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Sample records for cardiac rehabilitation cochrane

  1. Cardiac Rehabilitation

    Science.gov (United States)

    Cardiac rehabilitation (rehab) is a medically supervised program to help people who have A heart attack Angioplasty or coronary artery bypass grafting for coronary heart disease A heart valve repair or replacement A ...

  2. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  3. 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 ...

  4. [Cardiac Rehabilitation 2015].

    Science.gov (United States)

    Hoffmann, Andreas

    2015-11-25

    The goals of cardiac rehabilitation are (re-)conditioning and secondary prevention in patients with heart disease or an elevated cardiovascular risk profile. Rehabilitation is based on motivation through education, on adapted physical activity, instruction of relaxation techniques, psychological support and optimized medication. It is performed preferably in groups either in outpatient or inpatient settings. The Swiss working group on cardiac rehabilitation provides a network of institutions with regular quality auditing. Positive effects of rehabilitation programs on mortality and morbidity have been established by numerous studies. Although a majority of patients after cardiac surgery are being referred to rehabilitation, these services are notoriously underused after catheter procedures. PMID:26602848

  5. 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

  6. 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 for...... uncertain 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....

  7. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

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

    2012-01-01

    recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... 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...

  8. Cardiac Rehabilitation: Guidelines and Recommendations

    OpenAIRE

    Catherine Monpere

    1998-01-01

    Cardiac rehabilitation has been shown to improve exercise tolerance and symptomatology in patients experiencing angina or heart failure and reduce long term mortality after myocardial infarction, with a good cost-effectiveness ratio. In addition to these `hard' endpoints, cardiac rehabilitation improves the patient's quality of life and risk factor profile through a multifactorial intervention. Indeed, cardiac rehabilitation is no longer restricted to physical reconditioning, but should now b...

  9. 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...

  10. Cardiac risk stratification in cardiac rehabilitation programs: a review of protocols

    OpenAIRE

    Anne Kastelianne França da Silva; Marianne Penachini da Costa de Rezende Barbosa; Aline Fernanda Barbosa Bernardo; Franciele Marques Vanderlei; Francis Lopes Pacagnelli; Luiz Carlos Marques Vanderlei

    2014-01-01

    Objective: Gather and describe general characteristics of different protocols of risk stratification for cardiac patients undergoing exercise. Methods: We conducted searches in LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO electronic databases, using the following descriptors: Cardiovascular Disease, Rehabilitation Centers, Practice Guideline, Exercise and Risk Stratification in the past 20 years. Results: Were selected eight studies addressing methods of risk stratification i...

  11. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis

    OpenAIRE

    Kamper, Steven J.; Apeldoorn, A T; Chiarotto, A; Smeets, R.J.E.M.; Ostelo, R.W.J.G.; J. Guzman; van Tulder, M. W

    2015-01-01

    Objective To assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain. Design Systematic review and random effects meta-analysis of randomised controlled trials. Data sources Electronic searches of Cochrane Back Review Group Trials Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. Study selecti...

  12. Physical rehabilitation for critical illness myopathy and neuropathy: an abridged version of Cochrane Systematic Review.

    Science.gov (United States)

    Mehrholz, J; Pohl, M; Kugler, J; Burridge, J; Mückel, S; Elsner, B

    2015-10-01

    Intensive care unit (ICU) acquired or generalised weakness due to critical illness myopathy (CIM) and polyneuropathy (CIP) are major causes of chronically impaired motor function that can affect activities of daily living and quality of life. Physical rehabilitation of those affected might help to improve activities of daily living. Our primary objective was to assess the effects of physical rehabilitation therapies and interventions for people with CIP and CIM in improving activities of daily living such as walking, bathing, dressing and eating. Secondary objectives were to assess effects on muscle strength and quality of life, and to assess adverse effects of physical rehabilitation. On 16 July 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register and on 14 July 2014 we searched CENTRAL, MEDLINE, EMBASE and CINAHL Plus. In July 2014, we searched the Physiotherapy Evidence Database (PEDro) and three trials registries for ongoing trials and further data about included studies with no language restrictions. We also handsearched relevant conference proceedings and screened reference lists to identify further trials. We planned to include randomised controlled trials (RCTs), quasi-RCTs and randomised controlled cross-over trials of any rehabilitation intervention in people with acquired weakness syndrome due to CIP/CIM. We would have extracted data, assessed the risk of bias and classified the quality of evidence for outcomes in duplicate, according to the standard procedures of The Cochrane Collaboration. Outcome data collection would have been for activities of daily living (for example, mobility, walking, transfers and self care). Secondary outcomes included muscle strength, quality of life and adverse events. The search strategy retrieved 3587 references. After examination of titles and abstracts, we retrieved the full text of 24 potentially relevant studies. None of these studies met the inclusion criteria of our review. No data were

  13. Contributing to the growth of Physical and Rehabilitation Medicine (PRM): call for a Cochrane Field in PRM

    OpenAIRE

    Negrini, S; KIEKENS, C.; MEERPOHL, J. J.; Thomson, D.; M. Zampolini; CHRISTODOULOU, N.; Delarque, A.; Gutenbrunner, C.; MlCHAIL, X.

    2015-01-01

    The European Society of Physical and Rehabilitation Medicine (ESPRM), together with the European Journal of PRM and the PRM Section and Board of the European Union of Medical Specialists (UEMS), started an action to establish a relationship with Cochrane (formerl the Cochrane Collaboration). Cochrane is a global, independent network of researchers, professionals, patients, carers and people interested in health, with contributors from more than 130 countries. Its aim is to p...

  14. Cardiac rehabilitation: a comprehensive review

    OpenAIRE

    Lear Scott A; Ignaszewski Andrew

    2001-01-01

    Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...

  15. 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

  16. Motivational factors of adherence to cardiac rehabilitation

    OpenAIRE

    Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

    2012-01-01

    Background: Main suggested theories about patients’ adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients’ adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients’ participation and compl...

  17. 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...... of life (HRQoL) and prognosis in patients with establishedCHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system....... 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...

  18. 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...... of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system....... 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...

  19. 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

  20. 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...... systematic review and meta-analysis of exercise-based CR for CHD. METHODS: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included...... randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk of...

  1. 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...

  2. 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

  3. Cardiac risk stratification in cardiac rehabilitation programs: a review of protocols

    Directory of Open Access Journals (Sweden)

    Anne Kastelianne França da Silva

    2014-04-01

    Full Text Available Objective: Gather and describe general characteristics of different protocols of risk stratification for cardiac patients undergoing exercise. Methods: We conducted searches in LILACS, IBECS, MEDLINE, Cochrane Library, and SciELO electronic databases, using the following descriptors: Cardiovascular Disease, Rehabilitation Centers, Practice Guideline, Exercise and Risk Stratification in the past 20 years. Results: Were selected eight studies addressing methods of risk stratification in patients undergoing exercise. Conclusion: None of the methods described could cover every situation the patient can be subjected to; however, they are essential to exercise prescription.

  4. 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…

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

    DEFF Research Database (Denmark)

    Bjarnason-Wehrens, Birna; McGee, Hannah; Zwisler, Ann-Dorthe; Piepoli, Massimo F; Benzer, Werner; Schmid, Jean-Paul; Dendale, Paul; Pogosova, Nana-Goar V; Zdrenghea, Dumitru; Niebauer, Josef; Mendes, Miguel

    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.......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....

  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. 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.

  8. 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...

  9. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Science.gov (United States)

    2010-10-01

    ... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY... osteopathy as defined in section 1861(r)(1) of the Act. Physician-prescribed exercise means aerobic exercise... approval, an intensive cardiac rehabilitation site is considered a supplier (or prospective supplier)...

  10. Cardiac rehabilitation past, present and future: an overview

    OpenAIRE

    Mampuya, Warner M.

    2012-01-01

    Cardiac Rehabilitation has evolved over the past decades from a simple monitoring for the safe return to physical activities to a multidisciplinary approach that focuses on patient education, individually tailored exercise training, modification of the risk factors and the overall well-being of the cardiac patients. It has been proven to be an effective tool for the care of the patients with heart disease. Recent research in cardiac rehabilitation has demonstrated that tremendous benefits can...

  11. Psychometric validation of the Cardiac Rehabilitation Barriers Scale

    OpenAIRE

    Shanmugasegaram, Shamila; Gagliese, Lucia; Oh, Paul; Stewart, Donna E.; Brister, Stephanie J; Chan, Victoria; Sherry L. Grace

    2012-01-01

    Objective: The purpose of this study was to investigate the factor structure and psychometric properties of the Cardiac Rehabilitation Barriers Scale (CRBS). Design, setting, and participants: In total, 2636 cardiac inpatients from 11 hospitals completed a survey. One year later, participants completed a follow-up survey, which included the CRBS. A subsample of patients also completed a third survey which included the CRBS, the Cardiac Rehabilitation Enrolment Obstacles scale, and the Beliefs...

  12. Current state of cardiac rehabilitation in Japan.

    Science.gov (United States)

    Goto, Yoichi

    2014-01-01

    In Japan, metabolic risk factors have been increasing due to the westernization and urbanization of lifestyle. This justifiably raises a concern that the incidence of coronary heart disease (CHD) in Japan will increase over time, and indeed, recent epidemiological studies in Japan suggest the incidence of acute myocardial infarction (AMI) is increasing. Cardiac rehabilitation (CR) in Japan has been traditionally performed in the inpatient setting. To obtain reimbursement, a CR facility must fulfill certain criteria including being a medical institution with a cardiology/cardiac surgery section which has at least a cardiologist/cardiac surgeon and an experienced CR physician as full-time employees. These criteria create challenges to the availability of outpatient CR after hospital discharge. A recent analysis found outpatient CR participation rate was estimated to be between 3.8 and 7.6% in Japan. This review describes recent trends in the incidence of AMI and the current status of the use of CR in Japan. PMID:24607022

  13. Are older patients’ cardiac rehabilitation needs being met?

    OpenAIRE

    Tolmie, Elizabeth P; Lindsay, Grace M.; Kelly, Tim; Tolson, Debbie; Baxter, Susan; Belcher, Philip R.

    2009-01-01

    AIMS:The primary aim of this study was to examine the needs of older people in relation to cardiac rehabilitation and to determine if these were currently being met. A secondary aim was to compare illness representations, quality of life and anxiety and depression in groups with different levels of attendance at a cardiac rehabilitation programme. BACKGROUND: Coronary heart disease accounted for over seven million cardiovascular deaths globally in 2001. Associated deaths increase with a...

  14. 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.

  15. 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.

  16. [Selection criteria for referral to cardiac rehabilitation centers].

    Science.gov (United States)

    Greco, Cesare; Cacciatore, Giuseppe; Gulizia, Michele; Martinelli, Luigi; Oliva, Fabrizio; Olivari, Zoran; Seccareccia, Fulvia; Temporelli, Pier Luigi; Urbinati, Stefano

    2011-03-01

    Current guidelines state that cardiac rehabilitation is indicated after the acute phase of major cardiovascular diseases and interventions; on the other hand implementation of these indications is difficult because of several barriers, i.e. the number of patients per year with an indication exceeds by far the accommodation offer of cardiac rehabilitation centers; the demand for access to cardiac rehabilitation from acute cardiac care hospitals is low because the attention is focused on the acute phase of cardiac diseases. The present Consensus Document describes the changes in clinical epidemiology of the main cardiovascular diseases, showing that complications are increasingly more frequent in the postacute phase, especially in the setting of myocardial infarction. The Joint ANMCO/IACPR-GICR Committee defines priority criteria based on clinical risk for admission to cardiac rehabilitation centers as inpatients. This Consensus Document represents, therefore, an important step forward in the search for continuity of care in high-risk patients during the post-acute phase. PMID:21751732

  17. [Selection criteria for patient admission to cardiac rehabilitation centers].

