROUND: This study aimed to observe changes in quality of life and minimal clinical important differences of quality of life over time in cardiac rehabilitation patients and to compare these with published normal data. METHODS: In this non-randomised study, SF36 questionnaires were completed by 187 patients recruited to a Phase III cardiac rehabilitation multidisciplinary outpatient programme. Data was collected at beginning, end and six months after Phase III cardiac rehabilitation programme. RESULTS: There were significant improvements in physical functioning, role limitation due to physical function, pain and general health perception scales, over the above time frame, from both a statistically and a mean clinical important difference point of view. These improvements occurred mainly during the cardiac rehabilitation programme phase. CONCLUSIONS: These improvements meant that patients six months post-cardiac rehabilitation were only 5% below the quality of life for an aged matched normal group. However patients still had significant deficits in physical role and emotional role limitations. Suitable measurement of quality of life on an individual basis, supported by normal values is needed. This would facilitate the identification of shortfalls in patient quality of life and the subsequent tailoring of care to address these individualised patient needs.

  3. Using a Combined Platform of Swarm Intelligence Algorithms and GIS to Provide Land Suitability Maps for Locating Cardiac Rehabilitation Defibrillators

    Directory of Open Access Journals (Sweden)

    Neda KAFFASH-CHARANDABI

    2015-10-01

    Full Text Available Background: Cardiac arrest is a condition in which the heart is completely stopped and is not pumping any blood. Although most cardiac arrest cases are reported from homes or hospitals, about 20% occur in public areas. Therefore, these areas need to be investigated in terms of cardiac arrest incidence so that places of high incidence can be identi-fied and cardiac rehabilitation defibrillators installed there.Methods: In order to investigate a study area in Petersburg, Pennsylvania State, and to determine appropriate places for installing defibrillators with 5-year period data, swarm intelligence algorithms were used. Moreover, the location of the defibrillators was determined based on the following five evaluation criteria: land use, altitude of the area, econom-ic conditions, distance from hospitals and approximate areas of reported cases of cardiac arrest for public places that were created in geospatial information system (GIS.Results: The A-P HADEL algorithm results were more precise about 27.36%. The validation results indicated a wider coverage of real values and the verification results confirmed the faster and more exact optimization of the cost func-tion in the PSO method.Conclusion: The study findings emphasize the necessity of applying optimal optimization methods along with GIS and precise selection of criteria in the selection of optimal locations for installing medical facilities because the selected algorithm and criteria dramatically affect the final responses. Meanwhile, providing land suitability maps for installing facilities across hot and risky spots has the potential to save many lives.

  4. A mHealth cardiac rehabilitation exercise intervention: findings from content development studies

    Directory of Open Access Journals (Sweden)

    Pfaeffli Leila

    2012-05-01

    Full Text Available Abstract Background Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based cardiac rehabilitation (CR exercise intervention. Methods An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial. Results 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41 of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85% stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60% showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to

  5. Cardiovascular responses from immersion at recovery phase of the cardiac rehabilitation protocol - doi:10.5020/18061230.2011.p123

    Directory of Open Access Journals (Sweden)

    Jaqueline Vieira Sales

    2012-01-01

    Full Text Available Objective: To describe the cardiovascular responses from immersion at recovery phase of the cardiac rehabilitation protocol. Methods: This was an interventional, descriptive and prospective study with quantitative approach. The sample consisted of 20 patients with diagnoses of heart disease and hypertension with Functional Classification of Heart Failure from the New York Heart Association (NYHA, which have remained clinically stable and participating in the Cardiac Rehabilitation Program of Fortaleza University. The variables heart rate, blood pressure, saturation and dyspnea were investigated, being verified at rest, post-exercise and post-immersion. Data collection occurred over three sessions, with one week interval. Results: There was a significant response in heart rate and dyspnea, after application of immersion in the recovery phase (p 0.05. Conclusion: There were no clinical consequences resulting from the method used, showing significant improvements in symptoms, with adherence to the cardiac rehabilitation program after inclusion of immersion as a therapeutic complement.

  6. The effect of an educational intervention on coronary artery bypass graft surgery patients' participation rate in cardiac rehabilitation programs: a controlled health care trial

    Directory of Open Access Journals (Sweden)

    Novikov Ilia

    2011-10-01

    Full Text Available Abstract Background Cardiac rehabilitation has a beneficial effect on the prognosis and quality of life of cardiac patients, and has been found to be cost-effective. This report describes a comprehensive and low cost educational intervention designed to increase the attendance at cardiac rehabilitation programs of patients who have undergone coronary artery bypass graft surgery. Methods/Design A controlled prospective intervention trial. The control arm comprised 520 patients who underwent coronary artery bypass graft surgery between January 2004 and May 2005 in five medical centers across Israel. This group received no additional treatment beyond usual care. The intervention arm comprised 504 patients recruited from the same cardiothoracic departments between June 2005 and November 2006. This group received oral and written explanations about the advantages of participating in cardiac rehabilitation programs and a telephone call two weeks after hospital discharge intended to further encourage their enrollment. The medical staff attended a one-hour seminar on cardiac rehabilitation. In addition, it was recommended that referral to cardiac rehabilitation be added to the letter of discharge from the hospital. Both study groups were interviewed before surgery and one-year post surgery. A one-year post-operative interview assessed factors affecting patient attendance at cardiac rehabilitation programs, as well as the structure and content of the cardiac rehabilitation programs attended. Anthropometric parameters were measured at pre- and post-operative interviews;- and medical information was obtained from patient medical records. The effect of cardiac rehabilitation on one- and three-year mortality was assessed. Discussion We report a low cost yet comprehensive intervention designed to increase cardiac rehabilitation participation by raising both patient and medical staff awareness to the potential benefits of cardiac rehabilitation. Trial

  7. Impaired cerebrovascular function in coronary artery disease patients and recovery following cardiac rehabilitation.

    Directory of Open Access Journals (Sweden)

    Udunna C Anazodo

    2016-01-01

    Full Text Available Coronary artery disease (CAD poses a risk to the cerebrovascular function of older adults and has been linked to impaired cognitive abilities. Using magnetic resonance perfusion imaging, we investigated changes in resting cerebral blood flow (CBF and cerebrovascular reactivity (CVR to hypercapnia in 34 coronary artery disease (CAD patients and 21 age-matched controls. Gray matter volume images were acquired and used as a confounding variable to separate changes in structure from function. Compared to healthy controls, CAD patients demonstrated reduced CBF in the superior frontal, anterior cingulate, insular, pre- and post-central gyri, middle temporal and superior temporal regions. Subsequent analysis of these regions demonstrated decreased CVR in the anterior cingulate, insula, postcentral and superior frontal regions. Except in the superior frontal and precentral regions, regional reductions in CBF and CVR were identified in brain areas where no detectable reductions in gray matter volume were observed, demonstrating that these vascular changes were independent of brain atrophy. Because aerobic fitness training can improve brain function, potential changes in regional CBF were investigated in the CAD patients after completion of a 6-month exercise-based cardiac rehabilitation program. Increased CBF was observed in the bilateral anterior cingulate, as well as recovery of CBF in the dorsal aspect of the right anterior cingulate, where the magnitude of increased CBF was roughly equal to the reduction in CBF at baseline compared to controls. These exercise-related improvements in CBF in the anterior cingulate is intriguing given the role of this area in cognitive processing and regulation of cardiovascular autonomic control.

  8. Impact of exercise rehabilitation on cardiac neuronal function in heart failure. An iodine-123 metaiodobenzylguanidine scintigraphy study

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Bouvard, G. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France); Lecluse, E.; Grollier, G.; Potier, J.C. [Service de Cardiologie, CHU Cote de Nacre, Caen (France); Belin, A. [Service de Readaptation Cardiaque, CHU Cote de Nacre, Caen (France); Babatasi, G. [Service de Chirurgie Cardio-Thoracique, CHU Cote de Nacre, Caen (France); Amar, M.H. [Centre Francois Baclesse, Caen (France). Service de Recherche Clinique

    1998-03-01

    Exercise training can induce important haemodynamic and metabolic adaptations in patients with chronic heart failure due to severe left ventricular dysfunction. This study examined the impact of exercise rehabilitation on cardiac neuronal function using iodine-123 metaiobodenzylguanidine (MIBG) scintigraphy. Fourteen patients (11 men, 3 women; mean age 48 years; range: 36-66 years) with stable chronic heart failure of NYHA class II-III and an initial resting radionuclide left ventricular ejection fraction (LVEF) <50% were enrolled in the study. Patients underwent progressive, supervised endurance training (treadmill test, Bruce protocol) during a 6-month period (60 sessions, 3 sessions per week) at a cardiac rehabilitation referral centre in order to measure exercise parameters. Planar {sup 123}I-MIBG scintigraphy provided measurements of cardiac neuronal uptake (heart-mediastinum ratio activity, 4 h after intravenous injection of 185 MBq of MIBG). Radionuclide LVEF was also assessed at the outset and after 6 months of exercise training. Workload (801{+-}428 vs 1229{+-}245 kpm.min{sup -1}, P=0.001), exercise duration (504{+-}190 vs 649{+-}125 s, P=0.02), and myocardial MIBG uptake (135%{+-}19% vs 156%{+-}25%, P=0.02) increased significantly after rehabilitation. However, LVEF did not change significantly (23%{+-}9% vs 21%{+-}10%, p=NS). It is concluded that exercise rehabilitation induces improvement of cardiac neuronal function without having negative effects on cardiac contractility in patients with stable chronic heart failure. (orig.)

  9. Insomnia symptoms and heart rate recovery among patients in cardiac rehabilitation.

    Science.gov (United States)

    Horsley, Kristin J; Rouleau, Codie R; Garland, Sheila N; Samuels, Charles; Aggarwal, Sandeep G; Stone, James A; Arena, Ross; Campbell, Tavis S

    2016-08-01

    Insomnia symptoms (i.e., difficulty falling asleep, difficulty staying asleep, and early morning awakenings) are common among people with cardiovascular disease, and have been linked to adverse cardiovascular health outcomes. Reduced parasympathetic tone is one pathway through which risk may be conferred. The purpose of this study was to evaluate whether insomnia symptoms are associated with lower parasympathetic tone in cardiac rehabilitation patients with suspected insomnia. Participants (N = 121) completed a self-report measure of insomnia severity. 1-min heart rate recovery (HRR), an index of parasympathetic tone, was obtained during a maximal exercise test. Difficulty falling asleep, but not difficulty staying asleep or early awakenings, was associated with attenuated 1-min HRR. When analyses were restricted to participants with moderate and severe insomnia severity (n = 51), the strength of this association increased. In a sample of cardiac rehabilitation patients with insomnia, only the symptom of difficulty falling asleep was associated with lower parasympathetic tone, suggesting that individual insomnia symptoms may show specificity in their associations with physiological mechanisms. PMID:26944765

  10. Barriers to cardiac rehabilitation access of older heart failure patients and strategies for better implementation.

    Science.gov (United States)

    Pulignano, Giovanni; Tinti, Maria Denitza; Del Sindaco, Donatella; Tolone, Stefano; Minardi, Giovanni; Lax, Antonio; Uguccioni, Massimo

    2016-01-01

    In heart failure (HF), cardiac rehabilitation (CR) may reduce decompensations, hospitalization, and ultimately mortality in long term. Many studies over the past decade have demonstrated that aerobic exercise training is effective and safe in stable patients with HF. Exercise CR resulted in a clinically important improvement in the QOL. Several clinical and psychosocial factors are associated with decreased participation in CR programs of elderly HF patients, such as perception of exercise as tiring or painful, comorbidities, lack of physician encouragement, and opinion that CR will not improve their health status. Besides low functional capacity, and chronic deconditioning may also deter patients from participating in CR programs. Recent data suggest that current smoking, a BMI ≥30 kg/m2, diabetes mellitus, and cognitive dysfunction are associated with failure to enroll in outpatient CR in older age group. Moreover the lack of availability of CR facilities or the absence of financial refunds for enrolment of CHF patients in cardiac rehabilitation programs can play a crucial role. Many of this factors are modifiable through patient education and self care strategy instruction, health providers sensibilization, and implementing economic measures in order to make CR affordable.

  11. The influences of positive end expiratory pressure (PEEP) associated with physiotherapy intervention in phase I cardiac rehabilitation

    OpenAIRE

    Borghi-Silva Audrey; Mendes Renata Gonçalves; Costa Fernando de Souza Melo; Di Lorenzo Valéria Amorim Pires; Oliveira Claudio Ricardo de; Luzzi Sérgio

    2005-01-01

    PURPOSE: To evaluate the effects of positive end expiratory pressure and physiotherapy intervention during Phase I of cardiac rehabilitation on the behavior of pulmonary function and inspiratory muscle strength in postoperative cardiac surgery. METHODS: A prospective randomized study, in which 24 patients were divided in 2 groups: a group that performed respiratory exercises with positive airway expiratory pressure associated with physiotherapy intervention (GEP, n = 8) and a group that recei...

  12. Effect of cardiac rehabilitation program on exercise capacity in women undergoing coronary artery bypass graft in Hamadan-Iran

    Directory of Open Access Journals (Sweden)

    Ramin Shabani

    2010-01-01

    Conclusions: Women referred for rehabilitation have similar lev-els of compliance and improvement in exercise capacity and sup-ply of oxygen to cardiac muscles (measured by peak myocardial oxygen consumption. After CRP, women demonstrated signifi-cant improvements in exercise duration time, 6MWT, RPP and supply of oxygen to cardiac muscles. CRP can play an important role in improving functional independence in women.

  13. The Benefit of a Cardiac Rehabilitation Programme on Cardiovascular and Exercise Parameters in Patients with Type 2 Diabetes Mellitus: The First Study Among the Iranian Population

    Directory of Open Access Journals (Sweden)

    Mostafa Nejatian

    2011-02-01

    Full Text Available Background: An appropriate physical regimen in diabetic patients positively modified both motor and sensory neuromuscular parameters, improved functional capacity and slowed the progression of diabetes and its cardiovascular sequelae.Objective: We examined the effects of a cardiac rehabilitation (CR programme on cardiovascular and exercise parameters in diabetic patients undergoing coronary artery bypass surgery (CABG and compared them to non-diabetics.Methods: Data were collected prospectively on 1,316 consecutive patients who underwent pure CABG enrolled in an exercise-based cardiac rehabilitation programme (phase II at Tehran Heart Center and categorised into two groups; the diabetes group (n=361 and non-diabetics (n=955. The main outcome measures were cardiovascular parameters, exercise training energy expenditure (ETEE and treadmill velocity of first and last session of CR in the two groups.Results: Regarding the change in heart rate, peak and post-exercise heart rates were improved more in non-diabetics than the other group after attending cardiac rehabilitation programme. An increase in heart rate recovery was also detected in non-diabetics compared to diabetic patients. However,changes in post-exercise systolic blood pressure and also in resting and post-exercise diastolic blood pressures were not different between the two groups. Multivariate analysis showed more improvement in ETEE in non-diabetics than diabetics (β: 2.035, 95% CI for β: 0.687-3.382, p=0.003 in the presence of main confounders.Conclusion: Significant improvements can be occurred in heart rate recovery, post-training exercise heart rate, and also ETEE after attending cardiac rehabilitation programme in both diabetic and non-diabetic patients undergoing CABG, but the diabetic group took less advantage of this programme than non-diabetics.

  14. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  15. Cardiac Acceleration at the Onset of Exercise : A Potential Parameter for Monitoring Progress During Physical Training in Sports and Rehabilitation

    NARCIS (Netherlands)

    Hettinga, Florentina J.; Monden, Paul G.; van Meeteren, Nico L. U.; Daanen, Hein A. M.

    2014-01-01

    There is a need for easy-to-use methods to assess training progress in sports and rehabilitation research. The present review investigated whether cardiac acceleration at the onset of physical exercise (HRonset) can be used as a monitoring variable. The digital databases of Scopus and PubMed were se

  16. Effect of Intense Lifestyle Modification and Cardiac Rehabilitation on Psychosocial Cardiovascular Disease Risk Factors and Quality of Life

    Science.gov (United States)

    Aldana, Steven G.; Whitmer, William R.; Greenlaw, Roger; Avins, Andrew L.; Thomas, Dean; Salberg, Audrey; Greenwell, Andrea; Lipsenthal, Lee; Fellingham, Gill W.

    2006-01-01

    This study examined the effect of the Ornish Program for Reversing Heart Disease and cardiac rehabilitation(CR) on psychosocial risk factors and quality of life in patients with confirmed coronary artery disease. Participants had previously undergone a revascularization procedure. The 84 patients self-selected to participate in the Ornish Program…

  17. The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms

    NARCIS (Netherlands)

    Meurs, Maaike; Burger, Huibert; van Riezen, Jerry; Slaets, Joris P.; Rosmalen, Judith G. M.; van Melle, Joost P.; Roest, Annelieke M.; de Jonge, Peter

    2015-01-01

    Background: Post myocardial infarction (MI) depression is associated with reduced adherence to cardiac rehabilitation (CR) and increased mortality risk. The present study investigated whether all cause mortality reduction associated with CR is different for MI patients with and without depressive sy

  18. Cardiac rehabilitation programs improve metabolic parameters in patients with the metabolic syndrome and coronary heart disease.

    Science.gov (United States)

    Pérez, Ignacio P; Zapata, Maria A; Cervantes, Carlos E; Jarabo, Rosario M; Grande, Cristina; Plaza, Rose; Garcia, Sara; Rodriguez, Miriam L; Crespo, Silvia; Perea, Jesús

    2010-05-01

    This study was performed to determine the effectiveness of a cardiac rehabilitation and exercise training program on metabolic parameters and coronary risk factors in patients with the metabolic syndrome and coronary heart disease. The study involved 642 patients with coronary heart disease. Of them, 171 (26.7%) fulfilled criteria for the metabolic syndrome. Clinical data, laboratory tests, and exercise testing were performed before and after the program, which lasted 2 to 3 months. Except for waist circumference, there were no significant differences between groups; blood pressure, high-density lipoprotein cholesterol, triglycerides, and fasting glucose improvements during the follow-up were higher in patients with the metabolic syndrome (all Pmetabolic syndrome, functional capacity increased by 26.45% ( Pmetabolic equivalents, with a slight increase of 1.25% ( P=not significant) in the double product. Patients with the metabolic syndrome who took part in this secondary prevention program reported improvements in cardiovascular risk profile and functional capacity.

  19. Cardiac Rehabilitation Enrollment and the Impact of Systematic Nursing Interventions for Postmyocardial Infarction and Stent Patients.

    Science.gov (United States)

    Grossman, Joan A Cebrick

    2016-08-01

    A randomized experimental design was used to determine the most effective intervention for enhancing cardiac rehabilitation (CR) enrollment for postmyocardial infarction and stent patients. The 104 subjects (70 males and 34 females; 23-87 years old) were patients with a discharge diagnosis of a myocardial infarction followed by a percutaneous coronary intervention, which included a percutaneous transluminal coronary angioplasty and the placement of one or more coronary stents. Regardless of the intervention, patients who received face-to-face nursing interventions were more likely to enroll in CR than were patients who had indirect interventions, χ(2)(3) = 32.84, p interview were most likely to enroll, χ(2)(1) = 86.80, p interview, having an odds ratio of 1.73. PMID:26655562

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

    Institute of Scientific and Technical Information of China (English)

    Arthur R Menezes; Carl J Lavie; Richard V Milani; ROSS A Arena; Timothy S Church

    2012-01-01

    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.

  1. The effect of referral for cardiac rehabilitation on survival following acute myocardial infarction

    DEFF Research Database (Denmark)

    Lewinter, Christian; Bland, John M; Crouch, Simon;

    2014-01-01

    BACKGROUND: International guidelines recommend referral for cardiac rehabilitation (CR) after acute myocardial infarction (AMI). However, the impact on long-term survival after CR referral has not been adjusted by time-variance. We compared the effects of CR referral after hospitalization for AMI...... in two consecutive decades. METHODS AND RESULTS: A total of 2196 and 2055 patients were recruited in the prospective observational studies of the Evaluation of the Methods and Management of Acute Coronary Events (EMMACE) -1 and 2 in 1995 and 2003, (1995: median age 72 years, 39% women, 74% referred vs...... 2003: median age 71 years, 36% women, 64% referred) and followed up through September 2010. Survival functions showed CR referral to be an independent predictor for survival in 2003, but not in 1995 (hazard ratio (HR), 0.90; 95% confidence interval [CI]; 0.70 to 1.17, p = 0.44 in 1995 vs HR, 0.80; 95...

  2. A randomised clinical trial of comprehensive cardiac rehabilitation versus usual care for patients treated for infective endocarditis—the CopenHeartIE trial protocol

    Science.gov (United States)

    Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe; Sibilitz, Kirstine Lærum; Risom, Signe Stelling; Bundgaard, Henning; Gluud, Christian; Moons, Philip; Winkel, Per; Thygesen, Lau Caspar; Hansen, Jane Lindschou; Norekvål, Tone Merete; Berg, Selina Kikkenborg

    2012-01-01

    Introduction Infective endocarditis (IE) is among the most serious infectious diseases in the western world. Treatment requires lengthy hospitalisation, high-dosage antibiotic therapy and possible valve replacement surgery. Despite advances in treatment, the 1-year mortality remains at 20–40%. Studies indicate that patients experience persisting physical symptoms, diminished quality of life and difficulties returning to work up to a year postdischarge. No studies investigating the effects of rehabilitation have been published. We present the rationale and design of the CopenHeartIE trial, which investigates the effect of comprehensive cardiac rehabilitation versus usual care for patients treated for IE. Methods and analysis We will conduct a randomised clinical trial to investigate the effects of comprehensive cardiac rehabilitation versus usual care on the physical and psychosocial functioning of patients treated for IE. The trial is a multicentre, parallel design trial with 1 : 1 individual randomisation to either the intervention or control group. The intervention consists of five psychoeducational consultations provided by specialised nurses and a 12-week exercise training programme. The primary outcome is mental health (MH) measured by the standardised Short Form 36 (SF-36). The secondary outcome is peak oxygen uptake measured by the bicycle ergospirometry test. Furthermore, a number of exploratory analyses will be performed. Based on sample size calculation, 150 patients treated for left-sided (native or prosthetic valve) or cardiac device endocarditis will be included in the trial. A qualitative and a survey-based complementary study will be undertaken, to investigate postdischarge experiences of the patients. A qualitative postintervention study will explore rehabilitation participation experiences. Ethics and dissemination The study complies with the Declaration of Helsinki and was approved by the regional research ethics committee (no H-1

  3. Evidence-Based Rehabilitation Counseling Practice: A Pedagogical Imperative

    Science.gov (United States)

    Kosciulek, John F.

    2010-01-01

    This article describes how rehabilitation educators can aid students and practitioners in learning about and engaging in evidence-based rehabilitation counseling practice (EBRCP). Information describing (a) the definition and rationale for EBRCP, (b) controversies surrounding EBRCP, (c) facilitating rehabilitation counselor enthusiasm for EBRCP,…

  4. Enhancing Behavioral Change with Motivational Interviewing: a case study in a Cardiac Rehabilitation Unit

    Directory of Open Access Journals (Sweden)

    Giada ePietrabissa

    2015-03-01

    Full Text Available Background: psychological interventions in Cardiac Rehabilitation (CR programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients’ adherence to therapy. To this aim, Motivational Interviewing (MI has shown promising results in improving motivation to change and individuals’ confidence in their ability to do so. Objective: the purpose of this article is to integrate theory with practice by describing a 3-session case scenario. It illustrates how the use of MI’s skills and strategies can be used to enhance health. MI may be synergistic with other treatment approaches and it is used here in conjunction with Brief Strategic Therapy (BST. Conclusions: by the use of Motivational Interviewing principles and technique, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. Clinical Implications: Motivational Interviewing may be effective in motivating and facilitating health behavior change in patients suffering from heart failure.

  5. Motivational processes and well-being in cardiac rehabilitation: a self-determination theory perspective.

    Science.gov (United States)

    Rahman, Rachel Jane; Hudson, Joanne; Thøgersen-Ntoumani, Cecilie; Doust, Jonathan H

    2015-01-01

    This research examined the processes underpinning changes in psychological well-being and behavioural regulation in cardiac rehabilitation (CR) patients using self-determination theory (SDT). A repeated measures design was used to identify the longitudinal relationships between SDT variables, psychological well-being and exercise behaviour during and following a structured CR programme. Participants were 389 cardiac patients (aged 36-84 years; M(age) = 64 ± 9 years; 34.3% female) referred to a 12-week-supervised CR programme. Psychological need satisfaction, behavioural regulation, health-related quality of life, physical self-worth, anxiety and depression were measured at programme entry, exit and six month post-programme. During the programme, increases in autonomy satisfaction predicted positive changes in behavioural regulation, and improvements in competence and relatedness satisfaction predicted improvements in behavioural regulation and well-being. Competence satisfaction also positively predicted habitual physical activity. Decreases in external regulation and increases in intrinsic motivation predicted improvements in physical self-worth and physical well-being, respectively. Significant longitudinal relationships were identified whereby changes during the programme predicted changes in habitual physical activity and the mental quality of life from exit to six month follow-up. Findings provide insight into the factors explaining psychological changes seen during CR. They highlight the importance of increasing patients' perceptions of psychological need satisfaction and self-determined motivation to improve well-being during the structured component of a CR programme and longer term physical activity.

  6. Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

    Directory of Open Access Journals (Sweden)

    Mauro Felippe Felix Mediano

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: The benefit of a cardiac rehabilitation (CR program for patients with Chagas heart failure (CHF remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. METHODS: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session. Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test, muscle respiratory strength (manovacuometry, and body composition (anthropometry and skinfolds were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography, biomarkers (lipid profile, glucose, and glycated hemoglobin and quality of life (Minnesota Living with Heart Failure Questionnaire were assessed at baseline and at the end of the intervention. RESULTS: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF and respiratory strength improved after 8 months. Patients with right ventricular (RV dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CONCLUSIONS: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

  7. Rehabilitation status three months after first-time myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær; Vestergaard, Mogens; Søndergaard, Jens;

    2011-01-01

    To describe the rehabilitation status three months after first-time myocardial infarction (MI) to identify focus areas for long-term cardiac rehabilitation (CR) in general practice. Design. Population-based cross-sectional study.......To describe the rehabilitation status three months after first-time myocardial infarction (MI) to identify focus areas for long-term cardiac rehabilitation (CR) in general practice. Design. Population-based cross-sectional study....

  8. The interpretation and analysis of the core content of cardiac rehabilitation%心脏康复核心内容解读及分析

    Institute of Scientific and Technical Information of China (English)

    李婧; 王彦

    2014-01-01

    心脏康复作为心血管疾病重要的防治手段之一,日渐发挥其作用。现针对心脏康复的核心内容进行解读与分析,以期提高医护人员及患者对心脏康复的总体认识,为心脏康复的临床实践提供指导作用。%Cardiac rehabilitation is one of the important means for prevention and treatment of cardiovascular disease, increasingly playing its role. The aim of the article is to interpret and analyze the core content of cardiac rehabilitation in order to improve the medical staff and patients overall understanding of cardiac rehabilitation, and provide guidance for clinical practice of cardiac rehabilitation.

  9. Effects of Phase III Cardiac Rehabilitation Programs on Anxiety and Quality of Life in Anxious Patients after Coronary Artery Bypass Surgery

    OpenAIRE

    Gholamreza Babaei Ruchi; Fazlollah Ghofranipour; Saeed Sadeghian; Ali Ramezankhani; Alireza Heidarnia; Tahereh Dehdari; Soraya Etemadi

    2007-01-01

    Background: Patients with psychological problems after coronary artery bypass graft surgery (CABG) show poorer outcomes; nevertheless, there is a paucity of research into the effects of cardiac rehabilitation programs on such patients. The purpose of this study was to determine the effect of phase III cardiac rehabilitation programs on the anxiety and quality of life of anxious patients who had undergone CABG in Iran.Methods: Six weeks after CABG, 83 anxious patients participated in an 8-week...

  10. Treatment patterns and risk factor control in patients with and without metabolic syndrome in cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Gitt A

    2012-04-01

    Full Text Available Anselm Gitt1, Christina Jannowitz2, Marthin Karoff3, Barbara Karmann2, Martin Horack1, Heinz Völler4,51Institut für Herzinfarktforschung an der Universität Heidelberg, Ludwigshafen,2Medical Affairs, MSD Sharp and Dohme GmbH, Haar, 3Klinik Königsfeld der Deutschen Rentenversicherung Westfalen in Ennepetal (NRW, Klinik der Universität Witten-Herdecke, 4Kardiologie, Klinik am See, Rüdersdorf, 5Center of Rehabilitation Research, University Potsdam, GermanyAim: Metabolic syndrome (MetS is a clustering of factors that are associated with increased cardiovascular risk. We aimed to investigate the proportion of patients with MetS in patients undergoing cardiac rehabilitation (CR, and to describe differences between patients with MetS compared to those without MetS with regard to (1 patient characteristics including demographics, risk factors, and comorbidities, (2 risk factor management including drug treatment, and (3 control status of risk factors at entry to CR and discharge from CR.Methods: Post-hoc analysis of data from 27,904 inpatients (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management registry that underwent a CR period of about 3 weeks were analyzed descriptively in total and compared by their MetS status.Results: In the total cohort, mean age was 64.3 years, (71.7% male, with no major differences between groups. Patients had been referred after a ST elevation of myocardial infarction event in 41.1% of cases, non-ST elevation of myocardial infarction in 21.8%, or angina pectoris in 16.7%. They had received a percutaneous coronary intervention in 55.1% and bypass surgery (coronary artery bypass graft in 39.5%. Patients with MetS (n = 15,819 compared to those without MetS (n = 12,085 were less frequently males, and in terms of cardiac interventions, more often received coronary artery bypass surgery. Overall, statin use increased from 79.9% at entry to 95.0% at discharge (MetS: 79.7% to 95.2%. Patients with Met

  11. Current state of cardiac rehabilitation in Germany: patient characteristics, risk factor management and control status, by education level

    Directory of Open Access Journals (Sweden)

    Bestehorn K

    2011-10-01

    Full Text Available Kurt Bestehorn1, Christina Jannowitz2, Martin Horack3, Barbara Karmann2, Martin Halle4, Heinz Völler5 1Institute for Clinical Pharmacology, Technical University, Dresden; 2Medical Department, MSD Sharp and Dohme GmbH, Haar; 3Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen; 4Center for Prevention and Sports Medicine, Technical University, Munich; 5Klinik am See, Rehabilitation Center for Cardiovascular Diseases, Rüdersdorf, Germany Background: After the acute hospital stay, most cardiac patients in Germany are transferred for a 3–4-week period of inpatient cardiac rehabilitation. We aim to describe patient characteristics and risk factor management of cardiac rehabilitation patients with a focus on drug treatment and control status, differentiated by education level (low level, elementary school; intermediate level, secondary modern school; high level, grammar school/university. Methods: Data covering a time period between 2003 and 2008 from 68,191 hospitalized patients in cardiac rehabilitation from a large-scale registry (Transparency Registry to Objectify Guideline-Oriented Risk Factor Management were analyzed descriptively. Further, a multivariate model was applied to assess factors associated with good control of risk factors. Results: In the total cohort, patients with a manifestation of coronary artery disease (mean age 63.7 years, males 71.7% were referred to cardiac rehabilitation after having received percutaneous coronary intervention (51.6% or coronary bypass surgery (39.5%. Statin therapy increased from 76.3% at entry to 88.9% at discharge, and low density lipoprotein cholesterol <100 mg/dL rates increased from 31.1% to 69.6%. Mean fasting blood glucose decreased from 108 mg/dL to 104 mg/dL, and mean exercise capacity increased from 78 W to 95 W. Age and gender did not differ by education. In contrast with patients having high education, those with low education had more diabetes

  12. P-wave dispersion and its relationship to aortic stiffness in patients with acute myocardial infarction after cardiac rehabilitation

    OpenAIRE

    Acar, Rezzan Deniz; Bulut, Mustafa; Ergün, Sunay; Yesin, Mahmut; Boztosun, Bilal; Akçakoyun, Mustafa

    2014-01-01

    BACKGROUND The aim of our study was to investigate the P-wave dispersion from standard electrocardiograms (ECGs) in patients with acute myocardial infarction (AMI) after cardiac rehabilitation (CR) and determine its relation to arterial stiffness. METHODS This is a prospective study included 33 patients with AMI and successfully re-vascularized by percutaneous coronary intervention (PCI) underwent CR. Left ventricular ejection fraction (LVEF) was measured by biplane Simpson’s method. Left atr...

  13. Personality and the physician-patient relationship as predictors of quality of life of cardiac patients after rehabilitation

    OpenAIRE

    Farin Erik; Meder Milena

    2010-01-01

    Abstract Background Numerous studies document the influence of psychosocial variables on the course of coronary heart disease. This study examines the influence of personality traits (trait anger, cynicism) and aspects of the physician-patient relationship (promoting patient participation by the physician, active communication behavior of the patient, trust in the physician) on the health related quality of life (HRQOL) of cardiac patients after rehabilitation. Methods N = 331 patients with c...

  14. Reabilitação cardíaca com ênfase no exercício: uma revisão sistemática Rehabilitación cardíaca con énfasis en el ejercicio: una revisión sistemática Exercise-based cardiac rehabilitation: a systematic review

    Directory of Open Access Journals (Sweden)

    Djalma Rabelo Ricardo

    2006-10-01

    pacientes con enfermedad arterial coronaría. Se analizaron apenas ensayos clínicos controlados y randomizados (ECCR con folow-up igual o superior a seis meses, publicados entre 1990 y 2004. Se usaron los criterios propuestos por la Clinical Practice Guideline: cardiac rehabilitation para juzgar los estudios seleccionados. Hicieron parte de esta revisión 21 ECCR envolviendo 2220 pacientes entre 49 y 63 años (86% hombres. La mayoría de los ECCR presentaron resultados favorables a la RCEE para mortalidad total y cardíaca cuando fueron comparadas a los cuidados usuales (control. Ese hecho también fue observado para los eventos de reinfarto y revascularización del miocardio. Los resultados de la RCEE sobre los factores de riesgo modificables y la calidad de vida no fueron conclusivos cuando se compararon a la intervención control, a pesar de algunos estudios haber presentado diferencias estadísticas a favor de la RCEE. Esta revisión confirma los beneficios de la RCEE en el abordaje terapéutico de enfermos de coronarias, reduciendo sus tasas de mortalidad cardíaca y todas sus causas, además de contribuir para la disminución de ocurrencia de otros eventos de coronaría, tales como la revascularización miocárdica y la tasa de reinfarto. En relación a los factores de riesgo modificables y la calidad de vida hubo una tendencia favorable a la utilización de RCEE. Avanzando un poco más, parece ser que el ejercicio físico regular per si constituye el principal responsable por los resultados favorables de la intervención en relación a los hechos estudiados.The aim of this systematic review was to determine the effect of exercise-based cardiac rehabilitation (EBCR on mortality, modifiable risk factors and quality of life related to health, in patients with coronary artery disease. Only Randomized Controlled Trials (RCTs with follow up equal or higher than six months published between 1990 and 2004 were analyzed. The criteria proposed by the Clinical Practice

  15. Effects of home-based exercise rehabilitation on quality of life after coronary artery bypass graft and PCI early post-discharge

    Directory of Open Access Journals (Sweden)

    Shadi Moafi

    2011-11-01

    Full Text Available Background: The barriers to participation in cardiac rehabilitation programs are individual and economic problems and limited availability and access of rehabilitation services. Because of the important role of rehabilitation, home based exercise rehabilitation is a new approach to participate in such programs. The purpose of this study was to evaluate the effects of home-based rehabilitation on quality of life (QoL in patients with coronary artery disease after coronary artery bypass graft (CABG and PCI.Materials and Method: Participants included 18 CABG (3 women, 15 men and 40 PCI (12 women, 28 men low to moderate risk patients. Finally 17 patients in the exercise group and 16 patients in the control group remained. The SF-36 was used to evaluate changes in QoL before and after the program.Result: forty-three percent was dropped out from the program. Before and after program, the exercise group was better in all domains of QoL (p<0.05. After 8 weeks of cardiac rehabilitation, significant improvements were observed in quality of life in both groups (p<0.05 but the exercise group showed more improvements in three domains.Conclusion: Home-based exercise rehabilitation after CABG and PCI may improve QoL and provide an efficient low-cost approach to cardiac rehabilitation. It may be helpful due to limited availability and resources in Iran. Nevertheless, for increasing participation and decreasing drop out it needs more training

  16. Application of Rate Pressure Product in Ischemia Monitoring during Exercise Based Cardiac Rehabilitation%心脏康复运动中应用心率血压乘积对心肌缺血监控的研究

    Institute of Scientific and Technical Information of China (English)

    李浩松; 刘洵; 石晓明; 王一春; 刘博淼

    2016-01-01

    Objective:To investigate changes of myocardial blood supply and cardiovascular function when coronary heart disease patients undertake exer⁃cise,and to provide a simple manner for them to monitor cardiac ischemia by applying rate pressure product. Method:Fifty-four male recent coronary heart disease patients performed a graded exercise test on a treadmill. Both heart rate and systolic/diastolic blood pressure were measured at the last minute of I ,II and III exercise stage. Rate-pressure product was then calculated by multiplying heart rate by systolic blood pressure and divided the product by 100. A 12 lead electrocardiogram was monitored continuously and from which changes of ST segment level could be found. Results:1)The patients with less ST seg⁃ment depression during exercise showed a light cardiovascular response at the moment. Whereas those with more ST segment depression not only depicted a significant cardiovascular response at exercise stage I but also presented much increase for this response thereafter. 2)The patients with ST segment depres⁃sion reaching 1 mm at exercise stage III of the modified Bruce treadmill protocol demonstrated a relative large rate pressure product value ,over 200 for in⁃stance. Conclusions:Cardiovascular status and state of health of the subjects can be reflected by rate pressure product response. We should be aware that if rate pressure product shows a sudden increase when coronary heart disease patients undertaking exercise during rehabilitation ,it might be related to underly⁃ing myocardial insufficiency.%目的:探讨冠心病患者康复运动中心肌供血和心血管功能的变化,应用心率血压乘积为他们运动中心肌缺血的监控提供简便的措施。方法:54名男性冠心病患者(均处于稳定期)在活动跑台上进行症状限制性运动试验,在运动试验的第I级负荷末、第II级负荷末和第III级负荷末对受试者的心率、收缩压和舒张压进行测

  17. Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

    Science.gov (United States)

    Fukui, Shigefumi; Ogo, Takeshi; Takaki, Hiroshi; Ueda, Jin; Tsuji, Akihiro; Morita, Yoshiaki; Kumasaka, Reon; Arakawa, Tetsuo; Nakanishi, Michio; Fukuda, Tetsuya; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi; Goto, Yoichi

    2016-01-01

    Objective To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. Methods Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. Results No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, pBPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile. PMID:27220694

  18. Digital Health Intervention as an Adjunct to Cardiac Rehabilitation Reduces Cardiovascular Risk Factors and Rehospitalizations.

    Science.gov (United States)

    Widmer, R Jay; Allison, Thomas G; Lerman, Lilach O; Lerman, Amir

    2015-07-01

    Cardiac rehabilitation (CR) following myocardial infarction is vastly underused. As such, the aim of this study was to test a digital health intervention (DHI) as an adjunct to CR. Patients undergoing standard Mayo Clinic CR were recruited prior to CR (n = 25) or after 3 months CR (n = 17). Changes in risk factors and rehospitalizations plus emergency department (ED) visits were assessed after 3 months. Patients assigned to DHI during CR had significant reductions in weight (-4.0 ± 5.2 kg, P = .001), blood pressure (-10.8 ± 13.5 mmHg, P = .0009), and the group using DHI after 3 months of CR had significant reductions in weight (-2.5 ± 3.8 kg, P = .04) and systolic BP (-12.6 ± 12.4 mmHg, P = .001) compared to the control groups. Both DHI groups also displayed significant reductions in rehospitalizations/ED visits (-37.9 %, P = 0.01 and -28 %, P = .04, respectively). This study suggests that a guideline-driven DHI CR program can augment secondary prevention strategies during usual CR by improving risk factors for repeat events.

  19. Fatalism and short-termism as cultural barriers to cardiac rehabilitation among underprivileged men.

    Science.gov (United States)

    Savage, Mathieu; Dumas, Alex; Stuart, Stephen A

    2013-11-01

    Cardiovascular diseases are a leading cause of death and disability in Canada, and individuals of low socioeconomic status appear particularly vulnerable to such disorders. Although many health-related institutions have promoted cardiovascular health and have created cardiac rehabilitation programmes, they have not attained their desired outcomes, especially amongst socioeconomically deprived men. Drawing on Pierre Bourdieu's sociocultural theory, this qualitative study aims to understand the social mechanisms underpinning the lifestyles and health practices of men who had suffered a cardiovascular incident requiring hospitalisation. In all, 20 interviews were conducted with francophone men aged 40 to 65 years living in the province of Québec, Canada. The analysis strongly suggests that the respondents' living conditions and disease were significant obstacles to their adoption of a healthy lifestyle. Their despair and pessimism, apparently originating in the harshness of their financial realities, physical limitations and social networks, led them to believe that they could do little to control their lives, thereby limiting the fulfillment of any long-term ambitions. Therefore, the adoption of a habitus characterised by fatalistic and short-term perceptions of health influenced their lifestyle choices, leading them to maintain lives that were in stark contrast with the recommendations made by health promotion experts.