    Science.gov (United States)

    Greco, Cesare; Cacciatore, Giuseppe; Gulizia, Michele; Martinelli, Luigi; Oliva, Fabrizio; Olivari, Zoran; Seccareccia, Fulvia; Temporelli, Pier Luigi; Urbinati, Stefano

    2011-03-01

    Current guidelines state that cardiac rehabilitation is indicated after the acute phase of major cardiovascular diseases and interventions; on the other hand implementation of these indications is difficult because of several barriers, i.e. the number of patients per year with an indication exceeds by far the accommodation offer of cardiac rehabilitation centers; the demand for access to cardiac rehabilitation from acute cardiac care hospitals is low because the attention is focused on the acute phase of cardiac diseases. The present Consensus Document describes the changes in clinical epidemiology of the main cardiovascular diseases, showing that complications are increasingly more frequent in the post-acute phase, especially in the setting of myocardial infarction. The Joint ANMCO/IACPR-GICR Committee defines priority criteria based on clinical risk for admission to cardiac rehabilitation centers as inpatients. This Consensus Document represents, therefore, an important step forward in the search for continuity of care in high-risk patients during the post-acute phase. PMID:21560480

  18. 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...

  19. 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 ...

  20. 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.

  1. 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…

  2. Multidisciplinary VA Cardiac Rehabilitation: Preliminary Results and Treatment Efficacy.

    Science.gov (United States)

    Daly, Susan S.; And Others

    Initial studies have suggested that a cardiac rehabilitation program (CRP) may improve the physical and psychological functioning of participants. However, these studies have generally addressed a relatively young group of employed adult males. Three studies were designed to target an older, generally retired Veterans Administration population for…

  3. 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 a...

  4. [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

  5. 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

  6. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    OpenAIRE

    Krutika Gajjar; Dr.Parloop Bhatt; Dr.Yagnik S.Bhalodia; Dr.Sizan B.Patel; Chintan Patel

    2012-01-01

    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 medicat...

  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. 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...

  10. 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.

  11. 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...... expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis....

  12. 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...

  13. 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...

  14. 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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Background Learning and coping education strategies (LC) was implemented to enhance patient attendance in the cardiac rehabilitation programme. This study assessed the cost-utility of LC compared to standard education (standard) as part of a rehabilitation programme for patients with ischemic heart...... 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...... 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...

  16. Cardiac Rehabilitation Patient and Organizational Factors: What Keeps Patients in Programs?

    OpenAIRE

    Turk‐Adawi, Karam I.; Oldridge, Neil B; Tarima, Sergey S.; Stason, William B.; Shepard, Donald S.

    2013-01-01

    Background Despite documented benefits of cardiac rehabilitation, adherence to programs is suboptimal with an average dropout rate of between 24% and 50%. The goal of this study was to identify organizational and patient factors associated with cardiac rehabilitation adherence. Methods and Results Facilities of the Wisconsin Cardiac Rehabilitation Outcomes Registry Project (N=38) were surveyed and records of 4412 enrolled patients were analyzed. Generalized estimating equations were used to a...

  17. Return to flight status after cardiac rehabilitation: three case histories.

    Science.gov (United States)

    Dwyer, J

    2001-01-01

    A pilot's license to operate aircraft is not valid unless it is accompanied by a medical certificate. This certificate is revoked if a pilot is diagnosed with a cardiovascular illness. After a lengthy waiting period, the medical certificate may be reinstated if the pilot meets rigid standards. For many pilots, participation in a cardiac rehabilitation program is essential to achieve the minimal functional capacity in exercise testing (10.0 metabolic equivalents), document tolerance of medications, and achieve successful rehabilitation. Our staff has assisted 11 pilots in their quest to resume commercial or recreational flying after heart surgery, pacemaker implantation, or angioplasty. This article summarizes the case histories of three pilots who returned to fight status, in three Federal Aviation Administration categories (FAA), after a cardiac illness. The principle goals of our rehabilitation program for pilots are: (1) to achieve the highest possible outcome of the rehabilitation process; (2) to establish a safe and effective independent exercise program; (3) to obtain measures of compliance and success with the independent exercise program; (4) to document tolerance of medications and ensure that medications are acceptable to the FAA; (5) to document stability of the serum glucose in diabetic patients engaged in rigorous, prolonged exercise; and (6) prepare the patient for performance of a treadmill test in which 100% predicted maximum heart rate is achieved without symptoms of cardiovascular distress. An inherent effect of pursuing these goals is dramatic risk factor modification including improved blood pressure and lipid status and reduced body mass index. After resumption of flying, none of our pilot-patients have experienced cardiac symptoms during flight, nor have they required emergency department visits or hospitalization for any reason. PMID:11591042

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

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L; Berg, Selina K; Rasmussen, Trine B;

    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.......40) or the exploratory physical and mental outcomes. Cardiac rehabilitation increased the occurrence of self-reported non-serious adverse events (11/72 vs 3/75, p=0.02). CONCLUSIONS: Cardiac rehabilitation after heart valve surgery significantly improves VO2 peak at 4 months but has no effect on mental health and other...

  19. [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. PMID:25508792

  20. 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.

  1. 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

  2. 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

  3. Effects of music therapy on health-related outcomes in cardiac rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Mandel, Susan E; Hanser, Suzanne B; Secic, Michelle; Davis, Beth A

    2007-01-01

    This study tested effectiveness of music therapy in improving health-related outcomes of cardiac rehabilitation patients. Using a randomized, controlled trial with follow-up, the study was conducted in an outpatient cardiac rehabilitation program in Ohio. Sixty-eight of 103 recruited patients, 30 to 80 years of age, completed the protocol through posttreatment. Physiological and psychological outcomes were measured. Cardiac rehabilitation patients were randomly assigned to cardiac rehabilitation only or to music therapy plus cardiac rehabilitation. Music therapy included musical experiences, counseling, and Music-Assisted Relaxation and Imagery. The null hypothesis of no differences in health-related outcomes between cardiac rehabilitation patients who experienced cardiac rehabilitation with and without music therapy was rejected due to changes in systolic blood pressure pre to post-treatment. Interpretation of changes at 4 months posttreatment in anxiety, general health, and social functioning are limited, due to small sample sizes at follow-up. Pre to post-music therapy session improvements were also reported. Findings suggest that some health-related outcomes may be affected positively by participation in music therapy in addition to cardiac rehabilitation. Attrition contributed to limitations in statistical power. PMID:17645384

  4. Cardiac Rehabilitation Enhancing Programs in Patients with Myocardial Infarction: A literature Review

    Directory of Open Access Journals (Sweden)

    Ahyana Ahyana

    2013-01-01

    Full Text Available Background: Cardiac rehabilitation (CR is a process that involves a multidisciplinary team of health professionals in order to optimize the status of patients’ physical, psychological, social, and vocational well being. The CR program has been proven to influence health outcomes in patients with cardiac diseases, particularly myocardial infarction (MI and stable angina. However, patients’ compliance with cardiac rehabilitation programs remains a challenge.Purpose: The purpose of this study is to review and identify interventions that enhance cardiac rehabilitation behaviors in MI patients.Method: A literature review was conducted by analyzing related research reports published since 2000 to 2012. Only English language articles were included.Result: There were 10 experimental studies and 2 meta-analysis studies. Interventions widely used to enhance cardiac rehabilitation behaviors in MI patients were self-efficacy and self management derived programs. These programs involved interventions that enhance cardiac rehabilitation behaviors, including training exercise, behavioral change, education and psychological support, and lifestyle changing strategies. None have reported the use of culturally tailored intervention. Four phases of cardiac rehabilitation were accepted as each phase represents a different aspect of care: inpatient care, early post discharge period, exercise training, and long term follow up. Critical factors for patients in maintaining an optimum health condition after a cardiac event are, in order, status of patient’s physical, psychological, social, and vocational well being.Conclusion: Cardiac Rehabilitation program has been shown to improve quality of life and decrease mortality in MI patients. The development of culturally specific interventions to increase cardiac rehabilitation behaviors will provide a significant improvement for cardiac patient’s care that ultimately results in better health outcomes. Health care

  5. 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

  6. 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

  7. 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...... concerning RTW and level of depression were significant predictors of RTW. Gender and anxiety were not significant predictors....

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

    OpenAIRE

    Bielawa Lukasz.; Prusik Katarzyna; Ossowski Zbigniew; Kortas Jakub.; Wiech Monika; Prusik Krzysztof

    2012-01-01

    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 s...

  9. Early and late rehabilitation and physical training in elderly patients after cardiac surgery

    OpenAIRE

    C. Macchi; Fattirolli, F; RM.Lova; AA Conti.; ML.Luisi; R.Intini; R.Zipoli; C.Burgisser; L. Guarducci; G. Masotti; Gensini GF

    2007-01-01

    OBJECTIVE: Few randomized trials have enrolled patients who have undergone cardiac surgery, and even fewer have included patients aged 75 yrs or more. Furthermore, the optimal timing of cardiac rehabilitation for postsurgical patients has not yet been codified. The aim of this study was to verify whether rehabilitation outcomes are also favorable in postsurgical patients aged 75 yrs or more and whether an early rehabilitation program is as effective and safe as a late one. DESIGN: Th...

  10. [The ISYDE project. A survey on Cardiac Rehabilitation in Italy].

    Science.gov (United States)

    Urbinati, Stefano; Fattirolli, Francesco; Tramarin, Roberto; Chieffo, Carmine; Temporelli, Pierluigi; Griffo, Raffaele; Belardinelli, Romualdo; Vaghi, Paola; Briolotti, Luisa

    2003-03-01

    In 2001-2002 the Italian Working Group on Cardiac Rehabilitation (CR) developed the ISYDE project, a survey on CR in Italy. In 2001, the CR units were 144 (57% in the North of the country), 58% in general hospitals, 23% in private hospitals, 8% in rehabilitative hospital, and only 2% in university clinics. Patients admitted to CR were 60,819 (vs 37.049 in 1996, +64%); 86% of CR units treated > 100 pts/year (vs 66% in 1996; +32%). Patients were admitted to CR units after cardiosurgery in 55% of cases, after myocardial infarction in 22%, and for chronic heart failure in 9.6%, without significant differences respect to 1996. A special survey investigated the work-up performed in patients with recent myocardial infarction. The admission ranges from 11th to 20th day, the mean duration of the CR programs ranges from 21 to 34 days. Most of italian CR units have a definite program for risk stratification and secondary prevention. In particular, the programs of exercise training, educational interventions concerning diet, lifestyle, and smoking cessation, and psychological intervention are well designed, developed, and evaluated before discharge in most cases. In conclusion, although in recent years the number of CR units are increasing, and the quality of care may be well-established by serial evaluations scheduled before discharge and during the long-term follow-up, a further development is mandatory to face the needs of cardiac patients in the post-acute and chronic phase of a cardiac disease. PMID:12827829

  11. 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 (...