  20. Fatalism and short-termism as cultural barriers to cardiac rehabilitation among underprivileged men.

    Science.gov (United States)

    Savage, Mathieu; Dumas, Alex; Stuart, Stephen A

    2013-11-01

    Cardiovascular diseases are a leading cause of death and disability in Canada, and individuals of low socioeconomic status appear particularly vulnerable to such disorders. Although many health-related institutions have promoted cardiovascular health and have created cardiac rehabilitation programmes, they have not attained their desired outcomes, especially amongst socioeconomically deprived men. Drawing on Pierre Bourdieu's sociocultural theory, this qualitative study aims to understand the social mechanisms underpinning the lifestyles and health practices of men who had suffered a cardiovascular incident requiring hospitalisation. In all, 20 interviews were conducted with francophone men aged 40 to 65 years living in the province of Québec, Canada. The analysis strongly suggests that the respondents' living conditions and disease were significant obstacles to their adoption of a healthy lifestyle. Their despair and pessimism, apparently originating in the harshness of their financial realities, physical limitations and social networks, led them to believe that they could do little to control their lives, thereby limiting the fulfillment of any long-term ambitions. Therefore, the adoption of a habitus characterised by fatalistic and short-term perceptions of health influenced their lifestyle choices, leading them to maintain lives that were in stark contrast with the recommendations made by health promotion experts. PMID:24266752

  1. Determinants of eligibility and use of ehealth for cardiac rehabilitation patients: preliminary results.

    Science.gov (United States)

    Wiggers, Anne-Marieke; Peek, Niels; Kraaijenhagen, Roderik; Jaspers, Monique

    2014-01-01

    To foster implementation of eHealth in care practice, it is important to gain insight into the factors that influence acceptance. The aim of this study was to identify determinants of eligibility and use for completing an electronic needs assessment for cardiac rehabilitation. We analysed the influence of age, gender, diagnosis, health literacy, quality of life scores, and depression and anxiety scores. Among 240 patients entering CR in two clinics, 101 patients were deemed eligible to use the system by their CR professional, of which 75 (74.2%) actually used it. Only 50% of the patients who had an acute coronary syndrome and 20% of the patients with chronic heart failure were deemed eligible. Furthermore, there was a decreasing trend towards usage in female patients, patients with symptoms of anxiety, and patients with a better quality of life. In the future we will continue to explore barriers and success factors as experienced by the patients and the participating clinics to optimize the system.

  2. Is the Cardiovascular Response Equivalent Between a Supervised Center-Based Setting and a Self-care Home-Based Setting When Rating of Perceived Exertion Is Used to Guide Aerobic Exercise Intensity During a Cardiac Rehabilitation Program?

    DEFF Research Database (Denmark)

    Tang, Lars H; Zwisler, Ann-Dorthe; Berg, Selina K;

    2016-01-01

    OBJECTIVES: The aim of this study was to investigate if exercise intensity guided by rating of perceived exertion (RPE) results in an equivalent cardiovascular response when applied in either a center-based or a home-based setting. DESIGN: Data from patients with heart disease (post-valve surgery...... intensity was objectively measured using heart rate (HR) monitors. RESULTS: A total of 2622 RPE values with corresponding HR data were available. There was no difference in the level of association (interaction P = 0.51) between HR and RPE seen in the center-based setting (mean of 6.1 beats/min per 1...

  3. Improvement of myocardial perfusion detected by 201Tl scintigraphy on cardiac rehabilitation for patients with coronary artery disease

    International Nuclear Information System (INIS)

    The effect of cardiac rehabilitation (mean 70±48 months) on myocardial perfusion was assessed using thallium-201 (201Tl) exercise study in 63 patients with coronary artery disease (CAD). Subjects were those in a rehabilitation group (Rh=42) participating in supervised sports training two to three times per week and the control group (Ct=21) not taking active daily exercise. The interval between two 201Tl SPECT studies was 19±16 months. After physical training, total duration of the exercise test increased from 443±112 to 536±121 seconds (+19%) in the Rh group, and from 484±129 to 432±115 seconds in the Ct group (-10.7%) (p2 to 269.8±58 x 102 in the Rh group and decreased from 218.7±40 x 102 to 216.6±76 x 102 (p201Tl myocardial perfusion defect on exercise improved more in 54.8% (stress 59.5%, rest 35.7%) in the Rh group than in the Ct group (9.5%, p201Tl perfusion defect decreased from 68 (23.1%) to 49 regions (16.7%) of 294 total myocardial regions in the Rh group on exercise. However. it increased from 39 (26.5%) to 44 (29.9%) regions of 147 regions in the Ct group (p<0.01). Thus, cardiac rehabilitation increases exercise tolerance with improvement of myocardial perfusion. suggesting that cardiac rehabilitation is an advisable and effective treatment for patients with ischemic heart disease. (author)

  4. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  5. Empowered to Differ : Stakeholders' Influences in Community-Based Rehabilitation

    NARCIS (Netherlands)

    Finkenflugel, H.J.M.

    2004-01-01

    Since the advent of Community-based rehabilitation (CBR) in 1976, many developing countries have conducted CBR projects. CBR has been presented as a relevant and costeffective way to provide rehabilitation services to people with disabilities. Twenty-five years later it was concluded that, despite

  6. Evaluation of the Effect of Cardiac Rehabilitation on Left Ventricular Diastolic and Systolic Function and Cardiac Chamber Size in Patients Undergoing Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Kourosh Soleimannejad

    2015-10-01

    Full Text Available Background: Exercise and rehabilitation are important methods for decreasing the risk factors of coronary artery disease (CAD. We aimed to evaluate the effect of the cardiac rehabilitation (CR exercise program on the cardiac structure and physiology in patients undergoing percutaneous coronary intervention (PCI.Methods: In this randomized controlled study, 146 patients with CAD were divided equally into two groups: case group (undertaking CR after PCI and control group (without rehabilitation after PCI. All the patients in the case group underwent echocardiography (before and after CR, and echocardiography was performed for the control group simultaneously. The CR exercise program encompassed 24 sessions, twice or three times a week, with each session lasting between 15 and 45 minutes, depending on the individual patient’s tolerance. Left ventricular (LV ejection fraction, LV diastolic function, LV end-systolic and diastolic diameter, and right ventricular (RV end-diastolic diameter were measured in the CR group before and after rehabilitation and compared to those in the control group at the same times.Results: In this study, 146 patients (46 female and 100 male were evaluated: 73 in the rehabilitation group and 73 in the control group. The mean age of the patients in the CR and control groups was 58.05 ± 10.27 and 56.76 ± 10.07 years, respectively. The CR exercise program had useful effects on LV diastolic function after PCI. The distribution of LV diastolic dysfunction after the CR exercise program was changed significantly only in the CR group (p value = 0.043. In the CR group, normal, grade I, grade II, and grade III LV diastolic dysfunction were observed in 20.5%, 69.8%, 6.8%, and 2.7%, respectively. This distribution was changed respectively to 30.1%, 61.6%, 5.4%, and 2.7% following CR, which showed a significant improvement due to CR in LV diastolic function, most prominently in the patients with grade I diastolic dysfunction (p

  7. Peak oxygen uptake after cardiac rehabilitation: a randomized controlled trial of a 12-month maintenance program versus usual care.

    Directory of Open Access Journals (Sweden)

    Erik Madssen

    Full Text Available BACKGROUND: Exercise capacity is a strong predictor of survival in patients with coronary artery disease (CAD. Exercise capacity improves after cardiac rehabilitation exercise training, but previous studies have demonstrated a decline in peak oxygen uptake after ending a formal rehabilitation program. There is a lack of knowledge on how long-term exercise adherence can be achieved in CAD patients. We therefore assessed if a 12-month maintenance program following cardiac rehabilitation would lead to increased adherence to exercise and increased exercise capacity compared to usual care. MATERIALS AND METHODS: Two-centre, open, parallel randomized controlled trial with 12 months follow-up comparing usual care to a maintenance program. The maintenance program consisted of one monthly supervised high intensity interval training session, a written exercise program and exercise diary, and a maximum exercise test every third month during follow-up. Forty-nine patients (15 women on optimal medical treatment were included following discharge from cardiac rehabilitation. The primary endpoint was change in peak oxygen uptake at follow-up; secondary endpoints were physical activity level, quality of life and blood markers of cardiovascular risk. RESULTS: There was no change in peak oxygen uptake from baseline to follow-up in either group (intervention group 27.9 (±4.7 to 28.8 (±5.6 mL·kg (-1 min (-1, control group 32.0 (±6.2 to 32.8 (±5.8 mL·kg (-1 min (-1, with no between-group difference, p = 0.22. Quality of life and blood biomarkers remained essentially unchanged, and both self-reported and measured physical activity levels were similar between groups after 12 months. CONCLUSIONS: A maintenance exercise program for 12 months did not improve adherence to exercise or peak oxygen uptake in CAD patients after discharge from cardiac rehabilitation compared to usual care. This suggests that infrequent supervised high intensity interval training

  8. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    Energy Technology Data Exchange (ETDEWEB)

    El Demerdash, Salah [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Khorshid, Hazem, E-mail: hazemkhorshid@yahoo.com [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salah, Iman; Abdel-Rahman, Mohamed A. [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salem, Alaa M. [Department of Internal Medicine, Medical Division, National Research Centre, Cairo (Egypt)

    2015-07-15

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  9. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    International Nuclear Information System (INIS)

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  10. Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Sherin H.M. Mehani

    2013-03-01

    Full Text Available Chronic heart failure (CHF is a complex syndrome characterized by progressive decline in left ventricular function, low exercise tolerance and raised mortality and morbidity. Left ventricular diastolic dysfunction plays a major role in CHF and progression of most cardiac diseases. The current recommended goals can theoretically be accomplished via exercise and pharmacological therapy so the aim of the present study was to evaluate the impact of cardiac rehabilitation program on diastolic dysfunction and health related quality of life and to determine the correlation between changes in left ventricular diastolic dysfunction and domains of health-related quality of life (HRQoL. Forty patients with chronic heart failure were diagnosed as having dilated cardiomyopathy (DCM with systolic and diastolic dysfunction. The patients were equally and randomly divided into training and control groups. Only 30 of them completed the study duration. The training group participated in rehabilitation program in the form of circuit-interval aerobic training adjusted according to 55–80% of heart rate reserve for a period of 7 months. Circuit training improved both diastolic and systolic dysfunction in the training group. On the other hand, only a significant correlation was found between improvement in diastolic dysfunction and health related quality of life measured by Kansas City Cardiomyopathy Questionnaire. It was concluded that improvement in diastolic dysfunction as a result of rehabilitation program is one of the important underlying mechanisms responsible for improvement in health-related quality of life in DCM patients.

  11. Cardiac Rehabilitation is Associated with Lasting Improvements in Cognitive Function in Older Adults with Heart Failure

    Science.gov (United States)

    Alosco, Michael L.; Spitznagel, Mary Beth; Cohen, Ronald; Sweet, Lawrence H.; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Objective Heart failure (HF) is a known risk factor for cognitive impairment. Cardiac rehabilitation (CR) may attenuate poor neurocognitive outcomes in HF via improved physical fitness—a significant promoter of cognitive function. However, no study has examined the possible acute and lasting benefits of CR on cognitive function in persons with HF. Methods and Results 52 patients with HF completed a 12-week Phase II CR program. All participants were administered neuropsychological testing and completed a brief physical fitness assessment at baseline, completion of CR (i.e. 12-weeks), and 12-month follow-up. Repeated measures analyses showed a significant time effect for both attention/executive function and memory (p performance increased from baseline to 12-weeks and these gains remained up to 12-months; memory was unchanged from baseline to 12-weeks, but then improved between the 12-week and 12-month time points. Physical fitness improved from baseline to 12-weeks and these benefits were maintained 12-months later. Changes in physical fitness and cognitive function over time did not reach a statistically significant association, though poorer physical fitness was associated with decreased cognitive performance at the baseline and 12-month time points. Conclusions CR is associated with both acute and lasting cognitive benefits in patients with HF. Prospective studies with extended follow-ups are needed to clarify the mechanisms that underpin cognitive improvements following CR (e.g., improved cerebral perfusion) and whether CR can ultimately reduce risk for cognitive decline and conditions like Alzheimer’s disease in HF. PMID:25181916

  12. Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine

    Directory of Open Access Journals (Sweden)

    Monica Lamberti

    2016-08-01

    Full Text Available Objectives: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR program for return to work (RTW after acute coronary syndrome (ACS. Material and Methods: We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL, light (L, moderate (M, and heavy (H. Work-related outcomes were assessed with the Work Performance Scale (WPS of the Functional Status Questionnaire and as “days missed from work” (DMW in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs, and participation or non-participation in the CR program (CR+ and CR–. Results: One hundred thirty (66% patients took part in the CR program. Total WPS scores for CR+ and CR– subgroups were VL group: 18±4 vs. 14±4 (p < 0.001, L group: 18±3 vs. 14±3 (p < 0.0001, M group: 19±3 vs. 16±3 (p < 0.003, and H group: 20±4 vs. 17±3 (p < 0.006. Fewer DMW were reported by the CR+ group. Conclusions: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in the workplace, in particular among clerical workers.

  13. Safety of early enrollment into outpatient cardiac rehabilitation after open heart surgery.

    Science.gov (United States)

    Pack, Quinn R; Dudycha, Kent J; Roschen, Kyle P; Thomas, Randal J; Squires, Ray W

    2015-02-15

    The safety of early enrollment (after hospital discharge) into cardiac rehabilitation (CR) after recent coronary artery bypass graft (CABG) surgery or heart valve surgery (HVS) has not previously been assessed and has important policy implications. Consequently, we performed a detailed review of all clinical adverse events within 6 months of hospital discharge. We compared early and late attendees for patients undergoing CABG surgery or HVS and included patients with myocardial infarction (MI) as an additional control group. We analyzed 112 patients undergoing CABG surgery, 69 patients undergoing HVS, and 59 patients with MI. Median time (interquartile range) from hospital discharge to CR enrollment was 10.5 (8 to 15), 12 (8.5 to 21), and 9 days (7 to 14), respectively. There was no difference in major event rates between early and late enrollees (17% vs 17%, respectively, log-rank p = 0.98) or by diagnosis (15%, 16%, and 22% for CABG surgery, HVS, and MI, respectively; log-rank p = 0.50). Sternal instability and wound infection rates were similar. CR-related adverse events trended toward increased event rates in surgical and early enrollees, but of 44 events, only 3 were exercise related, none resulted in permanent harm, and 41 (93%) were managed in CR without need for emergency services. In conclusion, it appears that a policy of encouraging early enrollment into CR in patients with a recent open heart surgery seems unlikely to harm patients when careful individualized assessment and exercise prescription take place within the bounds of an established CR program. PMID:25543236

  14. Drive time to cardiac rehabilitation: at what point does it affect utilization?

    Directory of Open Access Journals (Sweden)

    Stewart Donna E

    2010-06-01

    Full Text Available Abstract Background A 30 minute drive time threshold has often been cited as indicative of accessible health services. Cardiac rehabilitation (CR is a chronic disease management program designed to enhance and maintain cardiovascular health, and geographic barriers to utilization are often cited. The purpose of this study was to empirically test the drive time threshold for CR utilization. Methods A prospective study, using a multi-level design of coronary artery disease outpatients nested within 97 cardiologists. Participants completed a baseline sociodemographic survey, and reported CR referral, enrollment and participation in a second survey 9 months later. CR utilization was verified with CR sites. Geographic information systems were used to generate drive times at 60, 80 and 100% of the speed limit to the closest CR site from participants' homes, to take into consideration various traffic conditions. Bivariate analysis was used to test for differences in CR referral, enrollment and degree of participation by drive time. Logistic regression was used to test drive time increments where significant differences were found. Results Drive times were generated for 1209 outpatients. Overall, CR referral was verified for 523 (43.3% outpatients, with verified enrollment for 444 (36.7% participating in a mean of 86.4 ± 25.7% of prescribed sessions. There were significant differences in CR referral and enrollment by drive time (ps Conclusions Physicians may be taking geography into consideration when referring patients to CR. Empirical consideration also reveals that patients are significantly less likely to enroll in CR where they must drive 60 minutes or more to the closest program. Once enrolled, distance has no significant effect on degree of participation.

  15. Feasibility and effects of adapted cardiac rehabilitation after stroke: a prospective trial

    Directory of Open Access Journals (Sweden)

    Marzolini Susan

    2010-06-01

    Full Text Available Abstract Background Despite the cardiovascular etiology of stroke, exercise and risk factor modification programs akin to cardiac rehabilitation (CR are not available. This study aimed to establish the feasibility of adapting a CR model for individuals with mild to moderate stroke disability. A secondary objective was to determine the program's effects on aerobic and walking capacity, and stroke risk factors. Methods A repeated measures design was used with a 3-month baseline period and 6-month adapted CR intervention (n = 43, mean ± SD age 65 ± 12 years, 30 ± 28 months post stroke. Feasibility was determined by the number of participants who completed the study, occurrence of adverse events and frequency, duration and intensity of exercise performed. To determine effectiveness of the program, outcomes measured included aerobic capacity (VO2peak, ventilatory threshold, 6-Minute Walk Test (6MWT distance, and risk factors. Descriptive statistics characterized the classes attended and number and intensity of exercise sessions. Paired t-tests, one-factor repeated measures analyses of variance contrasts and chi-square analyses were used to compare changes over time. Results Two participants withdrew during the baseline period. Of the remaining 41 participants who commenced the program, 38 (93% completed all aspects. No serious adverse effects occurred. Post-intervention, VO2peak improved relative to the stable baseline period (P = 0.046 and the increase in ventilatory threshold approached significance (P = 0.062. Conclusions CR is feasible after stroke and may be adapted to accommodate for those with a range of post-stroke disability. It is effective in increasing aerobic capacity. CR may be an untapped opportunity for stroke survivors to access programs of exercise and risk factor modification to lower future event risk. Trial registration ClinicalTrials.gov registration number: NCT01067495

  16. Effects of Phase III Cardiac Rehabilitation Programs on Anxiety and Quality of Life in Anxious Patients after Coronary Artery Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Gholamreza Babaei Ruchi

    2007-09-01

    Full Text Available Background: Patients with psychological problems after coronary artery bypass graft surgery (CABG show poorer outcomes; nevertheless, there is a paucity of research into the effects of cardiac rehabilitation programs on such patients. The purpose of this study was to determine the effect of phase III cardiac rehabilitation programs on the anxiety and quality of life of anxious patients who had undergone CABG in Iran.Methods: Six weeks after CABG, 83 anxious patients participated in an 8-week cardiac rehabilitation program that consisted of formal supervised exercise training and educational sessions. The state/trait anxiety inventory and SF-36 questionnaire were two instruments for collecting data in the present study. Of the total of 83, 66 participants saw out the eight-week period. Results: With the exception of the mental health aspect, significant improvements were noted in the following components of the quality of life measures after the cardiac rehabilitation program: physical functioning (P<0.001, role-physical (P<0.001, bodily pain (P<0.001, social functioning, (P=0.003, general health (P=0.020, vitality (P=0.006, and role-emotional (P=0.003. Additionally, significant reductions were observed in state anxiety (P=0.010 and trait anxiety (P=0.010(.Conclusion: These findings suggest that phase III cardiac rehabilitation may be an effective therapy for improving psychological outcomes of patients with psychological problems after CABG

  17. Rehabilitering

    DEFF Research Database (Denmark)

    Stokholm, Gitte; Jensen, Liselotte; Petersen, Charlotte

    Fokus på forståelse af rehabilitering som tværfaglig tilgang indrettet på borgerens præmisser. Der diskuteres faldgrupper og fortolkningsspørgsmål, der opstår, når man gerne vil handle politisk korrekt og lade de personer, det drejer sig om, komme til orde og få indflydelse. Emner er handicappoli......Fokus på forståelse af rehabilitering som tværfaglig tilgang indrettet på borgerens præmisser. Der diskuteres faldgrupper og fortolkningsspørgsmål, der opstår, når man gerne vil handle politisk korrekt og lade de personer, det drejer sig om, komme til orde og få indflydelse. Emner er...... handicappolitik nationalt og internationalt, funktsionshæmning i et samfundsmæssigt perspektiv, sundhedsfremme i rehabiliteringsprocessen, rehabilitering og sundhedspædagogik, lovgivning og rehabilitering. Desuden personlige fortællinger af mennesker, der har oplevet rehabilitering på egen krop....

  18. A Canadian, Multicentre, Randomized Clinical Trial of Home-Based Pulmonary Rehabilitation in Copd: Rationale and Methods

    Directory of Open Access Journals (Sweden)

    François Maltais

    2005-01-01

    Full Text Available BACKGROUND: Pulmonary rehabilitation remains largely underused. Self-monitored, home-based rehabilitation is a promising approach to improving the availability of pulmonary rehabilitation.

  19. Rehabilitering

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2008-01-01

    En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser.......En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser....

  20. Effect of Cardiac Rehabilitation Program on Exercise Capacity in Women Undergoing Coronary Artery Bypass Graft in Hamadan-Iran

    OpenAIRE

    Ramin Shabani; Abas A Gaeini; Nikoo, Mohamad R.; Hojatollah Nikbackt; Majid Sadegifar

    2010-01-01

    Objectives: The purpose of this study was to determine the effects of cardiac rehabilitation program (CRP) on exercise capacity and rate pressure product (RPP) in Iranian female patients undergoing coronary artery bypass grafting (CABG) in Hamadan, Iran. Methods: Sixty women after CABG were assigned into an exer-cise group (n = 30, mean age 58.5 ± 10.8 years), who performed physical training for 12 weeks, or a control group (n = 30, mean age 59.3 ± 8.6 years) who received usual care. Funct...

  1. The effect of the cardiac rehabilitation program on obese and non-obese females with coronary heart disease

    Directory of Open Access Journals (Sweden)

    Fatemeh Esteki Ghashghaei

    2012-01-01

    Full Text Available Introduction: Obesity is strongly associated with coronary heart disease and it is known as an independent risk factor. So, the aim of this study was to investigate the effects of phase II comprehensive cardiac rehabilitation program on obesity indexes, functional capacity, lipid profiles, and fasting blood sugar in obese and non-obese female patients with coronary heart disease and to compare changes in these groups. Materials and Methods: Two hundred and five women with coronary heart disease participated in our study. At the beginning of study, body mass index, functional capacity, and lipid profiles and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had BMI≥30 were known as obese and who had BMI<30 were known as non-obese patients. All of them completed the period of cardiac rehabilitation program, and 2 months later, all risk factors were examined for the second time in each group. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t-tests and paired t-tests were used. Results: Data revealed that unless in weight (P=0.00 and functional capacity (P=0.001, there were no significant differences in obese and non-obese female patients, at baseline. As a result of the cardiac rehabilitation program, both groups had significant improvement in functional capacity (P=0.00, weight reduction (P=0.00, triglyceride (P=0.01 and P=0.02, respectively, low-density lipoprotein cholesterol (P=0.01, and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P=0.00 and P=0.003, respectively. As well, significant improvement was observed in high-density lipoprotein (P=0.01 only in obese female, and non-obese female had significant differences in total cholesterol (P=0.003. However, there were not significant changes in total cholesterol (P=0.05 and fasting blood sugar (P=0.09 in obese female. Also, non-obese females didn′t have

  2. Personality and the physician-patient relationship as predictors of quality of life of cardiac patients after rehabilitation

    Directory of Open Access Journals (Sweden)

    Farin Erik

    2010-09-01

    Full Text Available Abstract Background Numerous studies document the influence of psychosocial variables on the course of coronary heart disease. This study examines the influence of personality traits (trait anger, cynicism and aspects of the physician-patient relationship (promoting patient participation by the physician, active communication behavior of the patient, trust in the physician on the health related quality of life (HRQOL of cardiac patients after rehabilitation. Methods N = 331 patients with chronic ischemic heart disease were surveyed using questionnaires at two time points (beginning and end of 3-weeks inpatient rehabilitation. In addition, characteristics of the disease and cardiac risk factors were provided by the physician. HRQOL was measured using a total of six scales and three instruments: SF-12, MacNew questionnaire, and SAQ. Hierarchical regression analyses were carried out to predict HRQOL after rehabilitation, in which the baseline values of HRQOL, sociodemographic variables, characteristics of the disease and risk factors, personality traits, and finally the aspects of the physician-patient relationship were included stepwise. As a number of variables were used for the regression models, multiple imputation was conducted. Results The baseline values explain most of the variance (42%-60%. After controlling the baseline values, the sociodemographic variables explain up to 5% incremental variance of HRQOL, with income being the most important predictor. The characteristics of the disease and cardiac risk factors explain between 0.4% and 3.8% incremental variance, however, variance increase is often not significant. The personality traits added in the fourth step explain up to 2% additional variance; trait anger is a significant predictor of HRQOL in three of the six scales. The features of the physician-patient relationship included in the last step lead to a significant increase in explained variance (between 1.3% and 3.9% for all six

  3. CAMERA-BASED SOFTWARE IN REHABILITATION/THERAPY INTERVENTION

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2014-01-01

    Use of an affordable, easily adaptable, ‘non-specific camera-based software’ that is rarely used in the field of rehabilitation is reported in a study with 91 participants over the duration of six workshop sessions. ‘Non-specific camera-based software’ refers to software that is not dependent......, and accessible software EyeCon is a potent and significant tool in the field of rehabilitation/therapy and warrants wider exploration....

  4. Lifestyle and the importance of health education in the cardiac rehabilitation after myocardial revascularization surgery - doi:10.5020/18061230.2007.p213

    Directory of Open Access Journals (Sweden)

    Denise Gonçaleves Moura Pinheiro

    2012-01-01

    Full Text Available In the treatment of ischemic cardiopathy, the prevention has a main role and the modifications in the lifestyle are indispensable for the good prognosis of the disease. The goal of the study was to describe the lifestyle regarding the prevalence of cardiovascular risk factors, such as smoking, alcohol consumption, dietary habits and sedentary behaviors before myocardial revascularization surgery and during the period of cardiac rehabilitation in a private institution that did not comprise structured health education activities. This was a retrospective, observational study, with a qualitative approach, held with 50 patients submitted to cardiac rehabilitation (36 men and 14 women; age 61±12.74 years. The data were collected from clinical records of the pre-cardiac rehabilitation evaluation which consisted of clinical data and information referring to the patients’ lifestyle. Amongst the most prevalent co-morbidities in the sample, there were: the hypertension (n=24; 48%, the diabetes mellitus (n=18; 36% and dyslipidemias (n=17; 34%. A high rate of smoke cessation (100% and 58% of sedentary behaviors (n=29 was observed after the cardiac surgery. This same number (n=29; 58% referred to have adhered to changes in dietary habits after the myocardial acute infarct. There was also an increase in the prevalence of alcohol consumption (n=21; 42% after myocardial revascularization. We conclude with this research that a cardiac rehabilitation program should provide to their patients, health education actions, for a necessary and real change in lifestyle habits, with the presence of a multidisciplinary team.

  5. Gender Differences in Patients' Beliefs About Biological, Environmental, Behavioral, and Psychological Risk Factors in a Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Mozhgan Saeidi

    2014-11-01

    Full Text Available Introduction: There are significant gender differences in the epidemiology and presentation of cardiovascular diseases (CVDs, physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program. Materials and Methods: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients’ medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test​​. To do the statistical analysis, SPSS version 20 was utilized. Results: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease (X2= 48.36; P

  6. Randomised controlled trial of a 12 week yoga intervention on negative affective states, cardiovascular and cognitive function in post-cardiac rehabilitation patients

    OpenAIRE

    Yeung, Alan; Kiat, Hosen; Denniss, A Robert; Cheema, Birinder S.; Bensoussan, Alan; Machliss, Bianca; Colagiuri, Ben; Chang, Dennis

    2014-01-01

    Background Negative affective states such as anxiety, depression and stress are significant risk factors for cardiovascular disease, particularly in cardiac and post-cardiac rehabilitation populations. Yoga is a balanced practice of physical exercise, breathing control and meditation that can reduce psychosocial symptoms as well as improve cardiovascular and cognitive function. It has the potential to positively affect multiple disease pathways and may prove to be a practical adjunct to cardi...

  7. Design of a randomized controlled trial of comprehensive rehabilitation in patients with myocardial infarction, stabilized acute coronary syndrome, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting: Akershus Comprehensive Cardiac Rehabilitation Trial (the CORE Study

    Directory of Open Access Journals (Sweden)

    Karin Kogstad Else

    2000-11-01

    Full Text Available Abstract Objectives 1. To assess the long-term effectiveness of a comprehensive cardiac rehabilitation programme on quality of life and survival in patients with a large spectrum of cardiovascular diseases (myocardial infarction, acute coronary syndrome, percutaneous transluminal coronary angioplasty and coronary artery bypass grafting. 2. To establish the degree of correlation between expected improvement of health-related quality of life and improvement in physical function attributable to rehabilitation in the intervention group, in comparison with similar changes in the conventional care group. Design Randomized, controlled, parallel-group design (intervention/conventional care. Setting Akershus County, southeast of Oslo City, Norway. Participants 500 patients, men and women, aged 40-85 years, who have sustained at least one of the above-mentioned cardiovascular diseases. Interventions 8 weeks of supervised, structured physical training of three periods of 20 min per week, targeting a heart rate of 60-70% of the individual's maximum; home-based physical exercise training with the same basic schedule as in the supervised period; quantification of patients' compliance with the exercise programme by the use of wristwatches, information stored in the watch memory being retrieved once a month during the 3-year follow-up period; and life-style modification with an emphasis on the cessation of smoking and on healthy nutrition and weight control.

  8. Cardiac acceleration at the onset of exercise: a potential parameter for monitoring progress during physical training in sports and rehabilitation.

    Science.gov (United States)

    Hettinga, Florentina J; Monden, Paul G; van Meeteren, Nico L U; Daanen, Hein A M

    2014-05-01

    There is a need for easy-to-use methods to assess training progress in sports and rehabilitation research. The present review investigated whether cardiac acceleration at the onset of physical exercise (HRonset) can be used as a monitoring variable. The digital databases of Scopus and PubMed were searched to retrieve studies investigating HRonset. In total 652 studies were retrieved. These articles were then classified as having emphasis on HRonset in a sports or rehabilitation setting, which resulted in 8 of 112 studies with a sports application and 6 of 68 studies with a rehabilitation application that met inclusion criteria. Two co-existing mechanisms underlie HRonset: feedforward (central command) and feedback (mechanoreflex, metaboreflex, baroreflex) control. A number of studies investigated HRonset during the first few seconds of exercise (HRonsetshort), in which central command and the mechanoreflex determine vagal withdrawal, the major mechanism by which heart rate (HR) increases. In subsequent sports and rehabilitation studies, interest focused on HRonset during dynamic exercise over a longer period of time (HRonsetlong). Central command, mechanoreflexes, baroreflexes, and possibly metaboreflexes contribute to HRonset during the first seconds and minutes of exercise, which in turn leads to further vagal withdrawal and an increase in sympathetic activity. HRonset has been described as the increase in HR compared with resting state (delta HR) or by exponential modeling, with measurement intervals ranging from 0-4 s up to 2 min. Delta HR was used to evaluate HRonsetshort over the first 4 s of exercise, as well as for analyzing HRonsetlong. In exponential modeling, the HR response to dynamic exercise is biphasic, consisting of fast (parasympathetic, 0-10 s) and slow (sympathetic, 1-4 min) components. Although available studies differed largely in measurement protocols, cross-sectional and longitudinal training studies showed that studies analyzing HRonset

  9. Study on upper limb rehabilitation system based on surface EMG.

    Science.gov (United States)

    Wang, Lan; Li, Hailong; Wang, Zhengyu; Meng, Fandong

    2015-01-01

    During the rehabilitation process, it is essential to accurately judge a patient's recovery in a timely manner. A reasonable and matched training program is significant in the development of rehabilitation system. This paper presents a new upper limb rehabilitation training system, which consists of an upper limb rehabilitation training device, a current detection circuit, a motor speed test circuit, a surface EMG (sEMG) sensor, and a dSPACE HIL simulation platform. The real-time output torque of the servo motor is calculated by using the motor's real-time current and speed, in order to monitor the patient's training situation. The signal of sEMG is collected in real time and is processed with root mean square (RMS) to characterize the degree of muscle activation. Based on this rehabilitation system, maximum voluntary contraction (MVC) experiments, passive training experiments under different speeds, and active training experiments under different damping are studied. The results show that this new system performs real-time and accurate monitoring of a patient's training situation. It can also assess a patient's recovery through muscle activation. To a certain extent, this system provides a platform for research and development of rehabilitation medical engineering.

  10. Evaluation of a Standardized Patient Education Program for Inpatient Cardiac Rehabilitation: Impact on Illness Knowledge and Self-Management Behaviors up to 1 Year

    Science.gov (United States)

    Meng, Karin; Seekatz, Bettina; Haug, Günter; Mosler, Gabriele; Schwaab, Bernhard; Worringen, Ulrike; Faller, Hermann

    2014-01-01

    Patient education is an essential part of the treatment of coronary heart disease in cardiac rehabilitation. In Germany, no standardized and evaluated patient education programs for coronary heart disease have been available so far. In this article, we report the evaluation of a patient-oriented program. A multicenter quasi-experimental,…

  11. Effect of gender and type 2 diabetes mellitus on heart rate recovery in patients with coronary artery disease after cardiac rehabilitation

    NARCIS (Netherlands)

    Soleimani, A.; Abbasi, K.; Nejatian, M.; Movahhedi, N.; Hajizaynali, M. Ali; Salehiomran, A.; Abbasi, S. Hesameddin; Alidoosti, M.; Sheikhfathollahi, M.; Abbasi, A.

    2010-01-01

    Aim. The purpose of this study was to clarify whether type 2 diabetic patients with coronary disease are subject to similar benefits on heart rate recovery (HRR) as non-diabetic coronary individuals after cardiac rehabilitation, assessing separately male and female subjects separately. Methods. Data

  12. Effect of gender and type 2 diabetes mellitus on heart rate recovery in patients with coronary artery disease after cardiac rehabilitation

    NARCIS (Netherlands)

    Soleimani, Abbas; Nejatian, Mostafa; Hajizaynali, Mohammad Ali; Abbasi, Seyed Hesameddin; Alidoosti, Mohammad; Sheikhfathollahi, Mahmood; Abbasi, Ali

    2009-01-01

    Introduction: The purpose of this study was to clarify whether type 2 diabetic patients with coronary disease are subject to similar benefits in heart rate recovery (HRR) as non-diabetic counterpatrs after cardiac rehabilitation, assessing men and women subjects separately. Material and methods: The

  13. Rehabilitering

    DEFF Research Database (Denmark)

    Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja

    2013-01-01

    Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...... beskæftigelsesindsatsen. Med dette temanummer af Social Politik ønsker vi at sætte fokus på rehabiliteringsbegrebets udbredelse og udfyldelse, og de konsekvenser de aktuelle social- og beskæftigelsespolitiske tendenser kan have for den konkrete rehabiliteringsindsats i praksis....

  14. Current trends in reducing cardiovascular disease risk factors from around the world: focus on cardiac rehabilitation in Brazil.

    Science.gov (United States)

    Borghi-Silva, Audrey; Mendes, Renata Gonçalves; Trimer, Renata; Cipriano, Gerson

    2014-01-01

    Cardiovascular diseases (CVD) are among the leading causes of morbidity and mortality in Brazil. Cardiac rehabilitation (CR) is a program composed of structured exercise training, comprehensive education and counseling to positively impact functional, psychological, social, and quality of life aspects in these patients. However, the delivery of formal CR programs is limited to major metropolitan centers in Brazil and does not exist in much of the national territory, specifically in the North and Northeast regions. Barriers to the inclusion of qualified patients are lack of referral by the health professionals, as well as transportation difficulties, low income, lack of insurance coverage, and low educational level. Government efforts to implement CR programs on a broader scale, to reach a larger portion of the CVD population, are imperative. Additional research must be focused on the assessment of CR referral and adherence patterns as well as the effectiveness of different CR delivery models.

  15. Cancer survivors' experience of exercise-based cancer rehabilitation

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Hammer, Nanna Maria; Andersen, Christina;

    2015-01-01

    BACKGROUND: Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative...... research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. MATERIAL......-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental...

  16. Serious Games for Home-based Stroke Rehabilitation.

    Science.gov (United States)

    Friedrich, Raoul; Hiesel, Patrick; Peters, Sebastian; Siewiorek, Daniel P; Smailagic, Asim; Brügge, Bernd

    2015-01-01

    On average, two thousand residents in the United States experience a stroke every day. These circumstances account for $28 billion direct costs annually and given the latest predictions, these costs will more than triple by 2030. In our research, we propose a portfolio of serious games for home-based stroke rehabilitation. The objective of the game approach is to enrich the training experience and establish a higher level of compliance to prescribed exercises, while maintaining a supportive training environment as found in common therapy sessions. Our system provides a collection of mini games based on rehabilitation exercises used in conventional physical therapy, monitors the patient's performance while exercising and provides clinicians with an interface to personalize the training. The clinician can set the current state of rehabilitation and change the playable games over time to drive diversification. While the system still has to be evaluated, an early stage case study with one patient offered positive indications towards this concept.

  17. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    2016-01-01

    Trials (CENTRAL) (The Cochrane Library, Issue 6, 2014) from December 2009 to July 2014. We also searched MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Science Citation Index Expanded (December 2009 to July 2014). SELECTION CRITERIA: We included randomised controlled trials (RCTs) of exercise...

  18. An interactive game-based shoulder wheel system for rehabilitation

    Directory of Open Access Journals (Sweden)

    Chou LW

    2012-11-01

    Full Text Available Chun-Ming Chang,1,* Yen-Ching Chang,2,3 Hsiao-Yun Chang,4 Li-Wei Chou5,6,* 1Department of Applied Informatics and Multimedia, Asia University, Taichung, Taiwan; 2Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan; 3Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan; 4Department of Biotechnology, Asia University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan*These authors contributed equally to this workBackground: Increases in the aging population and in the number of accidents have resulted in more people suffering from physical impairments or disabilities. Rehabilitation therapy thus attracts greater attention as a means of helping patients recover and return to a normal life. With the extremely long and tedious nature of traditional rehabilitation, patients are reluctant to continue the entire process, thus the expected effects of the therapy cannot be obtained. Games are well known to help patients improve their concentration and shift their attention away from the discomfort of their injuries during rehabilitation. Thus, incorporating game technology into a rehabilitation program may be a promising approach.Methods: In this study, a gaming system used for shoulder rehabilitation was developed. The mechanical parts and electric circuits were integrated to mimic the functionalities of a shoulder wheel. Several games were also designed to suit the rehabilitation needs of the patients based on the age and gender differences among the individual users, enabling individuals to undergo the rehabilitation process by playing games. Two surveys were conducted to evaluate the satisfaction of the participants regarding the gaming system.Results: The results of the online survey among a larger population

  19. The Effects of Exercise Cardiac Rehabilitation on Anxiety, Depression and Quality of Life in Coronary Artery Bypass Grafting Patients

    Directory of Open Access Journals (Sweden)

    A. Yalfani

    2012-04-01

    Full Text Available Introduction & Objective: Despite advancement in technology such as coronary artery bypasses grafting (CABG prevalence of anxiety and depression remain high after cardiac events, which have been found to influence recovery process, recurrent cardiac events and patients’ quality of life. Cardiac Rehabilitation (CR as part of secondary prevention aims to improve patients’ physical, psychological and quality of life (QoL status. As there is lack of study in this area in Iran, the present study aim to investigate the effects of a 12 week exercise CR on anxiety, depression and quality of life in the Iranian CABG patients.Materials & Methods: In this cross sectional study 72 consecutive CABG patients referred to and enrolled in a 12 week (3 session per week CR program in rehabilitation center of Shahid Beheshti hospital of Hamadan(Iran. 60 patients completed and 12(17% dropped out of the program. Patients underwent exercise testing using modified Bruce protocol before and immediately after CR. Initial exercise intensity was 45-55% of VO2 peak(peak of oxygen consumption which was progressively increased to 0.5 MET (metabolic equivalent unit per week to 70-85%. Patients also completed the quality of life questionnaire and hospital anxiety and depression scale (HADs at each time point.Results: Compared with pre CR exercise capacity, MET and BMI statistically improved after the program (P<0.001. The prevalence rate of anxiety and depression preprogram were 31.6% and 25% which statistically reduced post CR(11.6% and 8.4% . Further analysis indicated a significant improvement in all components of QoL (physical, mental and social similarly in men and women after the program. Additionally men and women did benefit from CR program similarly as there were no significant differences between men and women in terms of improvements in anxiety, depression and quality of life after the program.Conclusion: It is concluded that the completion of a CR program has

  20. Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS): a randomised controlled trial

    OpenAIRE

    Blake Catherine; Lennon Olive

    2009-01-01

    Abstract Background Coronary Heart Disease and Cerebrovascular Disease share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity and diabetes mellitus). Lifestyle interventions and pharmacological therapy are recognised as the cornerstones of secondary prevention. Cochrane review has proven the benefits of programmes incorporating exercise and lifestyle counselling in the cardiac disease population. ...

  1. Gait rehabilitation machines based on programmable footplates

    Directory of Open Access Journals (Sweden)

    Bernhardt Rolf

    2007-02-01

    Full Text Available Abstract Background Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. Results With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I. For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Conclusion Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles

  2. Determinants influencing the implementation of home-based stroke rehabilitation: a systematic review

    NARCIS (Netherlands)

    Siemonsma, P.; Dopp, C.; Alpay, L.; Tak, E.; Meeteren, N, van; Chorus, A.

    2014-01-01

    Purpose: Home-based rehabilitation is a promising alternative to regular center-based stroke rehabilitation. The objective of this study was to identify what is currently known about determinants that influence the implementation of home-based stroke rehabilitation (HBSR) in clinical practice. Metho

  3. Osseointegrated Implant Applications in Cosmetic and Functional Skull Base Rehabilitation

    OpenAIRE

    Benscoter, Brent J.; Jaber, James J.; Kircher, Matthew L.; Marzo, Sam J.; Leonetti, John P.

    2011-01-01

    This study discusses the indications, outcomes, and complications in patients that underwent osseointegrated implantation for skull base rehabilitation. We conducted a retrospective review of eight patients with skull base defects who had undergone implantation of a facial prosthetic retention device ± bone-anchored hearing aid at a tertiary academic referral center. Descriptive analysis of applications, techniques, outcomes, and complications were reviewed. The majority of patients were male...

  4. Use of intensified comprehensive cardiac rehabilitation to improve risk factor control in patients with type 2 diabetes mellitus or impaired glucose tolerance--the randomized DANish StUdy of impaired glucose metabolism in the settings of cardiac rehabilitation (DANSUK) study

    DEFF Research Database (Denmark)

    Soja, Anne Merete Boas; Zwisler, Ann-Dorthe Olsen; Frederiksen, Marianne;

    2007-01-01

    BACKGROUND: The DANish StUdy of impaired glucose metabolism in the settings of cardiac rehabilitation (DANSUK) examined the effect of an intensified multifactorial intervention on risk factor profile in 104 patients with type 2 diabetes mellitus (T2DM) or impaired glucose tolerance (IGT) attendin...

  5. The Benefit of a Cardiac Rehabilitation Programme on Cardiovascular and Exercise Parameters in Patients with Type 2 Diabetes Mellitus: The First Study Among the Iranian Population

    OpenAIRE

    Mostafa Nejatian; Manijeh Zarghampour; Abbasali Karimi; Mehrdad Sheikhvatan

    2011-01-01

    Background: An appropriate physical regimen in diabetic patients positively modified both motor and sensory neuromuscular parameters, improved functional capacity and slowed the progression of diabetes and its cardiovascular sequelae.Objective: We examined the effects of a cardiac rehabilitation (CR) programme on cardiovascular and exercise parameters in diabetic patients undergoing coronary artery bypass surgery (CABG) and compared them to non-diabetics.Methods: Data were collected prospecti...

  6. Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program

    OpenAIRE

    Bárbara Maria Hermes; Dannuey Machado Cardoso; Tiago José Nardi Gomes; Tamires Daros dos Santos; Marília Severo Vicente; Sérgio Nunes Pereira; Viviane Acunha Barbosa; Isabella Martins de Albuquerque

    2015-01-01

    Abstract Objective: To investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program. Methods: A prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II c...

  7. Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program

    Directory of Open Access Journals (Sweden)

    Bárbara Maria Hermes

    2015-08-01

    Full Text Available Abstract Objective: To investigate the efficiency of short-term inspiratory muscle training program associated with combined aerobic and resistance exercise on respiratory muscle strength, functional capacity and quality of life in patients who underwent coronary artery bypass and are in the phase II cardiac rehabilitation program. Methods: A prospective, quasi-experimental study with 24 patients who underwent coronary artery bypass and were randomly assigned to two groups in the Phase II cardiac rehabilitation program: inspiratory muscle training program associated with combined training (aerobic and resistance group (GCR + IMT, n=12 and combined training with respiratory exercises group (GCR, n=12, over a period of 12 weeks, with two sessions per week. Before and after intervention, the following measurements were obtained: maximal inspiratory and expiratory pressures (PImax and PEmax, peak oxygen consumption (peak VO2 and quality of life scores. Data were compared between pre- and post-intervention at baseline and the variation between the pre- and post-phase II cardiac rehabilitation program using the Student's t-test, except the categorical variables, which were compared using the Chi-square test. Values of P<0.05 were considered statistically significant. Results: Compared to GCR, the GCR + IMT group showed larger increments in PImax (P<0.001, PEmax (P<0.001, peak VO2 (P<0.001 and quality of life scores (P<0.001. Conclusion: The present study demonstrated that the addition of inspiratory muscle training, even when applied for a short period, may potentiate the effects of combined aerobic and resistance training, becoming a simple and inexpensive strategy for patients who underwent coronary artery bypass and are in phase II cardiac rehabilitation.

  8. Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial

    OpenAIRE

    Golabchi, Allahyar; Basati, Fatemeh; Kargarfard, Mehdi; Sadeghi, Masoumeh

    2012-01-01

    BACKGROUND Current guidelines recommend cardiac rehabilitation programs (CRP) as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function. METHODS This randomized, clinical trial included 29 men with ST elevation myocardial infarct...

  9. What is role of sex and age differences in marital conflict and stress of patients under Cardiac Rehabilitation Program?

    Science.gov (United States)

    Komasi, Saeid; Saeidi, Mozhgan

    2016-01-01

    BACKGROUND To investigate the role of sex and age differences in marital conflict and stress of patients who were under cardiac rehabilitation (CR) program. METHODS The data of this cross-sectional study were collected from the database of the CR Department of Imam Ali Hospital, Kermanshah, Iran. The demographics and medical data of 683 persons were collected from January 2003 and January 2010 using medical records, the Beck Anxiety Inventory, the Beck Depression Inventory, the Hudson’s Index of Marital Stress, and the Structured Clinical Interview for axis I disorders. Data were analyzed through Analysis of Covariance and Bonferroni test. RESULTS About 74.8% of the subjects were male. After adjustment for age, educational level, anxiety, and depression-the findings showed that women in CR program had a higher level of marital stress compared to men (54.75 ± 2.52 vs. 49.30 ± 0.89; P = 0.042). Furthermore, it was revealed that women who aged 56-65 years and more experienced higher level of marital stress compared to younger patients (P 0.050). CONCLUSION Marital conflict and stress threaten healthiness of women who aged 56-65 years more prominently than does in males or younger patients. Regarding the effect of marital stress on recurrence of the disease and cardiac-related morbidity and mortality in women, providing effective education and interventions to this group of patients, especially older women and even their spouses could be one of the useful objectives of CR programs. PMID:27752271

  10. The influence of a web-based tele-rehabilitation program on the physical fitness of coronary artery disease patients after the acute rehabilitation phase.

    OpenAIRE

    Frederix, Ines; Hansen, Dominique; Berger, Jan; Bonne, Kim; Van Driessche, Niels; DENDALE, PAUL

    2013-01-01

    Purpose: The aim of the study was to assess whether the addition of a motion sensor with automated feedback by email or SMS to the conventional in-hospital rehabilitation phase could enhance the physical condition of coronary artery disease patients. Methods: 37 coronary artery disease patients were included in this randomised, controlled trial after admission for PCI or CABG. All patients have been included during phase II of the cardiac rehabilitation program. Patients with a defibril...

  11. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

    Directory of Open Access Journals (Sweden)

    Eva Sahlin

    2015-02-01

    Full Text Available After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR. Region Västra Götaland (VGR started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57 and an occupational health service (OHS model (n = 45. Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

  12. Body Image and quality of life of senior citizens included in a cardiac rehabilitation program

    Directory of Open Access Journals (Sweden)

    Fernanda Vargas Amaral

    2013-12-01

    Full Text Available Most people who have to live with some kind of disease tend to adopt healthy habits and create new ways of seeing themselves. The aim of this study is to explore the relationship between the index of quality of life and self perception of patients included in a cardiovascular rehabilitation program in Florianopolis/Brazil. The sample consists of 24 subjects of 62 ± 1.3 years of age, who have coronary artery disease. The Minnesota Living With Heart Failure Questionnaire (MLHFQ was used to assess the quality of life, and to identify the degree of body image discontentment the Stunkard and Sorensen questionnaire (1993 was applied. Statistical analysis was made through statistics programs and the software SPSS 11.0. The degree of association between variables was studied with Kendall test. It was verified that the higher the BMI and the current body shape, the greatest the degree of body image dissatisfaction. The emotional symptoms also appear to be significantly correlated with a desire for a smaller body shape and with indicators of lower quality of life (r = 0474 = 0735, p major 0.05. The physical symptoms were also considerably associated with the emotional symptoms. These results suggest that the variables concerning the quality of life are meaningful to significant body image and satisfaction, which seems to correlate with fewer emotional problems and better facing of the disease. Cardiovascular Rehabilitation Programs that implement physical activity in daily habits proves to be a suitable tool for improving these ailments in this post-acute phase

  13. Blood gases and oxygen saturation response to active cycle of breathing techniques in COPD patients during phase I of cardiac rehabilitation

    International Nuclear Information System (INIS)

    Objective: To determine the effectiveness of active cycle of breathing techniques (ACBTs) on arterial blood gases (ABG), oxygen saturation and other vitals including chest expansion, heart rate, and respiratory rate in COPD patients during phase I of cardiac rehabilitation program after open heart surgery. Methodology: In this experimental study, sample size chosen was 100 patients, randomly divided into experimental (n=50) and control (n=50) groups. Pre-test values of ABG, oxygen saturation, chest expansion, respiratory rate, and heart rate of the participants were taken. Then, conventional physical therapy including spirometry was performed 2 hourly by the control group whereas the experimental group performed ACBTs along with spirometry twice a day for a period of one week. Participants were re-assessed after one week treatment. Results: There was highly significant difference (p<0.01) in pre-test and post-test values of PCO/sub 2/ and oxygen saturation in experimental group as compared to control group. The results of bicarbonate values, base excess and heart rate were statistically significant (p<0.01) in control group and there was no significant difference (p>0.05) in experimental group. The values of pH, chest expansion and respiratory rate were highly significant (p<0.01) in both control as well as experimental group. Conclusion: ACBT was more effective to decrease post CABG complication as compared to conventional chest physical therapy. Some parameters like bicarbonate values, base excess and heart rate did not show improvement with ACBT. (author)

  14. Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD

    OpenAIRE

    Renae J. McNamara; Elkins, Mark R.; Ferreira, Manuela L; Spencer, Lissa M.; Herbert, Robert D.

    2015-01-01

    This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD). Using a benefit–harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were gui...

  15. Evaluation of a telerehabilitation system for community-based rehabilitation.

    Science.gov (United States)

    Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

    2012-01-01

    The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation's Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed.

  16. Evaluation of a telerehabilitation system for community-based rehabilitation.

    Science.gov (United States)

    Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

    2012-01-01

    The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation's Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed. PMID:25945193

  17. Code of Ethics for Rehabilitation Educators and Counselors: A Call for Evidence-Based Practice

    Science.gov (United States)

    Burker, Eileen J.; Kazukauskas, Kelly A.

    2010-01-01

    Given the emphasis on evidence-based practice (EBP) in the 2010 Code of Professional Ethics for Rehabilitation Counselors, it has become even more critical for rehabilitation educators and rehabilitation counselors to understand EBP, how to implement it in teaching and in practice, and how to access available EBP resources. This paper defines and…

  18. Mechanistically based mapping of human cardiac fibrillation.

    Science.gov (United States)

    Narayan, Sanjiv M; Zaman, Junaid A B

    2016-05-01

    The mechanisms underpinning human cardiac fibrillation remain elusive. In his 1913 paper 'On dynamic equilibrium in the heart', Mines proposed that an activation wave front could propagate repeatedly in a circle, initiated by a stimulus in the vulnerable period. While the dynamics of activation and recovery are central to cardiac fibrillation, these physiological data are rarely used in clinical mapping. Fibrillation is a rapid irregular rhythm with spatiotemporal disorder resulting from two fundamental mechanisms - sources in preferred cardiac regions or spatially diffuse self-sustaining activity, i.e. with no preferred source. On close inspection, however, this debate may also reflect mapping technique. Fibrillation is initiated from triggers by regional dispersion in repolarization, slow conduction and wavebreak, then sustained by non-uniform interactions of these mechanisms. Notably, optical mapping of action potentials in atrial fibrillation (AF) show spiral wave sources (rotors) in nearly all studies including humans, while most traditional electrogram analyses of AF do not. Techniques may diverge in fibrillation because electrograms summate non-coherent waves within an undefined field whereas optical maps define waves with a visually defined field. Also fibrillation operates at the limits of activation and recovery, which are well represented by action potentials while fibrillatory electrograms poorly represent repolarization. We conclude by suggesting areas for study that may be used, until such time as optical mapping is clinically feasible, to improve mechanistic understanding and therapy of human cardiac fibrillation. PMID:26607671

  19. MEG-based neurofeedback for hand rehabilitation

    OpenAIRE

    Foldes, Stephen T.; Weber, Douglas J.; Collinger, Jennifer L.

    2015-01-01

    Background Providing neurofeedback (NF) of motor-related brain activity in a biologically-relevant and intuitive way could maximize the utility of a brain-computer interface (BCI) for promoting therapeutic plasticity. We present a BCI capable of providing intuitive and direct control of a video-based grasp. Methods Utilizing magnetoencephalography’s (MEG) high temporal and spatial resolution, we recorded sensorimotor rhythms (SMR) that were modulated by grasp or rest intentions. SMR modulatio...

  20. Rationale for hospital-based rehabilitation in obesity with comorbidities.

    Science.gov (United States)

    Capodaglio, P; Lafortuna, C; Petroni, M L; Salvadori, A; Gondoni, L; Castelnuovo, G; Brunani, A

    2013-06-01

    Severely obese patients affected by two or more chronic conditions which could mutually influence their outcome and disability can be defined as "complex" patients. The presence of multiple comorbidities often represents an obstacle for being admitted to clinical settings for the treatment of metabolic diseases. On the other hand, clinical Units with optimal standards for the treatment of pathological conditions in normal-weight patients are often structurally and technologically inadequate for the care of patients with extreme obesity. The aims of this review paper were to review the intrinsic (anthropometrics, body composition) and extrinsic (comorbidities) determinants of disability in obese patients and to provide an up-to-date definition of hospital-based multidisciplinary rehabilitation programs for severely obese patients with comorbidities. Rehabilitation of such patients require a here-and-now multidimensional, comprehensive approach, where the intensity of rehabilitative treatments depends on the disability level and severity of comorbidities and consists of the simultaneous provision of physiotherapy, diet and nutritional support, psychological counselling, adapted physical activity, specific nursing in hospitals with appropriate organizational and structural competences. PMID:23736902

  1. Rationale for hospital-based rehabilitation in obesity with comorbidities.

    Science.gov (United States)

    Capodaglio, P; Lafortuna, C; Petroni, M L; Salvadori, A; Gondoni, L; Castelnuovo, G; Brunani, A

    2013-06-01

    Severely obese patients affected by two or more chronic conditions which could mutually influence their outcome and disability can be defined as "complex" patients. The presence of multiple comorbidities often represents an obstacle for being admitted to clinical settings for the treatment of metabolic diseases. On the other hand, clinical Units with optimal standards for the treatment of pathological conditions in normal-weight patients are often structurally and technologically inadequate for the care of patients with extreme obesity. The aims of this review paper were to review the intrinsic (anthropometrics, body composition) and extrinsic (comorbidities) determinants of disability in obese patients and to provide an up-to-date definition of hospital-based multidisciplinary rehabilitation programs for severely obese patients with comorbidities. Rehabilitation of such patients require a here-and-now multidimensional, comprehensive approach, where the intensity of rehabilitative treatments depends on the disability level and severity of comorbidities and consists of the simultaneous provision of physiotherapy, diet and nutritional support, psychological counselling, adapted physical activity, specific nursing in hospitals with appropriate organizational and structural competences.

  2. The effect of integrated cardiac rehabilitation versus treatment as usual for atrial fibrillation patients treated with ablation: the randomised CopenHeartRFA trial protocol

    Science.gov (United States)

    Risom, Signe Stelling; Zwisler, Ann-Dorth Olsen; Rasmussen, Trine Bernholdt; Sibilitz, Kirstine Lærum; Svendsen, Jesper Hastrup; Gluud, Christian; Hansen, Jane Lindschou; Winkel, Per; Thygesen, Lau Caspar; Perhonen, Merja; Hansen, Jim; Dunbar, Sandra B; Berg, Selina Kikkenborg

    2013-01-01

    Introduction Atrial fibrillation affects almost 2% of the population in the Western world. To preserve sinus rhythm, ablation is undertaken in symptomatic patients. Observational studies show that patients with atrial fibrillation often report a low quality of life and are less prone to be physically active due to fear of triggering fibrillation. Small trials indicate that exercise training has a positive effect on exercise capacity and mental health, and both patients with recurrent atrial fibrillation and in sinus rhythm may benefit from rehabilitation in managing life after ablation. No randomised trials have been published on cardiac rehabilitation for atrial fibrillation patients treated with ablation that includes exercise and psychoeducational components. Aim To test the effects of an integrated cardiac rehabilitation programme versus treatment as usual for patients with atrial fibrillation treated with ablation. Methods and analysis design The trial is a multicentre parallel arm design with 1:1 randomisation to the intervention and control group with blinded outcome assessment. 210 patients treated for atrial fibrillation with radiofrequency ablation will be included. The intervention consists of a rehabilitation programme including four psychoeducative consultations with a specially trained nurse and 12 weeks of individualised exercise training, plus the standard medical follow-up. Patients in the control group will receive the standard medical follow-up. The primary outcome measure is exercise capacity measured by the VO2 peak. The secondary outcome measure is self-rated mental health measured by the Short Form 36 questionnaire. Postintervention, qualitative interviews will be conducted in 10% of the intervention group. Ethics and dissemination The protocol is approved by the regional research ethics committee (number H-1-2011-135), the Danish Data Protection Agency (reg. nr. 2007-58-0015) and follows the latest version of the Declaration of Helsinki

  3. What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

    Science.gov (United States)

    Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

    2016-03-01

    Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately

  4. What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

    Science.gov (United States)

    Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

    2016-03-01

    Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process.Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential.For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan.Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected

  5. [Mindfulness-based interventions in psychotherapy and in rehabilitation].

    Science.gov (United States)

    Szondy, Máté; Albu, Mónika; Denke, Diana

    2015-01-01

    Mindfulness means paying attention in a particular way: on purpose, in the present moment in a nonjudgmental and nonreactive way. During the last years we can see a growing interest about this topic both in psychology both in medicine. Our article reviews the concept of mindfulness, the wide range of its effects (from genexpression to social connections) and the theoretical models of mindfulness. We shortly review the methods which explicitly focus on the improvement of the skill of mindfulness (Mindfulness Based Stress Reduction, Mindfulness Based Cognitive Therapy, Acceptance and Commitment Therapy) and the role of mindfulness in (oncological and neurological) rehabilitation.

  6. [Mindfulness-based interventions in psychotherapy and in rehabilitation].

    Science.gov (United States)

    Szondy, Máté; Albu, Mónika; Denke, Diana

    2015-01-01

    Mindfulness means paying attention in a particular way: on purpose, in the present moment in a nonjudgmental and nonreactive way. During the last years we can see a growing interest about this topic both in psychology both in medicine. Our article reviews the concept of mindfulness, the wide range of its effects (from genexpression to social connections) and the theoretical models of mindfulness. We shortly review the methods which explicitly focus on the improvement of the skill of mindfulness (Mindfulness Based Stress Reduction, Mindfulness Based Cognitive Therapy, Acceptance and Commitment Therapy) and the role of mindfulness in (oncological and neurological) rehabilitation. PMID:26771698

  7. Rehabilitation status three months after first-time myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær; Vestergaard, Mogens; Søndergaard, Jens;

    2011-01-01

    Objective. To describe the rehabilitation status three months after fi rst-time myocardial infarction (MI) to identify focus areas for long-term cardiac rehabilitation (CR) in general practice. Design. Population-based cross-sectional study. Setting and subjects. Patients with fi rst-time MI...

  8. Aging is an Important Cause for a Lack of Understanding of the Main Risk Factor in Cardiac Rehabilitation Patients

    Directory of Open Access Journals (Sweden)

    Komasi

    2015-12-01

    Full Text Available Background Age, one of the key biomarkers among the nonclinical parameters of cardiovascular diseases (CVDs, has the greatest effect on the development and progression of CVDs. Objectives The current study was done to evaluate the effect of age on cardiac rehabilitation (CR patients’ attitudes regarding the main cause of their condition. Patients and Methods The administrative data of this cross-sectional study were obtained from the database of the CR department of a hospital in Iran. The demographic and clinical information of 901 patients was obtained from January 2004 and January 2012 using compiled forms of this database and the structured clinical interview for Axis I Disorders (SCID-I. Univariate analysis of variance and Bonferroni post-hoc analysis were used for the data analysis. Results After adjusting for gender, it was revealed that significant age differences existed between patients who perceived no specific risk factors (62.43 years and those who viewed biological (55.0, physiological (57.31, behavioral (57.85, and psychological (57.25 risk factors as the main cause of their condition (P < 0.05. The age differences between those who had no perceived risk factors (62.43 was significantly different from patients perceiving biological (55.0 and environmental (62.03 factors to be the main cause (P < 0.05. Conclusions Although older patients need more self-care and the quality of this self-care originates from their attitude toward CVD risk factors, their lack of awareness about the main risk factor of their condition is a major challenge for secondary prevention measures. In addition, younger patients’ significant emphasis on biological risk factors as uncorrectable factors can reduce their sense of responsibility toward attempting to control correctable risk factors. Correcting these patients’ attitudes regarding CVD risk factors can result in better responsibility feeling by the patients and can improve treatment outcomes.

  9. Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD

    Science.gov (United States)

    Elkins, Mark R.; Ferreira, Manuela L.; Spencer, Lissa M.; Herbert, Robert D.

    2015-01-01

    This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD). Using a benefit–harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were guided through an iterative process allowing them to progressively refine their estimates of the smallest improvement due to each form of rehabilitation that would outweigh the associated costs, risks and inconvenience presented in the scenario. 100 people with COPD participated (mean±sd age 72±9 years, forced expiratory volume in 1 s 54±16% predicted and baseline 6-min walk distance 377±101 m). For land-based pulmonary rehabilitation, the median smallest worthwhile effect was 20 m (95% CI 15–37 m). For water-based pulmonary rehabilitation, the median smallest worthwhile effect was 26 m (95% CI 15–33 m). These estimates did not differ significantly (p=0.10). People with COPD typically perceive that pulmonary rehabilitation would be worthwhile if it increased the 6-min walk distance by about 6%. The smallest worthwhile effects of land- and water-based pulmonary rehabilitation were similar. PMID:27730130

  10. Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD

    Directory of Open Access Journals (Sweden)

    Renae J. McNamara

    2015-06-01

    Full Text Available This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD. Using a benefit–harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were guided through an iterative process allowing them to progressively refine their estimates of the smallest improvement due to each form of rehabilitation that would outweigh the associated costs, risks and inconvenience presented in the scenario. 100 people with COPD participated (mean±sd age 72±9 years, forced expiratory volume in 1 s 54±16% predicted and baseline 6-min walk distance 377±101 m. For land-based pulmonary rehabilitation, the median smallest worthwhile effect was 20 m (95% CI 15–37 m. For water-based pulmonary rehabilitation, the median smallest worthwhile effect was 26 m (95% CI 15–33 m. These estimates did not differ significantly (p=0.10. People with COPD typically perceive that pulmonary rehabilitation would be worthwhile if it increased the 6-min walk distance by about 6%. The smallest worthwhile effects of land- and water-based pulmonary rehabilitation were similar.

  11. Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Jamie L Schutte

    2012-06-01

    Full Text Available The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs.  A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP, sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehab system was developed consisting of (1 a web-based portal to support a variety of clinical activities and (2 the Versatile Integrated System for Telerehabilitation (VISyTER video-conferencing system to support the collaboration and delivery of rehabilitation services remotely.  This descriptive evaluation examines the usability of the telerehab system incorporating both the portal and VISyTER. Telerehab system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ and Post-Study System Usability Questionnaire (PSSUQ, the Telehealth Usability Questionnaire (TUQ, and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability.  Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed.         

  12. Additional telerehabilitation contributes to a sustained improvement in physical fitness in coronary artery disease patients, who have completed phase 2 of cardiac rehabilitation

    OpenAIRE

    Frederix, Ines; Van Driessche, Niels; Laenen, Valerie; Loverix, Liselore; Hansen, Dominique; DENDALE, PAUL

    2013-01-01

    Purpose: The purpose of the study was to evaluate whether the addition of a motion sensor with automated feed-back by email or SMS to cardiac rehabilitation (CR) could result in improved health conditions of coronary artery disease (CAD) patients. Methods: 80 CAD patients in phase II of the CR program were included in this RCT after admission for PCI or CABG. Patients with a defibrillator, important arrhythmias or severe heart failure (NYHA class III and IV) were excluded from the trial. T...

  13. Characterization of Cardiac Patients Based on the Synergy Model

    Directory of Open Access Journals (Sweden)

    Tavangar

    2014-10-01

    Full Text Available Background Cardiac patients need comprehensive support due to the adverse effects of this disease on different aspects of their lives. Synergy intervention is a model that focuses on patients' requirements. Objectives This study aimed to determine the eightfold characteristic of cardiac patients based on the synergy model that represent their clinical requirements. Materials and Methods In this descriptive cross-sectional study, 40 cardiac patients hospitalized at the cardiac care unit (CCU of Yazd Afshar Hospital were randomly selected. The data were collected by using a two-part check-list including demographic characteristics and also by studying eight characteristics of patients through interviewing and reviewing their records. The results were analyzed using descriptive statistics such as frequency (percentage and analytical statistics such as Spearman and Mann-Whitney test with the SPSS software, version 18. Results The results showed that among patients' internal characteristics, reversibility (70.6%, vulnerability (68.6%, and predictability (80.4% at level 1 (the minimum score had the highest frequency and stability (49% and complexity (54.9% were at level 3 (average score. Among external characteristics participation in decision-making (80.4% at level 1 had the highest frequency while care (62.7% and recourses (98% were at level 3. Conclusions Ignoring any of the eightfold characteristics based on the synergy model interferes with comprehensive support of cardiac patients. Therefore, it is necessary for professional health practitioners, especially nurses, to consider patients' eightfold characteristics in order to provide quality care.

  14. The effect of community-based drug rehabilitation programs on recidivism in Malta

    OpenAIRE

    Axiak, Claire

    2016-01-01

    Background: The argument for financing therapeutic community-based drug rehabilitation programs for inmates is compelling. Numerous studies have established the positive effect of such treatment on reducing recidivism, especially treatment based on the therapeutic community model. Methods: This quasiexperimental retrospective cohort study examined the impact of therapeutic community-based drug rehabilitation programs on recidivism amongst drug inmates released from ...

  15. Evidence-based practice recommendations for memory rehabilitation.

    Science.gov (United States)

    Piras, F; Borella, E; Incoccia, C; Carlesimo, G A

    2011-03-01

    Memory impairment is a common consequence of neurological injury or disease, causing significant disability in everyday life, and is therefore a critical target for rehabilitation intervention. Here we report a review of the available evidence on the efficacy of restitution-oriented therapies and compensatory approaches for memory rehabilitation. A total of 110 studies was systematically classified and analyzed in order to generate evidence-based clinical recommendations for treatment providers. Different key aspects, such as types of brain damage, treatments characteristics and outcome measurements guided the evaluation of the literature as to appraise the potential interaction between patients characteristics, interventions and outcomes. The general conclusion is that memory re-training programs and compensatory approaches are probably effective in ameliorating memory disorders in patients with focal brain lesions, with some evidences of changes in memory functioning extending beyond the trained skills. Externally directed assistive devices and specific learning strategies are effective (with a level D and B of evidence, respectively) in retaining information relevant for daily needs also in patients with degenerative diseases. Some methodological concerns, such as the heterogeneity of subjects, interventions and outcomes studied, may limit the generalization of the present recommendations.

  16. Evidence based medicine in physical medicine and rehabilitation (German version

    Directory of Open Access Journals (Sweden)

    Helmut Kern

    2013-12-01

    Full Text Available In the last twenty years the term “Evidence Based Medicine (EBM” has been increasingly applied in all areas of medicine and is often used for decision-making in the medical and public health sector. It is also used to verify the significance and/or the effectiveness of different therapies. The original definition of EBM rests on the following three pillars: the physician’s individual expertise, the patient’s needs and the best external evidence. Today, however, the term EBM is often wrongly used as a synonym for best external evidence, without taking into consideration the other two pillars of the model which was created by Gordon Guyatt, David Sackett and Archibald Cochrane. This problem becomes even greater the more social insurance institutions and politicians use external evidence alone as the main guideline for financing therapies and therapy guidelines in physical medicine and general rehabilitation without taking into account the physician’s expertise and the patient’s needs.The wrong interpretation of EBM can lead to the following problems: well established clinical therapies are either questioned or not granted and are therefore withheld from patients (for example physical pain management. An absence of evidence for individual therapy methods does not prove their ineffectiveness! In this short statement the significance of EBM in Physical Medicine and general rehabilitation will be analysed and discussed.

  17. Assessing Cardiac Dynamics based on X-Ray Coronary Angiograms

    Directory of Open Access Journals (Sweden)

    Zheng Sun

    2013-02-01

    Full Text Available The problem of quantitatively assessing cardiac motion including global and local dynamic performances during cardiac cycles is addressed. In vivo X-ray coronary angiographic image sequences covering several cardiac cycles are used as source image data. The three-dimensional (3-D surface of the heart based on extended superquadrics (ESQ surface model in each phase is constructed from 3-D coronary vessel skeletons, which are reconstructed from a pair of nearly orthogonal angiographic sequences. Complex dynamic performances of the heart are decomposed into global and local components according to a priori anatomical and dynamic knowledge that have been confirmed by medical observations and non-rigid motion theory. Parameters of all components are quantitatively estimated through motion decomposition and compensation. Consequently, cardiac dynamics during cardiac cycles are comprehensively depicted with quantitative parameters. Validation of the proposed method with clinically acquired in vivo image data has been carried out, the results of which have verified the feasibility and accuracy of the proposed method.

  18. REHABILITATION OF HISTORIC HALF-TIMBERED WALLS WITH COMPPOSITE MATERIALS BASED ON HIGH-STRENGTH

    Directory of Open Access Journals (Sweden)

    Tomáš Čejka

    2015-12-01

    Full Text Available The major requirements for present day cultural heritage conservation include the minimization of interventions in historic structures, non-invasiveness and, last but not least, reversibility of rehabilitation and strengthening interventions. Due to these requirements, composites based on high-strength fibres and epoxy resin are increasingly applied during the rehabilitation, renovation and strengthening of building structures. The article points out potential applications of these materials in the renovation, rehabilitation and strengthening of half-timbered constructions.

  19. Post stroke rehabilitation based on SMART goals: a case study

    Directory of Open Access Journals (Sweden)

    Amir-ur Rehman

    2014-02-01

    Full Text Available Post stroke rehabilitation has been consistently reported in physiotherapy as being difficult to manage and limiting to rehabilitation outcome. It is reported that the first few months post stroke are crucial for rehabilitation to reach a maximum potential. However, after this period further recovery is unlikely. Specific, measurable, achievable, realistic, and time-framed (SMART goals are used for goal setting for rehabilitation. They can provide coordination between a multidisciplinary team to develop a plan for the individual needs of patients. This case study explored the use of SMART goals, which are often not used in a rehabilitation setting due to being time-consuming and difficult to create. This case report provides the first evidence that SMART goals may serve as a powerful tool for rehabilitation following stroke. The case study illustrates the clinical role of physiotherapists in the management of a patient with stroke. [J Exp Integr Med 2014; 4(1.000: 71-73

  20. Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS: A practical and evidence-based framework for clinical rehabilitation management

    Directory of Open Access Journals (Sweden)

    Johan A. Franck

    2015-10-01

    Full Text Available The volume of information on new treatment techniques supporting the restoration of arm-hand function (AHF and arm-hand skill performance (ASHP in stroke survivors overwhelms therapists in everyday clinical practice when choosing the appropriate therapy. The Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS is designed for paramedical staff to structure and implement training of AHF and AHSP in stroke survivors. The CARAS is based on four constructs: (a stratification according to the severity of arm–hand impairment (using the Utrecht Arm/Hand -Test [UAT], (b the individual’s rehabilitation goals and concomitant potential rehabilitation outcomes, (c principles of self-efficacy, and (d possibilities to systematically incorporate (new technology and new evidence-based training elements swiftly. The framework encompasses three programs aimed at treating either the severely (UAT 0-1, moderately (UAT 2-3, or mildly (UAT 4-7 impaired arm-hand. Program themes are: taking care of the limb and prevention of complications (Program 1, task-oriented gross motor grip performance (Program 2, and functional AHSP training (Program 3. Each program is preceded and followed by an assessment. Training modularity facilitates rapid interchange/adaptation of sub-elements. Proof-of-principle in clinical rehabilitation has been established. The CARAS facilitates rapid structured design and provision of state-of-the-art AHF and ASHP treatment in stroke patients.

  1. Between ideals and reality in home-based rehabilitation

    OpenAIRE

    Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

    2016-01-01

    Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were col...

  2. CASE STUDY: Community Based Ecological Mangrove Rehabilitation (CBEMR) in Indonesia

    OpenAIRE

    Brown, Ben; Fadillah, Ratna; Nurdin, Yusran; Soulsby, Iona; Ahmad, Rio

    2014-01-01

    While successful examples of large-scale (5 000-10 000 ha) ecological wetland/mangrove rehabilitation projects exist worldwide, mangrove rehabilitation efforts in Indonesia, both large and small, have mainly failed. The majority of projects (both government programs and non-government initiatives) have oversimplified the technical processes of mangrove rehabilitation, favouring the direct planting of a restricted subset of mangrove species (from the family Rhizophoracea), commonly in the lowe...

  3. Speckle Tracking Based Strain Analysis Is Sensitive for Early Detection of Pathological Cardiac Hypertrophy

    OpenAIRE

    Xiangbo An; Jingjing Wang; Hao Li; Zhizhen Lu; Yan Bai; Han Xiao; Youyi Zhang; Yao Song

    2016-01-01

    Cardiac hypertrophy is a key pathological process of many cardiac diseases. However, early detection of cardiac hypertrophy is difficult by the currently used non-invasive method and new approaches are in urgent need for efficient diagnosis of cardiac malfunction. Here we report that speckle tracking-based strain analysis is more sensitive than conventional echocardiography for early detection of pathological cardiac hypertrophy in the isoproterenol (ISO) mouse model. Pathological hypertrophy...

  4. Modern stroke rehabilitation through e-health-based entertainment

    CERN Document Server

    Krukowski, Artur

    2016-01-01

    This book describes a new, “e-Health” approach to stroke rehabilitation.  The authors propose an alternative approach that combines state of the art ICT technologies ranging from Augmented and Virtual Reality gaming environments to latest advances in immersive user interfaces for delivering a mixed-reality training platform, along with advanced embedded micro sensing and computing devices exhibiting enhanced power autonomy by using the latest Bluetooth Smart communication interfaces and energy saving approaches. These technologies are integrated under the umbrella of an online Personal Health Record (PHR) services allowing for delivery of personalized, patient-centric medical services whether at home, in a clinic or on the move. Describes innovative ways for achieving mixed-reality gaming environments; Enhances immersive experience by combining virtual projections with user interfaces based on body motion analysis; Offers cost-effective body motion capture by hybridizing wearable sensor data; Utilizes e...

  5. Exoskeleton Technology in Rehabilitation: Towards an EMG-Based Orthosis System for Upper Limb Neuromotor Rehabilitation

    Directory of Open Access Journals (Sweden)

    Luis Manuel Vaca Benitez

    2013-01-01

    Full Text Available The rehabilitation of patients should not only be limited to the first phases during intense hospital care but also support and therapy should be guaranteed in later stages, especially during daily life activities if the patient’s state requires this. However, aid should only be given to the patient if needed and as much as it is required. To allow this, automatic self-initiated movement support and patient-cooperative control strategies have to be developed and integrated into assistive systems. In this work, we first give an overview of different kinds of neuromuscular diseases, review different forms of therapy, and explain possible fields of rehabilitation and benefits of robotic aided rehabilitation. Next, the mechanical design and control scheme of an upper limb orthosis for rehabilitation are presented. Two control models for the orthosis are explained which compute the triggering function and the level of assistance provided by the device. As input to the model fused sensor data from the orthosis and physiology data in terms of electromyography (EMG signals are used.

  6. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  7. Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert;

    2011-01-01

    To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

  8. Material-based engineering strategies for cardiac regeneration.

    Science.gov (United States)

    Marion, Mieke H van; Bax, Noortje A M; Spreeuwel, Ariane C C van; van der Schaft, Daisy W J; Bouten, Carlijn V C

    2014-01-01

    Cardiac tissue is composed of muscle and non-muscle cells, surrounded by extracellular matrix (ECM) and spatially organized into a complex three-dimensional (3D) architecture to allow for coordinated contraction and electrical pulse propagation. Despite emerging evidence for cardiomyocyte turnover in mammalian hearts, the regenerative capacity of human cardiac tissue is insufficient to recover from damage, e.g. resulting from myocardial infarction (MI). Instead, the heart 'repairs' lost or injured tissue by ongoing synthesis and remodeling of scar tissue. Conventional therapies and timely (stem) cell delivery to the injured tissue markedly improve short-term function and remodeling, but do not attenuate later stage adverse remodeling, leading to functional deterioration and eventually failure of the heart. Material-based therapies have been successfully used to mechanically support and constrain the post-MI failing heart, preventing it from further remodeling and dilation. When designed to deliver the right microenvironment for endogenous or exogenous cells, as well as the mechanical and topological cues to guide neo-tissue formation, material-based therapies may even reverse remodeling and boost cardiac regeneration. This paper reviews the up-to-date status of material-based cardiac regeneration with special emphasis on 1) the use of bare biomaterials to deliver passive constraints that unload the heart, 2) the use of materials and cells to create engineered cardiac constructs for replacement, support, or regeneration of damaged myocardium, and 3) the development of bio-inspired and bioactive materials that aim to enhance the endogenous regenerative capacity of the heart. As the therapies should function in the infarcted heart, the damaged host environment and engineered in vitro test systems that mimic this environment, are reviewed as well.

  9. A value-based practice model of rehabilitation: consumers' recommendations in action.

    Science.gov (United States)

    Yoshida, Karen K; Self, Hazel M; Renwick, Rebecca M; Forma, Laura L; King, Audrey J; Fell, Leslie A

    2015-01-01

    The purpose of this paper is to present a model of rehabilitation practice that is based on the recommendations of consumers who used rehabilitation services and have a life-changing physical impairment (spinal cord injury - SCI). This value-based practice model is based on two qualitative studies. The first study developed the framework (social adaptation) for a new practice model based on values. The second study, described in this paper, used the framework to learn about recommendations for change in the rehabilitation process. Participants in the second study were 80 volunteers who live with a SCI in the community, across the province of Ontario, Canada. A snowball strategy was used to recruit interested participants. Participants were involved in face-to-face interviews which included questions on what helped and hindered their initial rehabilitation process, and their recommendations for change. In this paper, we described a model that demonstrates how consumer input is essential in shaping a comprehensive rehabilitation process. The model is based on overarching value statements that express the worthiness of all individuals, the value of the lived experience of disability and the responsibility of the rehabilitation process to enable client autonomy. Four "values in action" are articulated: caring and respect for the individual and his/her personhood; applying the lived experience of disability; fostering autonomy; and promoting hopefulness. These values have been initially described in another paper based on a specific subset of 15 women living with SCI related to body issues during rehabilitation. This paper builds on this value work and we develop key practices for a progressive rehabilitation culture and model, based on the larger study group of 80 participants (men and women with SCI). This value-based model, when integrated with traditional, physical improvement-focused rehabilitation, has the potential to create a more effective process by offering

  10. Reconsidering evidence-based practice in prosthetic rehabilitation : a shared enterprise

    NARCIS (Netherlands)

    van Twillert, S.; Geertzen, J.; Hemminga, T.; Postema, K.; Lettinga, A.

    2013-01-01

    Background: A divide is experienced between producers and users of evidence in prosthetic rehabilitation. Objective: To discuss the complexity inherent in establishing evidence-based practice in a prosthetic rehabilitation team illustrated by the case of prosthetic prescription for elderly dysvascul

  11. Developing and Evaluating Creativity Gamification Rehabilitation System: The Application of PCA-ANFIS Based Emotions Model

    Science.gov (United States)

    Su, Chung-Ho; Cheng, Ching-Hsue

    2016-01-01

    This study aims to explore the factors in a patient's rehabilitation achievement after a total knee replacement (TKR) patient exercises, using a PCA-ANFIS emotion model-based game rehabilitation system, which combines virtual reality (VR) and motion capture technology. The researchers combine a principal component analysis (PCA) and an adaptive…

  12. Abaqus/Standard-based quantification of human cardiac mechanical properties

    CERN Document Server

    Genet, Martin; Kuhl, Ellen; Guccione, Julius

    2016-01-01

    Computational modeling can provide critical insight into existing and potential new surgical procedures, medical or minimally-invasive treatments for heart failure, one of the leading causes of deaths in the world that has reached epidemic proportions. In this paper, we present our Abaqus/Standard-based pipeline to create subject-specific left ventricular models. We first review our generic left ventricular model, and then the personalization process based on magnetic resonance images. Identification of subject-specific cardiac material properties is done by coupling Abaqus/Standard to the python optimization library NL-Opt. Compared to previous studies from our group, the emphasis is here on the fully implicit solving of the model, and the two-parameter optimization of the passive cardiac material properties.

  13. Resultados del Programa de Rehabilitación Cardíaca Fase II, desarrollado por el Centro Nacional de Rehabilitación, Costa Rica Results of the Phase II Cardiac Rehabilitation Programat the National Center of Rehabilitation, Costa Rica

    Directory of Open Access Journals (Sweden)

    Manuel Wong

    2011-12-01

    Full Text Available Objetivo: Debido a la importancia de la enfermedad cardiovascular en Costa Rica y a la escasa información de los programas de rehabilitación cardiaca a nivel nacional, el presente estudio buscó describir los resultados del Programa de Rehabilitación Cardiaca, Fase II, en el Centro Nacional de Rehabilitación. Métodos: Se trata de un estudio retrospectivo de revisión de expedientes clínicos de pacientes portadores de enfermedad arterial coronaria, remitidos a un programa de rehabilitación cardiaca desde marzo de 2009 a mayo de 2010. De un total de 158 pacientes, 131 finalizaron la fase II. Se comparó la capacidad funcional máxima -estimada mediante una prueba de esfuerzo en banda sin fin- y el perfil de lípidos. Estas pruebas se realizaron al inicio y al final de esta fase II, la cual consta de 10 a 12 semanas de duración. Resultados: Se obtuvo un aumento significativo de la capacidad funcional estimada en Equivalentes Metabólicos (METs, con un promedio equivalente a un 29.7% al finalizar las 10 a 12 semanas (pAim: Due to the importance of the cardiovascular disease in Costa Rica, and the lack of information about Cardiac Rehabilitation Programs in our country, the objective of this study is to determine the results of a phase II Cardiac Rehabilitation program at the National Center of Rehabilitation. Methods: retrospective study based on a review of the clinical records of patients with coronary artery disease referred for the phase II Cardiac Rehabilitation Program from March 2009 to May 2010. Of a total of 158 patients, 131 finished the phase II. We compared the results of maximal functional capacity estimated by a treadmill stress testing, and lipid profile at the beginning and the end of the 10 - 12 week program. Results: we found a significant statistical increase in the functional capacity of Metabolic Equivalents (METs in average of 29,7% at the end of the 10-12 week program (p<0,05 estimated by a treadmill stress testing

  14. Implementation of coherent, evidence-based pathways in Danish rehabilitation practice

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Hounsgaard, L.

    2013-01-01

    a deeper understanding of how to facilitate the implementation of coherent and evidence-based guidelines in Danish rehabilitation contexts. Method: The study was based on a phenomenological hermeneutic approach and on theories within knowledge translation. Fifteen municipalities and four hospitals......-dependent variations. Conclusion: The PARIHS framework is based on concepts that capture factors of impact on clinical decision-making and interventions which enhance changes of daily practice in the participating rehabilitation settings. The rehabilitation pathways reinforced the foundation and ownership of the daily...