  12. The Canadian Cardiac Rehabilitation Registry: Inaugural Report on the Status of Cardiac Rehabilitation in Canada

    OpenAIRE

    Sherry L. Grace; Trisha L. Parsons; Kristal Heise; Bacon, Simon L

    2015-01-01

    Introduction. There are over 200 Cardiovascular Rehabilitation (CR) programs in Canada, providing services to more than 50,000 new patients annually. The objective of this study was to describe the impact of CR in Canada. Methods. A retrospective analysis of Canadian CR Registry data is presented. There were 12 programs participating, with 4546 CR participants. Results. The average wait time between patient referral and CR admission was 68 ± 64 days. Participants were 66.3 ± 11.5 years old, 7...

  13. 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...

  14. 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

  15. Italian survey on cardiac rehabilitation and secondary prevention after cardiac revascularization: ICAROS study. A survey from the Italian cardiac rehabilitation network: rationale and design.

    Science.gov (United States)

    Griffo, Raffaele; Fattirolli, Francesco; Temporelli, Pier Luigi; Tramarin, Roberto

    2008-09-01

    In this paper, the Italian Association for Cardiac Prevention and Rehabilitation (GICR) presents the rationale and design of the "Italian survey on CArdiac RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS)". The survey is a prospective, longitudinal, multicentric survey, with a on-line web-based data collection. Its design corresponds to the survey's goal, i.e. to describe accurately in the Italian cardiological setting, through a representative number of cardiac rehabilitation centers belonging to the GICR national network, the characteristics, content and effects in the medium term of cardiac rehabilitation (CRP) inpatient or outpatient programs offered to patients after coronary artery bypass (CABG) or percutaneous revascularization (PTCA). The primary aims of the study are: a) to define the principal clinical characteristics of patients who have undergone PTCA or CABG and have been admitted to a CRP program; b) to identify the components of the CRP programs in terms of diagnostic procedures and assessment tests performed, treatments administered, educational programs and physical exercise interventions employed; c) to identify and analyze drug treatments prescribed at discharge from the acute facility and those prescribed at the end of the CRP program; d) to verify the clinical outcome during the course of the CRP program and at 6 months and 1 year after the end of the post-acute CRP program, as well as patients' adherence to the prescribed pharmacological therapy and to the recommended life styles, and the achievement and maintenance of the targets in relation to the modifiable risk factors; e) to define the consumption of major healthcare resources (major cardiac events, hospital re-admission, emergency care access, specialist visits) during the first year following a CRP program. The survey population will consist of all patients consecutively discharged in the period November 3-30, 2008 at the end of an inpatient, day

  16. Safety of Monitoring Exercise for Early Hospital-based Cardiac Rehabilitation

    OpenAIRE

    Kim, Chul; Moon, Chang Jin; Lim, Min Ho

    2012-01-01

    Objective To survey the cardiovascular complications induced by cardiac monitoring exercise during 10 years of our cardiac rehabilitation (CR) clinic and report on the safety of monitoring exercise training for early hospital-based CR. Method All cardiac patients who participated in our exercise program from January 2000 through December 2009 were recruited as study subjects. We stratified the exercise risks of cardiac events and conducted the monitoring exercise with individualized prescript...

  17. [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

  18. 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.;

    , and it seems to be crucial to further emphasise the individuals lived experiences when exercise-based cardiac rehabilitation is followed. Hence this study aims to investigate how patients experience exercise-based cardiac rehabilitation in a hospital setting. Methods. This study, which included nine...... 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...... 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...

  19. Does the Effect of Supervised Cardiac Rehabilitation Programs on Body Fat Distribution Remained Long Time?

    OpenAIRE

    Nalini, Mehdi; Moradi, Bahieh; Esmaeilzadeh, Maryam; Maleki, Majid

    2013-01-01

    Introduction: An increased accumulation of fat in the intra-abdominal cavity is highly correlated with adverse coronary risk profiles. Cardiac rehabilitation (CR) produces a host of health benefits related to modifiable cardiovascular risk factors. Further research is needed to define better program for weight loss and risk improvement in coronary patients. The aim of this study was to determine the effect of supervised and unsupervised cardiac rehabilitation program on body composition and b...

  20. Cardiovascular responses from immersion at recovery phase of the cardiac rehabilitation protocol

    OpenAIRE

    Framartinho Carlos Silva Araújo; Heleno Carneiro Rolim de Moraes; Jaqueline Vieira Sales

    2011-01-01

    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...

  1. Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation

    OpenAIRE

    Hardcastle, Sarah J; McNamara, Keira; Tritton, Larette

    2015-01-01

    Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activ...

  2. 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...

  3. 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 ...

  4. 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...

  5. 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...

  6. 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. ...

  7. 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

    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...

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

    OpenAIRE

    Marie Veje Knudsen; Sussie Laustsen; Annemette Krintel Petersen; Sanne Angel

    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 following heart disease is a complex matter. The objective of this study was to explore the characteristics of lifestyle after cardiac rehabilitation. A phenomenological-hermeneutic approach with qualit...

  9. Third National Survey of Cardiac Rehabilitation Service Provision in Ireland: progress on the 1999 National Cardiovascular Health Strategy Recommendations

    OpenAIRE

    Delaney, Mary; Flynn, Rachel; Kiernan, Marian; Doyle, Frank; Lonergan, Moira; Ingram, Shirley; McGee, Hannah

    2006-01-01

    Background: The National Cardiovascular Health Strategy, including specific plans for cardiac rehabilitation, was launched in Ireland in 1999. A survey of cardiac rehabilitation services was conducted in 2006 to evaluate progress on service provision. Aim: To establish levels of service provision and service formats of cardiac rehabilitation services in 2005, compare them with the status pre-Strategy (1998) and to ascertain areas in which additional resources may be needed to achieve the 10 n...

  10. Adapted cardiac rehabilitation programme to improve uptake in patients of Moroccan and Turkish origin in The Netherlands: a qualitative study

    OpenAIRE

    Sloots, Maurits; Bartels, Edien A. C.; Angenot, Edmond L. D.; Geertzen, Jan H. B.; Dekker, Joost

    2012-01-01

    Aim. To explore the treatment experiences in patients of Moroccan and Turkish origin and their rehabilitation therapists regarding an adapted outpatient cardiac rehabilitation programme. Background. Non-native patients who participated in a cardiac rehabilitation programme at a Dutch rehabilitation centre had more difficulties to achieve the treatment aims than native Dutch patients. Therefore, an adapted programme for non-native patients, lacking proficiency in Dutch, has been instigated. Th...

  11. Standard and alternative adjunctive treatments in cardiac rehabilitation.

    OpenAIRE

    Levy, J K

    1993-01-01

    Cardiovascular rehabilitation is the process of restoring functional abilities degraded by a serious cardiovascular event or by a surgical procedure to preempt such an event. Cardiovascular rehabilitation also includes attempts to reverse risk factors that have contributed initially to the disease process. Rehabilitation programs generally comprise disease-related educational components, supervised prescriptive physical exercise, diet counseling and modification, cessation of tobacco use, psy...

  12. Relaxation therapy in cardiac rehabilitation : a randomized controlled clinical trial of breathing awareness as a relaxation method in the rehabilitation after myocardial infarction

    OpenAIRE

    Dixhoorn, J.J.

    1991-01-01

    textabstractCardiac rehabilitation is often a necessary supplement to medica! treatment of patients with acute ischaemie heart disease. Rehabilitation is directed to the functional recovery of the patient, physically as well as socially and mentally. Exercise training is at present the most common component of cardiac rehabilitation. However, most investigators have failed to show that exercise in itself would imprave the patient's functional state satisfactorily. Therefore, there is a need t...

  13. The effectiveness of exercise-based cardiac rehabilitation program for secondary prevention of coronary heart disease : a systematic review

    OpenAIRE

    Leong, Yuk-yan, Pauline; 梁玉恩

    2013-01-01

    Objective: To examine the effect of exercise-based cardiac rehabilitation program for secondary prevention of coronary heart disease on cardiac-related mortality, recurrent cardiovascular event and quality of life. Methods: All studies published between 1990 and 2013 in PubMed, and from 1980 to 2013 in EMBASE, which evaluated the effectiveness of exercise-based cardiac rehabilitation program for coronary heart disease. Using the specific keywords “Cardiac rehabilitation”, “Coronary heart...

  14. 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

  15. 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

  16. 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

  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. 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

  19. Cardiovascular responses from immersion at recovery phase of the cardiac rehabilitation protocol

    Directory of Open Access Journals (Sweden)

    Framartinho Carlos Silva Araújo

    2011-06-01

    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, withone 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 themethod used, showing significant improvements in symptoms, with adherence to the cardiac rehabilitation program after inclusion of immersion as a therapeutic complement.

  20. Effect of Cardiac Rehabilitation in Patients with ICD

    DEFF Research Database (Denmark)

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

    2015-01-01

    -rated health and QoL and effect of rehabilitation were tested using t-tests. Predictors of effect of rehabilitation were tested using logistic regression. RESULTS: A total of 196 patients (mean age 58 ± 13 years; 155 men, 41 women) were included. At hospital discharge, significant differences were found in...

  1. 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...

  2. 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...

  3. 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......-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...

  4. Effect of guideline based computerised decision support on decision making of multidisciplinary teams: cluster randomised trial in cardiac rehabilitation

    OpenAIRE

    Goud, R.; de Keizer, N F; ter Riet, G; Wyatt, J C; Hasman, A.; Hellemans, I.M.; Peek, N.

    2009-01-01

    OBJECTIVE: To determine the extent to which computerised decision support can improve concordance of multidisciplinary teams with therapeutic decisions recommended by guidelines. DESIGN: Multicentre cluster randomised trial. PARTICIPANTS: Multidisciplinary cardiac rehabilitation teams in Dutch centres and their cardiac rehabilitation patients. INTERVENTIONS: Teams received an electronic patient record system with or without additional guideline based decision support. MAIN OUTCOME MEASURES: C...

  5. 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; Spiering, Marquita; Kazemier, Marten; Pedersen, Susanne S.

    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....

  6. 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

  7. 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.

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

    DEFF Research Database (Denmark)

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

    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...... themes emerged: Hard to accept the disease: facing the disease is a difficult surrender to the patients, leading to vulnerability and helplessness; Understanding that life has become frail: patients feel shaken in an existential way as they realize that the disease is chronical and life-threatening; An...

  9. 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.

  10. 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...

  11. Peak Oxygen Uptake after Cardiac Rehabilitation: A Randomized Controlled Trial of a 12-Month Maintenance Program versus Usual Care

    OpenAIRE

    Madssen, Erik; Arbo, Ingerid; Granøien, Ingrid; Walderhaug, Liv; Moholdt, Trine

    2014-01-01

    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 l...

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

    OpenAIRE

    Madssen, Erik; Arbo, Ingerid Brænne; Granøien, Ingrid; Walderhaug, Liv; Moholdt, Trine Tegdan

    2014-01-01

    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 wo...

  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. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    2016-01-01

    the health and outcomes of people with CHD. This is an update of a Cochrane systematic review previously published in 2011. OBJECTIVES: To assess the effectiveness and cost-effectiveness of exercise-based CR (exercise training alone or in combination with psychosocial or educational interventions) compared...... 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...... artery disease. We included RCTs that reported at least one of the following outcomes: mortality, MI, revascularisations, hospitalisations, health-related quality of life (HRQL), or costs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all identified references for inclusion...

  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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... 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......, 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...

  16. 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.

  17. 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.

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

    DEFF Research Database (Denmark)

    Lewinter, Christian; Bland, John M; Crouch, Simon; Doherty, Patrick; Lewin, Robert J; Køber, Lars; Hall, Alistair S; Gale, Christopher P

    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...

  19. 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…

  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...

  1. Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation.