  15. Community based rehabilitation: a strategy for peace-building

    Directory of Open Access Journals (Sweden)

    Hodgson Jennifer

    2002-11-01

    Full Text Available Abstract Background Certain features of peace-building distinguish it from peacekeeping, and make it an appropriate strategy in dealing with vertical conflict and low intensity conflict. However, some theorists suggest that attempts, through peace-building, to impose liberal values upon non-democratic cultures are misguided and lack an ethical basis. Discussion We have been investigating the peace-building properties of community based approaches to disability in a number of countries. This paper describes the practice and impact of peace-building through Community Based Rehabilitation (CBR strategies in the context of armed conflict. The ethical basis for peace-building through practical community initiatives is explored. A number of benefits and challenges to using CBR strategies for peace-building purposes are identified. Summary During post-conflict reconstruction, disability is a powerful emotive lever that can be used to mobilize cooperation between factions. We suggest that civil society, in contrast to state-level intervention, has a valuable role in reducing the risks of conflict through community initiatives.

  16. 心脏康复锻炼对伴有左室功能不全冠心病患者的影响%The impacts of cardiac rehabilitation program on coronary artery disease patients with left ventricular dysfunction

    Institute of Scientific and Technical Information of China (English)

    张文芳

    2015-01-01

    目的:探讨心脏康复锻炼对冠心病患者运动能力、生活质量及功能状态的影响。方法对70例伴有轻度至中度左心功能不全的冠心病患者进行连续8周以运动为主的康复锻炼。对所有患者康复锻炼前及康复锻炼后8周进行评价。采用SF-36问卷调查评估患者生活质量。功能状态评估项目包括:睡眠时间、步行、骑自行车、运动及工作时间。结果康复锻炼后,患者最大运动负荷量代谢当量单位由康复前(7.00±2.36)增至康复后(9.08±2.95)(P﹤0.001),运动持续时间从康复前(13.17±5.25)分钟增加到康复后(18.11±4.85)分钟(P﹤0.001)。SF-36评估患者生活质量,患者在身体和心理方面康复前后有显著差异( P﹤0.05)。患者骑自行车、步行及运动时间康复前后有显著差异( P﹤0.05)。结论心脏康复锻炼能够改善轻至中度左心功能不全的冠心病患者的运动能力、生活质量及功能状态。医护人员应鼓励患者参加并遵循标准的康复锻炼计划。%Objective:To determine the impacts of cardiac rehabilitation on exercise capacity,quality of life( QOL), and functional status in patients with coronary artery disease( CAD). Methods:Seventy CAD patients with mild to moder-ate left ventricular dysfunction participated in an exercise-based rehabilitation program for eight consecutive weeks. Subjects underwent an exercise test before and 8 weeks after rehabilitation. QOL was assessed with the SF-36 questionnaire. Func-tional status was assessed in terms of sleep time,walking,cycling,exercise,and working duration. Results:After rehabil-itation,peak exercise capacity increased from(7. 00 ± 2. 36)to(9. 08 ± 2. 95)METs(P﹤0. 001)and exercise duration in-creased from(13. 17 ± 5. 25min)to(18. 11 ± 4. 85min)(P﹤0. 001). Patients′QOL improved in physical and psychologi-cal dimensions(P﹤0. 05). Cycling,walking,and exercising status

  17. Wearable Sensor-Based Rehabilitation Exercise Assessment for Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Kun-Hui Chen

    2015-02-01

    Full Text Available Since the knee joint bears the full weight load of the human body and the highest pressure loads while providing flexible movement, it is the body part most vulnerable and susceptible to osteoarthritis. In exercise therapy, the early rehabilitation stages last for approximately six weeks, during which the patient works with the physical therapist several times each week. The patient is afterwards given instructions for continuing rehabilitation exercise by him/herself at home. This study develops a rehabilitation exercise assessment mechanism using three wearable sensors mounted on the chest, thigh and shank of the working leg in order to enable the patients with knee osteoarthritis to manage their own rehabilitation progress. In this work, time-domain, frequency-domain features and angle information of the motion sensor signals are used to classify the exercise type and identify whether their postures are proper or not. Three types of rehabilitation exercise commonly prescribed to knee osteoarthritis patients are: Short-Arc Exercise, Straight Leg Raise, and Quadriceps Strengthening Mini-squats. After ten subjects performed the three kinds of rehabilitation activities, three validation techniques including 10-fold cross-validation, within subject cross validation, and leave-one-subject cross validation are utilized to confirm the proposed mechanism. The overall recognition accuracy for exercise type classification is 97.29% and for exercise posture identification it is 88.26%. The experimental results demonstrate the feasibility of the proposed mechanism which can help patients perform rehabilitation movements and progress effectively. Moreover, the proposed mechanism is able to detect multiple errors at once, fulfilling the requirements for rehabilitation assessment.

  18. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  19. Cardiac magnetic source imaging based on current multipole model

    Institute of Scientific and Technical Information of China (English)

    Tang Fa-Kuan; Wang Qian; Hua Ning; Lu Hong; Tang Xue-Zheng; Ma Ping

    2011-01-01

    It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current multipole model expanded to the first order terms. This magnetic imaging is realized in a reconstruction plane in the centre of human heart, where the current dipole array is employed to represent realistic cardiac current distribution. The current multipole as testing source generates magnetic fields in the measuring plane, serving as inputs of cardiac magnetic inverse problem. In the heart-torso model constructed by boundary element method, the current multipole magnetic field distribution is compared with that in the homogeneous infinite space, and also with the single current dipole magnetic field distribution.Then the minimum-norm least-squares (MNLS) method, the optimal weighted pseuDOInverse method (OWPIM), and the optimal constrained linear inverse method (OCLIM) are selected as the algorithms for inverse computation based on current multipole model innovatively, and the imaging effects of these three inverse methods are compared. Besides,two reconstructing parameters, residual and mean residual, are also discussed, and their trends under MNLS, OWPIM and OCLIM each as a function of SNR are obtained and compared.

  20. Acupuncture in stroke rehabilitation Literature retrieval based on international databases

    Institute of Scientific and Technical Information of China (English)

    Feng Sun; Jinchun Wang; Xia Wen

    2012-01-01

    OBJECTIVE: To identify global research trends of acupuncture in stroke rehabilitation using a bibliometric analysis of the Web of Science and the Clinical Trials registry database (ClinicalTrials.gov). DATA RETRIEVAL: We performed a bibliometric analysis of data retrievals for acupuncture in stroke rehabilitation from 1992 to 2011 using the Web of Science and ClinicalTrials.gov. SELECTION CRITERIA: Inclusion criteria: (1) Web of Science: (a) Peer-reviewed articles on acupuncture in stroke rehabilitation that were published and indexed in the Web of Science. (b) Type of articles: original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material and news items. (c) Year of publication: 1992-2011. (2) ClinicalTrials.gov: All clinical trials relating to acupuncture in stroke rehabilitation were searched in this database. Exclusion criteria: (1) Web of Science: (a) Articles that required manual searching or telephone access. (b) We excluded documents that were not published in the public domain. (c) We excluded a number of corrected papers from the total number of articles. (2) ClinicalTrials.gov: (a) We excluded clinical trials that were not in the ClinicalTrials.gov database. (b) We excluded clinical trials that dealt with magnetic stimulation other than acupuncture in stroke rehabilitation in the ClinicalTrials.gov database. MAIN OUTCOME MEASURES: (1) Type of literature; (2) annual publication output; (3) distribution according to journals; (4) distribution according to country; (5) distribution according to institution; (6) top cited articles over the last 20 years; and (7) clinical trials registered.RESULTS: (1) In all, 92 studies on acupuncture in stroke rehabilitation appeared in the Web of Science from 1992 to 2011, almost half of which derived from Chinese and American authors and institutes. The number of studies addressing acupuncture in stroke rehabilitation has gradually increased over the past 20 years. Most

  1. Goal attainment scaling in rehabilitation: a literature-based update.

    Science.gov (United States)

    Krasny-Pacini, A; Hiebel, J; Pauly, F; Godon, S; Chevignard, M

    2013-04-01

    Goal Attainment Scaling (GAS) is a method for quantifying progress on personal goals. Turner-Stokes's guide to GAS is a method for quantifying progress towards personal goals. Turner-Stokes's guide and the use of Kiresuk's T-score are the most widely used GAS-based approaches in rehabilitation. However, the literature describes a number of other approaches and emphasizes the need for caution when using the T-score. This article presents the literature debates on GAS, variations of GAS (in terms of the score level assigned to the patient's initial status and description of the scale's different levels), the precautions to be taken to produce valid GAS scales and the various ways of analyzing GAS results. Our objective is to (i) provide clinical teams with a critical view of GAS (the application of which is not limited to a single research group's practices) and (ii) present the most useful resources and guidelines on writing GAS scales. According to the literature, it appears to be preferable to set the patient's initial level to -2 (even when worsening is a possible outcome) and to describe all five GAS levels in detail. The use of medians and rank tests appears to be appropriate, given the ordinal nature of GAS. PMID:23562111

  2. Functional outcomes after home-based rehabilitation for heroin-induced spongiform leukoencephalopathy

    Institute of Scientific and Technical Information of China (English)

    Xuhong Li; Liming Deng; Bin Ye

    2012-01-01

    A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments.Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge.His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge.These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.

  3. Effects of treatment with a combination of cardiac rehabilitation and bosentan in patients with pulmonary Langerhans cell histiocytosis associated with pulmonary hypertension.

    Science.gov (United States)

    Fukuda, Yusuke; Miura, Shin-ichiro; Fujimi, Kanta; Yano, Masaya; Nishikawa, Hiroaki; Yanagisawa, Jun; Hiratsuka, Masafumi; Shiraishi, Takeshi; Iwasaki, Akinori; Saku, Keijiro

    2014-12-01

    Pulmonary hypertension (PH), which is classified as group 5 in the clinical classification of PH, is sometimes a complication of Pulmonary langerhans cell histiocytosis (PLCH), and is associated with high mortality. A 36-year-old woman had suffered from severe dyspnea 9 years previously and was diagnosed with PLCH and was on a waiting list for a lung transplant. Right heart failure had been observed and the mean pulmonary artery pressure was over 40 mmHg. The patient was diagnosed as PLCH with PH. After combined treatment with exercise rehabilitation and bosentan for 6 months, the cardiothoracic ratio, brain natriuretic peptide, and bodyweight were significantly decreased (cardiothoracic ratio from 43 to 38%, brain natriuretic peptide from 284 to10 pg/ml and bodyweight from 63 to 58 kg). Six-minute walk test also improved from 214 to 275 meters and the SF36 score for screening of depressive and anxiety disorders was improved. This is the report demonstrating the efficacy and safety of cardiac rehabilitation in combination with bosentan in a single patient with PLCH associated with PH. PMID:23897898

  4. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  5. Implementation of coherent, evidence-based pathways in Danish rehabilitation practice

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Kristensen, H. K.

    2013-01-01

    a deeper understanding of how to facilitate the implementation of coherent and evidence-based guidelines in Danish rehabilitation contexts. METHOD: The study was based on a phenomenological hermeneutic approach and on theories within knowledge translation. Fifteen municipalities and four hospitals......-dependent variations. CONCLUSION: The PARIHS framework is based on concepts that capture factors of impact on clinical decision-making and interventions which enhance changes of daily practice in the participating rehabilitation settings. The rehabilitation pathways reinforced the foundation and ownership of the daily...... Evidence-based rehabilitation pathways updated the professional knowledge and reinforced the therapists' ownership of the daily practice. Appointed facilitators are key stakeholders and important elements in anchoring an implementation. Local implementation processes being part of a cross...

  6. Effect of home-based pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis

    OpenAIRE

    Ozalevli Sevgi; Karaali Hayriye; Ilgin Duygu; Ucan Eyup

    2010-01-01

    Abstract Objective The aim of this study was to investigate the effects of a home-based pulmonary rehabilitation program on the functional outcome parameters in patients with idiopathic pulmonary fibrosis (IPF). Design A prospective study. Patients Seventeen patients diagnosed with IPF. Methods A home-based pulmonary rehabilitation program was carried out in 17 IPF patients for 12 weeks. Dyspnea severity during daily life activities (Medical Research Council Scale), pulmonary function (pulmon...

  7. Mirror neuron system based therapy for aphasia rehabilitation

    Directory of Open Access Journals (Sweden)

    wenli echen

    2015-10-01

    Full Text Available Objective: To investigate the effect of hand action observation training, i.e. mirror neuron system (MNS based training, on language function of aphasic patients after stroke. In addition, to reveal the tentative mechanism underlying this effect.Methods: Six aphasic patients after stroke, meeting the criteria, undergo three weeks’ training protocol (30 min per day, 6 days per week. Among them, four patients accepted an ABA training design, i.e. they implemented Protocol A (hand action observation combined with repetition in the first and third weeks while carried out Protocol B (static objects observation combined with repetition in the second week. Conversely, for the other two patients, BAB training design was adopted, i.e. patients took Protocol B in the first and the third weeks and accepted Protocol A in the second week. Picture naming test, western aphasia battery (WAB and Token Test were applied to evaluate the changes of language function before and after each week’s training. Furthermore, two subjects (one aphasic patient and one healthy volunteer attended a functional MRI (fMRI experiment, by which we tried to reveal the mechanism underlying possible language function changes after training.Results: Compared with static objects observation and repetition training (Protocol B, hand action observation and repetition training (Protocol A effectively improved most aspects of the language function in all six patients, as demonstrated in the picture naming test, subtests of oral language and aphasia quotient(AQ of WAB. In addition, the fMRI experiment showed that Protocol A induced more activations in the MNS of two participants when compared to Protocol B. Conclusion: The mirror neuron based therapy may facilitate the language recovery for aphasic patients and this to some extent provides a novel direction of rehabilitation for aphasia patients.

  8. The Need and Its Influence Factors for Community-based Rehabilitation Services for Disabled Persons in One District in Beijing

    Institute of Scientific and Technical Information of China (English)

    HONG DAI; HUI XUE; ZONG-JIE YIN; ZHONG-XIN XIAO

    2006-01-01

    Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57.4% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost (P<0.05), knowledge about rehabilitation medicine (P<0.05); and the belief in the therapeutic benefit of the community-based rehabilitation service (P<0.05). Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

  9. Homecare-based motor rehabilitation in musculoskeletal chronic graft versus host disease

    Directory of Open Access Journals (Sweden)

    A Tendas

    2011-01-01

    Full Text Available Chronic graft versus host disease (cGVHD is a frequent complication of allogeneic stem cell transplantation. Extensive musculoskeletal and skin involvement may induce severe functional impairment, disability and quality of life deterioration. Physical rehabilitation is recommended as ancillary therapy in these forms, but experiences are sparse. A 39-year-old man affected by musculoskeletal and skin chronic graft versus host disease (cGVHD was treated with a homecare-based motor rehabilitation program during palliation for disease progression. Significant functional improvement was obtained. Motor rehabilitation should be strongly considered for patients with musculoskeletal cGVHD, both in the palliative and in the curative phase of disease.

  10. Cardiac CT for planning redo cardiac surgery: effect of knowledge-based iterative model reconstruction on image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Seitaro [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto (Japan); Weissman, Gaby; Weigold, W. Guy [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Vembar, Mani [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States)

    2015-01-15

    The purpose of this study was to investigate the effects of knowledge-based iterative model reconstruction (IMR) on image quality in cardiac CT performed for the planning of redo cardiac surgery by comparing IMR images with images reconstructed with filtered back-projection (FBP) and hybrid iterative reconstruction (HIR). We studied 31 patients (23 men, 8 women; mean age 65.1 ± 16.5 years) referred for redo cardiac surgery who underwent cardiac CT. Paired image sets were created using three types of reconstruction: FBP, HIR, and IMR. Quantitative parameters including CT attenuation, image noise, and contrast-to-noise ratio (CNR) of each cardiovascular structure were calculated. The visual image quality - graininess, streak artefact, margin sharpness of each cardiovascular structure, and overall image quality - was scored on a five-point scale. The mean image noise of FBP, HIR, and IMR images was 58.3 ± 26.7, 36.0 ± 12.5, and 14.2 ± 5.5 HU, respectively; there were significant differences in all comparison combinations among the three methods. The CNR of IMR images was better than that of FBP and HIR images in all evaluated structures. The visual scores were significantly higher for IMR than for the other images in all evaluated parameters. IMR can provide significantly improved qualitative and quantitative image quality at in cardiac CT for planning of reoperative cardiac surgery. (orig.)

  11. Home-based general versus center-based selective rehabilitation in patients with posterior tibial tendon dysfunction

    OpenAIRE

    Bek, Nilgun; Simsek, Ibrahim Engin; Erel, Suat; Yakut, Yavuz; Uygur, Fatma

    2012-01-01

    Objective: The aim of this study was to compare the effect of home-based and supervised center-based selective rehabilitation in patients with Grade 1 to 3 posterior tibial tendon dysfunction (PTTD). Methods: The study included 49 subjects diagnosed with PTTD and referred to physiotherapy by an orthopedic surgeon. Subjects were randomly assigned into a home-based rehabilitation (21 cases; mean age: 33.56±17.59) group or center-based rehabilitation (28 cases; mean age: 28.57±14.74 years). ...

  12. Gait disorder rehabilitation using vision and non-vision based sensors: a systematic review.

    Science.gov (United States)

    Ali, Asraf; Sundaraj, Kenneth; Ahmad, Badlishah; Ahamed, Nizam; Islam, Anamul

    2012-08-01

    Even though the amount of rehabilitation guidelines has never been greater, uncertainty continues to arise regarding the efficiency and effectiveness of the rehabilitation of gait disorders. This question has been hindered by the lack of information on accurate measurements of gait disorders. Thus, this article reviews the rehabilitation systems for gait disorder using vision and non-vision sensor technologies, as well as the combination of these. All papers published in the English language between 1990 and June, 2012 that had the phrases "gait disorder", "rehabilitation", "vision sensor", or "non vision sensor" in the title, abstract, or keywords were identified from the SpringerLink, ELSEVIER, PubMed, and IEEE databases. Some synonyms of these phrases and the logical words "and", "or", and "not" were also used in the article searching procedure. Out of the 91 published articles found, this review identified 84 articles that described the rehabilitation of gait disorders using different types of sensor technologies. This literature set presented strong evidence for the development of rehabilitation systems using a markerless vision-based sensor technology. We therefore believe that the information contained in this review paper will assist the progress of the development of rehabilitation systems for human gait disorders.

  13. REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

    OpenAIRE

    N. V. Galtseva

    2015-01-01

    At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD) is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled traini...

  14. Home based rehabilitation for patients with COPD : an attractive alternative

    NARCIS (Netherlands)

    Wijkstra, Peter

    2007-01-01

    Pulmonary rehabilitation programs are well established to provide a multidisciplinary approach to control and alleviate symptoms and to optimise functional capacity in patients with chronic obstructive pulmonary disease (COPD). In the last decade a large number of studies have investigated the effec

  15. Speckle Tracking Based Strain Analysis Is Sensitive for Early Detection of Pathological Cardiac Hypertrophy.

    Directory of Open Access Journals (Sweden)

    Xiangbo An

    Full Text Available Cardiac hypertrophy is a key pathological process of many cardiac diseases. However, early detection of cardiac hypertrophy is difficult by the currently used non-invasive method and new approaches are in urgent need for efficient diagnosis of cardiac malfunction. Here we report that speckle tracking-based strain analysis is more sensitive than conventional echocardiography for early detection of pathological cardiac hypertrophy in the isoproterenol (ISO mouse model. Pathological hypertrophy was induced by a single subcutaneous injection of ISO. Physiological cardiac hypertrophy was established by daily treadmill exercise for six weeks. Strain analysis, including radial strain (RS, radial strain rate (RSR and longitudinal strain (LS, showed marked decrease as early as 3 days after ISO injection. Moreover, unlike the regional changes in cardiac infarction, strain analysis revealed global cardiac dysfunction that affects the entire heart in ISO-induced hypertrophy. In contrast, conventional echocardiography, only detected altered E/E', an index reflecting cardiac diastolic function, at 7 days after ISO injection. No change was detected on fractional shortening (FS, E/A and E'/A' at 3 days or 7 days after ISO injection. Interestingly, strain analysis revealed cardiac dysfunction only in ISO-induced pathological hypertrophy but not the physiological hypertrophy induced by exercise. Taken together, our study indicates that strain analysis offers a more sensitive approach for early detection of cardiac dysfunction than conventional echocardiography. Moreover, multiple strain readouts distinguish pathological cardiac hypertrophy from physiological hypertrophy.

  16. Speckle Tracking Based Strain Analysis Is Sensitive for Early Detection of Pathological Cardiac Hypertrophy.

    Science.gov (United States)

    An, Xiangbo; Wang, Jingjing; Li, Hao; Lu, Zhizhen; Bai, Yan; Xiao, Han; Zhang, Youyi; Song, Yao

    2016-01-01

    Cardiac hypertrophy is a key pathological process of many cardiac diseases. However, early detection of cardiac hypertrophy is difficult by the currently used non-invasive method and new approaches are in urgent need for efficient diagnosis of cardiac malfunction. Here we report that speckle tracking-based strain analysis is more sensitive than conventional echocardiography for early detection of pathological cardiac hypertrophy in the isoproterenol (ISO) mouse model. Pathological hypertrophy was induced by a single subcutaneous injection of ISO. Physiological cardiac hypertrophy was established by daily treadmill exercise for six weeks. Strain analysis, including radial strain (RS), radial strain rate (RSR) and longitudinal strain (LS), showed marked decrease as early as 3 days after ISO injection. Moreover, unlike the regional changes in cardiac infarction, strain analysis revealed global cardiac dysfunction that affects the entire heart in ISO-induced hypertrophy. In contrast, conventional echocardiography, only detected altered E/E', an index reflecting cardiac diastolic function, at 7 days after ISO injection. No change was detected on fractional shortening (FS), E/A and E'/A' at 3 days or 7 days after ISO injection. Interestingly, strain analysis revealed cardiac dysfunction only in ISO-induced pathological hypertrophy but not the physiological hypertrophy induced by exercise. Taken together, our study indicates that strain analysis offers a more sensitive approach for early detection of cardiac dysfunction than conventional echocardiography. Moreover, multiple strain readouts distinguish pathological cardiac hypertrophy from physiological hypertrophy.

  17. Rehabilitation of Masonry Buildings Using Seismic Isolation Systems in the Base – Case Study

    OpenAIRE

    Pintican, Maria Nicoleta Roman; Faur, Andrei; Dumitran, Mihaela; Iernuţan, Răzvan

    2014-01-01

    This paper aims to highlight the importance and efficiency of the rehabilitation of old buildings using an alternative to the classic rehabilitation, namely seismic isolation in the base. The method is efficient and will not interfer in the architecture and structure. The case study was conducted on a church that has a brick masonry structure. The structural analysis was pergormed by using SAP2000 soft, as for the study we used rubber bearings with metal inserts. The modeling was performed bo...

  18. BCI-Based Neuro-Rehabilitation Treatment for Parkinson’s Disease: cases Report

    OpenAIRE

    Turconi, Marcello Maria; Mezzarobba, Susanna; Franco, Giulia; Busan, Pierpaolo; Fornasa, Elisa; Jarmolowska, Joanna; Accardo, Agostino; Battaglini, Piero Paolo

    2014-01-01

    Parkinson's Disease (PD) is characterized by motor and cognitive decay, coupled to an alteration of brain oscillatory patterns. In this study a novel neuro-rehabilitation tool, based on the application of motor imagery into a Brain Computer Interface system, is presented with some preliminary data. Three patients were evaluated (with motor, neuropsychological and EEG testing) before and after a neuro-rehabilitation protocol made by 15 experimental sessions. Patients sh...

  19. Increasing Patient Engagement in Rehabilitation Exercises Using Computer-Based Citizen Science

    OpenAIRE

    Jeffrey Laut; Francesco Cappa; Oded Nov; Maurizio Porfiri

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Part...

  20. Toward cardiac electrophysiological mapping based on micro-Tesla NMR: a novel modality for localizing the cardiac reentry

    OpenAIRE

    Kiwoong Kim

    2012-01-01

    Matching the proton magnetic resonance frequency to the frequency of a periodic electrophysiological excitation of myocardium enables direct localization of the cardiac reentry by magnetic resonance imaging techniques. The feasibility of this new idea has been demonstrated by conducting a numerical simulation based on a realistic heart model and experimental parameters in SQUID-based micro-Tesla NMR.

  1. Toward cardiac electrophysiological mapping based on micro-Tesla NMR: a novel modality for localizing the cardiac reentry

    Science.gov (United States)

    Kim, Kiwoong

    2012-06-01

    Matching the proton magnetic resonance frequency to the frequency of a periodic electrophysiological excitation of myocardium enables direct localization of the cardiac reentry by magnetic resonance imaging techniques. The feasibility of this new idea has been demonstrated by conducting a numerical simulation based on a realistic heart model and experimental parameters in SQUID-based micro-Tesla NMR.

  2. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    DEFF Research Database (Denmark)

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    OBJECTIVES: In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). DESIGN: A one-year follow-up study. SETTING: A CR programme (Go......%). MAIN OUTCOME MEASURES: Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention.......01), self-care management (p 

  3. Preventive Cardiology and Rehabilitation

    OpenAIRE

    Russo, Nicola

    2014-01-01

    Background: Despite the favourable effects of new therapeutic approaches during the acute phase of cardiac diseases and consequent favourable short-term outcomes, post-acute management and long term prognosis still remain unsatisfactory. Cardiac rehabilitation (CR) is a multidisciplinary treatment with established beneficial effects for the vast majority of cardiac patients and universally considered an important aspect of secondary prevention. Although it has been shown to reduce both morbid...

  4. Cardiac tissue ablation with catheter-based microwave heating.

    Science.gov (United States)

    Rappaport, C

    2004-11-01

    The common condition of atrial fibrillation is often treated by cutting diseased cardiac tissue to disrupt abnormal electrical conduction pathways. Heating abnormal tissue with electromagnetic power provides a minimally invasive surgical alternative to treat these cardiac arrhythmias. Radio frequency ablation has become the method of choice of many physicians. Recently, microwave power has also been shown to have great therapeutic benefit in medical treatment requiring precise heating of biological tissue. Since microwave power tends to be deposited throughout the volume of biological media, microwave heating offers advantages over other heating modalities that tend to heat primarily the contacting surface. It is also possible to heat a deeper volume of tissue with more precise control using microwaves than with purely thermal conduction or RF electrode heating. Microwave Cardiac Ablation (MCA) is used to treat heart tissue that allows abnormal electrical conduction by heating it to the point of inactivation. Microwave antennas that fit within catheter systems can be positioned close to diseased tissue. Specialized antenna designs that unfurl from the catheter within the heart can then radiate specifically shaped fields, which overcome problems such as excessive surface heating at the contact point. The state of the art in MCA is reviewed in this paper and a novel catheter-based unfurling wide aperture antenna is described. This antenna consists of the centre conductor of a coaxial line, shaped into a spiral and insulated from blood and tissue by a non-conductive fluid filled balloon. Initially stretched straight inside a catheter for transluminal guiding, once in place at the cardiac target, the coiled spiral antenna is advanced into the inflated balloon. Power is applied in the range of 50-150 W at the reserved industrial, scientific and medical (ISM) frequency of 915 MHz for 30-90 s to create an irreversible lesion. The antenna is then retracted back into the

  5. CAMERA-BASED SOFTWARE IN REHABILITATION/THERAPY INTERVENTION (extended)

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2014-01-01

    on specific hardware. Adaptable means that human tracking and created artefact interaction in the camera field of view is relatively easily changed as one desires via a user-friendly GUI. The significance of having both available for contemporary intervention is argued. Conclusions are that the mature, robust......, and accessible software EyeCon is a potent and significant user-friendly tool in the field of rehabilitation/therapy and warrants wider exploration....

  6. An interactive game-based shoulder wheel system for rehabilitation

    OpenAIRE

    Chou LW; Chang HY; Chang YC; Chang CM

    2012-01-01

    Chun-Ming Chang,1,* Yen-Ching Chang,2,3 Hsiao-Yun Chang,4 Li-Wei Chou5,6,* 1Department of Applied Informatics and Multimedia, Asia University, Taichung, Taiwan; 2Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan; 3Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan; 4Department of Biotechnology, Asia University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung...

  7. Improving Vision-Based Motor Rehabilitation Interactive Systems for Users with Disabilities Using Mirror Feedback

    Directory of Open Access Journals (Sweden)

    Antoni Jaume-i-Capó

    2014-01-01

    Full Text Available Observation is recommended in motor rehabilitation. For this reason, the aim of this study was to experimentally test the feasibility and benefit of including mirror feedback in vision-based rehabilitation systems: we projected the user on the screen. We conducted a user study by using a previously evaluated system that improved the balance and postural control of adults with cerebral palsy. We used a within-subjects design with the two defined feedback conditions (mirror and no-mirror with two different groups of users (8 with disabilities and 32 without disabilities using usability measures (time-to-start (Ts and time-to-complete (Tc. A two-tailed paired samples t-test confirmed that in case of disabilities the mirror feedback facilitated the interaction in vision-based systems for rehabilitation. The measured times were significantly worse in the absence of the user’s own visual feedback (Ts=7.09 (P<0.001 and Tc=4.48 (P<0.005. In vision-based interaction systems, the input device is the user’s own body; therefore, it makes sense that feedback should be related to the body of the user. In case of disabilities the mirror feedback mechanisms facilitated the interaction in vision-based systems for rehabilitation. Results recommends developers and researchers use this improvement in vision-based motor rehabilitation interactive systems.

  8. Developing community based rehabilitation for cancer survivors: Organizing for coordination and coherence in practice

    DEFF Research Database (Denmark)

    la Cour, Karen; Cutchin, Malcolm

    2013-01-01

    . A Grounded Theory approach was used to analyze the data. Results. A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team......Background. Increasing incidence of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation......-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions. Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight...

  9. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty.

    Science.gov (United States)

    Lee, Minyoung; Suh, Dongwon; Son, Jaebum; Kim, Jungjin; Eun, Seon-Deok; Yoon, BumChul

    2016-01-01

    This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation. PMID:27149529

  10. Game System for Rehabilitation Based on Kinect is Effective for Mental Retardation

    Directory of Open Access Journals (Sweden)

    Fu Ying

    2015-01-01

    Full Text Available Kinect has already been widely used in the area of retardation, and this study is to evaluate whether the Game System for Rehabilitation based on Kinect is effective for children with mental retardation. The subjects in this paper are 112 children with mental retardation in Zhejiang province of China. The Game System for Rehabilitation based on Kinect was applied to assist the rehabilitation of children. Before the training, the Pediatric Evaluation of Disability Inventory (PEDI was used to evaluate abilities of children, including self-care, mobility, and social function. And after having been trained for a month, the abilities of these children were evaluated again by PEDI. The results in this paper is that, after the application of Game System for Rehabilitation based on Kinect, the PEDI score of children is significantly higher than the score before training. And it can be concluded that the Game System for Rehabilitation based on Kinect can significantly improve self-care, mobility, and social function of children with MR.

  11. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty.

    Science.gov (United States)

    Lee, Minyoung; Suh, Dongwon; Son, Jaebum; Kim, Jungjin; Eun, Seon-Deok; Yoon, BumChul

    2016-01-01

    This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

  12. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty

    Directory of Open Access Journals (Sweden)

    Minyoung Lee, PT, BSc

    2016-03-01

    Full Text Available This article explored the perspectives of 25 patients regarding virtual reality (VR-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/– 0.3 out of 5.0 and a high rate of expectation of therapeutic effect (96% and intention of exercise adherence (96%. Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time, leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

  13. Occupational therapy synergy between Comprehensive Community Based Rehabilitation Tanzania and Heifer International to reduce poverty

    Directory of Open Access Journals (Sweden)

    Anne Marie W. Hansen

    2013-01-01

    Full Text Available Background: This article describes a partnership between a community-based rehabilitation organisation and a non-governmental organisation (NGO in Tanzania. The partnership focused on income-generating (IG activities to tackle the problems of poverty faced by families with a child with a disability (CWD. Objectives: The aim of this case study was to describe the partnership between Comprehensive Community Based Rehabilitation Tanzania in Moshi (CCBRT-Moshi, a non-governmental organisation, and families to create an income-generating business, namely raising goats.Method: This was a team approach between CCBRT-Moshi and Heifer International, an organisation that focuses on IG activities to create a synergy or partnership between community-based rehabilitation and IG activities.Results: This partnership between occupational therapy rehabilitation services at CCBRT-Moshi and the NGO resulted in strengthening the effectiveness of occupational therapy services and leaving a more lasting impact on the people they served within the community by helping to reduce poverty in addition to providing rehabilitation and prevention interventions.Conclusion: This collaboration was successful as it provided a means for families to generate income from raising goats. Although the results have not been empirically verified, observational and anecdotal evidence suggests that families with CWDs have better quality of life and ultimately improved health through this synergistic partnership.

  14. “I Just Can’t Do It Anymore” Patterns of Physical Activity and Cardiac Rehabilitation in African Americans with Heart Failure: A Mixed Method Study

    Directory of Open Access Journals (Sweden)

    Margaret McCarthy

    2015-10-01

    Full Text Available Physical activity and cardiac rehabilitation (CR are components of heart failure (HF self-care. The aims of this study were to describe patterns of physical activity in African Americans (n = 30 with HF and to explore experience in CR. This was a mixed method, concurrent nested, predominantly qualitative study. Qualitative data were collected via interviews exploring typical physical activity, and CR experience. It was augmented by quantitative data measuring HF severity, self-care, functional capacity and depressive symptoms. Mean age was 60 ± 15 years; 65% were New York Heart Association (NYHA class III HF. Forty-three percent reported that they did less than 30 min of exercise in the past week; 23% were told “nothing” about exercise by their provider, and 53% were told to do “minimal exercise”. A measure of functional capacity indicated the ability to do moderate activity. Two related themes stemmed from the narratives describing current physical activity: “given up” and “still trying”. Six participants recalled referral to CR with one person participating. There was high concordance between qualitative and quantitative data, and evidence that depression may play a role in low levels of physical activity. Findings highlight the need for strategies to increase adherence to current physical activity guidelines in this older minority population with HF.

  15. A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD - A follow-up of 18 months

    NARCIS (Netherlands)

    Strijbos, JH; Postma, DS; vanAltena, R; Gimeno, F; Koeter, GH

    1996-01-01

    Aim: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 12-week homecare rehabilitation program (HCRP) in COPD patients. A control group received no rehabilitation therapy. Methods: After randomization and stratificat

  16. Neurological rehabilitation of stroke patients via motor imaginary-based brain-computer interface technology

    Institute of Scientific and Technical Information of China (English)

    Hongyu Sun; Yang Xiang; Mingdao Yang

    2011-01-01

    The present study utilized motor imaginary-based brain-computer interface technology combined with rehabilitation training in 20 stroke patients. Results from the Berg Balance Scale and the Holden Walking Classification were significantly greater at 4 weeks after treatment (P < 0.01), which suggested that motor imaginary-based brain-computer interface technology improved balance and walking in stroke patients.

  17. Facilitation of research-based evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, H.; Borg, T.; Hounsgaard, Lise

    2011-01-01

    Purpose: This study investigated the facilitation of evidence-based practice with the use of everyday life occupations and client-centred practice within occupational therapy in three settings of stroke rehabilitation. Method: The study was based on a phenomenological hermeneutical research...

  18. Computer- and Suggestion-based Cognitive Rehabilitation following Acquired Brain Injury

    DEFF Research Database (Denmark)

    Lindeløv, Jonas Kristoffer

    2015-01-01

    This thesis is an empirical investigation into two cost-effective treatment options for patients with acquired brain injury. Based on an experiment and a review, I argue that in general computer-based cognitive rehabilitation, as it is currently practiced, has virtually no effect on untrained tas...

  19. Vocational rehabilitation

    DEFF Research Database (Denmark)

    Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard;

    2014-01-01

    Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....

  20. Arbejdsrettet Rehabilitering

    DEFF Research Database (Denmark)

    Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard;

    2014-01-01

    Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....

  1. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Science.gov (United States)

    Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  2. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Directory of Open Access Journals (Sweden)

    Jeffrey Laut

    Full Text Available Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  3. Cardiac rehabilitation is safe and effective also in the elderly, but don't forget about drugs!

    Science.gov (United States)

    Del Sindaco, Donatella; Tinti, Maria Denitza; Pulignano, Giovanni; Tolone, Stefano; Minardi, Giovanni; Uguccioni, Massimo; Lax, Antonio

    2016-01-01

    In the setting of heart failure (HF) pharmacotherapy demonstrates a quantifiable improvement in exercise tolerance also in HF with preserved ejection fraction (HFpEF). For patients with HFpEF, often older, with higher prevalence of hypertension, diabetes mellitus, atrial fibrillation and other comorbidities, endpoints such as quality of life and functional capacity may be more clinically relevant. However several study show as the use of ACE-I and B-blocker were lesser than expected. Beta-blocker therapy is the keystone of pharmacotherapy of HF patients and exercise training is the essential core of rehabilitation programs, it is important to elucidate the relationship between these therapies. Exercise training improves the clinical status of HF, improving left ventricular ejection fraction and improving quality of life, but it is possible that b-blocker may attenuate exercise training adaptations. Despite this, possible adverse b-blocker effects are just presumed and not confirmed by published randomized clinical trials. Metanalysis suggests that b-blocker compared with placebo enhances improvements in cardiorespiratory performance in exercise training intervention. Despite these evidences, prescription of gold standard therapy and adherence are still suboptimal and should be a priority goal for all CR program. PMID:27374048

  4. Cardiac rehabilitation is safe and effective also in the elderly, but don't forget about drugs!

    Science.gov (United States)

    Del Sindaco, Donatella; Tinti, Maria Denitza; Pulignano, Giovanni; Tolone, Stefano; Minardi, Giovanni; Uguccioni, Massimo; Lax, Antonio

    2016-01-01

    In the setting of heart failure (HF) pharmacotherapy demonstrates a quantifiable improvement in exercise tolerance also in HF with preserved ejection fraction (HFpEF). For patients with HFpEF, often older, with higher prevalence of hypertension, diabetes mellitus, atrial fibrillation and other comorbidities, endpoints such as quality of life and functional capacity may be more clinically relevant. However several study show as the use of ACE-I and B-blocker were lesser than expected. Beta-blocker therapy is the keystone of pharmacotherapy of HF patients and exercise training is the essential core of rehabilitation programs, it is important to elucidate the relationship between these therapies. Exercise training improves the clinical status of HF, improving left ventricular ejection fraction and improving quality of life, but it is possible that b-blocker may attenuate exercise training adaptations. Despite this, possible adverse b-blocker effects are just presumed and not confirmed by published randomized clinical trials. Metanalysis suggests that b-blocker compared with placebo enhances improvements in cardiorespiratory performance in exercise training intervention. Despite these evidences, prescription of gold standard therapy and adherence are still suboptimal and should be a priority goal for all CR program.

  5. The Utilization of Rehabilitation in Patients with Hemophilia A in Taiwan: A Nationwide Population-Based Study

    Science.gov (United States)

    Yang, Yao-Hsu; Chang, Chia-Hao; Chen, Chih-Cheng; Chen, Pau-Chung

    2016-01-01

    Introduction Rehabilitation plays an important role in the physical health of patients with hemophilia. However, comprehensive information regarding the utilization of rehabilitation for such patients remains scarce. Aim This population-based study aimed to examine the characteristics, trends, and most important factors affecting rehabilitation usage in patients with hemophilia A using a nationwide database in Taiwan. Methods Data from 777 patients with hemophilia A who were registered in the National Health Insurance Research Database between 1998 and 2008 were analyzed using SAS 9.0. Results Musculoskeletal or nervous system-related surgical procedures and clotting factor VIII concentrate costs were identified as factors affecting rehabilitation usage; musculoskeletal or nervous system-related surgical procedures (odds ratio = 3.788; P hemophilia A would use rehabilitation services. Joint disorders, arthropathies, bone and cartilage disorders, intracranial hemorrhage, and brain trauma were common diagnoses during rehabilitation use. The costs of physical therapy (physiotherapy) comprised the majority (71.2%) of rehabilitation therapy categories. Increasingly, rehabilitation therapy was performed at physician clinics. The total rehabilitation costs were hemophilia A the most. The findings in this study could help clinicians comprehensively understand the rehabilitation utilization of patients with hemophilia A. PMID:27690229

  6. Biomechanical bases of rehabilitation of children with cerebral palsy

    Science.gov (United States)

    Davlet'yarova, K. V.; Korshunov, S. D.; Kapilevich, L. V.

    2015-11-01

    Biomechanical analysis and the study results of children's with cerebral palsy (CP) muscles bioelectrical activity while walking on a flat surface are represented. Increased flexion in the hip and shoulder joints and extension in the elbow joint in children with cerebral palsy were observed, with the movement of the lower limbs had less smooth character in comparison with the control group. Herewith, the oscillation amplitude was significantly increased, and the frequency in the m. gastrocnemius and m. lateralis was decreased. It was shown, that the dynamic stereotype of walking in children with cerebral palsy was characterized by excessive involvement of m. gastrocnemius and m.latissimus dorsi in locomotion. Thus, resulting biomechanical and bioelectrical parameters of walking should be considered in the rehabilitation programs development.

  7. GRADE in Systematic Reviews of Acupuncture for Stroke Rehabilitation: Recommendations based on High-Quality Evidence.

    Science.gov (United States)

    Xin, Zhang; Xue-Ting, Liu; De-Ying, Kang

    2015-11-12

    Systematic reviews (SRs) of randomized controlled trials (RCTs) have demonstrated acupuncture's effectiveness in stroke rehabilitation. The current study reviews the quality of evidence in SRs of acupuncture in stroke rehabilitation, and rates the strength of recommendation for its use based on this evidence using the GRADE (grading of recommendations, assessment, development and evaluations) approach. A comprehensive literature search was performed using multiple databases (e.g., Medline, Embase) with advanced search strategies. Two authors independently selected articles, collected data, and assessed the methodological quality of each identified SR according to AMSTAR (a measurement tool to assess systematic reviews) and OQAQ (Oxman and Guyatt's overview quality assessment questionnaire). Outcomes related to stroke rehabilitation were evaluated. SRs of high methodological quality (AMSTAR score ≥9 and OQAQ score ≥7) were graded using GRADE. Ultimately, acupuncture yields benefits in stroke rehabilitation (neurological function improvement: RR = 1.34; swallowing improvement: RR = 1.61, 1.49, 1.07; disability: SMD = 0.49 or 0.07). Poor evidentiary quality and insufficient information about harm led to weak recommendations. In conclusion, acupuncture may improve stroke rehabilitation, as the GRADE approach indicated a weak recommendation for acupuncture's usage in this context.

  8. Weather-induced ischemia and arrhythmia in patients undergoing cardiac rehabilitation: another difference between men and women

    Science.gov (United States)

    Schneider, Alexandra; Schuh, Angela; Maetzel, Friedrich-Karl; Rückerl, Regina; Breitner, Susanne; Peters, Annette

    2008-07-01

    Given the accumulating evidence that people with underlying heart disease are a particularly vulnerable group for triggers like changing meteorological parameters, the objective of this longitudinal study was to analyze the influence of weather parameters on blood pressure, arrhythmia and ischemia in cardiovascular patients. A panel study with repeated measurements was conducted in a rehabilitation clinic in Timmendorfer Strand (Baltic Sea, Germany) with 872 cardiovascular patients. Heart rate, blood pressure and electrocardiography changes were measured during repeated bicycle ergometries. Generalized Estimating Equations were used for regression analyses of immediate, delayed and cumulative influences of the daily measured meteorological data. For men, a decrease in air temperature and in water vapor pressure doubled the risk of ST-segment depression during ergometry [odds ratio (OR) for 1 day delay: 1.88 (1.24; 2.83) for air temperature] with a delay of 1-2 days. For women, an increase of their heart rate before the start of the ergometry [same day: 4.36 beats/min (0.99; 7.74) for air temperature] and a 2- to 3-fold higher risk for ventricular ectopic beats [1 day delay: OR 2.43 (1.17; 5.05) for air temperature] was observed with an increase in temperature and water vapor pressure in almost all analyzed time-windows. The study indicates that meteorological parameters can induce changes in heart function which may lead to adverse cardiovascular events especially in susceptible, diseased individuals. The observed effect on ST-segment depression could be a link between the association of weather changes and cardiovascular morbidity and mortality.

  9. Impedance Control of the Rehabilitation Robot Based on Sliding Mode Control

    Science.gov (United States)

    Zhou, Jiawang; Zhou, Zude; Ai, Qingsong

    As an auxiliary treatment, the 6-DOF parallel robot plays an important role in lower limb rehabilitation. In order to improve the efficiency and flexibility of the lower limb rehabilitation training, this paper studies the impedance controller based on the position control. A nonsingular terminal sliding mode control is developed to ensure the trajectory tracking precision and in contrast to traditional PID control strategy in the inner position loop, the system will be more stable. The stability of the system is proved by Lyapunov function to guarantee the convergence of the control errors. Simulation results validate the effectiveness of the target impedance model and show that the parallel robot can adjust gait trajectory online according to the human-machine interaction force to meet the gait request of patients, and changing the impedance parameters can meet the demands of different stages of rehabilitation training.

  10. Qualitative exploration of the benefits of group-based memory rehabilitation for people with neurological disabilities: implications for rehabilitation delivery and evaluation

    Science.gov (United States)

    Chouliara, Niki; Lincoln, Nadina B

    2016-01-01

    Objective To identify patient-perceived benefits of memory rehabilitation and draw transferrable lessons for the delivery and evaluation of similar interventions for people with neurological disabilities. Methods A qualitative study was conducted as part of a pragmatic randomised controlled trial comparing 2 memory rehabilitation approaches with a self-help control group. Postintervention interviews were conducted with 20 participants with a diagnosis of traumatic brain injury, multiple sclerosis or stroke. Data were analysed using a qualitative content analysis approach. Results Participants receiving memory rehabilitation reported that the sessions responded to previously unmet needs for information on brain injury and memory function and developed their insight along with a sense of self-efficacy and control over the management of their memory problems. Although they did not experience major improvements in their memory function per se, they reported that rehabilitation gave them the skills to effectively cope with the residual deficits. Respondents in the control groups did not report similar benefits. The opportunities for interaction offered by the group setting were greatly valued by all respondents. Mixed aetiology groups were received positively; however, marked differences in cognitive performance were frustrating for some participants. Conclusions The study highlighted important patient-perceived outcomes that should be considered by researchers and rehabilitation professionals when evaluating the effects of memory rehabilitation. The use of domain-specific outcome measures which reflect these areas is recommended. Qualitative changes in the use of memory aids may be achieved which cannot be captured by frequency indices alone. The benefits of the group-based rehabilitation approach were stressed by participants, suggesting that a combination of group and individual sessions might be a good practice. Trial registration number ISRCTN92582254; Results

  11. The Effect of Game-Based Interventions in Rehabilitation of Diabetics

    DEFF Research Database (Denmark)

    Christensen, Jan; Valentiner, Laura Staun; Petersen, Rikke Juelsgaard;

    2016-01-01

    on the effect of game-based interventions on HbA1c, diabetes-related knowledge, and physical outcomes in rehabilitation of diabetes patients. METHODS: We conducted a systematic literature search in MEDLINE, EMBASE, PEDro, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, and Psych INFO in October...

  12. Characterization of cardiac quiescence from retrospective cardiac computed tomography using a correlation-based phase-to-phase deviation measure

    Energy Technology Data Exchange (ETDEWEB)

    Wick, Carson A.; McClellan, James H. [School of Electrical and Computer Engineering, Georgia Institute of Technology, 777 Atlantic Drive Northwest, Atlanta, Georgia 30332 (United States); Arepalli, Chesnal D. [Department of Radiology, University of British Columbia, 3350-950 West 10th Avenue, Vancouver, British Columbia V5Z 4E3 (Canada); Auffermann, William F.; Henry, Travis S. [Department of Radiology and Imaging Sciences, Emory University, Division of Cardiothoracic Imaging, 1364 Clifton Road Northeast, Suite 309, Atlanta, Georgia 30322 (United States); Khosa, Faisal [Department of Radiology and Imaging Sciences, Emory University, Division of Emergency Radiology, 550 Peachtree Street Northeast, Atlanta, Georgia 30308 (United States); Coy, Adam M. [School of Medicine, Emory University, 100 Woodruff Circle, Atlanta, Georgia 30322 (United States); Tridandapani, Srini, E-mail: stridan@emory.edu [Department of Radiology and Imaging Sciences, Emory University, Winship Cancer Institute, 1701 Uppergate Drive Northeast, Suite 5018, Atlanta, Georgia 30322 and School of Electrical and Computer Engineering, Georgia Institute of Technology, 777 Atlantic Drive Northwest, Atlanta, Georgia 30332 (United States)

    2015-02-15

    Purpose: Accurate knowledge of cardiac quiescence is crucial to the performance of many cardiac imaging modalities, including computed tomography coronary angiography (CTCA). To accurately quantify quiescence, a method for detecting the quiescent periods of the heart from retrospective cardiac computed tomography (CT) using a correlation-based, phase-to-phase deviation measure was developed. Methods: Retrospective cardiac CT data were obtained from 20 patients (11 male, 9 female, 33–74 yr) and the left main, left anterior descending, left circumflex, right coronary artery (RCA), and interventricular septum (IVS) were segmented for each phase using a semiautomated technique. Cardiac motion of individual coronary vessels as well as the IVS was calculated using phase-to-phase deviation. As an easily identifiable feature, the IVS was analyzed to assess how well it predicts vessel quiescence. Finally, the diagnostic quality of the reconstructed volumes from the quiescent phases determined using the deviation measure from the vessels in aggregate and the IVS was compared to that from quiescent phases calculated by the CT scanner. Three board-certified radiologists, fellowship-trained in cardiothoracic imaging, graded the diagnostic quality of the reconstructions using a Likert response format: 1 = excellent, 2 = good, 3 = adequate, 4 = nondiagnostic. Results: Systolic and diastolic quiescent periods were identified for each subject from the vessel motion calculated using the phase-to-phase deviation measure. The motion of the IVS was found to be similar to the aggregate vessel (AGG) motion. The diagnostic quality of the coronary vessels for the quiescent phases calculated from the aggregate vessel (P{sub AGG}) and IVS (P{sub IV} {sub S}) deviation signal using the proposed methods was comparable to the quiescent phases calculated by the CT scanner (P{sub CT}). The one exception was the RCA, which improved for P{sub AGG} for 18 of the 20 subjects when compared to P

  13. Evidence-based careflow management systems: the case of post-stroke rehabilitation.

    Science.gov (United States)

    Panzarasa, S; Maddè, S; Quaglini, S; Pistarini, C; Stefanelli, M

    2002-04-01

    The activities of a care providers' team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system's main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals' set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing

  14. Impact of cardiac rehabilitation on angiographic outcomes after drug-eluting stents in patients with de novo long coronary artery lesions.

    Science.gov (United States)

    Lee, Jong-Young; Yun, Sung-Cheol; Ahn, Jung-Min; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Yoo, Yeong Sook; Park, Eun-Kyung; Jin, Young-Soo; Kim, Jeongsoon; Nam, Hyo-Jung; Min, Sun-Yang; Park, Seung-Jung

    2014-06-15

    Cardiac rehabilitation (CR) can reduce cardiovascular mortality and morbidity in coronary artery disease. Long coronary artery lesions may be associated with adverse outcomes after drug-eluting stent (DES) implantation. The purpose of this study was to evaluate angiographic outcomes after a comprehensive CR program in patients with DESs for long coronary artery lesions. A total of 576 patients treated with DESs for long (≥25 mm) coronary lesions were enrolled in this prospective CR registry. Comprehensive CR programs were successfully performed in 288 patients (50%). The primary end point was in-stent late luminal loss at the 9-month angiographic follow-up. There were few significant differences between the CR and non-CR groups in terms of baseline characteristics, including clinical, angiographic, and procedural variables. The rate of in-stent late luminal loss in the CR group was 35% less than in the usual care group (0.19 ± 0.33 mm in CR vs 0.29 ± 0.45 mm in non-CR, difference 0.08 mm, 95% confidence interval 0.01 to 0.16, p = 0.02) at the 9-month follow-up. After propensity-matched analysis (224 pairs), the results were consistent (0.18 ± 0.31 mm in CR vs 0.28 ± 0.41 mm in non-CR, difference 0.10 mm, 95% confidence interval 0.02 to 0.18, p = 0.02). The CR group showed a significant improvement in the overall risk profile compared with the non-CR group, including current smoking, biochemical profiles, depression, obesity, and exercise capacity. In conclusion, the comprehensive CR program significantly reduced late luminal loss after DES implantation for long coronary lesions. This may be associated with significant improvements in exercise capacity and overall risk profile.

  15. Empowered to gain a new foothold in life--A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack.

    Science.gov (United States)

    Simonÿ, Charlotte P; Dreyer, Pia; Pedersen, Birthe D; Birkelund, Regner

    2015-01-01

    This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients' particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients' total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and

  16. Empowered to gain a new foothold in life--A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack.

    Science.gov (United States)

    Simonÿ, Charlotte P; Dreyer, Pia; Pedersen, Birthe D; Birkelund, Regner

    2015-01-01

    This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients' particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients' total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and

  17. Empowered to gain a new foothold in life—A study of the meaning of participating in cardiac rehabilitation to patients afflicted by a minor heart attack

    Directory of Open Access Journals (Sweden)

    Charlotte P. Simonÿ

    2015-12-01

    Full Text Available This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR. CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients’ particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1 receiving a helpful but limited caring hand, (2 being supported to find new values in life, and (3 developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients’ total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting

  18. Exploring limits to market-based reform: managed competition and rehabilitation home care services in Ontario.

    Science.gov (United States)

    Randall, Glen E; Williams, A Paul

    2006-04-01

    The rise of neo-liberalism, which suggests that only markets can deliver maximum economic efficiency, has been a driving force behind the trend towards using market-based solutions to correct health care problems. However, the broad application of market-based reforms has tended to assume the presence of fully functioning markets. When there are barriers to markets functioning effectively, such as the absence of adequate competition, recourse to market-based solutions can be expected to produce less than satisfactory, if not paradoxical results. One such case is rehabilitation homecare in Ontario, Canada. In 1996, a "managed competition" model was introduced as part of a province-wide reform of home care in an attempt to encourage high quality at competitive prices. However, in the case of rehabilitation home care services, significant obstacles to achieving effective competition existed. Notably, there were few private provider agencies to bid on contracts due to the low volume and specialized nature of services. There were also structural barriers such as the presence of unionized employees and obstacles to the entry of new providers. This paper evaluates the impact of Ontario's managed competition reform on community-based rehabilitation services. It draws on data obtained through 49 in-depth key informant interviews and a telephone survey of home care coordinating agencies and private rehabilitation provider agencies. Instead of reducing costs and improving quality, as the political rhetoric promised, the analysis suggests that providing rehabilitation homecare services under managed competition resulted in higher per-visit costs and reduced access to services. These findings support the contention that there are limits to market-based reforms. PMID:16198035

  19. Acoustic cardiac signals analysis: a Kalman filter–based approach

    Directory of Open Access Journals (Sweden)

    Salleh SH

    2012-06-01

    Full Text Available Sheik Hussain Salleh,1 Hadrina Sheik Hussain,2 Tan Tian Swee,2 Chee-Ming Ting,2 Alias Mohd Noor,2 Surasak Pipatsart,3 Jalil Ali,4 Preecha P Yupapin31Department of Biomedical Instrumentation and Signal Processing, Universiti Teknologi Malaysia, Skudai, Malaysia; 2Centre for Biomedical Engineering Transportation Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 3Nanoscale Science and Engineering Research Alliance, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand; 4Institute of Advanced Photonics Science, Universiti Teknologi Malaysia, Johor Bahru, MalaysiaAbstract: Auscultation of the heart is accompanied by both electrical activity and sound. Heart auscultation provides clues to diagnose many cardiac abnormalities. Unfortunately, detection of relevant symptoms and diagnosis based on heart sound through a stethoscope is difficult. The reason GPs find this difficult is that the heart sounds are of short duration and separated from one another by less than 30 ms. In addition, the cost of false positives constitutes wasted time and emotional anxiety for both patient and GP. Many heart diseases cause changes in heart sound, waveform, and additional murmurs before other signs and symptoms appear. Heart-sound auscultation is the primary test conducted by GPs. These sounds are generated primarily by turbulent flow of blood in the heart. Analysis of heart sounds requires a quiet environment with minimum ambient noise. In order to address such issues, the technique of denoising and estimating the biomedical heart signal is proposed in this investigation. Normally, the performance of the filter naturally depends on prior information related to the statistical properties of the signal and the background noise. This paper proposes Kalman filtering for denoising statistical heart sound. The cycles of heart sounds are certain to follow first-order Gauss–Markov process. These cycles are observed with additional noise

  20. Acoustic cardiac signals analysis: a Kalman filter-based approach.

    Science.gov (United States)

    Salleh, Sheik Hussain; Hussain, Hadrina Sheik; Swee, Tan Tian; Ting, Chee-Ming; Noor, Alias Mohd; Pipatsart, Surasak; Ali, Jalil; Yupapin, Preecha P

    2012-01-01

    Auscultation of the heart is accompanied by both electrical activity and sound. Heart auscultation provides clues to diagnose many cardiac abnormalities. Unfortunately, detection of relevant symptoms and diagnosis based on heart sound through a stethoscope is difficult. The reason GPs find this difficult is that the heart sounds are of short duration and separated from one another by less than 30 ms. In addition, the cost of false positives constitutes wasted time and emotional anxiety for both patient and GP. Many heart diseases cause changes in heart sound, waveform, and additional murmurs before other signs and symptoms appear. Heart-sound auscultation is the primary test conducted by GPs. These sounds are generated primarily by turbulent flow of blood in the heart. Analysis of heart sounds requires a quiet environment with minimum ambient noise. In order to address such issues, the technique of denoising and estimating the biomedical heart signal is proposed in this investigation. Normally, the performance of the filter naturally depends on prior information related to the statistical properties of the signal and the background noise. This paper proposes Kalman filtering for denoising statistical heart sound. The cycles of heart sounds are certain to follow first-order Gauss-Markov process. These cycles are observed with additional noise for the given measurement. The model is formulated into state-space form to enable use of a Kalman filter to estimate the clean cycles of heart sounds. The estimates obtained by Kalman filtering are optimal in mean squared sense. PMID:22745550

  1. Acoustic cardiac signals analysis: a Kalman filter-based approach.

    Science.gov (United States)

    Salleh, Sheik Hussain; Hussain, Hadrina Sheik; Swee, Tan Tian; Ting, Chee-Ming; Noor, Alias Mohd; Pipatsart, Surasak; Ali, Jalil; Yupapin, Preecha P

    2012-01-01

    Auscultation of the heart is accompanied by both electrical activity and sound. Heart auscultation provides clues to diagnose many cardiac abnormalities. Unfortunately, detection of relevant symptoms and diagnosis based on heart sound through a stethoscope is difficult. The reason GPs find this difficult is that the heart sounds are of short duration and separated from one another by less than 30 ms. In addition, the cost of false positives constitutes wasted time and emotional anxiety for both patient and GP. Many heart diseases cause changes in heart sound, waveform, and additional murmurs before other signs and symptoms appear. Heart-sound auscultation is the primary test conducted by GPs. These sounds are generated primarily by turbulent flow of blood in the heart. Analysis of heart sounds requires a quiet environment with minimum ambient noise. In order to address such issues, the technique of denoising and estimating the biomedical heart signal is proposed in this investigation. Normally, the performance of the filter naturally depends on prior information related to the statistical properties of the signal and the background noise. This paper proposes Kalman filtering for denoising statistical heart sound. The cycles of heart sounds are certain to follow first-order Gauss-Markov process. These cycles are observed with additional noise for the given measurement. The model is formulated into state-space form to enable use of a Kalman filter to estimate the clean cycles of heart sounds. The estimates obtained by Kalman filtering are optimal in mean squared sense.

  2. Should Family and Friends Be Involved in Group-Based Rehabilitation Programs for Adults with Low Vision?

    Science.gov (United States)

    Rees, G.; Saw, C.; Larizza, M.; Lamoureux, E.; Keeffe, J.

    2007-01-01

    This qualitative study investigates the views of clients with low vision and vision rehabilitation professionals on the involvement of family and friends in group-based rehabilitation programs. Both groups outlined advantages and disadvantages to involving significant others, and it is essential that clients are given the choice. Future work is…

  3. New Concepts and Evidence Based Practice in Physiotherapy:Examples from Stroke Rehabilitation

    Institute of Scientific and Technical Information of China (English)

    Langhammer Birgitta; RPT; PhD

    2011-01-01

    Objective:The purpose of this paper is to give an oveuview of new concepts and evidence based physiotherapy practice in stroke rehabilitation in the acute,post acute and chronic stage of stroke.Background:Historically physiotherapy has developed through the years from a focus on health,beauty,and equilibrium between spiritual,moral and physical powers,to a client centered service to people and populations to develop,to maintain and to restore maximum movement and functional ability throughout the lifespan.Still the health perspective is strong and divided into first,second and third prophylaxis.New concepts like Evidence Based Medicine,Evidence Based Practice,International Classification of Function and research within neurophysiology have had a deep impact on physiotherapy services.practice and education.The highest levels of documentation are Meta analyses and Randomised Controlled Trials,and today many of the physiotherapy methods used in rehabilitation of neurological conditions are tried out in different trials,bringing up-todate knowledge into practice.This paper fo-cuse8 on rehabilitation of persons with stroke and physiotherapy methods in particular.Result:Physiotherapy in the acute stage improves motor function and enhances mobility.Rehabilitative efforts within the first few weeks as opposed to later favors better recovery.Type of physiotherapy in the acutestage is task oriented training with a focus on intensity and variability.Post acute therapy-based rehabilitation services targeted towards stroke patients living at home appear to improve independence in personal activities of daily living.In the chronic stage there is good evidence that aerobic exercise is beneficial for improving aerobic capacity inpeople with mild and moderate stroke.Progressive resistance strength training programmes reduce musculoskeletal impairment after stroke,without increasing tone or spasticity.

  4. 冠心病患者运动中心率-收缩压双乘积与血乳酸浓度和ST段水平的关系%Relationship between rate-pressure product and blood lactate concentration as well as ST segment level in coronary heart disease patients during exercise-based cardiac rehabilitation

    Institute of Scientific and Technical Information of China (English)

    刘洵; 林青华; 李淑荣; 姚莉; 谭思洁

    2013-01-01

    Objective:By using rate-pressure product (RPP) to predict both blood lactate(BL) and ST segment(ST) ischemic threshold in coronary heart disease patients to determine the optimal aerobic exercise intensity easily.Method:Forty-four coronary heart disease patients,aged (66.0±6.0) years,performed a graded exercise test on a treadmill,at the same time BL and RPP were recorded every three minutes,and ST in electrocardiogram was monitored continuously.Then,the formulae for predicting BL and ST from RPP were established.Result:The formula for predicting BL from RPP was as following:Y=1.6723-0.0071X+0.00000027X3 (Y=BL,X=RPP,P<0.05).An exercise intensity corresponding to the lactate threshold was around RPP 180 beats·mmHg· 100-1.The formula for predicting ST from RPP was as following:Y=0.5652-0.00005X2+0.000000072X3(y=ST,X=RPP,P<0.05).An exercise intensity corresponding to the ischemic threshold was around RPP 210 beats·mmHg· 100-1.Conclusion:Not only myocardial ischemia but also skeletal muscle oxygen deficiency should be considered prudently,the while coronary heart disease patients exercising during rehabilitation.The RPP can be applied as an alternative option to predict changes of those variables.%目的:使冠心病患者能够利用心率-收缩压双乘积(RPP)这一简便指标推测其乳酸无氧阈和心肌缺血阈,以便确定适宜的有氧运动强度.方法:44例女性冠心病患者(66.0±6.0岁)在活动跑台上进行了递增负荷运动实验,其间连续监测心电图中ST段的变化,并每3min测定1次血乳酸浓度(BL)和RPP.然后建立用RPP推测BL和ST的公式.结果:RPP推测BL的数学公式为,Y=2.6723-0.0071X+ 0.00000027 X3(P<0.05),其中y为BL,X为RPP.乳酸阈强度约为RPP 180搏动次数·mmHg· 100-1.RPP推测ST的数学公式为,Y=0.5652-0.00005 X2+0.000000072 X3(P<0.05),其中y为ST,X为RPP.缺血阈强度约为RPP 210搏动次数·mmHg·100-1.结论:冠心病患者的康复运动不但要考虑到心肌的缺血

  5. Cardiac tissue engineering and regeneration using cell-based therapy

    Directory of Open Access Journals (Sweden)

    Alrefai MT

    2015-05-01

    Full Text Available Mohammad T Alrefai,1–3 Divya Murali,4 Arghya Paul,4 Khalid M Ridwan,1,2 John M Connell,1,2 Dominique Shum-Tim1,2 1Division of Cardiac Surgery, 2Division of Surgical Research, McGill University Health Center, Montreal, QC, Canada; 3King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 4Department of Chemical and Petroleum Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA Abstract: Stem cell therapy and tissue engineering represent a forefront of current research in the treatment of heart disease. With these technologies, advancements are being made into therapies for acute ischemic myocardial injury and chronic, otherwise nonreversible, myocardial failure. The current clinical management of cardiac ischemia deals with reestablishing perfusion to the heart but not dealing with the irreversible damage caused by the occlusion or stenosis of the supplying vessels. The applications of these new technologies are not yet fully established as part of the management of cardiac diseases but will become so in the near future. The discussion presented here reviews some of the pioneering works at this new frontier. Key results of allogeneic and autologous stem cell trials are presented, including the use of embryonic, bone marrow-derived, adipose-derived, and resident cardiac stem cells. Keywords: stem cells, cardiomyocytes, cardiac surgery, heart failure, myocardial ischemia, heart, scaffolds, organoids, cell sheet and tissue engineering

  6. Why evidence-based medicine is a good approach in physical and rehabilitation medicine. Thesis.

    Science.gov (United States)

    Negrini, S

    2014-10-01

    According to a good definition, evidence-based medicine (EBM) is: "The explicit, conscientious, and judicious use of the current best evidence in making decisions about the care of individual patients (and populations)". More appropriate in a clinical context like that of physical and rehabilitation medicine (PRM) is looking at evidence based clinical practice (EBCP), whose definition is: "The integration of best research evidence with clinical expertise and patient values". In the past the term evidence-based physical and rehabilitation medicine (EBPRM) was also proposed. In this thesis, after some historical notes on EBM and on PRM, we will discuss why in our view EBPRM must be the real foundation of our everyday PRM clinical practice.

  7. Towards an SEMG-based tele-operated robot for masticatory rehabilitation.

    Science.gov (United States)

    Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza

    2016-08-01

    This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane.

  8. Towards an SEMG-based tele-operated robot for masticatory rehabilitation.

    Science.gov (United States)

    Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza

    2016-08-01

    This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane. PMID

  9. A systematic review of the effectiveness of alternative cadres in community based rehabilitation

    Directory of Open Access Journals (Sweden)

    Mannan Hasheem

    2012-08-01

    Full Text Available Abstract Background The Millennium Development Goals (MDGs aim to improve population health and the quality and dignity of people’s lives, but their achievement is constrained by the crisis in human resources for health. An important potential contribution towards achieving the MDGs for persons with disabilities will be the newly developed Guidelines for Community Based Rehabilitation (CBR, launched in 2010. Given the global shortage of medical and nursing personnel and highly skilled rehabilitation practitioners, effective implementation of the CBR guidelines will require additional health workers, with improved distribution and a new skill set, allowing them to work across the health, education, livelihoods, social, and development sectors. Methods We conducted a systematic review to evaluate existing evidence regarding the effectiveness of alternative cadres working in CBR in low and middle income countries. We searched the following databases: PUBMED, LILACS, SCIE, ISMEAR, WHOLIS, AFRICAN MED IND. We also searched the online archive of the Asia Pacific Disability Rehabilitation Journal (available from 2002 to 2010, which was not covered by any of the other databases. There was no limit set on inclusion with regard to how recent a publication was in the general search. Results The search yielded 235 abstracts, only 6 of which addressed CBR through some type of evaluative component. Three of the studies explored the effects of CBR interventions, mainly related to physical disabilities, while three explored issues concerned with the work performance of rehabilitation workers. Altogether the studies covered four different countries. Conclusion All six studies related to specific service delivery in local contexts, using outcome measures that were not comparable across studies. We do not, therefore, feel that the current results provide adequate methodology or evidence for reliably generalizing their results. Due to the dearth of evidence

  10. Design considerations for a theory-driven exergame-based rehabilitation program to improve walking of persons with stroke.

    Science.gov (United States)

    Wüest, Seline; van de Langenberg, Rolf; de Bruin, Eling D

    2014-01-01

    Virtual rehabilitation approaches for promoting motor recovery has attracted considerable attention in recent years. It appears to be a useful tool to provide beneficial and motivational rehabilitation conditions. Following a stroke, hemiparesis is one of the most disabling impairments and, therefore, many affected people often show substantial deficits in walking abilities. Hence, one of the major goals of stroke rehabilitation is to improve patients' gait characteristics and hence to regain their highest possible level of walking ability. Because previous studies indicate a relationship between walking and balance ability, this article proposes a stroke rehabilitation program that targets balance impairments to improve walking in stroke survivors. Most currently, available stroke rehabilitation programs lack a theory-driven, feasible template consistent with widely accepted motor learning principles and theories in rehabilitation. To address this hiatus, we explore the potential of a set of virtual reality games specifically developed for stroke rehabilitation and ordered according to an established two-dimensional motor skill classification taxonomy. We argue that the ensuing "exergame"-based rehabilitation program warrants individually tailored balance progression in a learning environment that allows variable practice and hence optimizes the recovery of walking ability. PMID:25309631

  11. Cable-based parallel manipulator for rehabilitation of shoulder and elbow movements.

    Science.gov (United States)

    Nunes, Wilgo Moreira; Rodrigues, Lucas Antônio Oliveira; Oliveira, Lucas Paiva; Ribeiro, José Francisco; Carvalho, João Carlos Mendes; Gonçalves, Rogério Sales

    2011-01-01

    In this paper a cable-based system is presented for rehabilitation of the shoulder and elbow movements. Cable-based manipulators have very good kinematic and dynamic characteristics, and they also show other properties such as: transportability and low-cost construction, which make them also suitable for medical applications and rehabilitation. The general robotics structure consists of four cables that allow the movement of vertical flexion-extension, abduction-adduction and horizontal flexion-extension with different limits of movement and speed of the shoulder. The structure can also perform the elbow movements of the flexion-extension. The development of this robotic device is justified by the large number of people with upper limb problems. These problems are due of stroke, polio, arthritis, recovery after accidents or trauma and can be applied to movements of physical therapy. The kinematics model of cable-based parallel robots is obtained similarly to the model obtained from traditional parallel structures. The graphical simulations of the cable-based parallel structure for rehabilitation of the movements of the human arm are presented showing the viability of the proposed structure. Finally preliminary experimental tests are presented. PMID:22275699

  12. Rheumatologic rehabilitation: towards recommendations

    Directory of Open Access Journals (Sweden)

    S. Maddali Bongi

    2014-11-01

    Full Text Available Rheumatic patients are highly complex and often affected by chronic diseases. Rehabilitation is generally needed for proper management of the underlying disease. This article describes the characteristics of an effective rheumatologic rehabilitation, takes into account data published in international literature, suggests recommendations based on scientific evidence to develop a correct rehabilitation plan for rheumatic patients and proposes the basis to draw up guidelines in the field of rheumatologic rehabilitation.

  13. Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

    OpenAIRE

    Nguyen, Huong Q.; Gill, Dawn P; Wolpin, Seth; Steele, Bonnie G; Benditt, Joshua O.

    2009-01-01

    Objective To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation. Methods Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9) or MOBILE-Self-Monitored (n = 8). All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instruct...

  14. Study protocol: Home-based physical rehabilitation for survivors of a critical illness [ACTRN12605000166673

    OpenAIRE

    Elliott, Doug; McKinley, Sharon; Alison, Jennifer A.; Aitken, Leanne M; King, Madeleine T

    2006-01-01

    Introduction Numerous primary studies and several review papers have highlighted delayed physical and psychological recovery for survivors of critical illness, often beyond 6 months after discharge. This randomized controlled trial with blinded assessment aims to test the effects of an 8-week, home-based, individually tailored physical rehabilitation programme on physical and psychological recovery for survivors of a critical illness after discharge from hospital. Method Participants are surv...

  15. Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

    OpenAIRE

    Scobbie, L.; McLean, D; Dixon, D; Duncan, E; Wyke, S

    2013-01-01

    Background: Goal setting is considered ‘best practice’ in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning and coping planning and appraisal and feedback. All stages are recorded in a patient-held reco...

  16. Rehabilitation System based on the Use of Biomechanical Analysis and Videogames through the Kinect Sensor

    OpenAIRE

    John E. Muñoz-Cardona; Oscar A. Henao-Gallo; José F. López-Herrera

    2013-01-01

    This paper presents development of a novel system for physical rehabilitation of patients with multiple pathologies, through dynamic with exercise videogames (exergames) and analysis of the movements of patients using developed software. This system is based on the use of the Kinect sensor for both purposes: amusing the patient in therapy through of specialist exergames and provide a tool to record and analyze MoCap data taken through the Kinect sensor and processed using biomechanical analys...

  17. Rehabilitation of patients with motor disabilities using computer vision based techniques

    OpenAIRE

    Reyes-Amaro, Alejandro; Fadraga-González, Yanet; Vera-Pérez, Oscar Luis; Domínguez-Campillo, Elizabeth; Nodarse-Ravelo, Jenny; Mesejo-Chiong, Alejandro; Moyà-Alcover, Biel; Jaume-i-Capó, Antoni

    2012-01-01

    In this paper we present details about the implementation of computer vision based applications for the rehabilitation of patients with motor disabilities. The applications are conceived as serious games, where the computer-patient interaction during playing contributes to the development of different motor skills. The use of computer vision methods allows the automatic guidance of the patient’s movements making constant specialized supervision unnecessary. The hardware requirements are limit...

  18. Interdisciplinary rehabilitation

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ IntroductionInterdisciplinary rehabilitation, or care by a team of rehabilitation professionals, has been a core strategy of rehabilitation medicine since its beginning. As a result, quality assessments of these programs universally include evaluating the effectiveness of their interdisciplinary teams. Rehabilitation programs for individuals with physical and cognitive disabilities originally were institutionally based, an environment that facilitated the communication needed for interdisciplinary care. These programs addressed a full spectrum of problems, including health, physical functioning, psychological adjustment, social integration, and vocational or other significant role participation. The implementation of truly interdisciplinary programs has always been difficult because of this complexity, but recent restrictions in the resources available to provide rehabilitation have increased this difficulty. With less professional time available because of limited funds, the interdisciplinary process is being challenged to show its value, and to be as efficient as possible.This paper discusses the benefits to be gained through the interdisciplinary process, factors that reduce its cost effectiveness and strategies to maintain its advantages at the least possible cost.

  19. Late group-based rehabilitation has no advantages compared with supervised home-exercises after total knee arthroplasty

    DEFF Research Database (Denmark)

    Madsen, Majbritt; Larsen, Kristian; Madsen, Inger Kirkegård;

    2013-01-01

    This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA)....

  20. Training-Based Interventions in Motor Rehabilitation after Stroke: Theoretical and Clinical Considerations

    Directory of Open Access Journals (Sweden)

    Annette Sterr

    2004-01-01

    Full Text Available Basic neuroscience research on brain plasticity, motor learning and recovery has stimulated new concepts in neurological rehabilitation. Combined with the development of set methodological standards in clinical outcome research, these findings have led to a double-paradigm shift in motor rehabilitation: (a the move towards evidence-based procedures for the assessment of clinical outcome & the employment of disablement models to anchor outcome parameters, and (b the introduction of practice-based concepts that are derived from testable models that specify treatment mechanisms. In this context, constraint-induced movement therapy (CIT has played a catalytic role in taking motor rehabilitation forward into the scientific arena. As a theoretically founded and hypothesis-driven intervention, CIT research focuses on two main issues. The first issue is the assessment of long-term clinical benefits in an increasing range of patient groups, and the second issue is the investigation of neuronal and behavioural treatment mechanisms and their interactive contribution to treatment success. These studies are mainly conducted in the research environment and will eventually lead to increased treatment benefits for patients in standard health care. However, gradual but presumably more immediate benefits for patients may be achieved by introducing and testing derivates of the CIT concept that are more compatible with current clinical practice. Here, we summarize the theoretical and empirical issues related to the translation of research-based CIT work into the clinical context of standard health care.

  1. Pipeline rehabilitation planning

    Energy Technology Data Exchange (ETDEWEB)

    Palmer-Jones, Roland; Hopkins, Phil; Eyre, David [PENSPEN (United Kingdom)

    2005-07-01

    An operator faced with an onshore pipeline that has extensive damage must consider the need for rehabilitation, the sort of rehabilitation to be used, and the rehabilitation schedule. This paper will consider pipeline rehabilitation based on the authors' experiences from recent projects, and recommend a simple strategy for planning pipeline rehabilitation. It will also consider rehabilitation options: external re-coating; internal lining; internal painting; programmed repairs. The main focus will be external re-coating. Consideration will be given to rehabilitation coating types, including tape wraps, epoxy, and polyurethane. Finally it will discuss different options for scheduling the rehabilitation of corrosion damage including: the statistical comparison of signals from inspection pigs; statistical comparison of selected measurements from inspection pigs and other inspections; the use of corrosion rates estimated for the mechanisms and conditions; expert judgement. (author)

  2. An acoustic feature-based similarity scoring system for speech rehabilitation assistance.

    Science.gov (United States)

    Syauqy, Dahnial; Wu, Chao-Min; Setyawati, Onny

    2016-08-01

    The purpose of this study is to develop a tool to assist speech therapy and rehabilitation, which focused on automatic scoring based on the comparison of the patient's speech with another normal speech on several aspects including pitch, vowel, voiced-unvoiced segments, strident fricative and sound intensity. The pitch estimation employed the use of cepstrum-based algorithm for its robustness; the vowel classification used multilayer perceptron (MLP) to classify vowel from pitch and formants; and the strident fricative detection was based on the major peak spectral intensity, location and the pitch existence in the segment. In order to evaluate the performance of the system, this study analyzed eight patient's speech recordings (four males, four females; 4-58-years-old), which had been recorded in previous study in cooperation with Taipei Veterans General Hospital and Taoyuan General Hospital. The experiment result on pitch algorithm showed that the cepstrum method had 5.3% of gross pitch error from a total of 2086 frames. On the vowel classification algorithm, MLP method provided 93% accuracy (men), 87% (women) and 84% (children). In total, the overall results showed that 156 tool's grading results (81%) were consistent compared to 192 audio and visual observations done by four experienced respondents. Implication for Rehabilitation Difficulties in communication may limit the ability of a person to transfer and exchange information. The fact that speech is one of the primary means of communication has encouraged the needs of speech diagnosis and rehabilitation. The advances of technology in computer-assisted speech therapy (CAST) improve the quality, time efficiency of the diagnosis and treatment of the disorders. The present study attempted to develop tool to assist speech therapy and rehabilitation, which provided simple interface to let the assessment be done even by the patient himself without the need of particular knowledge of speech processing while at the

  3. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions.

    Science.gov (United States)

    Silver, Julie K; Gilchrist, Laura S

    2011-05-01

    Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in physical and occupational therapy. Patients may need physical and occupational therapy services for a variety of cancer-related or cancer-treatment-related problems, including pain, fatigue, deconditioning, and difficulty with gait. They may also have problems resuming their previous level of function, which can impact on activities of daily living, instrumental activities of daily living, return to previous home and community activity levels, and return to work. This review discusses the role of physical and occupational therapy in helping cancer patients improve pain and musculoskeletal issues, deconditioning and endurance effects, fatigue, balance and falls, and lymphedema and psychosocial problems. PMID:21765263

  4. Rehabilitation System based on the Use of Biomechanical Analysis and Videogames through the Kinect Sensor

    Directory of Open Access Journals (Sweden)

    John E. Muñoz-Cardona

    2013-11-01

    Full Text Available This paper presents development of a novel system for physical rehabilitation of patients with multiple pathologies, through dynamic with exercise videogames (exergames and analysis of the movements of patients using developed software. This system is based on the use of the Kinect sensor for both purposes: amusing the patient in therapy through of specialist exergames and provide a tool to record and analyze MoCap data taken through the Kinect sensor and processed using biomechanical analysis through Euler angles. All interactive system is installed in a rehabilitation center and works with different pathologies (stroke, IMOC, craneoencephallic trauma, etc., patients interact with the platform while the specialist records data for later analysis, which is performed by software designed for this purpose. The motion graphics are shown in the sagittal, frontal and rotationalplanefrom20 points distributed in the body. The final system is portable, non-invasive, inexpensive, natural interaction with the patient and easily implemented for medical purposes.

  5. Utility of the Canadian Occupational Performance Measure as an admission and outcome measure in interdisciplinary community-based geriatric rehabilitation

    DEFF Research Database (Denmark)

    Larsen, Anette Enemark; Carlsson, Gunilla

    2012-01-01

    In a community-based geriatric rehabilitation project, the Canadian Occupational Performance Measure (COPM) was used to develop a coordinated, interdisciplinary, and client-centred approach focusing on occupational performance. The purpose of this study was to evaluate the utility of the COPM as ...... physician, home care, occupational therapy, physiotherapy......In a community-based geriatric rehabilitation project, the Canadian Occupational Performance Measure (COPM) was used to develop a coordinated, interdisciplinary, and client-centred approach focusing on occupational performance. The purpose of this study was to evaluate the utility of the COPM...... as an admission and outcome measure in an interdisciplinary geriatric rehabilitation context in Denmark. Eighteen occupational and physiotherapists administered the COPM among elderly citizens. Of 185 citizens referred to the study, 152 were admitted to rehabilitation based on health indices, and 124 completed...

  6. Psychosocial aspects in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Pogosova, N. V.; Saner, H.; Pedersen, S. S.;

    2015-01-01

    A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health- related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...

  7. Psychosocial aspects in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Pogosova, Nana; Saner, Hugo; Pedersen, Susanne S.;

    2015-01-01

    A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality....... Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening...

  8. Facilitation of research-based evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Borg, T.; Hounsgaard, L.

    2011-01-01

    Purpose:This study investigated the facilitation of evidence-based practice with the use of everyday life occupations and client-centred practice within occupational therapy in three settings of stroke rehabilitation. Method:The study was based on a phenomenological hermeneutical research approach...... of evidence-based occupational therapy....... to local contexts.The implementation resulted in various new working routines. Learning processes became part of developing the occupational therapists’ professional identities, expressed in more professional confidence. Collaboration in the organisation of the implementation process was significant...

  9. Facilitation of research-based evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, H.; Borg, T.; Hounsgaard, Lise

    2011-01-01

    Purpose: This study investigated the facilitation of evidence-based practice with the use of everyday life occupations and client-centred practice within occupational therapy in three settings of stroke rehabilitation. Method: The study was based on a phenomenological hermeneutical research...... of the implementation of evidence-based occupational therapy....... adapted to local contexts. The implementation resulted in various new working routines. Learning processes became part of developing the occupational therapists' professional identities, expressed in more professional confidence. Collaboration in the organisation of the implementation process...

  10. An active contour framework based on the Hermite transform for shape segmentation of cardiac MR images

    Science.gov (United States)

    Barba-J, Leiner; Escalante-Ramírez, Boris

    2016-04-01

    Early detection of cardiac affections is fundamental to address a correct treatment that allows preserving the patient's life. Since heart disease is one of the main causes of death in most countries, analysis of cardiac images is of great value for cardiac assessment. Cardiac MR has become essential for heart evaluation. In this work we present a segmentation framework for shape analysis in cardiac magnetic resonance (MR) images. The method consists of an active contour model which is guided by the spectral coefficients obtained from the Hermite transform (HT) of the data. The HT is used as model to code image features of the analyzed images. Region and boundary based energies are coded using the zero and first order coefficients. An additional shape constraint based on an elliptical function is used for controlling the active contour deformations. The proposed framework is applied to the segmentation of the endocardial and epicardial boundaries of the left ventricle using MR images with short axis view. The segmentation is sequential for both regions: the endocardium is segmented followed by the epicardium. The algorithm is evaluated with several MR images at different phases of the cardiac cycle demonstrating the effectiveness of the proposed method. Several metrics are used for performance evaluation.