    Directory of Open Access Journals (Sweden)

    Sarah J Hardcastle

    Full Text Available Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activity for at least two years following the cardiac rehabilitation programme. Participants were recruited from circuit training classes in East Sussex in the UK. Thematic content analysis revealed seven main themes: fear of death and ill health avoidance, critical incidents, overcoming aging, social influences, being able to enjoy life, provision of routine and structure, enjoyment and psychological well-being. Fear of death, illness avoidance, overcoming aging, and being able to enjoy life were powerful motives for continued participation in exercise. The social nature of the exercise class was also identified as a key facilitator of continued participation. Group-based exercise suited those that continued exercise participation post cardiac rehabilitation and fostered adherence.

  2. Using Visual Methods to Understand Physical Activity Maintenance following Cardiac Rehabilitation.

    Science.gov (United States)

    Hardcastle, Sarah J; McNamara, Keira; Tritton, Larette

    2015-01-01

    Few studies have explored the factors associated with long-term maintenance of exercise following cardiac rehabilitation. The present study used auto-photography and interviews to explore the factors that influence motivation and continued participation in physical activity among post cardiac rehabilitation patients. Twenty-three semi-structured interviews were conducted alongside participant-selected photographs or drawings with participants that had continued participation in physical activity for at least two years following the cardiac rehabilitation programme. Participants were recruited from circuit training classes in East Sussex in the UK. Thematic content analysis revealed seven main themes: fear of death and ill health avoidance, critical incidents, overcoming aging, social influences, being able to enjoy life, provision of routine and structure, enjoyment and psychological well-being. Fear of death, illness avoidance, overcoming aging, and being able to enjoy life were powerful motives for continued participation in exercise. The social nature of the exercise class was also identified as a key facilitator of continued participation. Group-based exercise suited those that continued exercise participation post cardiac rehabilitation and fostered adherence. PMID:26381147

  3. Process and Outcome in Cardiac Rehabilitation: An Examination of Cross-Lagged Effects.

    Science.gov (United States)

    Evon, Donna M.; Burns, John W.

    2004-01-01

    Cardiac rehabilitation patients improve cardiorespiratory fitness and quality of life, yet therapeutic processes that produce these changes remain unknown. A cross-lagged panel design was used to determine whether early-treatment enhancement of self-efficacy regarding abilities to change diet and exercise habits and the quality of the…

  4. Collaboration: a solution to the challenge of conducting nursing research in cardiac rehabilitation.

    Science.gov (United States)

    Gallagher, Robyn; Sadler, Leonie; Kirkness, Ann; Belshaw, Julie; Roach, Kellie; Warrington, Darrell

    2013-01-01

    Clinical nurse leaders such as clinical nurse consultants are required to conduct research and incorporate outcomes of this research into their every day practice. However, undertaking research presents issues for cardiac rehabilitation clinical nurse consultants because they may have competing demands, difficulty with finding replacements and may be relatively isolated from other researchers. The solution to this situation is the formation of a collaborative research team with other cardiac rehabilitation clinical nurse consultants, with the inclusion of an experienced university academic as a mentor for the cardiac rehabilitation clinical nurse consultants working in an Area Health Service encompassing both rural and metropolitan hospitals in New South Wales, Australia. The related research project aimed to evaluate and improve the clients' knowledge and practices related to the use of sublingual glyceryl trinitrate. The team's experiences and suggestions for clinical nurse Leaders are presented in this paper. Essential team characteristics include having shared motivation, good communication practices, flexibility and tolerance, an effective team size, achieving success, willingness to accept challenges and an experienced mentor. The benefits of developing a collaborative team for research led by clinical nurse consultants in cardiac rehabilitation by far outweigh the time and effort involved in the process. PMID:24596995

  5. 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...

  6. 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; Angel, Sanne

    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 fol......- lowing heart disease is a complex matter. The objective of this study was to explore the character- istics of lifestyle after cardiac rehabilitation. A phenomenological-hermeneutic approach with qualitative interviews was performed in 20 patients six months after completing a hospital-based cardiac...... rehabilitation programme in 2012 at Aarhus University Hospital, Denmark. The patients were diagnosed with ischemic heart disease, heart failure or left heart valve disease. The interviews were analysed using the interpretation theory by Ricoeur. The variation in reactions to car- diac rehabilitation were: 1...

  7. 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

  8. 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.

  9. 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...

  10. Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation.

    Science.gov (United States)

    Bjarnason-Wehrens, B; Mayer-Berger, W; Meister, E R; Baum, K; Hambrecht, R; Gielen, S

    2004-08-01

    Aerobic endurance training has been an integral component of the international recommendations for cardiac rehabilitation for more than 30 years. Notwithstanding, only in recent years have recommendations for a dynamic resistance-training program been cautiously put forward. The perceived increased risk of cardiovascular complications related to blood pressure elevations are the primary concern with resistance training in cardiac patients; recent studies however have demonstrated that this need not be a contraindication in all cardiac patients. While blood pressure certainly may rise excessively during resistance training, the actual rise depends on a variety of controllable factors including magnitude of the isometric component, the load intensity, the amount of muscle mass involved as well as the number of repetitions and/or the load duration. Intra-arterial blood pressure measurements in cardiac patients have demonstrated that that during low-intensity resistance training [40-60% maximum voluntary contraction (MVC)] with 15-20 repetitions, only modest elevations in blood pressure are revealed, similar to those seen during moderate endurance training. When properly implemented by an experienced exercise therapist, in specific patient groups an individually tailored, medically supervised dynamic resistance training program carries no inherent higher risk for the patient than aerobic endurance training. As an adjunct to endurance training, in selected patients, resistance training can increase muscle strength and endurance, as well as positively influence cardiovascular risk factors, metabolism, cardiovascular function, psychosocial well-being and quality of life. According to present data, resistance training is however not recommended for all patient groups. The appropriate training method and correct performance are highly dependent on each patient's clinical status, cardiac stress tolerance and possible comorbidities. Most studies have used middle-aged men of

  11. Predictors of cardiac rehabilitation attendance following primary percutaneous coronary intervention for ST-elevation myocardial infarction in Australia.

    Science.gov (United States)

    Soo Hoo, Soon Yeng; Gallagher, Robyn; Elliott, Doug

    2016-06-01

    Cardiac rehabilitation is an important component of recovery and secondary prevention following urgent primary percutaneous coronary intervention. However, attendance and factors that predict participation by patients admitted with ST-elevation myocardial infarction remain unclear. This Australian study was conducted using a descriptive, comparative design. Consecutive patients (n = 246) at two hospitals were interviewed by telephone at four weeks and six months. Open-ended questions were used to assess cardiac rehabilitation attendance, sociodemographics, modifiable risk factors, clinical outcomes, and post-discharge health support. Post-discharge home visits at four weeks (odds ratio: 2.64, 95% confidence interval: 1.48-4.71) and at six months were associated with better cardiac rehabilitation attendance; more males participated at four weeks and at six months. The results suggest the need to integrate post-discharge health support with cardiac rehabilitation to facilitate recovery after primary percutaneous coronary intervention, particularly for females with ST-elevation myocardial infarction. PMID:26858136

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

    OpenAIRE

    Jaqueline Vieira Sales; Heleno Carneiro Rolim de Moraes; Framartinho Carlos Silva Araújo

    2012-01-01

    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 Prog...

  13. Comparison of Cardiac Rehabilitation Programs Combined with Relaxation and Meditation Techniques on Reduction of Depression and Anxiety of Cardiovascular Patients

    OpenAIRE

    Delui, Mahdy Hassanzadeh; Yari, Maliheh; khouyinezhad, Gholamreza; Amini, Maral; Bayazi, Mohammad Hosein

    2013-01-01

    Cardiovascular disease (CVD) is a major cause of death in developed countries. Most cardiac rehabilitation programs include psychological interventions. The aim of this study was to determine the effectiveness of rehabilitation techniques in cardiac patients including psychological-physical interventions such as Meditation and Relaxation. We enrolled 45 patients with CVD and depression. The patients were allocated to 3 groups (Relaxation, Meditation and Control). There was a significant reduc...

  14. Effects of a self-regulation lifestyle program for post-cardiac rehabilitation patients

    OpenAIRE

    Janssen, Veronica Regina

    2012-01-01

    Background As maintenance of lifestyle change and risk factor modification following completion of cardiac rehabilitation (CR) has been shown to be notoriously difficult, we developed a brief self-regulation lifestyle program for post-CR patients. Design Randomized-controlled trial. Method Following completion of CR 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 o...

  15. 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...

  16. Predictors of Metabolic Syndrome in Participants of a Cardiac Rehabilitation Program

    OpenAIRE

    Lear, Scott A.; Andrew Ignaszewski; Jiri Frohlich; Alejandra Farias Godoy

    2012-01-01

    Metabolic syndrome increases the risk of all-cause mortality, cardiovascular mortality and cardiovascular events in patients with cardiovascular disease (CVD). This study assessed the predictors of metabolic syndrome, both its incidence and resolution in a cohort of cardiac rehabilitation program graduates. Methods. A total of 154 and 80 participants without and with metabolic syndrome respectively were followed for 48 months. Anthropometric measurements, metabolic risk factors, and quality o...

  17. Exercise Training and Cardiac Rehabilitation in Primary and Secondary Prevention of Coronary Heart Disease

    OpenAIRE

    Lavie, Carl J.; Thomas, Randal J.; Squires, Ray W.; Allison, Thomas G.; Milani, Richard V.

    2009-01-01

    Substantial data have established a sedentary lifestyle as a major modifiable risk factor for coronary heart disease (CHD). Increased levels of physical activity, exercise training, and overall cardiorespiratory fitness have provided protection in the primary and secondary prevention of CHD. This review surveys data from observational studies supporting the benefits of physical activity, exercise training, and overall cardiorespiratory fitness in primary prevention. Clearly, cardiac rehabilit...

  18. 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...

  19. Development of the Health Incentive Program Questionnaire (HIP-Q) in a cardiac rehabilitation population

    OpenAIRE

    Mitchell, Marc S.; Goodman, Jack M; Alter, David A.; Oh, Paul I.; Guy E.J. Faulkner

    2015-01-01

    The purpose of this study was to develop a questionnaire to facilitate the design of acceptable financial health incentive programs. A multiphase psychometric questionnaire development method was used. Theoretical and literature reviews and three focus groups generated a pool of content areas and items. New items were developed to ensure adequate content coverage. Field testing was conducted with a convenience sample of cardiac rehabilitation (CR) patients (n = 59) to establish face and const...

  20. 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...

  1. 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...

  2. 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...

  3. 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.

  4. 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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

    study was conducted among all hospitals receiving acute cardiac patients (n = 67). The response rate was 79%, with no differences according to catchment area, number of beds, or geographical location. The hospitals were classified as having full CR if all core components (physical training, psychosocial...... training (77%; 77%), psychosocial support (89%; 79%), dietary counselling (85%; 89%), smoking cessation (94%; 68%), and clinical control by a physician (100%; 93%). The content varied greatly. Full phase I CR was offered at 57% (95% confidence interval (95% CI): 44-70%) of the hospitals and 47% (95% CI: 34...

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

    Directory of Open Access Journals (Sweden)

    Ana A. S. Santos

    2016-01-01

    Full Text Available 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.

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. Rehabilitation

    Science.gov (United States)

    ... doing things you did before. This process is rehabilitation. Rehabilitation often focuses on Physical therapy to help your ... who has had a stroke may simply want rehabilitation to be able to dress or bathe without ...