  11. Indirect three-dimensional printing: A method for fabricating polyurethane-urea based cardiac scaffolds.

    Science.gov (United States)

    Hernández-Córdova, R; Mathew, D A; Balint, R; Carrillo-Escalante, H J; Cervantes-Uc, J M; Hidalgo-Bastida, L A; Hernández-Sánchez, F

    2016-08-01

    Biomaterial scaffolds are a key part of cardiac tissue engineering therapies. The group has recently synthesized a novel polycaprolactone based polyurethane-urea copolymer that showed improved mechanical properties compared with its previously published counterparts. The aim of this study was to explore whether indirect three-dimensional (3D) printing could provide a means to fabricate this novel, biodegradable polymer into a scaffold suitable for cardiac tissue engineering. Indirect 3D printing was carried out through printing water dissolvable poly(vinyl alcohol) porogens in three different sizes based on a wood-stack model, into which a polyurethane-urea solution was pressure injected. The porogens were removed, leading to soft polyurethane-urea scaffolds with regular tubular pores. The scaffolds were characterized for their compressive and tensile mechanical behavior; and their degradation was monitored for 12 months under simulated physiological conditions. Their compatibility with cardiac myocytes and performance in novel cardiac engineering-related techniques, such as aggregate seeding and bi-directional perfusion, was also assessed. The scaffolds were found to have mechanical properties similar to cardiac tissue, and good biocompatibility with cardiac myocytes. Furthermore, the incorporated cells preserved their phenotype with no signs of de-differentiation. The constructs worked well in perfusion experiments, showing enhanced seeding efficiency. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1912-1921, 2016. PMID:26991636

  12. Exercise-based cardiac rehabilitation for adults after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L; Berg, Selina K; Tang, Lars H;

    2016-01-01

    : the Cochrane Central Register of Controlled Trials (CENTRAL); the Database of Abstracts of Reviews of Effects (DARE); MEDLINE (Ovid); EMBASE (Ovid); CINAHL (EBSCO); PsycINFO (Ovid); LILACS (Bireme); and Conference Proceedings Citation Index-S (CPCI-S) on Web of Science (Thomson Reuters) on 23 March 2015. We...

  13. Rehabilitation in vestibular system diseases

    OpenAIRE

    Maksim Valeryevich Zamergrad

    2013-01-01

    Vestibular rehabilitation is an important component of combination treatment in a patient with vertigo. Vestibular rehabilitation is indicated for different diseases of the central or peripheral vestibular system. The goal of vestibular rehabilitation is to ensure gaze stabilization, to train postural stability, and to reduce subjective vertigo. Vestibular rehabilitation is based on the stimulation of vestibular adaptation, sensory substitution, and habituation. Vestibular suppressants, inade...

  14. Guidelines for sinkhole and subsidence rehabilitation based on generic geological models of a dolomite environment on the East Rand, South Africa

    Science.gov (United States)

    Kleinhans, Ilse; Van Rooy, J. Louis

    2016-05-01

    A sound understanding of the various factors influencing and associated with the formation of sinkholes or subsidences on dolomite land is essential for the selection of appropriate rehabilitation methods. The investigation and rehabilitation of numerous sinkholes and subsidences located on dolomite in the East Rand of South Africa, created an opportunity to develop a broad based understanding of different karst environments, their susceptibility to sinkhole and subsidence formation and best practice rehabilitation methods. This paper is based on the guidelines developed whereby the geological model of the sinkhole or subsidence is used to recommend an appropriate rehabilitation method. Nine typical geological models with recommended rehabilitation methods are presented in this paper.

  15. Prioritizing Areas for Rehabilitation by Monitoring Change in Barangay-Based Vegetation Cover

    Directory of Open Access Journals (Sweden)

    Ria S. Estoque

    2012-03-01

    Full Text Available Analysis of spatial and temporal changes of vegetation cover using remote sensing (RS technology, in conjunction with Geographic Information Systems (GIS, is becoming increasingly important in environmental conservation. The objective of this study was to use RS data and GIS techniques to assess the vegetation cover in 1989 and 2009, in the barangays (smallest administrative units of the city of San Fernando, La Union, the Philippines, for planning vegetation rehabilitation. Landsat images were used to prepare both the 1989 and 2009 land cover maps, which were then used to detect changes in the vegetation cover for the barangays. In addition to conventional accuracy assessment parameters such as; proportion correct, and standard Kappa index of agreement, two other parameters; quantity, and allocation disagreements were used to assess the accuracy of the land cover classification. Results revealed that there were gains and losses of vegetation cover in most of the barangays, but overall vegetation cover increased by 11% (around 625 ha based on the original extent of 1989. Those barangays that showed substantial net losses in vegetation cover need to be prioritised for rehabilitation planning. As exemplified in this study, the collection, processing and analysis of relevant RS and GIS information, can facilitate priority-setting in the planning of environmental rehabilitation and conservation by the local government at both city and barangay levels.

  16. Rehabilitative Interventions and Brain Plasticity in Autism Spectrum Disorders: Focus on MRI-Based Studies.

    Science.gov (United States)

    Calderoni, Sara; Billeci, Lucia; Narzisi, Antonio; Brambilla, Paolo; Retico, Alessandra; Muratori, Filippo

    2016-01-01

    Clinical and research evidence supports the efficacy of rehabilitative intervention for improving targeted skills or global outcomes in individuals with autism spectrum disorder (ASD). However, putative mechanisms of structural and functional brain changes are poorly understood. This review aims to investigate the research literature on the neural circuit modifications after non-pharmacological intervention. For this purpose, longitudinal studies that used magnetic resonance imaging (MRI)-based techniques at the start and at the end of the trial to evaluate the neural effects of rehabilitative treatment in subjects with ASD were identified. The six included studies involved a limited number of patients in the active group (from 2 to 16), and differed by acquisition method (task-related and resting-state functional MRI) as well as by functional MRI tasks. Overall, the results produced by the selected investigations demonstrated brain plasticity during the treatment interval that results in an activation/functional connectivity more similar to those of subjects with typical development (TD). Repeated MRI evaluation may represent a promising tool for the detection of neural changes in response to treatment in patients with ASD. However, large-scale randomized controlled trials after standardized rehabilitative intervention are required before translating these preliminary results into clinical use. PMID:27065795

  17. Rehabilitative interventions and brain plasticity in autism spectrum disorders: focus on MRI-based studies

    Directory of Open Access Journals (Sweden)

    Sara eCalderoni

    2016-03-01

    Full Text Available Clinical and research evidence supports the efficacy of rehabilitative intervention for improving targeted skills or global outcomes in individuals with autism spectrum disorder (ASD. However, putative mechanisms of structural and functional brain changes are poorly understood. This review aims to investigate the research literature on the neural circuit modifications after non-pharmacological intervention. For this purpose, longitudinal studies that used magnetic resonance imaging (MRI-based techniques at the start and at the end of the trial to evaluate the neural effects of rehabilitative treatment in subjects with ASD were identified. The six included studies involved a limited number of patients in the active group (from 2 to 16, and differed by acquisition method (task-related and resting-state functional MRI as well as by functional MRI tasks. Overall, the results produced by the selected investigations demonstrated brain plasticity during the treatment interval that results in an activation/functional connectivity more similar to those of subjects with typical development. Repeated MRI evaluation may represent a promising tool for the detection of neural changes in response to treatment in patients with ASD. However, large-scale randomized controlled trials after standardized rehabilitative intervention are required before translating these preliminary results into clinical use.

  18. The Development and Feasibility of a Ward-Based Physiotherapy and Nutritional Rehabilitation Package for People Experiencing Critical Illness

    OpenAIRE

    Salisbury, L. G.; Merriweather, J. L.; Walsh, T. S.

    2010-01-01

    Objective: To investigate ward-based rehabilitation after critical illness and undertake a pilot study exploring the feasibility of delivering enhanced physiotherapy and nutritional rehabilitation.Design: Service evaluation (part A) and pilot feasibility randomized controlled trial (part B).Setting: Hospital inpatient wards following discharge from intensive care.Participants: Part A involved 24 people with an intensive care stay of four days or more. Part B involved 16 participants randomize...

  19. Internet Use among Community-Based Rehabilitation Workers in Bosnia and Herzegovina: A Cross-Sectional Survey

    OpenAIRE

    Yeung, Euson; Balogh, Robert; Cole, Donald; Jakovic, Djenana; Michel D Landry

    2011-01-01

    Purpose: The Internet may be one way to support and improve rehabilitation practice and service delivery in low- and middle-income countries (LMICs) such as Bosnia and Herzegovina. Little information exists on use of the Internet to enhance the practice and professional development of community-based rehabilitation (CBR) workers in LMICs. The purpose of this study was to assess the patterns of and barriers to Internet use by CBR workers in Bosnia and Herzegovina.

  20. Development of a system based on 3D vision, interactive virtual environments, ergonometric signals and a humanoid for stroke rehabilitation.

    Science.gov (United States)

    Ibarra Zannatha, Juan Manuel; Tamayo, Alejandro Justo Malo; Sánchez, Angel David Gómez; Delgado, Jorge Enrique Lavín; Cheu, Luis Eduardo Rodríguez; Arévalo, Wilson Alexander Sierra

    2013-11-01

    This paper presents a stroke rehabilitation (SR) system for the upper limbs, developed as an interactive virtual environment (IVE) based on a commercial 3D vision system (a Microsoft Kinect), a humanoid robot (an Aldebaran's Nao), and devices producing ergonometric signals. In one environment, the rehabilitation routines, developed by specialists, are presented to the patient simultaneously by the humanoid and an avatar inside the IVE. The patient follows the rehabilitation task, while his avatar copies his gestures that are captured by the Kinect 3D vision system. The information of the patient movements, together with the signals obtained from the ergonometric measurement devices, is used also to supervise and to evaluate the rehabilitation progress. The IVE can also present an RGB image of the patient. In another environment, that uses the same base elements, four game routines--Touch the balls 1 and 2, Simon says, and Follow the point--are used for rehabilitation. These environments are designed to create a positive influence in the rehabilitation process, reduce costs, and engage the patient. PMID:23827333

  1. Development of a system based on 3D vision, interactive virtual environments, ergonometric signals and a humanoid for stroke rehabilitation.

    Science.gov (United States)

    Ibarra Zannatha, Juan Manuel; Tamayo, Alejandro Justo Malo; Sánchez, Angel David Gómez; Delgado, Jorge Enrique Lavín; Cheu, Luis Eduardo Rodríguez; Arévalo, Wilson Alexander Sierra

    2013-11-01

    This paper presents a stroke rehabilitation (SR) system for the upper limbs, developed as an interactive virtual environment (IVE) based on a commercial 3D vision system (a Microsoft Kinect), a humanoid robot (an Aldebaran's Nao), and devices producing ergonometric signals. In one environment, the rehabilitation routines, developed by specialists, are presented to the patient simultaneously by the humanoid and an avatar inside the IVE. The patient follows the rehabilitation task, while his avatar copies his gestures that are captured by the Kinect 3D vision system. The information of the patient movements, together with the signals obtained from the ergonometric measurement devices, is used also to supervise and to evaluate the rehabilitation progress. The IVE can also present an RGB image of the patient. In another environment, that uses the same base elements, four game routines--Touch the balls 1 and 2, Simon says, and Follow the point--are used for rehabilitation. These environments are designed to create a positive influence in the rehabilitation process, reduce costs, and engage the patient.

  2. Organization of rehabilitation services.

    Science.gov (United States)

    Graham, Laura A

    2013-01-01

    In the past 20 years there have been many changes in the way that neurological rehabilitation is delivered worldwide. This is in part a reflection of improved acute medical therapies and intensive care and also related to the development of a more holistic approach to recovery, embracing the principles of the WHO International Classification of Functioning as a model for rehabilitation. Traditionally, rehabilitation services have tended to develop piecemeal according to local resources and need. By definition such services should be driven by a patient-centered approach and thus there is wide variety in service provision nationally and internationally. This chapter describes the background to current service set-ups and provision, exploring models of rehabilitation delivery and common presentations in neurological rehabilitation. Relevant legislation and guidance documents are reviewed. The text provides an overview of different aspects of rehabilitation services including acute and inpatient provision, outpatient services, community-based rehabilitation, residential facilities, and vocational services.

  3. Home-based rehabilitation interventions for adults living with HIV: a scoping review.

    Science.gov (United States)

    Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

    2016-01-01

    Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most. PMID:27002360

  4. Impedance control in a wave-based teleoperator for rehabilitation motor therapies assisted by robots.

    Science.gov (United States)

    Mendoza, Marco; Bonilla, Isela; González-Galván, Emilio; Reyes, Fernando

    2016-01-01

    This paper presents an improved wave-based bilateral teleoperation scheme for rehabilitation therapies assisted by robot manipulators. The main feature of this bilateral teleoperator is that both robot manipulators, master and slave, are controlled by impedance. Thus, a pair of motion-based adaptive impedance controllers are integrated into a wave-based configuration, in order to guarantee a stable human-robot interaction and to compensate the position drift, characteristic of the available schemes of bilateral teleoperation. Moreover, the teleoperator stability, in the presence of time delays in the communication channel, is guaranteed because the wave-variable approach is included to encode the force and velocity signals. It should be noted that the proposed structure enables the implementation of several teleoperator schemes, from passive therapies, without the intervention of a human operator on the master side, to fully active therapies where both manipulators interact with humans in a stable manner. The suitable performance of the proposed teleoperator is verified through some results obtained from the simulation of the passive and active-constrained modes, by considering typical tasks in motor-therapy rehabilitation, where an improved behavior is observed when compared to implementations of the classical wave-based approach. PMID:26483305

  5. Impedance control in a wave-based teleoperator for rehabilitation motor therapies assisted by robots.

    Science.gov (United States)

    Mendoza, Marco; Bonilla, Isela; González-Galván, Emilio; Reyes, Fernando

    2016-01-01

    This paper presents an improved wave-based bilateral teleoperation scheme for rehabilitation therapies assisted by robot manipulators. The main feature of this bilateral teleoperator is that both robot manipulators, master and slave, are controlled by impedance. Thus, a pair of motion-based adaptive impedance controllers are integrated into a wave-based configuration, in order to guarantee a stable human-robot interaction and to compensate the position drift, characteristic of the available schemes of bilateral teleoperation. Moreover, the teleoperator stability, in the presence of time delays in the communication channel, is guaranteed because the wave-variable approach is included to encode the force and velocity signals. It should be noted that the proposed structure enables the implementation of several teleoperator schemes, from passive therapies, without the intervention of a human operator on the master side, to fully active therapies where both manipulators interact with humans in a stable manner. The suitable performance of the proposed teleoperator is verified through some results obtained from the simulation of the passive and active-constrained modes, by considering typical tasks in motor-therapy rehabilitation, where an improved behavior is observed when compared to implementations of the classical wave-based approach.

  6. Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

    OpenAIRE

    Nguyen, Huong Q.; Gill, Dawn P; Seth Wolpin; et al.

    2009-01-01

    Huong Q Nguyen1, Dawn P Gill1, Seth Wolpin1, Bonnie G Steele2, Joshua O Benditt11University of Washington, seattle, WA, USA; 2VA Puget Sound Health Care System, Seattle, WA, USAObjective: To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation.Methods: Participants who completed a two-week run-in were randomly assigned to either MOBILE...

  7. [Design of an embedded stroke rehabilitation apparatus system based on Linux computer engineering].

    Science.gov (United States)

    Zhuang, Pengfei; Tian, XueLong; Zhu, Lin

    2014-04-01

    A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.

  8. RESEARCH AND DEVELOPMENT OF DSP-BASED FACE RECOGNITION SYSTEM FOR ROBOTIC REHABILITATION NURSING BEDS

    Directory of Open Access Journals (Sweden)

    Ming XING

    2016-04-01

    Full Text Available This article describes the development of DSP as the core of the face recognition system, on the basis of understanding the background, significance and current research situation at home and abroad of face recognition issue, having a in-depth study to face detection, Image preprocessing, feature extraction face facial structure, facial expression feature extraction, classification and other issues during face recognition and have achieved research and development of DSP-based face recognition system for robotic rehabilitation nursing beds. The system uses a fixed-point DSP TMS320DM642 as a central processing unit, with a strong processing performance, high flexibility and programmability.

  9. [Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

    Science.gov (United States)

    Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

    2014-04-01

    In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

  10. The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Park, Hae Yean; Maitra, Kinsuk; Martinez, Kristina Marie

    2015-06-01

    Traumatic brain injury (TBI) is the leading cause of death and disability among people younger than 35 years in the United States. Cognitive difficulty is a common consequence of TBI. To address cognitive deficits of patients with TBI, various cognitive rehabilitation approaches have been used for the clinical setting. The purpose of this study was to investigate the overall effect of occupation-based cognitive rehabilitation on patients' improvement in cognitive performance components, activity of daily living (ADL) performance, and values, beliefs and spirituality functions of patients with TBI. The papers used in this study were retrieved from the Cochrane Database, EBSCO (CINAHL), PsycINFO, PubMed and Web of Science published between 1997 and 2014. The keywords for searching were cognitive, rehabilitation, occupation, memory, attention, problem-solving, executive function, ADL, values, beliefs, spirituality, randomized controlled trials and TBI. For the meta-analysis, we examined 60 effect sizes from nine studies that are related to the occupation-based cognitive rehabilitation on persons with TBI. In persons with TBI, overall mental functions, ADL, and values, beliefs and spirituality were significantly improved in the groups that received occupation-based cognitive rehabilitation compared with comparison groups (mean d = 0.19, p functioning and positively be able to affect their psychosocial functions. Collecting many outcome measures in studies with relatively few participants and the final data are less reliable than the whole instrument itself. Future research should evaluate the effectiveness of specific occupation-based cognitive rehabilitations programmes in order to improve consistency among rehabilitation providers. PMID:25808426

  11. A population-based lifestyle intervention to promote healthy weight and physical activity in people with cardiac disease: The PANACHE (Physical Activity, Nutrition And Cardiac HEalth study protocol

    Directory of Open Access Journals (Sweden)

    Allman-Farinelli Margaret

    2010-04-01

    Full Text Available Abstract Background Maintaining a healthy weight and undertaking regular physical activity are important for the secondary prevention of cardiovascular disease (CVD. However, many people with CVD are overweight and insufficiently active. In addition, in Australia only 20-30% of people requiring cardiac rehabilitation (CR for CVD actually attend. To improve outcomes of and access to CR the efficacy, effectiveness and cost-effectiveness of alternative approaches to CR need to be established. This research will determine the efficacy of a telephone-delivered lifestyle intervention, promoting healthy weight and physical activity, in people with CVD in urban and rural settings. The control group will also act as a replication study of a previously proven physical activity intervention, to establish whether those findings can be repeated in different urban and rural locations. The cost-effectiveness and acceptability of the intervention to CR staff and participants will also be determined. Methods/Design This study is a randomised controlled trial. People referred for CR at two urban and two rural Australian hospitals will be invited to participate. The intervention (healthy weight group will participate in four telephone delivered behavioural coaching and goal setting sessions over eight weeks. The coaching sessions will be on weight, nutrition and physical activity and will be supported by written materials, a pedometer and two follow-up booster telephone calls. The control (physical activity group will participate in a six week intervention previously shown to increase physical activity, consisting of two telephone delivered behavioural coaching and goal setting sessions on physical activity, supported by written materials, a pedometer and two booster phone calls. Data will be collected at baseline, eight weeks and eight months for the intervention group (baseline, six weeks and six months for the control group. The primary outcome is weight change

  12. The Efficacy of Supervised Home-based Pulmonary Rehabilitation in Patients with Chronic Respiratory Disorders

    Directory of Open Access Journals (Sweden)

    İpek Candemir

    2015-12-01

    Full Text Available Objective: Pulmonary rehabilitation (PR programs can be carried out in hospital or home basis with a different organizational aspect and program content. This study aimed to evaluate the efficacy of a multidisciplinary supervised home-based PR program in patients with chronic respiratory disorders. Methods: Forty patients with chronic respiratory disorders who admitted to our center between September 2007 and May 2012 were enrolled. In all patients before and after PR, dyspnea was assessed with Medical Research Council (MRC dyspnea scale, exercise capacity with Incremental Shuttle Walk Test (ISWT and Endurance Shuttle Walk Test (ESWT, health related quality of life with St. Geoerge Respiratory Questionnaire (SGRQ, psychosocial evaluation with hospital anxiety and depression scale (HAD, the body composition with bioelectrical impedance method. Ten patients did not complete home-based PR for various reasons. Results: In patients with Chronic Obstructive Pulmonary Disease (COPD, dyspnea sensation (p=0.026, exercise capacity (p=0.001, quality of life (p=0.001, body composition (p=0.012, anxiety and depression score (p=0.001 improvements were statistically significant. In all patients with COPD and non-COPD perception of dyspnea, exercise capacity, quality of life, anxiety and depression score improvements were above minimal clinically important differences. Conclusion: In this study supervised home-based pulmonary rehabilitation has been shown as an effective and safe modality when applied by an experiencied and multidisciplinary team in selected severe COPD or non-COPD patients.

  13. Air Pollution and the Risk of Cardiac Defects: A Population-Based Case-Control Study.

    Science.gov (United States)

    Hwang, Bing-Fang; Lee, Yungling Leo; Jaakkola, Jouni J K

    2015-11-01

    Previous epidemiologic studies have assessed the role of the exposure to ambient air pollution in the development of cardiac birth defects, but they have provided somewhat inconsistent results. To assess the associations between exposure to ambient air pollutants and the risk of cardiac defects, a population-based case-control study was conducted using 1087 cases of cardiac defects and a random sample of 10,870 controls from 1,533,748 Taiwanese newborns in 2001 to 2007.Logistic regression was performed to calculate odds ratios for 10 ppb increases in O3 and 10 μg/m increases in PM10. In addition, we compared the risk of cardiac defects in 4 categories-high exposure (>75th percentile); medium exposure (75th to 50th percentile); low exposure (patent ductus arteriosus (PDA) were associated with 10 ppb increases in O3 exposure during the first 3 gestational months among term and preterm babies. In comparison between high PM10 exposure and reference category, there were statistically significant elevations in the effect estimates of ASD for all and terms births. In addition, there was a negative or weak association between SO2, NO2, CO, and cardiac defects.The study proved that exposure to outdoor air O3 and PM10 during the first trimester of gestation may increase the risk of VSD, ASD, and PDA. PMID:26554783

  14. MR-Based Cardiac and Respiratory Motion-Compensation Techniques for PET-MR Imaging.

    Science.gov (United States)

    Munoz, Camila; Kolbitsch, Christoph; Reader, Andrew J; Marsden, Paul; Schaeffter, Tobias; Prieto, Claudia

    2016-04-01

    Cardiac and respiratory motion cause image quality degradation in PET imaging, affecting diagnostic accuracy of the images. Whole-body simultaneous PET-MR scanners allow for using motion information estimated from MR images to correct PET data and produce motion-compensated PET images. This article reviews methods that have been proposed to estimate motion from MR images and different techniques to include this information in PET reconstruction, in order to overcome the problem of cardiac and respiratory motion in PET-MR imaging. MR-based motion correction techniques significantly increase lesion detectability and contrast, and also improve accuracy of uptake values in PET images.

  15. Objective Evaluation of Vergence Disorders and a Research-Based Novel Method for Vergence Rehabilitation

    Science.gov (United States)

    Kapoula, Zoï; Morize, Aurélien; Daniel, François; Jonqua, Fabienne; Orssaud, Christophe; Brémond-Gignac, Dominique

    2016-01-01

    Purpose We performed video-oculography to evaluate vergence eye movement abnormalities in students diagnosed clinically with vergence disorders. We tested the efficiency of a novel rehabilitation method and evaluated its benefits with video-oculography cross-correlated with clinical tests and symptomatology. Methods A total of 19 students (20–27 years old) underwent ophthalmologic, orthoptic examination, and a vergence test coupled with video-oculography. Eight patients were diagnosed with vergence disorders with a high symptomatology score (CISS) and performed a 5-week session of vergence rehabilitation. Vergence and rehabilitation tasks were performed with a trapezoid surface of light emitting diodes (LEDs) and adjacent buzzers (US 8851669). We used a novel Vergence double-step (Vd-s) protocol: the target stepped to a second position before the vergence movement completion. Afterward the vergence test was repeated 1 week and 1 month later. Results Abnormally increased intertrial variability was observed for many vergence parameters (gain, duration, and speed) for the subjects with vergence disorders. High CISS scores were correlated with variability and increased latency. After the Vd-s, variability of all parameters dropped to normal or better levels. Moreover, the convergence and divergence latency diminished significantly to levels better than normal; benefits were maintained 1 month after completion of Vd-s. CISS scores dropped to normal level, which was maintained up to 1 year. Conclusions and Translational Relevance: Intertrial variability is the major marker of vergence disorders. The Vd-s research-based method leads to normalization of vergence properties and lasting removal of symptoms. The efficiency of the method is due to the spatiotemporal parameters of repetitive trials that stimulate neural plasticity. PMID:26981330

  16. Participant experiences of a community-based maintenance program post-pulmonary rehabilitation.

    Science.gov (United States)

    Desveaux, Laura; Rolfe, Debbie; Beauchamp, Marla; Goldstein, Roger; Brooks, Dina

    2014-02-01

    The aim of the present study was to describe the perspectives of individuals with chronic obstructive pulmonary disease (COPD) who participated in a minimally supervised maintenance exercise intervention and identify the barriers and facilitators associated with participation. The intervention was delivered in a community center and was designed to maintain exercise capacity and quality of life following discharge from pulmonary rehabilitation. This study utilized qualitative focus groups (FGs) involving individuals with COPD (n = 12) who had been attending the maintenance community program for at least 6 months. All individuals who met the inclusion criteria for the FGs consented to participate. Four themes were identified: (1) issues around attendance; (2) perceived benefits of the program; (3) perceived burdens of the program; and (4) recommendations for program improvement. Participants expressed more benefits than barriers, stating that their experience of improved function and quality of life facilitated their attendance. Barriers included exacerbations, fatigue, access to transportation, and weather. Participants endorsed the benefits of a community-based maintenance exercise program after pulmonary rehabilitation. Minimally supervised community-based programs with access to a case manager may provide a useful approach to enhancing adherence to exercise. PMID:24431408

  17. A Game-Based Virtualized Reality Approach for Simultaneous Rehabilitation of Motor Skill and Confidence

    Directory of Open Access Journals (Sweden)

    Alasdair G. Thin

    2012-01-01

    Full Text Available Virtualized reality games offer highly interactive and engaging user experience and therefore game-based approaches (GBVR may have significant potential to enhance clinical rehabilitation practice as traditional therapeutic exercises are often repetitive and boring, reducing patient compliance. The aim of this study was to investigate if a rehabilitation training programme using GBVR could simultaneously improve both motor skill (MS and confidence (CON, as they are both important determinants of daily living and physical and social functioning. The study was performed using a nondominant hand motor deficit model in nonambidextrous healthy young adults, whereby dominant and nondominant arms acted as control and intervention conditions, respectively. GBVR training was performed using a commercially available tennis-based game. CON and MS were assessed by having each subject perform a comparable real-world motor task (RWMT before and after training. Baseline CON and MS for performing the RWMT were significantly lower for the nondominant hand and improved after GBVR training, whereas there were no changes in the dominant (control arm. These results demonstrate that by using a GBVR approach to address a MS deficit in a real-world task, improvements in both MS and CON can be facilitated and such approaches may help increase patient compliance.

  18. MOEMS-based cardiac enzymes detector for acute myocardial infarction

    Science.gov (United States)

    Amritsar, Jeetender; Stiharu, Ion G.; Packirisamy, Muthukumaran; Balagopal, Ganesharam; Li, Xing

    2004-10-01

    Biomedical applications of MOEMS are limited only by the mankind imagination. Precision measurements on minute amounts of biological material could be performed by optical means with a remarkable accuracy. Although available in medical laboratories for general purposes, such analyzers are making their way directly to the users in the form of dedicated equipment. Such an example is a test kit to detect the existence of cardiac enzymes in the blood stream. Apart from the direct users, the medical personnel will make use of such tools given the practicality of the kit. In a large proportion of patients admitted to the hospital suspected of Acute Myocardial Infarction (AMI), the symptoms and electrocardiographic changes are inconclusive. This necessitates the use of biochemical markers of myocardial damage for correct exclusion or conformation of AMI. In this study the concept of MOEMS is applied for the detection of enzyme reaction, in which glass spectrums are scanned optically when enzyme molecules adsorb on their surface. This paper presents the optical behavior of glass spectrums under Horseradish Peroxide (HRP) enzyme reaction. The reported experimental results provide valuable information that will be useful in the development of biosensors for enzymatic detection. This paper also reports the dynamic behavior of different glass spectrums.

  19. Crystalloid-based cardioplegia for minimally invasive cardiac surgery.

    Science.gov (United States)

    Misfeld, Martin; Davierwala, Piroze

    2012-01-01

    With the ever-increasing popularity of minimally invasive (MI) cardiac surgery, procedures like aortic valve replacement, with or without concomitant aortic surgery, and mitral and tricuspid valve procedures are now routinely performed through a minimal-access partial upper sternotomy and right anterolateral small thoracotomy, respectively, in our institution. To have optimal visualization through a small incision, it is extremely important to reduce the number of instruments, retractors, and cannulae passing through the incision to a bare minimum and to avoid repeated manipulation of the operative field. Repeated use of blood cardioplegia to maintain myocardial protection can sometimes prevent the surgeon from executing the aforementioned measures. However, if adequate myocardial protection can be achieved and maintained by administering a single dose of crystalloid cardioplegia, it would help expedite the operation with greater ease. At our institution, myocardial protection during aortic valve surgery is achieved using either blood or crystalloid cardioplegia according to surgeon preference. However, crystalloid cardioplegia has become the standard myocardial protection strategy for performing MI mitral valve surgery. Our experience with crystalloid cardioplegia for MI mitral valve surgery is the focus of this article.

  20. Estimation of the optimal VV delay by an IEGM-based method in cardiac resynchronization therapy

    NARCIS (Netherlands)

    Min, Xiaoyi; Meine, Mathias; Baker, James H.; Pires, Luis A.; Turk, Kyong T.; Horn, Evelyn M.; Kowal, Robert C.; Paris, Michael; Park, Euljoon; Fain, Eric S.

    2007-01-01

    Determination of the optimal interventricular (VV) delay in cardiac resynchronization therapy currently relies on costly, time-consuming echocardiographic (ECHO) methods. This study evaluated the performance of a new intracardiac electrogram (IEGM)-based VV method compared to the aortic velocity tim

  1. Meta-Analyses of Human Cell-Based Cardiac Regeneration Therapies: Controversies in Meta-Analyses Results on Cardiac Cell-Based Regenerative Studies.

    Science.gov (United States)

    Gyöngyösi, Mariann; Wojakowski, Wojciech; Navarese, Eliano P; Moye, Lemuel À

    2016-04-15

    In contrast to multiple publication-based meta-analyses involving clinical cardiac regeneration therapy in patients with recent myocardial infarction, a recently published meta-analysis based on individual patient data reported no effect of cell therapy on left ventricular function or clinical outcome. A comprehensive review of the data collection, statistics, and the overall principles of meta-analyses provides further clarification and explanation for this controversy. The advantages and pitfalls of different types of meta-analyses are reviewed here. Each meta-analysis approach has a place when pivotal clinical trials are lacking and sheds light on the magnitude of the treatment in a complex healthcare field.

  2. Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Kristensen, H. K.; Borg, T.

    2012-01-01

    within stroke rehabilitation. METHODS: The study was based on a phenomenological hermeneutical and an action research approach in collaboration with three occupational therapy settings including 25 occupational therapists. Data collection consisted of 41 field observations, 14 individual interviews......BACKGROUND: When implementing evidence-based practice in occupational therapy the investigation of clinical reasoning provides important information on research utilization. AIM: This study investigates aspects affecting occupational therapists' reasoning when implementing research-based evidence......, and six focus-group interviews. RESULTS: New knowledge concerning the substantial influence of professional values in the occupational therapists' local cultures was indicated. It was of importance that the therapists as a group are given the opportunity to explicit and critically appraise values...

  3. Aspects affecting occupational therapists' reasoning when implementing research-based evidence in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Borg, T.; Hounsgaard, L.

    2012-01-01

    within stroke rehabilitation. Methods: The study was based on a phenomenological hermeneutical and an action research approach in collaboration with three occupational therapy settings including 25 occupational therapists. Data collection consisted of 41 field observations, 14 individual interviews......Background: When implementing evidence-based practice in occupational therapy the investigation of clinical reasoning provides important information on research utilization. Aim: This study investigates aspects affecting occupational therapists’ reasoning when implementing research-based evidence......, and six focus-group interviews. Results: New knowledge concerning the substantial influence of professional values in the occupational therapists’ local cultures was indicated. It was of importance that the therapists as a group are given the opportunity to explicit and critically appraise values...

  4. Detection of an IncA/C plasmid encoding VIM-4 and CMY-4 β-lactamases in Klebsiella oxytoca and Citrobacter koseri from an inpatient in a cardiac rehabilitation unit.

    Science.gov (United States)

    Caltagirone, Mariasofia; Bitar, Ibrahim; Piazza, Aurora; Spalla, Melissa; Nucleo, Elisabetta; Navarra, Antonella; Migliavacca, Roberta

    2015-07-01

    A 62-year-old patient was transferred to the cardiac rehabilitation unit of the I.R.C.C.S. Fondazione S. Maugeri after undergoing a heart transplantation at the Acute Care Hospital I.R.C.C.S. S. Matteo of Pavia. On 1 August 2013 and during hospitalization in the rehabilitation unit, Klebsiella oxytoca and Citrobacter koseri clinical isolates were simultaneously recovered from the patient's preputial swab. Both the K. oxytoca and C. koseri strains were carbapenem- resistant by MicroScan System (Beckman Coulter). Carbapenem-resistant K. pneumoniae had previously been reported in the same rehabilitation facility. The aim of the study was to identify the carbapenem resistance mechanisms among the enterobacterial species recovered. Phenotypic screening tests useful to detect the β-lactamases/carbapenemases were performed. Carbapenem MICs were obtained by Etest. AmpC and MBL encoding genes were identified by PCR and sequencing. Conjugation assays and plasmid characterization were performed. Both of the K. oxytoca and C. koseri isolates were multi drug resistant, showing resistance to amoxicillin-clavulanic acid, three generation cephalosporins, ertapenem (K. oxytoca MIC, >32 mg/L; C. koseri MIC, 4 mg/L), imipenem (K. oxytoca MIC, 4 mg/L; C. koseri MIC, 12 mg/L), thrimethoprim sulphamethoxazole and gentamicin. Susceptibility was retained to fluoroquinolones, colistin and tigecycline. Molecular characterization confirmed the co-presence of blaCMY-4 and blaVIM-4 determinants in a 150 Kb transferable plasmid of IncA/C group. This case is the first detection in Italy of the K. oxytoca and C. koseri clinical isolates co-producing the CMY-4 and VIM-4 enzymes.

  5. Epidemiological and clinical use of GMHAT-PC (Global Mental Health assessment tool – primary care in cardiac patients

    Directory of Open Access Journals (Sweden)

    Krishna Murali

    2009-04-01

    Full Text Available Abstract Background A computer assisted interview, the GMHAT/PC has been developed to assist General Practitioners and other Health Professionals to make a quick, convenient and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in our previous studies involving General Practitioners and Nurses. Little is known about its use in cardiac rehabilitation settings. Aim The study aims to assess the feasibility of using a computer assisted diagnostic interview by nurses for patients attending Cardiac Rehabilitation Clinics and to examine the level of agreement between the GMHAT/PC diagnosis and a Psychiatrist clinical diagnosis. Prevalence of mental illness was also measured. Design Cross sectional validation and feasibility study. Methods Nurses using GMHAT/PC examined consecutive patients presenting to a cardiac rehabilitation centre. A total of 118 patients were assessed by nurses and consultant psychiatrist in cardiac rehabilitation centres. The kappa coefficient (κ, sensitivity, and specificity of the GMHAT/PC diagnosis were analysed as measures of validity. The time taken for the interview as well as feedback from patients and interviewers were indicators of feasibility. Data on prevalence of mental disorders in an outpatient cardiac rehabilitation setting was collected. Results The mean duration of the interview was 14 minutes. Feedback from patients and interviewers indicated good practical feasibility. The agreement between GMHAT/PC interview-based diagnoses and consultant psychiatrists' ICD-10 criteria-based clinical diagnosis was good or excellent (κ = 0.76, sensitivity = 0.73, specificity = 0.90. The prevalence of mental disorders in this group was 22%, predominantly depression. Very few cases were on treatment. Conclusion GMHAT/PC can assist nurses in making accurate mental health assessments and diagnoses in a cardiac rehabilitation setting and is acceptable to cardiac patients. It can

  6. Gesture Therapy: A Vision-Based System for Arm Rehabilitation after Stroke

    Science.gov (United States)

    Sucar, L. Enrique; Azcárate, Gildardo; Leder, Ron S.; Reinkensmeyer, David; Hernández, Jorge; Sanchez, Israel; Saucedo, Pedro

    Each year millions of people in the world survive a stroke, in the U.S. alone the figure is over 600,000 people per year. Movement impairments after stroke are typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. However, due to economic pressures, stroke patients are receiving less therapy and going home sooner, so the potential benefit of the therapy is not completely realized. Thus, it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. Current solutions are too expensive, as they require a robotic system for rehabilitation. We have developed a low-cost, computer vision system that allows individuals with stroke to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a web based virtual environment for facilitating repetitive movement training, with state-of-the art computer vision algorithms that track the hand of a patient and obtain its 3-D coordinates, using two inexpensive cameras and a conventional personal computer. An initial prototype of the system has been evaluated in a pilot clinical study with promising results.

  7. Effectiveness of training community-based rehabilitation workers on multiple disabilities: A pilot study

    Directory of Open Access Journals (Sweden)

    Vijay Samuel V Raj

    2015-01-01

    Full Text Available Context: Community-based rehabilitation (CBR as a developmental strategy addresses the needs of people with disabilities and their family. CBR personals at remote rural play an important role in early detection and prevention of disabilities. The identification with proper guidance can help to overcome the scarcity in early detection. An effective training for rehabilitation workers should contain training program emphasis on multiple disabilities. Aims: The aim of this study was to assess the effectiveness of training CBR personal with relation to knowledge on multiple disabilities. Settings and Design: An experimental design of 12 month's intervention confined to Chamarajanagar district. Subjects and Methods: A total of 20 subjects of trained CBR personals with the age group of 20–45 years were included in this study. The initial baseline evaluation was performed with a pretest questionnaire to assess their knowledge. The training with practical exposure on multiple disabilities was carried out at an interval of 3 months. The posttest at 12 months was analyzed. Statistical Analysis Used: SPSS version 16 for Windows was used for analysis. The results were statistically analyzed using paired test, Chi-square test, and ANOVA for between and within the groups. Results: The results showed significance on effectiveness of training. There was an improvement in outcome measures reflecting on identification and management of disabilities. Conclusions: The knowledge regarding early identification of disabilities plays an important role. Implementation of training methods on a regular interval and as a part in continuing education plays an important source for better outcome.

  8. A Bio-Inspired Model-Based Approach for Context-Aware Post-WIMP Tele-Rehabilitation

    Directory of Open Access Journals (Sweden)

    Víctor López-Jaquero

    2016-10-01

    Full Text Available Tele-rehabilitation is one of the main domains where Information and Communication Technologies (ICT have been proven useful to move healthcare from care centers to patients’ home. Moreover, patients, especially those carrying out a physical therapy, cannot use a traditional Window, Icon, Menu, Pointer (WIMP system, but they need to interact in a natural way, that is, there is a need to move from WIMP systems to Post-WIMP ones. Moreover, tele-rehabilitation systems should be developed following the context-aware approach, so that they are able to adapt to the patients’ context to provide them with usable and effective therapies. In this work a model-based approach is presented to assist stakeholders in the development of context-aware Post-WIMP tele-rehabilitation systems. It entails three different models: (i a task model for designing the rehabilitation tasks; (ii a context model to facilitate the adaptation of these tasks to the context; and (iii a bio-inspired presentation model to specify thoroughly how such tasks should be performed by the patients. Our proposal overcomes one of the limitations of the model-based approach for the development of context-aware systems supporting the specification of non-functional requirements. Finally, a case study is used to illustrate how this proposal can be put into practice to design a real world rehabilitation task.

  9. Motion adaptive patch-based low-rank approach for compressed sensing cardiac cine MRI.

    Science.gov (United States)

    Yoon, Huisu; Kim, Kyung Sang; Kim, Daniel; Bresler, Yoram; Ye, Jong Chul

    2014-11-01

    One of the technical challenges in cine magnetic resonance imaging (MRI) is to reduce the acquisition time to enable the high spatio-temporal resolution imaging of a cardiac volume within a short scan time. Recently, compressed sensing approaches have been investigated extensively for highly accelerated cine MRI by exploiting transform domain sparsity using linear transforms such as wavelets, and Fourier. However, in cardiac cine imaging, the cardiac volume changes significantly between frames, and there often exist abrupt pixel value changes along time. In order to effectively sparsify such temporal variations, it is necessary to exploit temporal redundancy along motion trajectories. This paper introduces a novel patch-based reconstruction method to exploit geometric similarities in the spatio-temporal domain. In particular, we use a low rank constraint for similar patches along motion, based on the observation that rank structures are relatively less sensitive to global intensity changes, but make it easier to capture moving edges. A Nash equilibrium formulation with relaxation is employed to guarantee convergence. Experimental results show that the proposed algorithm clearly reconstructs important anatomical structures in cardiac cine image and provides improved image quality compared to existing state-of-the-art methods such as k-t FOCUSS, k-t SLR, and MASTeR.