  12. Impact of supervised cardiac rehabilitation on urinary albumin excretion in patients with cardiovascular disease.

    Science.gov (United States)

    Kimura, Sahika; Ueda, Yuka; Ise, Takayuki; Yagi, Shusuke; Iwase, Takashi; Nishikawa, Koji; Yamaguchi, Koji; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Katoh, Shinsuke; Akaike, Masashi; Yasui, Natsuo; Sata, Masataka

    2015-01-01

    Urinary albumin excretion is a predictor of cardiovascular death. Cardiac rehabilitation (CR) with exercise training (ET) has been shown to improve exercise capacity and prognosis in patients with cardiovascular disease (CVD). However, it remains unclear whether CR reduces urinary albumin excretion in CVD patients. We performed a retrospective, observational study using data obtained from 98 male CVD patients without macroalbuminuria and estimated glomerular filtration rate (eGFR) creatinine ratio (ACR) was significantly decreased in the supervised group at 6 months after enrollment (43 ± 71 mg/g to 17 ± 20 mg/g creatinine, P CVD and reduction in cardiovascular morbidity and mortality in CVD patients. PMID:25742947

  13. 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...... variation. The overall uptake rate was 52%. Simultaneous CABG was associated with a higher probability of referral to CR (OR 2.02 (95%CI 1.12-3.65)); being unmarried (0.44 (0.27-0.72)) and having TAVI with a lower probability (0.26; 0.13-0.52). The referral pattern varied across administrative regions, with...

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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...

  19. 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.

  20. 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

    cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic...... patients eligible. Thus a novel, disease-oriented document has been generated, where all components of CR for cardiovascular conditions have been revised, presenting both well-established and controversial aspects. A general table applicable to all cardiovascular conditions and specific tables for each...

  1. 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.

  2. 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

  3. ISYDE-2008. Study presentation. The Italian survey on cardiac rehabilitation: a snapshot of current cardiac rehabilitation programmes and providers in Italy.

    Science.gov (United States)

    Tramarin, Roberto; De Feo, Stefania; Ambrosetti, Marco; Griffo, Raffaele; Maslowsky, Franco; Vaghi, Paola

    2007-12-01

    The Italian Society of Cardiac Rehabilitation and Prevention (GICR) has developed the ISYDE-2008 survey with the purpose to take a detailed snapshot in terms of number, distribution, facilities, staffing levels, organization, and programme details of CR units in Italy and to compare actual provision with the recommendation of National GL for CR and secondary prevention. The study will be carried out with a web-based questionnaire running on the GICR website in 2 weeks from Jan. 28 to Feb. 10, 2008. The first part of the questionnaire is designed to collect information on the institutional organization of the CR unit, on its location and functional relationships within the hospital, on the number of beds for inpatient CR units and hours of activity for outpatient and home-based services, on the composition of the core and multidisciplinary teams, and finally on the components of CR programmes. In the second part of the survey, CR directors will be requested to report for each patient discharged during the 2 weeks of the study, indications for admission to CR, time of enrolment, comorbidity, complications, risk profile, diagnostic procedures, exercise and educational programme, discharge modalities, treatment at discharge and follow-up schedule. More than 2300 pts are expected to enter in the survey, whose results depicting the status of CR in Italy will be available within April 2008. PMID:18361217

  4. Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

    Directory of Open Access Journals (Sweden)

    Lane Deirdre

    2003-09-01

    Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

  5. 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…

  6. 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…

  7. The effect of integrated cardiac rehabilitation versus treatment as usual for atrial fibrillation patients treated with ablation

    DEFF Research Database (Denmark)

    Risom, Signe Stelling; Zwisler, Ann-Dorth Olsen; Rasmussen, Trine Bernholdt;

    2013-01-01

    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...... measure is exercise capacity measured by the VO(2) 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....... 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...

  8. 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.

  9. Drivers of Racial and Ethnic Disparities in Cardiac Rehabilitation Use: Patient and Provider Perspectives.

    Science.gov (United States)

    Mead, Holly; Ramos, Christal; Grantham, Sarah C

    2016-06-01

    Cardiac rehabilitation (CR) use is lower for racial and ethnic minorities than White patients. The purpose of this study was to identify factors that drive this disparity at the system, provider, and patient levels. A mixed methods study combined descriptive analysis of 2007 Medicare claims data and thematic analysis of 19 clinician interviews, 8 minority patient focus groups and 8 one-on-one interviews with minority heart patients across three communities. The disparity between White and non-White CR use ranged from 7 to 11 percentage points among study sites (p decision-making around referral processes. These findings suggest that the health care system needs to address multiple levels of problems to mitigate disparities in CR use. PMID:26400868

  10. 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

  11. 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

  12. 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.

  13. Exercise tolerance testing in a cardiac rehabilitation setting: an exploratory study of its safety and practicality for exercise prescription and outcome data collection

    OpenAIRE

    Simms, Kay; Myers, Chris; Adams, Jenny; Hartman, Julie; Lindsey, Christopher; Doler, Mike; Suhr, Janet

    2007-01-01

    An exercise test is a valuable tool that should be a part of every patient's assessment before beginning cardiac rehabilitation. We analyzed data from one exercise tolerance test used in a cardiac rehabilitation program among 103 subjects: 65 men with a mean age of 60.5 years and 38 women with a mean age of 62.4 years. Resultsindicated that, after cardiac rehabilitation, subjects had significantimprovementin maximum metabolic equivalents (an increase of 0.9, P < 0.0001), which indicates funct...

  14. 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. PMID:25753948

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

    International Nuclear Information System (INIS)

    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) 123I-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-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.)

  16. 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.

  17. [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

  18. 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...

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Völler H

    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

  1. 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...

  2. 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...

  3. 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...

  4. 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.

  5. Introduction to the Cochrane Collaboration

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The Cochrane Collaboration was established in 1993, and named after the epidemiologist, Archie Cochrane (1909-1988), a British medical researcher who contributed greatly to the development of epidemiology as a science.The organisation benefits from thousands of contributors worldwide,working collaboratively from w ithin many independent groups of people ('entities').For this reason,the term 'collaboration' is used.The Cochrane Collaboration's principles include fostering good communication, open decision-making and teamwork; reducing barriers to contributing; and encouraging diversity.These things cannot be achieved without people co-operating with each other, setting aside self-interest,and working together to provide evidence with which to improve health care.

  6. 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.

  7. 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 P<.001). At study end, in patients with the metabolic syndrome, functional capacity increased by 26.45% ( P<.001), as measured by metabolic 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. PMID:20546381

  8. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology.

    Science.gov (United States)

    Pogosova, Nana; Saner, Hugo; Pedersen, Susanne S; Cupples, Margaret E; McGee, Hannah; Höfer, Stefan; Doyle, Frank; Schmid, Jean-Paul; von Känel, Roland

    2015-10-01

    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 of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. 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 questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team. PMID:25059929

  9. 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)

  10. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Rasmussen, Søren; Frederiksen, Marianne; Abadini, Sadollah; Appel, Jon; Rasmussen, Hanne; Gluud, Christian; Iversen, Lars; Sigurd, Bjarne; Madsen, Mette; Fischer-Hansen, Jørgen; Group, DANREHAB

    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 ...... Depression Scale did not differ significantly. CONCLUSION: At 12 months, the CCR and UC groups did not differ regarding the primary composite outcome. Comprehensive cardiac rehabilitation significantly reduced length of hospital stay and improved cardiac risk factors.......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......, risk profile, and quality of life. The trial included 770 participants (20-94 years) with congestive heart failure (12%), ischemic heart disease (58%), or high risk of ischemic heart disease (30%). Comprehensive cardiac rehabilitation is composed of 6 weeks of intensive intervention and systematic...

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. Cardiac rehabilitation may not provided a quality of life benefit in coronary artery disease patients

    Directory of Open Access Journals (Sweden)

    Tavella Rosanna

    2012-11-01

    Full Text Available Abstract Background Improvements in patient-reported health-related quality of life (HRQoL are important goals of cardiac rehabilitation (CR. In patients undergoing coronary angiography for angina and with documented coronary artery disease (CAD, the present study compared HRQoL over 6 months in CR participants and non-participants. Clinical predictors of CR participants were also assessed. Methods A total of 221 consecutive patients undergoing angiography for angina with documented CAD and who were eligible for a CR program were recruited. CR participants were enrolled in a six-week Phase II outpatient CR course (31%, n = 68 within 2 months following angiography and the non-participants were included as a control. At baseline (angiography, one and six months post angiography, clinical and HRQoL data were obtained including the Short Form-36 (SF-36 and the Seattle Angina Questionnaire (SAQ. The response rate for the HRQoL assessment was 68% (n = 150. Cross sectional comparisons were age-adjusted and performed using logistic or linear regression as appropriate. Longitudinal changes in HRQoL were assessed using least squares regression. Finally, a multiple logistic regression was fitted with CR participant as the final outcome. Results At angiography, the CR non-participants were older, and age-adjusted analyses revealed poorer physical (angina limitation: 54 ± 25 versus 64 ± 22, p Conclusion Following angiography, CAD patients reported improvements in both generic and disease-specific HRQoL, however CR participation did not influence this outcome. This may be explained by biases in CR enrollment, whereby acute patients, who may be less limited in HRQoL compared to stable, chronic patients, are targeted for CR participation. Further investigation is required so CR programs maximize the quality of life benefits to all potential CR patients.

  17. 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.

  18. 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.

  19. 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

  20. Relationship Between Exercise Workload During Cardiac Rehabilitation and Outcomes in Patients With Coronary Heart Disease.

    Science.gov (United States)

    Brawner, Clinton A; Abdul-Nour, Khaled; Lewis, Barry; Schairer, John R; Modi, Shalini S; Kerrigan, Dennis J; Ehrman, Jonathan K; Keteyian, Steven J

    2016-04-15

    The purpose of this retrospective, observational study was to describe the relation between exercise workload during cardiac rehabilitation (CR), expressed as metabolic equivalents of task (METs), and prognosis among patients with coronary heart disease. We included patients with coronary heart disease who participated in CR between January 1998 and June 2007. METs were calculated from treadmill workload. Cox regression analysis was used to describe the relationship between METs and time to a composite outcome of all-cause mortality, nonfatal myocardial infarction, or heart failure hospitalization. Among 1,726 patients (36% women; median age 59 years [interquartile range, 52 to 66]), there were 467 events (27%) during a median follow-up of 5.8 years (interquartile range, 2.6 to 8.7). In analyses adjusted for age, sex, Charlson co-morbidity index, hypertension, diabetes, and CR referral diagnosis, METs were independently related to the composite outcome at CR start (Wald chi-square 43, hazard ratio 0.59 [95% confidence interval 0.51 to 0.70]) and CR end (Wald chi-square 47, hazard ratio 0.68 [95% confidence interval 0.61 to 0.76]). Patients exercising below 3.5 METs on exit from CR represent a high-risk group with 1- and 3-year event rates ≥7% and ≥18%, respectively. In conclusion, METs during CR is available at no additional cost and can be used to identify patients at increased risk for an event who may benefit from closer follow-up, extended length of stay in CR, and/or participation in other strategies aimed at maximizing adherence to secondary preventive behaviors and improving exercise capacity. PMID:26897640

  1. 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

  2. Impaired Cerebrovascular Function in Coronary Artery Disease Patients and Recovery Following Cardiac Rehabilitation

    Science.gov (United States)

    Anazodo, Udunna C.; Shoemaker, J. K.; Suskin, Neville; Ssali, Tracy; Wang, Danny J. J.; St. Lawrence, Keith S.

    2016-01-01

    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 CAD patients and 21 age-matched controls. Gray matter volume (GMV) 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 (AC), insular, pre- and post-central gyri, middle temporal, and superior temporal regions. Subsequent analysis of these regions demonstrated decreased CVR in the AC, insula, post-central 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 GMV 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-months exercise-based cardiac rehabilitation program. Increased CBF was observed in the bilateral AC, as well as recovery of CBF in the dorsal aspect of the right AC, 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 AC is intriguing given the role of this area in cognitive processing and regulation of cardiovascular autonomic control. PMID:26779011

  3. Factors Associated With Failure to Complete Phase II Cardiac Rehabilitation: Survey Registry in Rajaie Cardiovascular Medical and Research Center

    Directory of Open Access Journals (Sweden)

    Bahieh Moradi

    2011-12-01

    Full Text Available Background: A significant proportion of patients who begin CR (cardiac rehabilitation do not complete the program. Objectives: The purpose of this study was to determine the predicting factors that interfere with adherence and completion of an outpatient CR program. Patients and Methods: A cross-sectional survey was conducted with all 128 patients who entered the CR program at the Rajaie Cardiovascular Medical and Research Center in Tehran, IR Iran, from March 2009 to March 2010. The demographic variables included age, sex, education, employment status, insurance status, and return to work. These variables were compared in patients who completed and did not complete phase II CR. The reason for CR incompletion was asked in follow-up phone interviews. Results: The most frequent clinical diagnosis among the patients enrolled in the CR program was coronary artery disease. 83.6% of patients who participated had a CABG or PCI procedure during the last year. CR participation increased when cardiac revascularization procedures were performed during the first hospitalization. 88 of the 128 patients dropped out, yielding a dropout rate of 68.7%, which was significantly (P < 0.01 higher than the same study in other countries. Sex and age did not predict the completion rate. As education increased, cardiac rehabilitation utilization and completion increased. Unemployed patients were less likely than employed patients to complete the program. Conclusions: Our data indicate a low rate of CR completion, with lower rates among unemployed, uninsured, and less educated patients.

  4. 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

  5. Rehabilitering

    DEFF Research Database (Denmark)

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

    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...

  6. 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

  7. Long-Term Outcomes of Cardiac Rehabilitation in Diabetic and Non-diabetic Patients With Myocardial Infarction

    OpenAIRE

    Kim, Hyun Jun; Joo, Min Cheol; Noh, Se Eung; Kim, Ji Hee

    2015-01-01

    Objective To investigate the long-term outcomes of cardiac rehabilitation (CR) on exercise capacity in diabetic (DM) and non-diabetic (non-DM) patients with myocardial infarction (MI). Methods Of the MI patients who received hospital-based CR from February 2012 to January 2014, we retrospectively reviewed the medical records of the patients who continued follow-up through the outpatient clinic and community-based self-exercise after CR. A total of 37 patients (12 with DM and 25 without DM) we...

  8. 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

  9. 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...

  10. 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

    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...

  11. Searching for unpublished data for Cochrane reviews

    DEFF Research Database (Denmark)

    Schroll, Jeppe Bennekou; Bero, Lisa; Gøtzsche, Peter C

    2013-01-01

    To describe the experiences of authors of Cochrane reviews in searching for, getting access to, and using unpublished data.......To describe the experiences of authors of Cochrane reviews in searching for, getting access to, and using unpublished data....

  12. Long-term secondary prevention programs after cardiac rehabilitation for the reduction of future cardiovascular events: focus on regular physical activity.

    Science.gov (United States)

    Scrutinio, Domenico; Temporelli, Pier Luigi; Passantino, Andrea; Giannuzzi, Pantaleo

    2009-05-01

    Cardiac rehabilitation/secondary prevention programs are recognized as integral to the comprehensive care of patients with coronary heart disease, and as such are recommended in most contemporary clinical practice guidelines. The interventions are aimed at reducing disability, optimizing cardiovascular risk reduction by drug therapy and promoting healthy behavior. Healthy lifestyle habits must be recognized as capable of substantially reducing the risk for cardiovascular events in patients with coronary heart disease. This review highlights the recommended components of cardiac rehabilitation/secondary prevention programs, with special emphasis on regular physical activity. PMID:19450055

  13. 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.

  14. 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

  15. 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...

  16. Improved Exercise Tolerance and Quality of Life With Cardiac Rehabilitation of Older Patients After Myocardial Infarction: Results of a Randomized, Controlled Trial

    OpenAIRE

    Niccolo Marchionni; Francesco Fattirolli; Stefano Fumagalli; Neil Oldridge; Francesco Del Lungo; Linda Morosi; Costanza Burgisser; Giulio Masotti

    2003-01-01

    Background - Whether cardiac rehabilitation (CR) is effective in patients older than 75 years, who have been excluded from most trials, remains unclear. We enrolled patients 46 to 86 years old in a randomized trial and assessed the effects of 2 months of post-myocardial infarction (MI) CR on total work capacity (TWC, in kilograms per meter) and health-related quality of life (HRQL). Methods and Results - Of 773 screened patients, 270 without cardiac failure, dementia, disability, or contraind...

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

    OpenAIRE

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

    2015-01-01

    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 rehabi...

  18. 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.

  19. 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,…

  20. Effectiveness of inpatient and outpatient strategies in increasing referral and utilization of cardiac rehabilitation: a prospective, multi-site study

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-12-01

    Full Text Available Abstract Background Despite the evidence of benefit, cardiac rehabilitation (CR remains highly underutilized. The present study examined the effect of two inpatient and one outpatient strategy on CR utilization: allied healthcare provider completion of referral (a policy that had been endorsed and approved by the cardiac program leadership in advance; PRE-APPROVED; CR intake appointment booked before hospital discharge (PRE-BOOKED; and early outpatient education provided at the CR program shortly after inpatient discharge (EARLY ED. In this prospective observational study, 2,635 stable cardiac inpatients from 11 Ontario hospitals completed a sociodemographic survey, and clinical data were extracted from charts. One year later, participants were a mailed survey that assessed CR use. Participating inpatient units and CR programs to which patients were referred were coded to reflect whether each of the strategies was used (yes/no. The effect of each strategy on participants’ CR referral and enrollment was examined using generalized estimating equations. Results A total of 1,809 participants completed the post-test survey. Adjusted analyses revealed that the implementation of one of the inpatient strategies was significantly related to greater referral and enrollment (PRE-APPROVED: OR = 1.96, 95%CI = 1.26 to 3.05, and OR = 2.91, 95%CI = 2.20 to 3.85, respectively. EARLY ED also resulted in significantly greater enrollment (OR = 4.85, 95%CI = 2.96 to 7.95. Conclusions These readily-implementable strategies could significantly increase access to and enrollment in CR for the cardiac population. The impact of these strategies on wait times warrants exploration.

  1. Prevalence and characteristics of impaired glucose metabolism in patients referred to comprehensive cardiac rehabilitation: the DANSUK study

    DEFF Research Database (Denmark)

    Boas Soja, Anne Merete; Zwisler, Ann-Dorthe Olsen; Melchior, Thomas;

    2006-01-01

    BACKGROUND: Lifestyle and pharmacological interventions can delay the progression of impaired glucose tolerance (IGT) to type 2 diabetes (T2DM), and there is growing evidence that earlier detection of T2DM and intensified risk factor management may result in improved cardiovascular morbidity...... diagnosed with isolated IFG according to the World Health Organization definition. Using fasting plasma glucose alone, 19% of the patients with unrecognized T2DM and two-thirds of patients with IGT would be misclassified. Using IFG as a means to detect IGT showed a sensitivity of only 33% and a positive...... predictive value of 39%. CONCLUSION: More than 60% of the patients (123/201) referred to cardiac rehabilitation had impaired glucose metabolism and 18% of the screened patients (29/159) would be misclassified if an OGTT was omitted. IFG and IGT did not identify the same patients or the same cardiovascular...

  2. 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...

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

    Directory of Open Access Journals (Sweden)

    Borghi-Silva Audrey

    2005-01-01

    Full Text Available 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 received only the physiotherapy intervention (GPI, n = 16. Pulmonary function was evaluated by spirometry on the preoperative and on the fifth postoperative days; inspiratory muscle strength was measured by maximal inspiratory pressure on the same days. RESULTS: Spirometric variables were significantly reduced from the preoperative to the fifth postoperative day for the GPI, while the GEP had a significant reduction only for vital capacity (P < .05. When the treatments were compared, smaller values were observed in the GPI for peak flow on the fifth postoperative day. Significant reductions of maximal inspiratory pressure from preoperative to the first postoperative day were found in both groups. However, the reduction in maximal inspiratory pressure from the preoperative to the fifth postoperative day was significant only in the GPI (P < .05. CONCLUSIONS: These data suggest that cardiac surgery produces a reduction in inspiratory muscle strength, pulmonary volume, and flow. The association of positive expiratory pressure with physiotherapy intervention was more efficient in minimizing these changes, in comparison to the physiotherapy intervention alone. However, in both groups, the pulmonary volumes were not completely reestablished by the fifth postoperative day, and it was necessary to continue the treatment after hospital convalescence.

  4. Acute Physiological Responses to Short- and Long-Stage High-Intensity Interval Exercise in Cardiac Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gerhard Tschakert, Julia M. Kroepfl, Alexander Mueller, Hanns Harpf, Leonhard Harpf, Heimo Traninger, Sandra Wallner-Liebmann, Tatjana Stojakovic, Hubert Scharnagl, Andreas Meinitzer, Patriz Pichlhoefer, Peter Hofmann

    2016-03-01

    Full Text Available Despite described benefits of aerobic high-intensity interval exercise (HIIE, the acute responses during different HIIE modes and associated health risks have only been sparsely discovered in heart disease patients. Therefore, the aim of this study was to investigate the acute responses for physiological parameters, cardiovascular and inflammatory biomarkers, and catecholamines yielded by two different aerobic HIIE protocols compared to continuous exercise (CE in phase III cardiac rehabilitation. Eight cardiac patients (7 with coronary heart disease, 1 with myocarditis; 7 males, 1 female; age: 63.0 ± 9.4 years; height: 1.74 ± 0.05 m; weight: 83.6 ± 8.7 kg, all but one treated with ß-blocking agents, performed a maximal symptom-limited incremental exercise test (IET and three different exercise tests matched for mean load (Pmean and total duration: 1 short HIIE with a peak workload duration (tpeak of 20 s and a peak workload (Ppeak equal to the maximum power output (Pmax from IET; 2 long HIIE with a tpeak of 4 min, Ppeak was corresponding to the power output at 85 % of maximal heart rate (HRmax from IET; 3 CE with a target workload equal to Pmean of both HIIE modes. Acute metabolic and peak cardiorespiratory responses were significantly higher during long HIIE compared to short HIIE and CE (p 0.05. All health-related variables remained in a normal range in any test except NT-proBNP, which was already elevated at baseline. Despite a high Ppeak particularly in short HIIE, both HIIE modes were as safe and as well tolerated as moderate CE in cardiac patients by using our methodological approach.

  5. 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

  6. Asserted and neglected issues linking evidence-based and Chinese medicines for cardiac rehabilitation

    OpenAIRE

    Ferreira, Arthur Sá; de Moura, Nathalia Gomes Ribeiro

    2014-01-01

    High blood pressure is among the most prevalent chronic disease in adults that impacts on the quality of life of patients, which are often subjected to physical rehabilitation. Chinese medicine intervention in patients with hypertension presents promising albeit inconclusive results, mostly due to methodological issues. This paper discusses asserted and neglected issues linking evidence-based and Chinese medicines as related to systemic arterial hypertension, as well as their impact on the ph...