  10. Cell-based therapies for cardiac repair : a meeting report on scientific observations and European regulatory viewpoints

    NARCIS (Netherlands)

    Schüssler-Lenz, Martina; Beuneu, Claire; Menezes-Ferreira, Margarida; Jekerle, Veronika; Bartunek, Jozef; Chamuleau, Steven; Celis, Patrick; Doevendans, Pieter; O'Donovan, Maura; Hill, Jonathan; Hystad, Marit; Jovinge, Stefan; Kyselovič, Ján; Lipnik-Stangelj, Metoda; Maciulaitis, Romaldas; Prasad, Krishna; Samuel, Anthony; Tenhunen, Olli; Tonn, Torsten; Rosano, Giuseppe; Zeiher, Andreas; Salmikangas, Paula

    2016-01-01

    In the past decade, novel cell-based products have been studied in patients with acute and chronic cardiac disease to assess whether these therapies are efficacious in improving heart function and preventing the development of end-stage heart failure. Cardiac indications studied include acute myocar

  11. REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

    Directory of Open Access Journals (Sweden)

    N. V. Galtseva

    2015-01-01

    Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire. 

  12. Electronically aided rehabilitation exercise to improve the cardiac function of patients with chronic hear failure%电动辅助康复训练对慢性心力衰竭患者心功能的影响

    Institute of Scientific and Technical Information of China (English)

    朱宏宇; 胡安祥; 周传骥; 韩金国; 胡伟; 司福中; 杨国梁

    2010-01-01

    Objective To study the effect of assistive functional rehabilitation exercise on cardiac functioning of patients with chronic heart failure (CHF). Methods Sixty CHF patients were divided randomly into a treatment group (the rehabilitation group) and a control group, with 30 in each group. All the patients were administered routine therapy. In the treatment group, the patients were administered rehabilitation exercises with the assistance of a electric equipment made by the authors, daily for 5 days a week for a total of 3 months. The New York Heart Association (NYHA) cardiac function grading, the left ventricular ejection fraction(LVEF), the left ventricular end diastolic diameter (LVEDD) and the brain natriuretic peptide (BNP) level in plasma as well as the 6 min walking range were observed in both groups before and after treatment. Results After 3-months of treatment, the NYHA grading, LVEF, LVEDD, BNP level in plasma and 6 min walking range were all significantly improved in both groups when compared with those before the treatment, with the treatment group improved to a significantly larger extent than the control group ( p<0.05 ). Conclusion Assistive rehabilitation exercise in addition to the routine therapy can significantly help improve the cardiac function in CHF patients.%目的 观察电动辅助康复训练对慢性心力衰竭(CHF)患者心功能的影响.方法 将60例CHF患者随机分为治疗组及对照组,2组患者均给予常规药物治疗,治疗组在此基础上采用电动辅助训练装置进行心脏功能康复训练.于治疗前、治疗3个月后对2组患者心功能进行评定,评定指标包括:美国纽约心脏病协会(NYHA)心脏功能分级、左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)、血浆B型脑利钠肽(BNP)水平、6min步行距离等.结果 2组患者分别经3个月治疗后,发现其各项心功能指标均较治疗前明显好转;且以治疗组患者的改善幅度相对较显著,与对照组

  13. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation.

    Science.gov (United States)

    Solberg, E E; Borjesson, M; Sharma, S; Papadakis, M; Wilhelm, M; Drezner, J A; Harmon, K G; Alonso, J M; Heidbuchel, H; Dugmore, D; Panhuyzen-Goedkoop, N M; Mellwig, K-P; Carre, F; Rasmusen, H; Niebauer, J; Behr, E R; Thiene, G; Sheppard, M N; Basso, C; Corrado, D

    2016-04-01

    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal.

  14. State of the science on postacute rehabilitation: setting a research agenda and developing an evidence base for practice and public policy: an introduction

    Directory of Open Access Journals (Sweden)

    Heinemann Allen W

    2007-11-01

    Full Text Available Abstract The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness along with academic, professional, provider, accreditor and other organizations, sponsored a 2-day State-of-the-Science of Post-Acute Rehabilitation Symposium in February 2007. The aim of this symposium was to serve as a catalyst for expanded research on postacute care (PAC rehabilitation so that health policy is founded on a solid evidence base. The goals were to: (1 describe the state of our knowledge regarding utilization, organization and outcomes of postacute rehabilitation settings, (2 identify methodologic and measurement challenges to conducting research, (3 foster the exchange of ideas among researchers, policymakers, industry representatives, funding agency staff, consumers and advocacy groups, and (4 identify critical questions related to setting, delivery, payment and effectiveness of rehabilitation services. Plenary presentation and state-of-the-science summaries were organized around four themes: (1 the need for improved measurement of key rehabilitation variables and methods to collect and analyze this information, (2 factors that influence access to postacute rehabilitation care, (3 similarities and differences in quality and quantity of services across PAC settings, and (4 effectiveness of postacute rehabilitation services. The full set of symposium articles, including recommendations for future research, appear in Archives of Physical Medicine and Rehabilitation.

  15. Original Functional Rehabilitation Programme Based on Healing Physiology After Reconstruction of Articular Cartilage in Knee Joint

    OpenAIRE

    Guliyan, Volodymyr; Plenzler, Marcin; Straszewski, Dariusz; Paśnik, Marcin; Korbolewska, Olga; Suszczyński, Wojciech; Śmigielski, Robert

    2014-01-01

    Objectives: The evaluation of the quality of articular cartilage remodelling by means of arthroscopy findings and MRI imaging in a patient, who completed the original rehabilitation program. Methods: The rehabilitation program was conducted according to the Carolina Medical Center rehabilitation protocol. The patient was a 46 years old woman with fourth-degree cartilage damage (Outerbridge classification) located on the right medial femoral condyle of the following size: 1.5x2cm and 1x1.5cm. ...

  16. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons

    Directory of Open Access Journals (Sweden)

    Yi Long

    2016-09-01

    Full Text Available Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM optimized by particle swarm optimization (PSO to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz, a three-layer wavelet packet analysis (WPA is used for feature extraction, after which, the kernel principal component analysis (kPCA is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance.

  17. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons.

    Science.gov (United States)

    Long, Yi; Du, Zhi-Jiang; Wang, Wei-Dong; Zhao, Guang-Yu; Xu, Guo-Qiang; He, Long; Mao, Xi-Wang; Dong, Wei

    2016-01-01

    Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM) optimized by particle swarm optimization (PSO) to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS) attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz), a three-layer wavelet packet analysis (WPA) is used for feature extraction, after which, the kernel principal component analysis (kPCA) is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA) is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance. PMID:27598160

  18. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons

    Science.gov (United States)

    Long, Yi; Du, Zhi-Jiang; Wang, Wei-Dong; Zhao, Guang-Yu; Xu, Guo-Qiang; He, Long; Mao, Xi-Wang; Dong, Wei

    2016-01-01

    Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM) optimized by particle swarm optimization (PSO) to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS) attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz), a three-layer wavelet packet analysis (WPA) is used for feature extraction, after which, the kernel principal component analysis (kPCA) is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA) is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance. PMID:27598160

  19. Reduction of motion artifacts in cardiac CT based on partial angle reconstructions from short scan data

    Science.gov (United States)

    Hahn, Juliane; Bruder, Herbert; Allmendinger, Thomas; Stierstorfer, Karl; Flohr, Thomas; Kachelriess, Marc

    2016-03-01

    Until today, several software-based approaches to increase the temporal resolution in cardiac computed tomography by estimating motion vector fields (MVFs) have been developed. Thereunder, the majority are motion compensation algorithms, which estimate the MVFs employing a three-dimensional registration routine working on reconstructions of multiple cardiac phases.2, 6, 7, 12 We present an algorithm that requires nothing more than the data needed for a short scan reconstruction for motion estimation and motion-compensated reconstruction, which both are based on the reconstruction of volumes from a limited angular range.2, 3, 7, 8 Those partial angle reconstructions are centered at different time points during the short scan and have a temporal resolution of about 10ms each. The MVFs are estimated by a constrained cost function optimization routine employing a motion artifact measuring cost function. During optimization, the MVFs are applied directly by warping the partial angle reconstructions, and the motion compensation is established by simply adding the shifted images. In order to enforce smooth vector fields and keep the number of parameters low, the motion is modeled by a low degree polynomial. Furthermore, to find a good estimation of the MVFs even in phases with rapid cardiac motion, the constrained optimization is re-initialized multiple times. The algorithm is validated with the help of a simulation study and applied to patient data, where motion- compensated reconstructions are performed in various cardiac phases. We show that the image quality can be improved, also in more rapid cardiac phases due to re-initialization of the optimization routine.

  20. Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

    Directory of Open Access Journals (Sweden)

    Huong Q Nguyen

    2009-08-01

    Full Text Available Huong Q Nguyen1, Dawn P Gill1, Seth Wolpin1, Bonnie G Steele2, Joshua O Benditt11University of Washington, seattle, WA, USA; 2VA Puget Sound Health Care System, Seattle, WA, USAObjective: To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD following pulmonary rehabilitation.Methods: Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9 or MOBILE-Self-Monitored (n = 8. All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instructed to continue to log their daily exercise and symptoms. MOBILE-Coached also received weekly reinforcement text messages on their cell phones; reports of worsening symptoms were automatically flagged for follow-up. Usability and satisfaction were assessed. Participants completed incremental cycle and six minute walk (6MW tests, wore an activity monitor for 14 days, and reported their health-related quality of life (HRQL at baseline, three, and six months.Results: The sample had a mean age of 68 ± 11 and forced expiratory volume in one second (FEV1 of 40 ± 18% predicted. Participants reported that logging their exercise and symptoms was easy and that keeping track of their exercise helped them remain active. There were no differences between groups over time in maximal workload, 6MW distance, or HRQL (p > 0.05; however, MOBILE-Self-Monitored increased total steps/day whereas MOBILE-Coached logged fewer steps over six months (p = 0.04.Conclusions: We showed that it is feasible to deliver a cell phone-based exercise persistence intervention to patients with COPD post-rehabilitation and that the addition of coaching appeared to be no better than self-monitoring. The latter finding needs to be interpreted with caution since this was a purely exploratory study.Trial registration: Clinical

  1. ICA based automatic segmentation of dynamic H(2)(15)O cardiac PET images.

    Science.gov (United States)

    Margadán-Méndez, Margarita; Juslin, Anu; Nesterov, Sergey V; Kalliokoski, Kari; Knuuti, Juhani; Ruotsalainen, Ulla

    2010-05-01

    In this study, we applied an iterative independent component analysis (ICA) method for the separation of cardiac tissue components (myocardium, right, and left ventricle) from dynamic positron emission tomography (PET) images. Previous phantom and animal studies have shown that ICA separation extracts the cardiac structures accurately. Our goal in this study was to investigate the methodology with human studies. The ICA separated cardiac structures were used to calculate the myocardial perfusion in two different cases: 1) the regions of interest were drawn manually on the ICA separated component images and 2) the volumes of interest (VOI) were automatically segmented from the component images. For the whole myocardium, the perfusion values of 25 rest and six drug-induced stress studies obtained with these methods were compared to the values from the manually drawn regions of interest on differential images. The separation of the rest and stress studies using ICA-based methods was successful in all cases. The visualization of the cardiac structures from H (2) (15) O PET studies was improved with the ICA separation. Also, the automatic segmentation of the VOI seemed to be feasible. PMID:19273031

  2. False Alarm Reduction in BSN-Based Cardiac Monitoring Using Signal Quality and Activity Type Information

    Directory of Open Access Journals (Sweden)

    Tanatorn Tanantong

    2015-02-01

    Full Text Available False alarms in cardiac monitoring affect the quality of medical care, impacting on both patients and healthcare providers. In continuous cardiac monitoring using wireless Body Sensor Networks (BSNs, the quality of ECG signals can be deteriorated owing to several factors, e.g., noises, low battery power, and network transmission problems, often resulting in high false alarm rates. In addition, body movements occurring from activities of daily living (ADLs can also create false alarms. This paper presents a two-phase framework for false arrhythmia alarm reduction in continuous cardiac monitoring, using signals from an ECG sensor and a 3D accelerometer. In the first phase, classification models constructed using machine learning algorithms are used for labeling input signals. ECG signals are labeled with heartbeat types and signal quality levels, while 3D acceleration signals are labeled with ADL types. In the second phase, a rule-based expert system is used for combining classification results in order to determine whether arrhythmia alarms should be accepted or suppressed. The proposed framework was validated on datasets acquired using BSNs and the MIT-BIH arrhythmia database. For the BSN dataset, acceleration and ECG signals were collected from 10 young and 10 elderly subjects while they were performing ADLs. The framework reduced the false alarm rate from 9.58% to 1.43% in our experimental study, showing that it can potentially assist physicians in diagnosing a vast amount of data acquired from wireless sensors and enhance the performance of continuous cardiac monitoring.

  3. Municipality-based physical rehabilitation after acute hip fracture surgery in Denmark

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas Quaade; Kehlet, Henrik;

    2015-01-01

    description and implementation of an optimised PR programme according to the best available evidence. FUNDING: The study was supported by grants from The IMK Foundation, The Research Foundation of the Capital Region, The Research Foundation of the Danish Physical Therapy Organization, The Research Foundation......INTRODUCTION: Patients who are surgically treated for an acute hip fracture in Denmark commence early in-hospital physical rehabilitation (PR) with more than 95% of patients referred to further PR following discharge. However, the specifics of the PR services after discharge are unknown. Thus...... selected municipalities out of 98. Information was gathered on PR and categorised into outpatient PR (including one-to-one and group), home-based PR, 24-hour in-patient PR units and nursing homes. RESULTS: Sixty PR centres (97%) within 51 municipalities (91%) participated. The PR was initiated within 1...

  4. The Influence of Rehabilitative and Punishment Ideology on Correctional Officers' Perceptions of Informal Bases of Power.

    Science.gov (United States)

    Gordon, Jill A; Stichman, Amy J

    2016-10-01

    Maintaining order is a key goal for prison managers. Much of the research on order maintenance focuses, however, on disruptions of order, even when order is more common. Examining factors related to perceptions on how officers get inmates to comply is, therefore, an important consideration. Using a survey of correctional officers from a Mid-Atlantic state, this study considers three dimensions of French and Raven's theory on the bases of power. The focus is to examine correctional orientation and compliance regarding three dimensions of power that rely on informal control and relationships. The results indicate that officers' belief in rehabilitative ideals is consistently related to the dimensions of legitimate, referent, and expert control. Other individual and organizational factors are also related to dimensions of power. Implications for policies and for future research are discussed.

  5. Performance Based Contracts in the Road Sector : Towards Improved Efficiency in the Management of Maintenance and Rehabilitation - Brazil's Experience

    OpenAIRE

    Lancelot, Eric

    2010-01-01

    This note aims at providing feedback on Brazil's successful experience in using performance based contracts in the rehabilitation and maintenance of the road networks. Since its introduction in the early 2000's, the use of this contract management model has progressively spread to reach, as of today, one third of the federal network and more than 10 percent of the states' networks, and exp...

  6. Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors

    DEFF Research Database (Denmark)

    Midtgaard, J; Christensen, Jesper Frank; Tolver, Anders;

    2013-01-01

    Sedentary behavior and impaired cardiovascular reserve capacity are common late effects of cancer therapy emphasizing the need for effective strategies to increase physical activity (PA) in cancer survivors. We examined the efficacy of a 12-month exercise-based rehabilitation program on self...

  7. A Kinect-Based System for Physical Rehabilitation: A Pilot Study for Young Adults with Motor Disabilities

    Science.gov (United States)

    Chang, Yao-Jen; Chen, Shu-Fang; Huang, Jun-Da

    2011-01-01

    This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their…

  8. Exploring the bases for a mixed reality stroke rehabilitation system, Part I: A unified approach for representing action, quantitative evaluation, and interactive feedback

    Directory of Open Access Journals (Sweden)

    Wolf Steven L

    2011-08-01

    Full Text Available Abstract Background Although principles based in motor learning, rehabilitation, and human-computer interfaces can guide the design of effective interactive systems for rehabilitation, a unified approach that connects these key principles into an integrated design, and can form a methodology that can be generalized to interactive stroke rehabilitation, is presently unavailable. Results This paper integrates phenomenological approaches to interaction and embodied knowledge with rehabilitation practices and theories to achieve the basis for a methodology that can support effective adaptive, interactive rehabilitation. Our resulting methodology provides guidelines for the development of an action representation, quantification of action, and the design of interactive feedback. As Part I of a two-part series, this paper presents key principles of the unified approach. Part II then describes the application of this approach within the implementation of the Adaptive Mixed Reality Rehabilitation (AMRR system for stroke rehabilitation. Conclusions The accompanying principles for composing novel mixed reality environments for stroke rehabilitation can advance the design and implementation of effective mixed reality systems for the clinical setting, and ultimately be adapted for home-based application. They furthermore can be applied to other rehabilitation needs beyond stroke.

  9. FLEXIBLE PAVEMENT REHABILITATION DESIGN BASED ON PAVEMENT SERVICE LIFE TIME SPAN LEFT

    OpenAIRE

    Gamelyak, I.; Shevchuk, V.

    2005-01-01

    The design of flexible pavement rehabilitation is analysed in terms of durability-cost. A notion of the remaining service life span is described. the model of rehabilitation strategy selection is presented for both design project and operation stages. the results can be used in the pavement management system.

  10. Professional and patient-based evaluation of oral rehabilitation in patients with tooth agenesis

    DEFF Research Database (Denmark)

    Dueled, Erik; Gotfredsen, Klaus; Trab Damsgaard, Mogens;

    2009-01-01

    OBJECTIVES: The outcome of oral rehabilitation is usually monitored with clinical tests rather than by patient's perception of change. The aim of this study was to describe the objective measure and subjective perception of oral rehabilitation in patients with tooth agenesis. MATERIAL AND METHODS...

  11. Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    McGorrian Catherine

    2013-01-01

    Full Text Available Abstract Background Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic. Methods Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2 and the Hospital Anxiety and Depression Scale (HADS, along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data. Results There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%, and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61. Younger patients were less likely than older to describe significant depression on their HADS scale (p Conclusions High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.

  12. Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

    2015-01-01

    The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.

  13. Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

    Science.gov (United States)

    Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

    2014-01-01

    A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity. PMID:25571187

  14. Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

    Science.gov (United States)

    Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

    2013-03-01

    With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.

  15. Hybrid Force Control Based on ICMAC for an Astronaut Rehabilitative Training Robot

    Directory of Open Access Journals (Sweden)

    Lixun Zhang

    2012-08-01

    Full Text Available A novel Astronaut Rehabilitative Training Robot (ART based on a cable‐driven mechanism is represented in this paper. ART, a typical passive force servo system, can help astronauts to bench press in a microgravity environment. The purpose of this paper is to design controllers to eliminate the surplus force caused by an astronaut’s active movements. Based on the dynamics modelling of the cable‐driven unit, a hybrid force controller based on improved credit assignment CMAC (ICMAC is presented. A planning method for the cable tension is proposed so that the dynamic load produced by the ART can realistically simulate the gravity and inertial force of the barbell in a gravity environment. Finally, MATLAB simulation results of the man‐machine cooperation system are provided in order to verify the effectiveness of the proposed control strategy. The simulation results show that the hybrid control method based on the structure invariance principle can inhibit the surplus force and that ICMAC can improve the dynamic performance of the passive force servo system. Furthermore, the hybrid force controller based on ICMAC can ensure the stability of the system.

  16. A virtual reality-based vocational training system (VRVTS) for people with schizophrenia in vocational rehabilitation.

    Science.gov (United States)

    Tsang, Mayie M Y; Man, David W K

    2013-03-01

    Employment provides schizophrenic patients with a positive identity and hope. Cognitive impairments have been suggested to slow down the progress in work rehabilitation. The purpose of this study was to investigate the efficacy and effectiveness of VR as a cognitive intervention for enhancing vocational outcomes. 95 inpatients with schizophrenia were randomly assigned to a virtual reality-based vocational training group (VRG), a therapist-administered group (TAG) and a conventional group (CG). Twenty-five of them in each group had completed the study. Their performances were evaluated, before and after interventions, by Brief Neuropsychological Cognitive Examination, Digit Vigilance Test, Rivermead Behavioural Memory Test, Wisconsin Card Sorting Test (WCST) and Vocational Cognitive Rating Scale. Patients in the VRG were found to perform better than patients in the TAG and CG in cognitive functioning, as shown by the WCST-percentage of error (F (2, 72)=7.146, p<0.001) and the WCST-percentage of conceptual level response (F (2, 72)=8.722, p<0.001). The post-hoc test revealed that the VRG showed a better performance than both the TAG (p=0.03) and the CG (p<0.001) in the WCST-percentage of error. The VRG also showed a better performance than patients in both the TAG (p=0.01) and the CG (p<0.001) in the WCST-percentage of conceptual level response. The VRG also showed a better self-efficacy score than CG. Both VRG and TAG showed a better work performance as reflected by the on-site tests. Further studies on the use of VR in schizophrenia rehabilitation and for vocational success are discussed.

  17. Smoking cessation treatment in community-based substance abuse rehabilitation programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Flammino, Frank; Nunes, Edward V; Jiang, Huiping; Kourniotis, Eva; Lima, Jennifer; Brady, Ron; Burgess, Cynthia; Arfken, Cynthia; Pihlgren, Eric; Giordano, Louis; Starosta, Aron; Robinson, James; Rotrosen, John

    2008-07-01

    Nicotine dependence is highly prevalent among drug- and alcohol-dependent patients. A multisite clinical trial of smoking cessation (SC) treatment was performed at outpatient community-based substance abuse rehabilitation programs affiliated with the National Drug Abuse Treatment, Clinical Trials Network. Cigarette smokers (N=225) from five methadone maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned in a 2:1 ratio to receive either (1) SC treatment as an adjunct to substance abuse treatment-as-usual (TAU) or (2) substance abuse TAU. Smoking cessation treatment consisted of 1 week of group counseling before the target quit date and 8 weeks of group counseling plus transdermal nicotine patch treatment (21 mg/day for Weeks 1-6 and 14 mg/day for Weeks 7 and 8) after the target quit date. Smoking abstinence rates in SC, 10%-11% during treatment and 5%-6% at the 13- and 26-week follow-up visits, were significantly better than those in TAU during treatment (p< .01). In addition, SC was associated with significantly greater reductions as compared with TAU in cigarettes smoked per day (75% reduction, p< .001), exhaled carbon monoxide levels (p< .001), cigarette craving (p< .05), and nicotine withdrawal (p< .05). Smoking cessation did not differ from TAU on rates of retention in substance abuse treatment, abstinence from primary substance of abuse, and craving for primary substance of abuse. Compliance with SC treatment, moderate at best, was positively associated with smoking abstinence rates. Smoking cessation treatment resulted in significant reductions in daily smoking and modest smoking abstinence rates without having an adverse impact on substance abuse rehabilitation when given concurrently with outpatient substance abuse treatment. Substance abuse treatment programs should not hesitate to implement SC for established patients.

  18. Rehabilitation Engineering: What is Rehabilitation Engineering?

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Rehabilitation Engineering What is rehabilitation engineering? What types of assistive ... the area of rehabilitation engineering? What is rehabilitation engineering? Source: Michael Goldfarb, Vanderbilt University Rehabilitation engineering is ...

  19. Hybrid Pixel-Based Method for Cardiac Ultrasound Fusion Based on Integration of PCA and DWT

    Directory of Open Access Journals (Sweden)

    Samaneh Mazaheri

    2015-01-01

    Full Text Available Medical image fusion is the procedure of combining several images from one or multiple imaging modalities. In spite of numerous attempts in direction of automation ventricle segmentation and tracking in echocardiography, due to low quality images with missing anatomical details or speckle noises and restricted field of view, this problem is a challenging task. This paper presents a fusion method which particularly intends to increase the segment-ability of echocardiography features such as endocardial and improving the image contrast. In addition, it tries to expand the field of view, decreasing impact of noise and artifacts and enhancing the signal to noise ratio of the echo images. The proposed algorithm weights the image information regarding an integration feature between all the overlapping images, by using a combination of principal component analysis and discrete wavelet transform. For evaluation, a comparison has been done between results of some well-known techniques and the proposed method. Also, different metrics are implemented to evaluate the performance of proposed algorithm. It has been concluded that the presented pixel-based method based on the integration of PCA and DWT has the best result for the segment-ability of cardiac ultrasound images and better performance in all metrics.

  20. Rehabilitation Research.

    Science.gov (United States)

    Wright, George N.; Trotter, Ann Beck

    A total of 97 studies are reported in this review of research in vocational rehabilitation. Projects were selected on the following criteria: (1) pertinence to rehabilitation counseling practice, (2) research approach, (3) broad generalizability, and (4) supported by the Vocational Rehabilitation Administration for a one-to-five-year period and…

  1. Non-contact detection of cardiac rate based on visible light imaging device

    Science.gov (United States)

    Zhu, Huishi; Zhao, Yuejin; Dong, Liquan

    2012-10-01

    We have developed a non-contact method to detect human cardiac rate at a distance. This detection is based on the general lighting condition. Using the video signal of human face region captured by webcam, we acquire the cardiac rate based on the PhotoPlethysmoGraphy theory. In this paper, the cardiac rate detecting method is mainly in view of the blood's different absorptivities of the lights various wavelengths. Firstly, we discompose the video signal into RGB three color signal channels and choose the face region as region of interest to take average gray value. Then, we draw three gray-mean curves on each color channel with time as variable. When the imaging device has good fidelity of color, the green channel signal shows the PhotoPlethysmoGraphy information most clearly. But the red and blue channel signals can provide more other physiological information on the account of their light absorptive characteristics of blood. We divide red channel signal by green channel signal to acquire the pulse wave. With the passband from 0.67Hz to 3Hz as a filter of the pulse wave signal and the frequency spectrum superimposed algorithm, we design frequency extracted algorithm to achieve the cardiac rate. Finally, we experiment with 30 volunteers, containing different genders and different ages. The results of the experiments are all relatively agreeable. The difference is about 2bmp. Through the experiment, we deduce that the PhotoPlethysmoGraphy theory based on visible light can also be used to detect other physiological information.

  2. Image-Based Structural Modeling of the Cardiac Purkinje Network

    Directory of Open Access Journals (Sweden)

    Benjamin R. Liu

    2015-01-01

    Full Text Available The Purkinje network is a specialized conduction system within the heart that ensures the proper activation of the ventricles to produce effective contraction. Its role during ventricular arrhythmias is less clear, but some experimental studies have suggested that the Purkinje network may significantly affect the genesis and maintenance of ventricular arrhythmias. Despite its importance, few structural models of the Purkinje network have been developed, primarily because current physical limitations prevent examination of the intact Purkinje network. In previous modeling efforts Purkinje-like structures have been developed through either automated or hand-drawn procedures, but these networks have been created according to general principles rather than based on real networks. To allow for greater realism in Purkinje structural models, we present a method for creating three-dimensional Purkinje networks based directly on imaging data. Our approach uses Purkinje network structures extracted from photographs of dissected ventricles and projects these flat networks onto realistic endocardial surfaces. Using this method, we create models for the combined ventricle-Purkinje system that can fully activate the ventricles through a stimulus delivered to the Purkinje network and can produce simulated activation sequences that match experimental observations. The combined models have the potential to help elucidate Purkinje network contributions during ventricular arrhythmias.

  3. PHYSICAL REHABILITATION OF LOW BACK PAIN BASED ON A CONCEPTUAL SYSTEM APPROACHES

    Directory of Open Access Journals (Sweden)

    LAZARIEVA Olena

    2014-11-01

    Full Text Available In Europe, back pain is a common disease, this is according to European statistics. In accordance with the new case, the pain each year occurs in 5% of the population. The aim of this work is to develop a conceptual approaches to the physical rehabilitation process at the surgical treatment of patients with back pain. Materials and methods . There was researched an experience of the domestic and foreign researches in physical rehabilitation area. Methods of the research were the analysis of the references and theoretical research methods (as an analysis, interpretation and synthesis of scientific and educational literature on the study problem. Abstraction (or idealization and schematization is the allocation of the essential foundations. Also we used experimenting with schemes (as a development of their content, sophistication and usability testing at development of concepts, practical models and physical rehabilitation programs. Results. The physical rehabilitation concept at the surgical treatment of patients with back pain was developed, given by the modern science in the diagnostics field, performing difficult complex spinal surgery with the using of new tools and the knowledge from the physical rehabilitation improvement. Conclusion. The using of a systematic methodology for physical rehabilitation in the surgical treatment of patients with vertebral pathology, helps to optimize research, diagnostic, therapeutic, rehabilitative and preventive measures, providing them with the required comprehensiveness, consistency, orderliness.

  4. Web-based multimedia courseware for emergency cardiac patient management simulations.

    Science.gov (United States)

    Ambrosiadou, V; Compton, T; Panchal, T; Polovina, S

    2000-01-01

    This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses. The University of Hertfordshire is the only University in Britain using simulations of cardiac emergency scenaria for nurse and paramedic science education and therefore this project will add the multimedia dimension in distributed courses over the web and will assess the improvement in the educational process. The use of network and multimedia technologies, provide interactive learning, immediate feedback to students' responses, individually tailored instructions, objective testing and entertaining delivery. The end product of this project will serve as interactive material to enhance experiential learning for nursing students using the simulations of cardiac emergency scenaria. The emergency treatment simulations have been developed using VisSim and may be compiled as C code. The objective of the project is to provide a web based user friendly multimedia interface in order to demonstrate the way in which patients may be managed in critical situations by applying advanced technological equipment and drug administration. Then the user will be able to better appreciate the concepts involved by running the VisSim simulations. The evaluation group for the proposed software will be the Department of Nursing and Paramedic Sciences About 200 nurses use simulations every year for training purposes as part of their course requirements.

  5. Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation.

    Science.gov (United States)

    Qu, Hongen; Xie, Yongji; Liu, Xiaoxuan; He, Xin; Hao, Manzhao; Bao, Yong; Xie, Qing; Lan, Ning

    2016-01-01

    Neuromuscular electrical stimulation (NMES) is a promising assistive technology for stroke rehabilitation. Here we present the design and development of a multimuscle stimulation system as an emerging therapy for people with paretic stroke. A network-based multichannel NMES system was integrated based on dual bus architecture of communication and an H-bridge current regulator with a power booster. The structure of the system was a body area network embedded with multiple stimulators and a communication protocol of controlled area network to transmit muscle stimulation parameter information to individual stimulators. A graphical user interface was designed to allow clinicians to specify temporal patterns and muscle stimulation parameters. We completed and tested a prototype of the hardware and communication software modules of the multichannel NMES system. The prototype system was first verified in nondisabled subjects for safety, and then tested in subjects with stroke for feasibility with assisting multijoint movements. Results showed that synergistic stimulation of multiple muscles in subjects with stroke improved performance of multijoint movements with more natural velocity profiles at elbow and shoulder and reduced acromion excursion due to compensatory trunk rotation. The network-based NMES system may provide an innovative solution that allows more physiological activation of multiple muscles in multijoint task training for patients with stroke. PMID:27149687

  6. Development of network-based multichannel neuromuscular electrical stimulation system for stroke rehabilitation.

    Science.gov (United States)

    Qu, Hongen; Xie, Yongji; Liu, Xiaoxuan; He, Xin; Hao, Manzhao; Bao, Yong; Xie, Qing; Lan, Ning

    2016-01-01

    Neuromuscular electrical stimulation (NMES) is a promising assistive technology for stroke rehabilitation. Here we present the design and development of a multimuscle stimulation system as an emerging therapy for people with paretic stroke. A network-based multichannel NMES system was integrated based on dual bus architecture of communication and an H-bridge current regulator with a power booster. The structure of the system was a body area network embedded with multiple stimulators and a communication protocol of controlled area network to transmit muscle stimulation parameter information to individual stimulators. A graphical user interface was designed to allow clinicians to specify temporal patterns and muscle stimulation parameters. We completed and tested a prototype of the hardware and communication software modules of the multichannel NMES system. The prototype system was first verified in nondisabled subjects for safety, and then tested in subjects with stroke for feasibility with assisting multijoint movements. Results showed that synergistic stimulation of multiple muscles in subjects with stroke improved performance of multijoint movements with more natural velocity profiles at elbow and shoulder and reduced acromion excursion due to compensatory trunk rotation. The network-based NMES system may provide an innovative solution that allows more physiological activation of multiple muscles in multijoint task training for patients with stroke.

  7. 心脏康复训练对女性微血管性心绞痛治疗效果研究%Cardiac Rehabilitation in the Treatment of Women with Microvascular Angina

    Institute of Scientific and Technical Information of China (English)

    高玉; 周江荣; 孙桂兰

    2015-01-01

    目的:探讨心脏康复训练对女性微血管心绞痛治疗的效果。方法:将60例微血管心绞痛女性患者按照随机数字表法分为试验组和对照组,各30例,试验组予常规药物治疗+24周康复治疗,对照组予常规药物治疗,比较两组在心脏焦虑评分、6 min步行试验、超声心动指标的差异。结果:(1)试验组治疗前后对比自身,心脏焦虑评分总分[(32.26±6.57)分vs (22.40±5.14)分],6 min步行距离[(373.83±61.25)m vs (430.51±49.31)m],每搏输出量[(65.11±11.31)ml vs (70.51±7.97)ml)、心输出量[(5.04±1.61)L/min vs (5.91±1.49)L/min]、左室射血分数[(63.21±7.56)% vs (71.23±8.92)%],差异均有统计学意义(P<0.05)。(2)与对照组比较,心脏焦虑评分[(22.40±5.14)分 vs (31.60±5.48)分]、6 min步行距离[(430.51±49.31)m vs (392.41±68.25)m]、每搏输出量[(70.51±7.97)ml vs (65.12±9.12)ml]、左室射血分数[(71.23±8.92)% vs (64.24±6.28)%]有改善,差异均有统计学意义(P<0.05)。结论:24周心脏康复训练能改善微血管性心绞痛女性运动耐量,心理状态,以及心功能指标。%Objective:To investigate the effect of cardiac rehabilitation(CR) for psychological and physiological morbidity in women with microvascular angina.Method:60 women with microvascular angina were randomly assigned to the experimental group(routin drugs+24 week CR exercise program) and the control group(routin drugs),30 cases in each group.All women completed the cardiac anxiety questionnaire,six-minute walk test and echocardiography assessment of cardiac function.Result:(1)After CR,patients demonstrated improved cardiac anxiety questionnaire score [(32.26±6.57) vs (22.40±5.14)],6-minute walk test [(373.83±61.25)m vs (430.51±49.31)m],stroke volume [(65.11±11.31)ml vs (70.51±7.97)ml],cardiac output [(5.04±1.61)L/min vs (5.91±1.49)L/min], left ventricular ejection fraction [(63.21±7.56)% vs (71.23±8.92)),there were statistical

  8. Profile of stroke patients treated at a community - based rehabilitation centre in a Cape Town health district

    Directory of Open Access Journals (Sweden)

    A. J. Rhoda

    2003-02-01

    Full Text Available Stroke is a leading cause of death and disability in both developed and developing countries. Limited information is available, in South Africa, on the epidemiological profile of stroke survivors requiring rehabilitation. A descriptive study was therefore undertaken to compile, amongst others the demographic and medical profile of stroke patients attending  rehabilitation at a primary health care facility (Bishop Lavis Rehabilitation Centre.  Both medical- and rehabilitation records were reviewed to ensure completeness of information and to minimize missing clinical data bias. Relevant data was  captured on a data capture sheet.  The latter was based on key findings from the literature and developed by the researcher. The mean age of the population of stroke patients studied was 59 years, which is markedly younger than what has been reported globally in the literature. As was expected, hypertension was found to be the most prevalent risk factor. The presence of a combination of risk factors in the  majority of the group (on average, 2.4 risk factors per person warrants the introduction of aggressive health  education and stroke prevention programmes at this primary health care centre.

  9. The use of ratings of perceived exertion to indicate appropriate exercise intensities in cardiac rehabilitation%主观用力感觉在预测心脏康复适宜运动度中的作用

    Institute of Scientific and Technical Information of China (English)

    刘洵; 原晓晶

    2006-01-01

    Purpose: The objective of the study was to examine the extent that ratings of perceived exertion (RPE) can be used to predict physiological and clinical responses to exercise in post myocardial infarction patients (PMIP). This may enable appropriate exercise intensities to be recommended. Methods:Forty-six male recent PMIP with beta block therapy (aged 60.9±7.5 years) and 55 male recent PMIP without beta blockade therapy (aged 63.6±7.3 years)performed a graded exercise test on a motorized treadmill until volitional cessation or reaching any of the American College of Sports Medicine (ACSM)criteria. Oxygen uptake (VO2) and volume of expired gas (VO2) were measured every 30 seconds during the exercise. Heart rate (HR), blood lactate (BL) and ratings of perceived exertion (RPE) were recorded every three minutes, and a 12 lead electrocardiogram was monitored continuously. Results: The results showed that there was a non-significant difference between the two groups in VO2, BL,VE and ST segment depression in relation to the RPE scale. (P>0.05). However a significant difference in HR was observed between the two groups throughout the exercise test (P<0.01). An RPE level of 13 can be regarded as the transfer point from aerobic to anaerobic metabolism for the patients both with and without beta blockade therapy. Conclusion: Based on above evidence, it is recommended that during cardiac rehabilitation PMIP should not increase exercise intensity further when it feels ' somewhat hard'.%目的:探讨主观用力感觉(RPE)在预测急性期后心梗患者(PMIP)对运动的生理和临床反应中的作用,这将有利于适宜运动强度的制定.方法:46名服用β阻断剂的男性PMIP(年龄60.9±7.5岁),55名未服用β阻断剂的男性PMIP(年龄63.6±73岁)在活动跑台上进行递增负荷实验,终止实验的标准依美国运动医学会的指南(ACSM)或病人的主观要求.运动中每30 s测量一次摄氧量(VO2)和通气量(VE)、每3min记录一次

  10. Exploring Music-Based Rehabilitation for Parkinsonism through Embodied Cognitive Science

    Science.gov (United States)

    Schiavio, Andrea; Altenmüller, Eckart

    2015-01-01

    Recent embodied approaches in cognitive sciences emphasize the constitutive roles of bodies and environment in driving cognitive processes. Cognition is thus seen as a distributed system based on the continuous interaction of bodies, brains, and environment. These categories, moreover, do not relate only causally, through a sequential input–output network of computations; rather, they are dynamically enfolded in each other, being mutually implemented by the concrete patterns of actions adopted by the cognitive system. However, while this claim has been widely discussed across various disciplines, its relevance and potential beneficial applications for music therapy remain largely unexplored. With this in mind, we provide here an overview of the embodied approaches to cognition, discussing their main tenets through the lenses of music therapy. In doing so, we question established methodological and theoretical paradigms and identify possible novel strategies for intervention. In particular, we refer to the music-based rehabilitative protocols adopted for Parkinson’s disease patients. Indeed, in this context, it has recently been observed that music therapy not only affects movement-related skills but that it also contributes to stabilizing physiological functions and improving socio-affective behaviors. We argue that these phenomena involve previously unconsidered aspects of cognition and (motor) behavior, which are rooted in the action-perception cycle characterizing the whole living system. PMID:26539155

  11. Exploring Music-Based Rehabilitation for Parkinsonism through Embodied Cognitive Science

    Directory of Open Access Journals (Sweden)

    Andrea eSchiavio

    2015-10-01

    Full Text Available Recent embodied approaches in cognitive sciences emphasise the constitutive roles of bodies and environment in driving cognitive processes. Cognition is thus seen as a distributed system based on the continuous interaction of bodies, brains, and environment. These categories, moreover, do not relate only causally, through a sequential input-output network of computations; rather, they are dynamically enfolded in each other, being mutually implemented by the concrete patterns of actions adopted by the cognitive system. However, while this claim has been widely discussed across various disciplines, its relevance and potential beneficial applications for music therapy remain largely unexplored. With this in mind, we provide here an overview of the embodied approaches to cognition, discussing their main tenets through the lenses of music therapy. In doing so we question established methodological and theoretical paradigms and identify possible novel strategies for intervention. In particular, we refer to the music-based rehabilitative protocols adopted for Parkinson’s Disease (PD patients. Indeed, in this context it has recently been observed that music therapy not only affects movement-related skills but that it also contributes to stabilising physiological functions and improving socio-affective behaviours. We argue that these phenomena involve previously unconsidered aspects of cognition and (motor behaviour, which are rooted in the action-perception cycle characterising the whole living system.

  12. Outcomes from a pilot study using computer-based rehabilitative tools in a military population.

    Science.gov (United States)

    Sullivan, Katherine W; Quinn, Julia E; Pramuka, Michael; Sharkey, Laura A; French, Louis M

    2012-01-01

    Novel therapeutic approaches and outcome data are needed for cognitive rehabilitation for patients with a traumatic brain injury; computer-based programs may play a critical role in filling existing knowledge gaps. Brain-fitness computer programs can complement existing therapies, maximize neuroplasticity, provide treatment beyond the clinic, and deliver objective efficacy data. However, these approaches have not been extensively studied in the military and traumatic brain injury population. Walter Reed National Military Medical Center established its Brain Fitness Center (BFC) in 2008 as an adjunct to traditional cognitive therapies for wounded warriors. The BFC offers commercially available "brain-training" products for military Service Members to use in a supportive, structured environment. Over 250 Service Members have utilized this therapeutic intervention. Each patient receives subjective assessments pre and post BFC participation including the Mayo-Portland Adaptability Inventory-4 (MPAI-4), the Neurobehavioral Symptom Inventory (NBSI), and the Satisfaction with Life Scale (SWLS). A review of the first 29 BFC participants, who finished initial and repeat measures, was completed to determine the effectiveness of the BFC program. Two of the three questionnaires of self-reported symptom change completed before and after participation in the BFC revealed a statistically significant reduction in symptom severity based on MPAI and NBSI total scores (p < .05). There were no significant differences in the SWLS score. Despite the typical limitations of a retrospective chart review, such as variation in treatment procedures, preliminary results reveal a trend towards improved self-reported cognitive and functional symptoms.

  13. Bilateral upper-limb rehabilitation after stroke using a movement-based game controller

    Directory of Open Access Journals (Sweden)

    Juha M. Hijmans, PhD

    2011-10-01

    Full Text Available This study aimed to determine the effectiveness of a bilateral, self-supported, upper-limb rehabilitation intervention using a movement-based game controller for people with chronic stroke. Fourteen participants received a control treatment, followed by a washout period, and then the intervention. The intervention comprised playing computer games with the CyWee Z (CyWee Group Ltd; Taipei, Taiwan, a movement-based game controller similar to the Nintendo Wii remote. The CyWee Z was incorporated into a handlebar, making bilateral exercises possible by allowing the unaffected side to support and assist the affected side. The intervention lasted for 8 to 10 sessions of 45 to 60 minutes over a period of 2.5 weeks. The Fugl-Meyer Assessment upper-limb section (FMA-UL was used as the primary outcome. The Wolf Motor Function Test and the Disabilities of Arm, Shoulder, and Hand outcome measure were used as secondary outcomes. Postintervention, motor performance as measured by the FMA-UL was significantly improved compared with all preintervention assessments (p < 0.001, whereas no changes were found on both secondary outcomes. It can be concluded from this pilot study that upper-limb motor performance of adults with chronic stroke improves with repetitive, game-assisted, self-supported bilateral exercises.