  7. Cochrane and its prospects in Bosnia and Herzegovina: Relying on Cochrane Croatia

    Directory of Open Access Journals (Sweden)

    Mersiha Mahmić-Kaknjo

    2015-05-01

    Full Text Available In this article we describe Cochrane and its products: Cochrane systematic reviews (CSRs and other Cochrane evidence. Cochrane is a unique, international, non-profit organisation that offers health care providers, health care consumers and other decision makers unbiased and highly reliable information on health, which is pivotal for conscientious and responsible decision making in overall healthcare. Cochrane offers the highest ranked evidence in Evidence Based Medicine (EBM – systematic reviews. Currently, CSRs are freely available in BH, and therefore, they ought to be widely used, and understood. We will present the new Cochrane Strategy to 2020, which was the main topic of the 6th Croatian Cochrane Symposium (CroCoS, as well as explore prospects for spreading Cochrane activities to Bosnia and Herzegovina (BH, through collaboration with Cochrane Croatia. BH has no officially organized Cochrane activity, as yet. We hope that this article will raise awareness about Cochrane in BH, help promote its activities, and deepen the existing collaboration with Cochrane Croatia. There are already some changes being introduced concerning Cochrane – at least, in one half, the Federation of BH (FBH. Two documents symbolising official recognition of policy changes towards Cochrane have recently been published in the Official Gazette of FBH. Conclusion. Since founding a BH Cochrane Branch would be costly and difficult to achieve in a complicated environment, such as the one we have, BH could use the good will, experience, knowledge, and translated educational, training and web materials of Cochrane Croatia, particularly given the language similarities, to promote evidence based medicine in BH.

  8. Saskatchewan Residents’ Use of The Cochrane Library

    Directory of Open Access Journals (Sweden)

    Dorothy Anne Forbes

    2007-09-01

    Full Text Available The Cochrane Library is a source of reliable information on the effects of healthcare interventions for health care practitioners and consumers. In July 2004, Saskatchewan became the first province in Canada to provide all residents with access to The Cochrane Library. The purpose of this study was to evaluate the use of The Cochrane Library. Training sessions were offered to promote the use of The Cochrane Library. Attendees were informed of the evaluation study and invited to participate. Those who consented to participate were telephoned and audio-taped interviews were conducted at three (n=94, six (n=71, nine (n=79, and 12 months (n=72 following the sessions. Usage of The Cochrane Library was also tracked using data available from Wiley-Blackwell. Most participants were librarians (n=31.5%, between 40 to 65 years of age (71.6% and female (92.4%. Data from Wiley-Blackwell revealed that from October 2004 to September 2007, the component of The Cochrane Library most frequently accessed was The Cochrane Database of Systematic Reviews (abstracts=26,016; full texts =15,934. Telephone interviews with participants revealed that the majority (65.2% used The Cochrane Library at the three month interview, however this proportion fell to 27.4% at the twelve month interview even though most (83.6%-88.2% reported that The Cochrane Library was somewhat to very helpful.Most respondents claimed to have learned something from The Cochrane Library; others reported that the knowledge gained helped in their decision-making or confirmed their beliefs. Respondents accessed The Cochrane Library in response to patron requests for information on a variety of health care topics. Information was used to support changes in health care practice and policy and for the preparation of educational papers and presentations. The reported reasons for not using The Cochrane Library were lack of time, limited access to an internet ready computer in the work setting, reliance on

  9. Systematic review of the use of behaviour change techniques (BCTs) in home-based cardiac rehabilitation programmes for patients with cardiovascular disease—protocol

    OpenAIRE

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

    2015-01-01

    Background Cardiovascular diseases (CVDs), including myocardial infarction, heart failure, peripheral arterial disease and strokes, are highly prevalent conditions and are associated with high morbidity and mortality. Cardiac rehabilitation (CR) is an effective form of secondary prevention for CVD but there is a lack of information regarding which specific behaviour change techniques (BCTs) are included in programmes that are associated with improvements in cardiovascular risk factors. This s...

  10. 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...

  11. 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...

  12. 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.

  13. 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...

  14. 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.

  15. 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...

  16. 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

  17. 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.

  18. [Atherosclerosis of the lower extremities as a linked comorbidity in Patients Admitted for cardiac rehabilitation (THINKPAD): rationale, design, and study group].

    Science.gov (United States)

    Ambrosetti, Marco; Diaco, Tommaso; Febo, Oreste; Calisi, Pasqualina; Favretto, Giuseppe; Carlon, Roberto; Temporelli, Pier Luigi

    2012-03-01

    Peripheral arterial disease (PAD) is a frequent comorbidity among patients entering cardiac rehabilitation (CR) programmes and an important source of disability and impaired prognosis. The prevalence of PAD across the wide range of conditions for CR is poorly understood, as far as its impact on drug optimization and intervention delivered. The "ATHerosclerosis of the lower extremities as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) study was carried out by the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) in order to explore PAD both as a comorbidity and a primary indication at the entry of CR. The study was a retrospective case series. In the study period (from May 1, 2012 to June 30, 2012), data on consecutive patients discharged from 17 CR units in Northern Italy were collected. Web-based electronic case report forms (e-CRF), accessible in a dedicated section of the IACPR website (www.iacpr.it), were used for data entry, and data were transferred via web to a central database. The data collection instrument was designed with a multiple choice format, with jump menus or select boxes and obligatory items. A sample size of 1,300 subjects is expected, with first data available by the end of 2012. PMID:22928398

  19. 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.

  20. Update to the study protocol, including statistical analysis plan for a randomized clinical trial comparing comprehensive cardiac rehabilitation after heart valve surgery with control

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine Laerum; Berg, Selina Kikkenborg; Hansen, Tina Birgitte;

    2015-01-01

    cost-benefit will be assessed. A mixed-method design will be used to evaluate qualitative and quantitative findings, encompassing a survey-based study before the trial and a qualitative pre- and post-intervention study. CONCLUSION: This randomized clinical trial will contribute with evidence of whether...... cardiac rehabilitation should be provided after heart valve surgery. The study is approved by the local regional Research Ethics Committee (H-1-2011-157), and the Danish Data Protection Agency (j.nr. 2007-58-0015). TRIAL REGISTRATION: Trial registered 16 March 2012; ClinicalTrials.gov ( NCT01558765 )....

  1. 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...

  2. Cardiac rehabilitation referral and enrolment across an academic health sciences centre with eReferral and peer navigation: a randomised controlled pilot trial

    Science.gov (United States)

    Ali-Faisal, Sobia F; Benz Scott, Lisa; Johnston, Lauren; Grace, Sherry L

    2016-01-01

    Objectives To describe (1) cardiac rehabilitation (CR) referral across cardiac units in a tertiary centre with eReferral; (2) characteristics associated with CR referral and enrolment and (3) the effects of peer navigation (PN) on referral and enrolment. This pilot was a 2 parallel-arm, randomised, single-blind trial with allocation concealment. Setting 3 cardiac units (ie, interventional, general cardiology, and cardiac surgery) in 1 of 2 hospitals of a tertiary centre. Participants CR-eligible adult cardiac inpatients were randomised to PN or usual care. 94 (54.7%) patients consented, of which 46 (48.9%) were randomised to PN. Outcomes were ascertained in 76 (80.9%) participants. Intervention The PN (1) visited participant at the bedside, (2) mailed a card to participant's home reminding about CR and (3) called participant 2 weeks postdischarge to discuss CR barriers. Outcome measures The primary outcome of enrolment was defined as participant attendance at a scheduled CR intake appointment (yes/no). The secondary outcome was referral. Blinded outcome assessment was conducted 12 weeks postdischarge, via CR chart extraction. Results Those who received care on the cardiac surgery unit (77.9%) were more likely to be referred than those treated on the general cardiology (61.1%) or interventional unit (33.3%; p=0.04). Patients who had cardiac surgery, hypertension and hyperlipidaemia were significantly more likely, and those with congenital heart disease, cancer and a previous cardiac diagnosis were less likely to be referred. Participants referred to a site closer to home (76.2% of those referred) were more likely to enrol than those not (23.7%, p<0.05). PN had no effect on referral (77.6%, p=0.45) or enrolment (46.0%, p=0.24). Conclusions There is wide variability in CR referral, even within academic centres, and despite eReferral. Referral was quite high, and thus, PN did not improve CR utilisation. Results support triaging patients to the CR programme closest

  3. 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

  4. 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.

  5. Follow-up of cardiac parameters by isotope diagnostic methods in patients after in-patient post-infarction rehabilitation

    International Nuclear Information System (INIS)

    The size and the extent of the myocardial infarction was determined by 74 MBq 201Tl imaging at rest using 201TlCl intravenous injection. ECG-gated equilibrium radionuclide studies were performed in each case on the first day of rehabilitation, then 3 and 9 weeks after the first examination, finally 6 months after the patient finished the three-week in-patient rehabilitation. No significant changes were observed in the average value of the endodiastolic volume of the left ventricle and in the number of ventricular segments with wall motion abnormality, though the physical performance of the patients increased. (author) 33 refs.; 6 tabs

  6. 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

  7. Cochrane i Norge - Hvordan formidler vi resultatene fra Cochrane-oversikter?

    Directory of Open Access Journals (Sweden)

    Claire Glenton

    2013-11-01

    Full Text Available Cochrane-systematiske oversikter oppleves ofte som lite tilgjengelige. En av hovedaktivitetene til det norske Cochrane-miljøet er å utvikle måter å presentere resultatene fra Cochrane-oversikter på for at de lettere tas i bruk. Vi beskriver her fire hovedprinsipper for dette arbeidet, og gir eksempler på dokumentformater vi har vært med på å utvikle. De overordnete prinsippene er: 1 Informasjonen bør være forståelig for personer uten ekspertkunnskap om forskningsmetodikk. Vi har erfart at når det gjelder forståelsen av resultater fra systematiske oversikter går det største skillet mellom forskere og ikke-forskere og i mindre grad mellom ulike grupper som helsepersonell, pasienter og byråkrater. 2 Informasjonen bør presenteres på en mest mulig nøytral måte. 3 Informasjonen bør være brukertilpasset. Det innebærer at vi innhenter tilbakemeldinger fra sluttbrukere i utviklingsarbeidet og gjør nødvendige tilpasninger i flere omganger. 4 Informasjonsstrukturen bør følge ”1:3:25-prinsippet”. Her presenteres informasjonen både summarisk (1 side, kort oppsummert (3 sider, og mer utdypende (25 sider. I artikkelen beskriver vi flere presentasjonsformater vi har utviklet, blant annet ”Summary of Findings” der resultatene av Cochrane-oversikter presenteres i lettfattelige tabeller; ”plain language summaries”, som er tekstbaserte oppsummeringer rettet mot en bred lesergruppe; ”SUPPORT summaries” rettet mot byråkrater og ”policymakers”; og ”DECIDE Frameworks” der resultatene presenteres sammen med annen informasjon som er relevant i en beslutningsprosess.Glenton C, Rosenbaum S. Cochrane in Norway – How do we disseminate findings from Cochrane reviews? Nor J Epidemiol 2013; 23 (2: 215-219.ENGLISH SUMMARYCochrane systematic reviews are often perceived as inaccessible. One of the main activities of the Norwegian branch of the Cochrane Collaboration is to develop ways to present the results of Cochrane

  8. 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...