  14. Novel self-sensing carbon nanotube-based composites for rehabilitation of structural steel members

    Science.gov (United States)

    Ahmed, Shafique; Doshi, Sagar; Schumacher, Thomas; Thostenson, Erik T.; McConnell, Jennifer

    2016-02-01

    Fatigue and fracture are among the most critical forms of damage in metal structures. Fatigue damage can initiate from microscopic defects (e.g., surface scratches, voids in welds, and internal defects) and initiate a crack. Under cyclic loading, these cracks can grow and reach a critical level to trigger fracture of the member which leads to compromised structural integrity and, in some cases, catastrophic failure of the entire structure. In our research, we are investigating a solution using carbon nanotube-based sensing composites, which have the potential to simultaneously rehabilitate and monitor fatigue-cracked structural members. These composites consist of a fiber-reinforced polymer (FRP) layer and a carbon nanotube-based sensing layer, which are integrated to form a novel structural self-sensing material. The sensing layer is composed of a non-woven aramid fabric that is coated with carbon nanotubes (CNT) to form an electrically conductive network that is extremely sensitive to detecting deformation as well as damage accumulation via changes in the resistance of the CNT network. In this paper, we introduce the sensing concept, describe the manufacturing of a model sensing prototype, and discuss a set of small-scale laboratory experiments to examine the load-carrying capacity and damage sensing response.

  15. Psychiatric rehabilitation in community-based day centres: Motivation and satisfaction.

    OpenAIRE

    Eklund, Mona; Tjörnstrand, Carina

    2013-01-01

    Abstract Objective: This study investigated attendees' motivation and motives for participation in day centres and their satisfaction with the rehabilitation, while also addressing the influence of day centre orientation (work- or meeting-place orientation), gender and age. Methods: Ninety-three Swedish day centre attendees participated in a cross-sectional study and completed questionnaires about motivation, motives, and satisfaction with the rehabilitation. Data were analysed with non-p...

  16. Catheter-Based Educational Experiences: A Canadian Survey of Current Residents and Recent Graduates in Cardiac Surgery.

    Science.gov (United States)

    Juanda, Nadzir; Chan, Vincent; Chan, Ryan; Rubens, Fraser D

    2016-03-01

    The past decade has witnessed significant developments in the use of catheter-based therapies in cardiovascular medicine. We sought to assess the educational opportunities for cardiac surgery trainees to determine their readiness for participation in these strategies. A web-based survey was distributed to current residents, recent graduates, and program directors in Canadian cardiac surgery residency programs from 2008-2013. The survey was distributed to 110 residents and graduates. Forty-five percent completed the survey. Thirty-five percent expressed that they experienced resistance organizing their rotations because they had to compete with non-cardiac surgery colleagues, and 6 were denied local cardiac catheterization rotations. By the end of the rotation, 56% were comfortable performing a diagnostic cardiac catheterization independently. Exposure to being the operator performing diagnostic catheterization was significantly associated with the positive perception of being able to perform a diagnostic catheterization independently (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.33-19.81; P = 0.017). Eighty-eight percent of respondents expressed the need for more exposure in catheter-based rotations. Seven of 11 program directors completed the survey. All believed such rotations should be mandatory and foresaw a bigger role for hybrid catheter-based/cardiac surgery procedures in the future. Trainees and program directors perceive that increased exposure to catheter-based therapies is important to career development as a cardiac surgeon. This survey will contribute to the development of a cardiac surgery training curriculum as we foresee more hybrid and team procedures.

  17. A Serious Game for Upper Limb Stroke Rehabilitation Using Biofeedback and Mirror-Neurons Based Training.

    Science.gov (United States)

    Cargnin, Diego João; Cordeiro d'Ornellas, Marcos; Cervi Prado, Ana Lúcia

    2015-01-01

    Upper limb stroke rehabilitation requires early, intensive and repetitive practice to be effective. Consequently, it is often difficult to keep patients committed to their rehabilitation regimen. In addition to direct measures of rehabilitation achievable through targeted assessments, other factors can indirectly lead to rehabilitation. Current levels of integration between commodity graphics software, hardware, and body-tracking devices have provided a reliable tool to build what are referred to as serious games, focusing on the rehabilitation paradigm. More specifically, serious games can captivate and engage players for a specific purpose such as developing new knowledge or skills. This paper discusses a serious game application with a focus on upper limb rehabilitation in patients with hemiplegia or hemiparesis. The game makes use of biofeedback and mirror-neurons to enhance the patient's engagement. Results from the application of a quantitative self-report instrument to assess in-game engagement suggest that the serious game is a viable instructional approach rather than an entertaining novelty and, furthermore, demonstrates the future potential for dual action therapy-focused games. PMID:26262069

  18. Accelerated rehabilitation following Achilles tendon repair after acute rupture - Development of an evidence-based treatment protocol.

    Science.gov (United States)

    Brumann, Mareen; Baumbach, Sebastian F; Mutschler, Wolf; Polzer, Hans

    2014-11-01

    The acute rupture of the Achilles tendon is a protracted injury. Surgery is only the beginning of a long rehabilitation period. Therefore, the rehabilitation protocol is an integral aspect to restore the pre-injury activity level. Despite several trials available comparing different treatment regimes, there is still no consensus regarding the optimal protocol. Consequently, the aim of our study was to systematically search the evidence available and define a precise rehabilitation programme after operative repair of acute Achilles tendon rupture based on the trials with the highest level of evidence. We performed a systematic literature search in Medline, Embase and Cochrane library. We identified twelve randomized controlled trials comparing different treatment regimes after operative repair of the Achilles tendon. Five trials compared full to non weight bearing, all applying immobilization in equinus. Immediate full weight bearing led to significant higher patient satisfaction, earlier ambulation and return to pre-injury activity. Four trials compared early ankle mobilization to immobilization. All trials found mobilization to be superior as it shortens time to return to work and sports significantly. Three trials compared the combination of full weight bearing and early ankle mobilization to immobilization. This combination was most beneficial. Patients showed significantly higher satisfaction, less use of rehabilitation resources, earlier return to pre-injury activities and further demonstrated significantly increased calf muscle strength, reduced atrophy and tendon elongation. No study found an increased rerupture rate for the more progressive treatment. In conclusion, the rehabilitation protocol after Achilles tendon repair should allow immediate full weight bearing. After the second postoperative week controlled ankle mobilization by free plantar flexion and limited dorsiflexion at 0° should be applied. PMID:25059505

  19. Community-based Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE):study protocol for a cluster randomised controlled trial

    OpenAIRE

    Asher, L.; M Silva; Hanlon, C.; Weiss, HA; Birhane, R; Ejigu, DA; Medhin, G; Patel, V.; Fekadu, A.

    2016-01-01

    Background Care for most people with schizophrenia is best delivered in the community and evidence-based guidelines recommend combining both medication and a psychosocial intervention, such as community-based rehabilitation. There is emerging evidence that community-based rehabilitation for schizophrenia is effective at reducing disability in middle-income country settings, yet there is no published evidence on the effectiveness in settings with fewer mental health resources. This paper descr...

  20. Mobile Phone-Based Joint Angle Measurement for Functional Assessment and Rehabilitation of Proprioception

    Directory of Open Access Journals (Sweden)

    Quentin Mourcou

    2015-01-01

    Full Text Available Assessment of joint functional and proprioceptive abilities is essential for balance, posture, and motor control rehabilitation. Joint functional ability refers to the capacity of movement of the joint. It may be evaluated thereby measuring the joint range of motion (ROM. Proprioception can be defined as the perception of the position and of the movement of various body parts in space. Its role is essential in sensorimotor control for movement acuity, joint stability, coordination, and balance. Its clinical evaluation is commonly based on the assessment of the joint position sense (JPS. Both ROM and JPS measurements require estimating angles through goniometer, scoliometer, laser-pointer, and bubble or digital inclinometer. With the arrival of Smartphones, these costly clinical tools tend to be replaced. Beyond evaluation, maintaining and/or improving joint functional and proprioceptive abilities by training with physical therapy is important for long-term management. This review aims to report Smartphone applications used for measuring and improving functional and proprioceptive abilities. It identifies that Smartphone applications are reliable for clinical measurements and are mainly used to assess ROM and JPS. However, there is lack of studies on Smartphone applications which can be used in an autonomous way to provide physical therapy exercises at home.

  1. Vibration based structural assessment of the rehabilitation intervention in r.c. segmental bridge

    Directory of Open Access Journals (Sweden)

    Franchetti Paolo

    2015-01-01

    Full Text Available A vibration based structural assessment campaign was carried out on a r.c. segmental bridge in North East Italy. The bridge has a cantilever static scheme, fixed at the top of the piers and with a hinge at the centre of the span. The particular configuration of the hinge consists in a couple of steel elements, each one composed by a tongue and groove joint. Since the year 1960, the hinge was subjected to consumption and degradation, that caused a malfunctioning of the device. An intervention of rehabilitation of the bridge led to a reinforcement of the existing hinges with the coupling of new metallic devices: new tongue and groove hinges were applied, that by one side allow the horizontal displacements and rotation, by the other side strongly reduce the relative vertical displacements of the two parts of the bridge. A dynamic test campaign was set up in order to assess the effectiveness of the intervention. The principal dynamic parameters were calculated and analysed with respect to the intervention that was realized. The tests clearly showed the effectiveness of the intervention, and helped the designer to have a better understanding of the structural behaviour of the bridge.

  2. Rehabilitating Maralinga

    International Nuclear Information System (INIS)

    March 2003 saw the release of the final report of the Maralinga Rehabilitation Technical Advisory Committee (MARTAC) on the rehabilitation of the former nuclear test sites at Maralinga and Emu in South Australia. Operations, beginning in 1996, have rehabilitated the Maralinga lands for their return to the Mralinga-Tjarutja. A participant in the clean-up, Stuart Woollett describes the reasons for the rehabilitation project and gives an overview of operations. The contamination of concern was mainly Plutonium 239 and Americium 241. Rehabilitation involved the collection and containment of contaminated soils at four sites: Taranaki, TM sites, Wewak and Kuli, as well as treatment of debris pits. The rehabilitation has resulted in unrestricted access to the TM and Wewak sites and access with suggested limitations activities in the Taranaki area

  3. Essential features influencing collaboration in team-based non-specific back pain rehabilitation: Findings from a mixed methods study

    OpenAIRE

    Hellman, Therese; Jensen, Irene; Bergström, Gunnar; Brämberg, Elisabeth Björk

    2016-01-01

    ABSTRACT The aim of the study presented in this article was to explore how professionals, without guidelines for implementing interprofessional teamwork, experience the collaboration within team-based rehabilitation for people with back pain and how this collaboration influences their clinical practice. This study employed a mixed methods design. A questionnaire was answered by 383 participants and 17 participants were interviewed. The interviews were analysed using content analysis. The quan...

  4. Multiple Sclerosis: Changes in Thalamic Resting-State Functional Connectivity Induced by a Home-based Cognitive Rehabilitation Program.

    Science.gov (United States)

    De Giglio, Laura; Tona, Francesca; De Luca, Francesca; Petsas, Nikolaos; Prosperini, Luca; Bianchi, Valentina; Pozzilli, Carlo; Pantano, Patrizia

    2016-07-01

    Purpose To investigate thalamic connectivity changes after use of a video game-based cognitive rehabilitation program, as thalamic damage and alterations in thalamocortical functional connectivity (FC) are important factors in cognitive dysfunction in patients with multiple sclerosis (MS). Materials and Methods This prospective study was approved by the local ethical committee. Twenty-four patients with MS and cognitive impairment were randomly assigned to either an intervention or a wait-list group. Patients were evaluated with cognitive tests and 3-T resting-state functional magnetic resonance (MR) imaging at baseline and after an 8-week period. In addition, 11 healthy subjects underwent baseline resting-state functional MR imaging. Patients in the intervention group performed the video game-based cognitive rehabilitation program, while those in the wait-list group served as control subjects. Repeated measures analysis of variance was used to test efficacy of the intervention. The thalamic resting-state network was identified with a seed-based method; both first-level and high-level analyses were performed by using software tools. Results Patients showed lower baseline FC compared with healthy subjects. A significant improvement was seen in results of the Paced Auditory Serial Addition Test and the Stroop Test after 8 weeks of cognitive rehabilitation (F = 6.616, [P = .018] and F = 5.325 [P = .030], respectively). At follow-up, the intervention group had an increased FC in the cingulum, precuneus, and bilateral parietal cortex and a lower FC in the cerebellum and in left prefrontal cortex compared with the wait-list group (P game-based cognitive rehabilitation program. (©) RSNA, 2016. PMID:26953867

  5. Significance and Developmental Status of Community-based Rehabilitation in the Disabled Rehabilitation System%社区康复在残疾人康复体系中的意义及发展现状

    Institute of Scientific and Technical Information of China (English)

    李艳; 史琤莉; 张长杰; 陈娆

    2012-01-01

    As a rehabilitation strategy in the project of community development, community-based rehabilitation (CBR) can improve quality of life effectively in the community disabled, possessing the characteristics of wide coverage, convenience, being economical and effectiveness, so it has been developed and promoted in our country. At present, there are various problems in CBR, which could not meet the diverse demand of people with disablities in community. As a result, it is important to propagandize rehabilitation concept, built rehabilitation team, strengthen multidiscipUnary cooperation and emphasize the development of the disabled rehabilitation system in rural community.%社区康复作为社区发展计划的一项康复策略,具有覆盖面广、方便、经济、有效的特点,可有效提高社区残疾人的生存质量,在我国得到发展推广.目前在残疾人中开展社区康复也面临诸多问题,已不能满足社区残疾人多样化的康复需求,所以宣传社区康复理念、建立康复队伍、加强多部门合作,重视农村社区康复发展成为必然趋势.

  6. Upper limb posture estimation in robotic and virtual reality-based rehabilitation.

    Science.gov (United States)

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F; Cuesta-Gómez, A; Unzueta, Luis; Epelde, Gorka; Ruiz, Oscar E; De Mauro, Alessandro; Florez, Julian

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  7. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2014-01-01

    Full Text Available New motor rehabilitation therapies include virtual reality (VR and robotic technologies. In limb rehabilitation, limb posture is required to (1 provide a limb realistic representation in VR games and (2 assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a the mathematical formulation and solution to the problem, (b the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c its integration into a rehabilitation VR game platform, and (d the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i animate avatars that represent the patient in VR games and (ii obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  8. Benefits and costs of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease - a multi-centre randomised controlled equivalence trial

    OpenAIRE

    Holland, Anne E; Mahal, Ajay; Hill, Catherine J; Lee, Annemarie L; Burge, Angela T; Moore, Rosemary; Nicolson, Caroline; O’Halloran, Paul; Cox, Narelle S.; Lahham, Aroub; Ndongo, Rebecca; Bell, Emily; McDonald, Christine F.

    2013-01-01

    Background Pulmonary rehabilitation is widely advocated for people with chronic obstructive pulmonary disease (COPD) to improve exercise capacity, symptoms and quality of life, however only a minority of individuals with COPD are able to participate. Travel and transport are frequently cited as barriers to uptake of centre-based programs. Other models of pulmonary rehabilitation, including home-based programs, have been proposed in order to improve access to this important treatment. Previous...

  9. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial ☆ ☆☆

    OpenAIRE

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart,Nicholas

    2015-01-01

    Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participa...

  10. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool. PMID:27568126

  11. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool.

  12. Functional electrical stimulation based on a pelvis support robot for gait rehabilitation of hemiplegic patients after stroke.

    Science.gov (United States)

    Ye, Jing; Nakashima, Yasutaka; Zhang, Bo; Kobayashi, Yo; Fujie, Masakatsu G

    2014-01-01

    More and more stroke survivors are suffering from physical motor impairments. Current therapeutic interventions have various limits to the efficient recovery of normal motor function of the lower limbs. Therefore, we propose a novel gait rehabilitation system for hemiplegic patients after stroke. It integrates functional electrical stimulation (FES) with a pelvis-supporting robotic system. A corresponding relationship between the gait phase and the active lateral movement of the pelvis is first constructed from experiments on simulated hemiplegic patients. By estimating the gait phase from the lateral motion of the pelvis based on this relationship, the timing of FES sent to the muscles of the lower limbs can be automatically determined during a gait cycle. After experiments on simulated hemiplegic stroke survivors with the FES control algorithm, the proposed algorithm and the gait rehabilitation system are verified to be feasible and promising.

  13. Regression-Based Cardiac Motion Prediction From Single-Phase CTA

    DEFF Research Database (Denmark)

    Metz, C.T.; Baka, N.; Kirisli, H.;

    2012-01-01

    State of the art cardiac CT enables the acquisition of imaging data of the heart over the entire cardiac cycle at concurrent high spatial and temporal resolution. However, in clinical practice, acquisition is increasingly limited to 3D images. Estimating the shape of the cardiac structures...

  14. Realization of Intelligent Measurement and Control System for Limb Rehabilitation Based on PLC and Touch Screen

    Science.gov (United States)

    Liu, Xiangquan

    According to the treatment needs of patients with limb movement disorder, on the basis of the limb rehabilitative training prototype, function of measure and control system are analyzed, design of system hardware and software is completed. The touch screen which is adopt as host computer and man-machine interaction window is responsible for sending commands and training information display; The PLC which is adopt as slave computer is responsible for receiving control command from touch screen, collecting the sensor data, regulating torque and speed of motor by analog output according to the different training mode, realizing ultimately active and passive training for limb rehabilitation therapy.

  15. Cardiac C-arm CT: 4D non-model based heart motion estimation and its application

    Science.gov (United States)

    Prümmer, M.; Fahrig, R.; Wigström, L.; Boese, J.; Lauritsch, G.; Strobel, N.; Hornegger, J.

    2007-03-01

    The combination of real-time fluoroscopy and 3D cardiac imaging on the same C-arm system is a promising technique that might improve therapy planning, guiding, and monitoring in the interventional suite. In principal, to reconstruct a 3D image of the beating heart at a particular cardiac phase, a complete set of X-ray projection data representing that phase is required. One approximate approach is the retrospectively ECG-gated FDK reconstruction (RG-FDK). From the acquired data set of N s multiple C-arm sweeps, those projection images which are acquired closest in time to the desired cardiac phase are retrospectively selected. However, this approach uses only 1/ N s of the obtained data. Our goal is to utilize data from other cardiac phases as well. In order to minimize blurring and motion artifacts, cardiac motion has to be compensated for, which can be achieved using a temporally dependent spatial 3D warping of the filtered-backprojections. In this work we investigate the computation of the 4D heart motion based on prior reconstructions of several cardiac phases using RG-FDK. A 4D motion estimation framework is presented using standard fast non-rigid registration. A smooth 4D motion vector field (MVF) represents the relative deformation compared to a reference cardiac phase. A 4D deformation regridding by adaptive supersampling allows selecting any reference phase independently of the set of phases used in the RG-FDK for a motion corrected reconstruction. Initial promising results from in vivo experiments are shown. The subjects individual 4D cardiac MVF could be computed from only three RG-FDK image volumes. In addition, all acquired projection data were motion corrected and subsequently used for image reconstruction to improve the signal-to-noise ratio compared to RG-FDK.

  16. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  17. Improving Low-dose Cardiac CT Images based on 3D Sparse Representation

    Science.gov (United States)

    Shi, Luyao; Hu, Yining; Chen, Yang; Yin, Xindao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis

    2016-03-01

    Cardiac computed tomography (CCT) is a reliable and accurate tool for diagnosis of coronary artery diseases and is also frequently used in surgery guidance. Low-dose scans should be considered in order to alleviate the harm to patients caused by X-ray radiation. However, low dose CT (LDCT) images tend to be degraded by quantum noise and streak artifacts. In order to improve the cardiac LDCT image quality, a 3D sparse representation-based processing (3D SR) is proposed by exploiting the sparsity and regularity of 3D anatomical features in CCT. The proposed method was evaluated by a clinical study of 14 patients. The performance of the proposed method was compared to the 2D spares representation-based processing (2D SR) and the state-of-the-art noise reduction algorithm BM4D. The visual assessment, quantitative assessment and qualitative assessment results show that the proposed approach can lead to effective noise/artifact suppression and detail preservation. Compared to the other two tested methods, 3D SR method can obtain results with image quality most close to the reference standard dose CT (SDCT) images.

  18. A Study of Mechanical Optimization Strategy for Cardiac Resynchronization Therapy Based on an Electromechanical Model

    Directory of Open Access Journals (Sweden)

    Jianhong Dou

    2012-01-01

    Full Text Available An optimal electrode position and interventricular (VV delay in cardiac resynchronization therapy (CRT improves its success. However, the precise quantification of cardiac dyssynchrony and magnitude of resynchronization achieved by biventricular (BiV pacing therapy with mechanical optimization strategies based on computational models remain scant. The maximum circumferential uniformity ratio estimate (CURE was used here as mechanical optimization index, which was automatically computed for 6 different electrode positions based on a three-dimensional electromechanical canine model of heart failure (HF caused by complete left bundle branch block (CLBBB. VV delay timing was adjusted accordingly. The heart excitation propagation was simulated with a monodomain model. The quantification of mechanical intra- and interventricular asynchrony was then investigated with eight-node isoparametric element method. The results showed that (i the optimal pacing location from maximal CURE of 0.8516 was found at the left ventricle (LV lateral wall near the equator site with a VV delay of 60 ms, in accordance with current clinical studies, (ii compared with electrical optimization strategy of ERMS, the LV synchronous contraction and the hemodynamics improved more with mechanical optimization strategy. Therefore, measures of mechanical dyssynchrony improve the sensitivity and specificity of predicting responders more. The model was subject to validation in future clinical studies.

  19. A hospital based study on causes peculiar of congestive car-diac failure (CCF)

    Institute of Scientific and Technical Information of China (English)

    Hamzullah Khan; Hikmatullah Jan; Mohammad Hafizullah; Mahmoodul Hassan; Adnan Gul

    2008-01-01

    Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Post-graduate Medical Institute,Lady Reading Hospital Peshawar,from March 2005 to September 2007.Relevant information regarding the risk factors of congestive cardiac failure were recorded on questionnaire prepared in accordance with the objectives of the study.Results:1 019 patients with established diagnosis of cardiac fail-ure (based on clinical findings and relevant investigations) were included.Out of total sampling 583 (57.12%)were males and 436(42.78%)were females.The age range of the patients was from 6 years to 82 years with mean age of 48.5 years and mode of age was 45 years.The distribution of causative factors of CCF was:ischemic heart disease (IHD)36.31%,hypertension 26.30%,dilated cardiomyopathy 10.10%,obstr-uctve and restrictive cardiomyopathies 5.39%,valvular heart diseases (VHD)9.32%,congenital heart dis-ease like ventricular septal defects (VSD)4.41%,atrial septal defects (ASD)0.58%,atrial fibrillation (AF)2.25%,constrictive pericardidtis 1.07%,Pericardial effusion 0.68%,chronic obstructive pulmonary disease and pulmonary hypertension 1.47%,thyrotoxicosis 0.68%,complete heart block 0.29% and paget disease in 0.09% cases.Conclusion:Ischemic heart disease,hypertension,cardiomypathies,valvular heart disease and congenital heart disease are major contributor to CCF in our patients.

  20. SVM-based classification of LV wall motion in cardiac MRI with the assessment of STE

    Science.gov (United States)

    Mantilla, Juan; Garreau, Mireille; Bellanger, Jean-Jacques; Paredes, José Luis

    2015-01-01

    In this paper, we propose an automated method to classify normal/abnormal wall motion in Left Ventricle (LV) function in cardiac cine-Magnetic Resonance Imaging (MRI), taking as reference, strain information obtained from 2D Speckle Tracking Echocardiography (STE). Without the need of pre-processing and by exploiting all the images acquired during a cardiac cycle, spatio-temporal profiles are extracted from a subset of radial lines from the ventricle centroid to points outside the epicardial border. Classical Support Vector Machines (SVM) are used to classify features extracted from gray levels of the spatio-temporal profile as well as their representations in the Wavelet domain under the assumption that the data may be sparse in that domain. Based on information obtained from radial strain curves in 2D-STE studies, we label all the spatio-temporal profiles that belong to a particular segment as normal if the peak systolic radial strain curve of this segment presents normal kinesis, or abnormal if the peak systolic radial strain curve presents hypokinesis or akinesis. For this study, short-axis cine- MR images are collected from 9 patients with cardiac dyssynchrony for which we have the radial strain tracings at the mid-papilary muscle obtained by 2D STE; and from one control group formed by 9 healthy subjects. The best classification performance is obtained with the gray level information of the spatio-temporal profiles using a RBF kernel with 91.88% of accuracy, 92.75% of sensitivity and 91.52% of specificity.

  1. Surface based cardiac and respiratory motion extraction for pulmonary structures from multi-phase CT

    Science.gov (United States)

    von Berg, Jens; Barschdorf, Hans; Blaffert, Thomas; Kabus, Sven; Lorenz, Cristian

    2007-03-01

    During medical imaging and therapeutic interventions, pulmonary structures are in general subject to cardiac and respiratory motion. This motion leads potentially to artefacts and blurring in the resulting image material and to uncertainties during interventions. This paper presents a new automatic approach for surface based motion tracking of pulmonary structures and reports on the results for cardiac and respiratory induced motion. The method applies an active shape approach to ad-hoc generated surface representations of the pulmonary structures for phase to phase surface tracking. Input of the method are multi-phase CT data, either cardiac or respiratory gated. The iso-surface representing the transition between air or lung parenchyma to soft tissue, is triangulated for a selected phase p 0. An active shape procedure is initialised in the image of phase p I using the generated surface in p 0. The used internal energy term penalizes shape deformation as compared to p 0. The process is iterated for all phases p i to p i+1 of the complete cycle. Since the mesh topology is the same for all phases, the vertices of the triangular mesh can be treated as pseudo-landmarks defining tissue trajectories. A dense motion field is interpolated. The motion field was especially designed to estimate the error margins for radiotherapy. In the case of respiratory motion extraction, a validation on ten biphasic thorax CT images (2.5mm slice distance) was performed with expert landmarks placed at vessel bifurcations. The mean error on landmark position was below 2.6mm. We further applied the method to ECG gated images and estimated the influence of the heart beat on lung tissue displacement.

  2. Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

    Directory of Open Access Journals (Sweden)

    Mary Wickenden

    2012-05-01

    Full Text Available Background: The focus of this paper is the new broadened conceptualisation of community-based rehabilitation (CBR, which promotes the empowerment and inclusion of people with disabilities (PWDs in diverse ways within their communities. New guidelines for CBR were launched in October 2010 by WHO/ILO/UNESCO/IDDC, and this paper describes part of the process by which these were produced using participatory approaches involving International Non-Government Organisations (INGOs and local partners. The paper reviews the evolution of CBR and describes how grassroots consultation by INGOs working with key stakeholders in the disability arena can influence policy on disability issues, and reciprocally how policy change can inform organisations’ practice and research activities. This ongoing bidirectional influence is illustrated with data from the participatory consultation process about the new CBR guidelines carried out by Sightsavers in Uganda and GhanaObjectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document.Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries.Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team.Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes

  3. Control of electro-rheological fluid based resistive torque elements for use in active rehabilitation devices

    Science.gov (United States)

    Nikitczuk, Jason; Weinberg, Brian; Mavroidis, Constantinos

    2007-04-01

    In this paper we present control algorithms for novel electro-rheological fluid based resistive torque generation elements that will be used to drive the joint of a new type of portable and controllable active knee rehabilitation orthotic device (AKROD) for iso-inertial, isokinetic, and isometric exercising as well as gait retraining. The AKROD is composed of straps and rigid components for attachment to the leg, with a central hinge mechanism where a gear system is connected. The key features of AKROD include: a compact, lightweight design with highly tunable torque capabilities through a variable damper component, full portability with on-board power, control circuitry, and sensors (encoder and torque), and real-time capabilities for closed loop computer control for optimizing gait retraining. The variable damper component is achieved through an electro-rheological fluid (ERF) element that connects to the output of the gear system. Using the electrically controlled rheological properties of ERFs, compact brakes capable of supplying high resistive and controllable torques are developed. In this project, a prototype for the AKROD has been developed and tested. The AKROD's ERF resistive actuator was tested in laboratory experiments using a custom-made ERF testing apparatus (ETA). ETA provides a computer-controlled environment to test ERF brakes and actuators in various conditions and scenarios including emulating the interaction between human muscles involved with the knee and the AKROD's ERF actuators/brakes. The AKROD's ERF resistive actuator was tested in closed loop torque control experiments. A hybrid (non-linear, adaptive) proportional-integral (PI) torque controller was implemented to achieve this goal.

  4. Controlling a Rehabilitation Robot with Brain-Machine Interface: An approach based on Independent Component Analysis and Multiple Kernel Learning

    Directory of Open Access Journals (Sweden)

    Yi-Hung Liu

    2013-03-01

    Full Text Available Patients suffering from severe motor disabilities usually require assistance from other people when doing rehabilitation exercises, which causes the rehabilitation process to be time-consuming and inconvenient. Therefore, we propose an automatic feature extraction method for a brain-machine interface that allows patients to control a robot using their own brain waves. A brain–machine interface (BMI based on the P300 event-related potential (ERP, called Brain Controlled Rehabilitation System (BCRS, was developed to detect the intentions of patients. Using the BCRS, patients can communicate with the robot through their brain waves. However, deciding how to obtain an automatically extracted, useful EEG signal is a difficult and important problem for BMI research. In this paper, Independent Component Analysis – Multiple Kernel Learning (ICA-MKL is used to directly extract a useful signal and build the classification mode for BCRS. The results reveal that this method is useful for automatically extracting the P300 signal and the accuracy is better than MKL. In additional, the same method can be extended into any motor imaginary area and the accuracy of ICA-MKL for brain imaginary data is also good to removing eye-blink artifacts and the accuracy performance is also good.

  5. Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis.

    Science.gov (United States)

    Pau, Massimiliano; Coghe, Giancarlo; Corona, Federica; Leban, Bruno; Marrosu, Maria Giovanna; Cocco, Eleonora

    2015-01-01

    Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed. PMID:26583146

  6. Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Massimiliano Pau

    2015-01-01

    Full Text Available Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML and anteroposterior (AP directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed.

  7. Engagement in Game-based Rehabilitation for Women with Fibromyalgia Syndrome

    DEFF Research Database (Denmark)

    Petersson, Eva; Brooks, Anthony Lewis

    2014-01-01

    This paper reports on two linked studies exploring the general potentials, with foci on constraints and facilitators, of engagement in rehabilitation during motion-controlled video gameplay (MCVG). 17 female participants diagnosed with fibromyalgia syndrome (FMS) took part in the studies, wherein...

  8. A Community-Based Multilevel Approach to Drug Treatment and Rehabilitation.

    Science.gov (United States)

    Dell Orto, Arthur E.

    The failure of incarcerative approaches in the alleviation of drug abuse combined with the advent of more liberal public opinion toward drugs has resulted in the development of various rehabilitation treatment methods. The complexity and heterogeneity of the problem, however, indicate the desirability of a multidimensional approach which…

  9. Treatment and rehabilitation on a stroke unit improves 5-year survival. A community-based study

    DEFF Research Database (Denmark)

    Jørgensen, H S; Kammersgaard, L P; Nakayama, H;

    1999-01-01

    We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect...

  10. Social inequality in cancer rehabilitation: A population-based cohort study

    DEFF Research Database (Denmark)

    Vilstrup Holm, Lise; Hansen, D.G.; Larsen, P.V.;

    2013-01-01

    expressed a rehabilitation need in the physical, emotional and financial area and had to a higher extent unmet needs in a number of areas. Men living alone and men outside the workforce had increased odds of unmet needs in the physical area. Conclusions. Despite equal access to care, SES had a significant...

  11. Inertial Sensing Based Assessment Methods to Quantify the Effectiveness of Post-Stroke Rehabilitation.

    Science.gov (United States)

    Li, Hsin-Ta; Huang, Jheng-Jie; Pan, Chien-Wen; Chi, Heng-I; Pan, Min-Chun

    2015-07-06

    In clinical settings, traditional stroke rehabilitation evaluation methods are subjectively scored by occupational therapists, and the assessment results vary individually. To address this issue, this study aims to develop a stroke rehabilitation assessment system by using inertial measurement units. The inertial signals from the upper extremities were acquired, from which three quantitative indicators were extracted to reflect rehabilitation performance during stroke patients' movement examination, i.e., shoulder flexion. Both healthy adults and stroke patients were recruited to correlate the proposed quantitative evaluation indices and traditional rehab assessment scales. Especially, as a unique feature of the study the weight for each of three evaluation indicators was estimated by the least squares method. The quantitative results demonstrate the proposed method accurately reflects patients' recovery from pre-rehabilitation, and confirm the feasibility of applying inertial signals to evaluate rehab performance through feature extraction. The implemented assessment scheme appears to have the potential to overcome some shortcomings of traditional assessment methods and indicates rehab performance correctly.

  12. Driving and Low Vision: An Evidence-Based Review of Rehabilitation

    Science.gov (United States)

    Strong, J. Graham; Jutai, Jeffrey W.; Russell-Minda, Elizabeth; Evans, Mal

    2008-01-01

    This systematic review of the effectiveness of driver rehabilitation interventions found that driver training programs enhance driving skills and awareness, but further research is needed to determine their effectiveness in improving driving performance of drivers with low vision. More research is also needed to determine the effectiveness of low…

  13. [Cardiac amyloidosis].

    Science.gov (United States)

    Hoyer, Caroline; Angermann, Christiane E; Knop, Stefan; Ertl, Georg; Störk, Stefan

    2008-03-15

    Amyloidoses are a heterogeneous group of multisystem disorders, which are characterized by an extracellular deposition of amyloid fibrils. Typically affected are the heart, liver, kidneys, and nervous system. More than half of the patients die due to cardiac involvement. Clinical signs of cardiac amyloidosis are edema of the lower limbs, hepatomegaly, ascites and elevated jugular vein pressure, frequently in combination with dyspnea. There can also be chest pain, probably due to microvessel disease. Dysfunction of the autonomous nervous system or arrhythmias may cause low blood pressure, dizziness, or recurrent syncope. The AL amyloidosis caused by the deposition of immunoglobulin light chains is the most common form. It can be performed by monoclonal gammopathy. The desirable treatment therapy consists of high-dose melphalan therapy twice followed by autologous stem cell transplantation. Due to the high peritransplantation mortality, selection of appropriate patients is mandatory. The ATTR amyloidosis is an autosomal dominant disorder caused by the amyloidogenic form of transthyretin, a plasmaprotein that is synthesized in the liver. Therefore, liver transplantation is the only curative therapy. The symptomatic treatment of cardiac amyloidosis is based on the current guidelines for chronic heart failure according to the patient's New York Heart Association (NYHA) state. Further types of amyloidosis with possible cardiac involvement comprise the senile systemic amyloidosis caused by the wild-type transthyretin, secondary amyloidosis after chronic systemic inflammation, and the beta(2)-microglobulin amyloidosis after long-term dialysis treatment. PMID:18344065

  14. Chronic rejection in DLA identical dogs after orthotopic cardiac transplantation

    NARCIS (Netherlands)

    O.C.K.M. Penn

    1979-01-01

    textabstractThe justification for clinical cardiac transplantation is that it should solve end-stage cardiac disease when no other medical or surgical treatment is available (76). However, after cardiac transplantation the main barriers to long-term survival and complete rehabilitation include the m

  15. Rehabilitation of poststroke cognition.

    Science.gov (United States)

    Shigaki, Cheryl L; Frey, Scott H; Barrett, A M

    2014-11-01

    Given the increasing rates of stroke and our aging population, it is critical that we continue to foster innovation in stroke rehabilitation. Although there is evidence supporting cognitive rehabilitation in stroke, the set of cognitive domains effectively addressed to date represents only a small subset of the problems experienced by stroke survivors. Further, a gap remains between investigational treatments and our evolving theories of brain function. These limitations present opportunities for improving the functional impact of stroke rehabilitation. The authors use a case example to encourage the reader to consider the evidence base for cognitive rehabilitation in stroke, focusing on four domains critical to daily life function: (1) speech and language, (2) functional memory, (3) executive function and skilled learned purposive movements, and (4) spatial-motor systems. Ultimately, they attempt to draw neuroscience and practice closer together by using translational reasoning to suggest possible new avenues for treating these disorders. PMID:25520021

  16. Physical rehabilitation as the base component of treatment and rehabilitation women sick with gonarthrosis of the third radiological stages of disease

    Directory of Open Access Journals (Sweden)

    Andriychuk O.Y.

    2012-08-01

    Full Text Available The rehabilitations of women, patients given in relation to the programs are resulted, on gonarthrosis to the roentgenologic stage. The changes of indexes expressed of the pain feeling are analysed, morning constraint, pain index and amplitude of motions in joints for patients. 132 patients took part in research. As an index of amplitude of motions information of the active unbending was utillized in a knee-joint. Testing was conducted in three months and six months. Probed and determined a pain index at passive and active motions in a knee. The complex program of physical rehabilitation is offered. The program included a medical physical culture, massotherapy, mechanotherapy, physiotherapy, dietotherapy, psychological support and educational programs. Rehabilitation on the author program set positive changes intensity of the pain feelings, morning constraint, pain index and amplitude of motions, in a knee.

  17. Implementation of evidence-based rehabilitation for non-specific back pain and common mental health problems: a process evaluation of a nationwide initiative

    OpenAIRE

    Brämberg, Elisabeth Björk; Klinga, Charlotte; Jensen, Irene; Busch, Hillevi; Bergström, Gunnar; Brommels, Mats; Hansson, Johan

    2015-01-01

    Background Nationwide implementation of guaranteed access to evidence-based rehabilitation was established in Sweden in 2009, through an Act of the Swedish Government. The rehabilitation guarantee’s primary goal was to increase the rate of return-to-work, reduce and prevent long-term absenteeism after diagnoses related to back pain and common mental health problems. This study aims to develop knowledge about factors influencing large-scale implementation of complex and extensive interventions...

  18. Evaluation of a video-based Internet intervention as preparation for inpatient psychosomatic rehabilitation: study protocol for a randomized controlled trial

    OpenAIRE

    Becker, Jan; Beutel, Manfred E; Gerzymisch, Katharina; Schulz, Dirk; Siepmann, Martin; Knickenberg, Rudolf J; Schmädeke, Stefan; Ferdinand, Peter; Zwerenz, Rüdiger

    2016-01-01

    Background Patients’ treatment expectations are a key factor in psychotherapy. Several studies have linked higher expectations to better treatment success. Therefore, we want to evaluate the impact of a targeted video-based intervention on patients’ expectations and the treatment success of inpatient rehabilitation. Methods/design All patients who will be referred to inpatient psychosomatic rehabilitation in three clinics will receive a study flyer with information about how to log in to the ...

  19. Assessment of phase based dose modulation for improved dose efficiency in cardiac CT on an anthropomorphic motion phantom

    Science.gov (United States)

    Budde, Adam; Nilsen, Roy; Nett, Brian

    2014-03-01

    State of the art automatic exposure control modulates the tube current across view angle and Z based on patient anatomy for use in axial full scan reconstructions. Cardiac CT, however, uses a fundamentally different image reconstruction that applies a temporal weighting to reduce motion artifacts. This paper describes a phase based mA modulation that goes beyond axial and ECG modulation; it uses knowledge of the temporal view weighting applied within the reconstruction algorithm to improve dose efficiency in cardiac CT scanning. Using physical phantoms and synthetic noise emulation, we measure how knowledge of sinogram temporal weighting and the prescribed cardiac phase can be used to improve dose efficiency. First, we validated that a synthetic CT noise emulation method produced realistic image noise. Next, we used the CT noise emulation method to simulate mA modulation on scans of a physical anthropomorphic phantom where a motion profile corresponding to a heart rate of 60 beats per minute was used. The CT noise emulation method matched noise to lower dose scans across the image within 1.5% relative error. Using this noise emulation method to simulate modulating the mA while keeping the total dose constant, the image variance was reduced by an average of 11.9% on a scan with 50 msec padding, demonstrating improved dose efficiency. Radiation dose reduction in cardiac CT can be achieved while maintaining the same level of image noise through phase based dose modulation that incorporates knowledge of the cardiac reconstruction algorithm.

  20. Novel phase-based noise reduction strategy for quantification of left ventricular function and mass assessment by cardiac CT: Comparison with cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Wai, Bryan, E-mail: bwai@partners.org [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Thai, Wai-ee [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Brown, Heather [Qi Imaging, Redwood City, California (United States); Truong, Quynh A. [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2013-08-15

    Background: Tube current modulation in retrospective ECG gated cardiac computed tomography (CT) results in increased image noise and may reduce the accuracy of left ventricular (LV) ejection fraction (EF) and mass assessment. Objective: To examine the effects of a novel CT phase-based noise reduction (NR) algorithm on LV EF and mass quantification as compared to cardiac magnetic resonance (CMR). Methods: In 40 subjects, we compared the LV EF and mass between CT and CMR. In a subset of 24 subjects with tube current modulated CT, the effect of phase-based noise reduction strategies on contrast-to-noise ratio (CNR) and the assessment of LV EF and mass was compared to CMR. Results: There was excellent correlation between CT and CMR for EF (r = 0.94) and mass (r = 0.97). As compared to CMR, the limits of agreement improved with increasing strength of NR strategy. There was a systematic underestimation of LV mass by CT compared to CMR with no NR (−10.3 ± 10.1 g) and low NR (−10.3 ± 12.5 g), but was attenuated with high NR (−0.5 ± 8.3 g). Studies without NR had lower CNR compared to low and high NR at both the ES phase and ED phase (all p < 0.01). Conclusions: A high NR strategy on tube current modulated functional cardiac CT improves correlation of EF compared to CMR and reduces variability of EF and mass evaluation by increasing the CNR. In an effort to reduce radiation dose with tube current modulation, this strategy provides better image quality when LV function and mass quantification is needed.