  9. A Cochran-Armitage-type and a score-free global test for multivariate ordinal data.

    Science.gov (United States)

    Jelizarow, Monika; Mansmann, Ulrich; Goeman, Jelle J

    2016-07-20

    We propose a Cochran-Armitage-type and a score-free global test that can be used to assess the presence of an association between a set of ordinally scaled covariates and an outcome variable within the range of generalized linear models. Both tests are developed within the framework of the well-established 'global test' methodology and as such are feasible in high-dimensional data situations under any correlation and enable adjustment for covariates. The Cochran-Armitage-type test, for which an intimate connection with the traditional score-based Cochran-Armitage test is shown, rests upon explicit assumptions on the distances between the covariates' ordered categories. The score-free test, in contrast, parametrizes these distances and thus keeps them flexible, rendering it ideally suited for covariates measured on an ordinal scale. As confirmed by means of simulations, the Cochran-Armitage-type test focuses its power on set-outcome relationships where the distances between the covariates' categories are equal or close to those assumed, whereas the score-free test spreads its power over a wide range of possible set-outcome relationships, putting more emphasis on monotonic than on non-monotonic ones. Based on the tests' power properties, it is discussed when to favour one or the other, and the practical merits of both of them are illustrated by an application in the field of rehabilitation medicine. Our proposed tests are implemented in the R package globaltest. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26924287

  10. Specificity of testing in a cardiac rehabilitation setting resulting in a patient's return to high-intensity outdoor activity following aortic dissection repair.

    Science.gov (United States)

    Bartee, Sparky; Shrestha, Sanjay; Ramos, Beatriz; Bilbrey, Tim; Carbone, Pasquale; Schussler, Jeffrey M; Deutsch, Rick; Adams, Jenny

    2016-04-01

    A 66-year-old man who had undergone aortic dissection repair a year earlier sought to assess the feasibility of returning to the high-intensity outdoor activities he had long enjoyed. In response to his inquiry, the cardiac rehabilitation staff at Baylor Hamilton Heart and Vascular Hospital designed a comprehensive testing plan that simulated the specific movements and anticipated cardiac requirements associated with his goal activities. The activities included 1) lifting and manipulating a 50-pound suitcase, 2) hiking to the top of Half Dome in California's Yosemite National Park, and 3) scuba diving. To illustrate our approach, we describe some of the tests that were performed and report the results. After analyzing the detailed physiological data collected during testing, we provided the patient with an exercise prescription and specific guidelines that he could use to gauge his level of physical exertion during his outdoor adventures. Within approximately 6 months of testing, he successfully performed the goal activities without adverse symptoms. PMID:27034550

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

    OpenAIRE

    Bestehorn, Kurt

    2011-01-01

    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, Rüd...

  12. 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...

  13. Saskatchewan Residents’ Use of The Cochrane Library

    Directory of Open Access Journals (Sweden)

    Dorothy Anne Forbes

    2007-11-01

    Full Text Available There is strong evidence of failure to translate research findings into the health care decision-making process of consumers, practitioners and policy makers (Grimshaw, 2007. Recognizing that The Cochrane Database of Systematic Reviews contained in The Cochrane Library (the Library are the “gold standard” of systematic reviews, Saskatchewan’s Health Quality Council provided funding for a provincial license and an evaluation study. In July 2004, Saskatchewan became the first province in Canada to provide all residents with access to the Library. The primary aim of the study was to enhance and evaluate the use of the Library over three years. Since September 2004, over 46 training sessions have been conducted on searching the Library online databases. Attendees at the workshops were informed of the evaluation study and invited to participate. Those who consented to participate were telephoned following the workshops and audio-taped interviews were conducted. Usage of the Library was also tracked using data available from Wiley InterScience. Three month (n=94, six month (n=71, nine month (n=79, and 12 month (n=72 telephone interviews were conducted. Most participants were librarians (n=31.5%, followed by nurses (16.3%, therapists (7.6%, library support staff (5.4%, pharmacists (4.3%, physicians (3.3%, and others (30.5. Most were between 40 to 65 years of age (71.6% and female (92.4%. Most respondents had accessed the Library at the three-month (65.2% and six-month (64.2% follow-up interviews. However, this percent fell to 45.2% at the nine-month and 27.4% at the twelve-month interview. MeSH searches were more frequent than standard keyword searches and HTML full text retrievals were more common than PDF versions. It is assumed that HTML versions were scanned for particular information whereas PDF versions were selected when the person wished to save and read the whole review. Librarians, practitioners and consumers are more likely to be

  14. EFFECTIVENESS OF LOW INTENSITY EXERCISES ON SIX MINUTE WALK DISTANCE AND HAEMODYNAMIC VARIABLES IN CABG AND VALVE REPLACEMENT PATIENTS DURING PHASE 1 CARDIAC REHABILITATION IN A TERTIARY CARE SETUP: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Renu B.Pattanshetty

    2014-10-01

    Full Text Available BACKGROUND AND OBJECTIVES: Cardiovascular diseases are common and devastating health problem in India. The most common is the coronary artery diseases and heart valve diseases. Cardiac rehabilitation programme is an essential, useful and safe part of the care for patients with cardiovascular disease. The present study was under taken to compare the effectiveness of low level intensity exercises on haemodynamic variables and functional capacity in subjects enrolled in phase 1 cardiac rehabilitation. MATERIAL AND METHODS: Thirty (30 adult subjects both male and female comprising of CABG (15 subjects and valve replacement (15 subjects were included. Low intensity exercises were given to both groups which included range of motion exercises, stretching and minimal strength training. Haemodynamic variables and six minute walk distance were assessed pre and post invention in all the subjects. RESULTS: The study demonstrated BMI to be lower valve replacement group than CABG group (p = 0.008. Ejection fraction(% were higher in valve replacement subjects compared to CABG subjects (p = 0.027. Significant mean differences were noted in the heart rate between both the groups. (p = 0.045. There was a significant improvement in the six minute walk distance (p = 0.048 in both groups. CONCLUSION: Low intensity exercises demonstrated improvements in heart rate and functional capacity in subjects with CABG and valve replacement in phase I cardiac rehabilitation.

  15. 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)

  16. “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.

  17. 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

  18. Unapređenje medicinske prakse u Hrvatskoj pomoću Cochrane kolaboracije

    OpenAIRE

    Puljak, Livia; Rako, Dalibora

    2009-01-01

    Hrvatski ogranak Talijanskog Cochrane Centra je osnovan 2008. godine s ciljem promicanja medicine utemeljene na dokazima, Cochrane kolaboracije i Cochrane knjižnice (engl. The Cochrane Library) u Hrvatskoj te da potakne hrvatske zdravstvene djelatnike da postanu autori Cochrane sustavnih preglednih članaka. Od svog osnutka 1993. godine, Cochrane kolaboracija je posvećena pripremanju, održavanju i promicanju sustavnih preglednih članaka u korist kliničke medicinske prakse. Cochrane knjižnica j...

  19. Cochrane methods - twenty years experience in developing systematic review methods

    OpenAIRE

    Chandler, Jackie; Hopewell, Sally

    2013-01-01

    : This year, The Cochrane Collaboration reached its 20th anniversary. It has played a pivotal role in the scientific development of systematic reviewing and in the development of review methods to synthesize research evidence, primarily from randomized trials, to answer questions about the effects of healthcare interventions. We introduce a series of articles, which form this special issue describing the development of systematic review methods within The Cochrane Collaboration. We also discu...

  20. 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

  1. 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

  2. Paralysis: Rehabilitation

    Science.gov (United States)

    ... Forum About Us Donate Living with Paralysis > Rehabilitation Rehabilitation Rehabilitation and exercise are key to enhancing your health and quality of life. Find a rehabilitation center near you and become familiar with different ...

  3. Papel del especialista en ejercicio físico en el programa de rehabilitación cardíaca Role played by the physical training specialist in the Program of Cardiac Rehabilitation.

    Directory of Open Access Journals (Sweden)

    Reinol Hernández González

    2000-01-01

    Full Text Available Se mencionan algunos de los efectos positivos del ejercicio físico en pacientes cardiópatas, como son el aumento de la capacidad funcional en mujeres y en pacientes clasificados de alto riesgo, la mejoría de la frecuencia cardíaca y la presión arterial, etc. El artículo tuvo como objetivo explicar el funcionamiento de la sección de entrenamiento físico dentro de los programas de rehabilitación cardíaca. Se explicó el funcionamiento de la sección de ejercicio físico del Centro de Rehabilitación del Instituto de Cardiología de La Habana, así como el papel preponderante del especialista en ejercicio físico dentro de la rehabilitación cardíaca. Como conclusión, se determinó que en los programas de rehabilitación cardíaca, siempre existiera el Especialista en ejercicio físico, con los conocimientos necesarios que garanticen la salud y la seguridad del paciente. Some of the positive effects of physical exercise on patients suffering from heart disease, such as the increase of functional capacity in women and patients classified as high risk, the improvement of heart rate and arterial pressure, etc., are mentioned here. The objective of this paper was to explain the functioning of the section of physical training within the cardiac rehablitation programs. The functioning of this section at the Rehabilitation Center of the Cardiology Institute of Havana, as well as the leading role played by the physical training specialist in the cardiac rehabilitation were explained. To conclude, it was determined that in the cardiac rehabilitation programs there will always be a physical training specialist with the necessary knowledge to guarantee patient?s health and safety.

  4. Rehabilitation of Syndesmotic (High) Ankle Sprains

    OpenAIRE

    Williams, Glenn N; Allen, Eric J.

    2010-01-01

    Context: High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program. Evidence Acquisition: All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryothe...

  5. Discussion around the Steinberg-Cochran-Guinan model

    International Nuclear Information System (INIS)

    The Steinberg-Cochran-Guinan model (material dynamic comportment model) is presented. Theoretical and experimental results (especially on beryllium) give a modification of the S.C.G. model, taking into account influence of high deformation speed on elastic limit and on the strain hardening function. (A.B.). 8 refs., 2 tabs

  6. Parenting Training for Intellectually Disabled Parents: A Cochrane Systematic Review

    Science.gov (United States)

    Coren, Esther; Thomae, Manuela; Hutchfield, Jemeela

    2011-01-01

    Objectives: This article presents a Cochrane/Campbell systematic review of the evidence on the effect of parent training to support the parenting of parents with intellectual disabilities. Method: Randomized controlled trials (RCTs) comparing parent training interventions for parents with intellectual disability with usual care or with a control…

  7. Is management of acute traumatic brain injury effective?A literature review of published Cochrane Systematic Reviews

    Institute of Scientific and Technical Information of China (English)

    LEI Jin; GAO Guo-yi; JIANG Ji-yao

    2012-01-01

    Objective:To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury(TBI)mentioned in Cochrane Systematic Reviews published in the Cochrane Database of Systematic Reviews(CDSR).Methods:An exhausted literature search for all published Cochrane Systematic Reviews discussing therapeutic rather than prevention or rehabilitative interventions of TBI was conducted.We retrieved such databases as CDSR and Cochrane Injury Group,excluded the duplications,and eventually obtained 20 results,which stand for critical appraisal for as many as 20 different measures for TBI patients.The important data of each systematic review,including total population,intervention,outcome,etc,were collected and presented in a designed table.Besides,we also tried to find out the possible weakness of these clinical trials included in each review.Results:Analysis of these reviews yielded meanfuling observations:(1)The effectiveness of most ordinary treatments in TBI is inconclusive except that corticosteroids are likely to be ineffective or harmful,and tranexamic acid,nimodipine and progesterone show a promising effect in bleeding trauma,traumatic subarachnoid hemorrhage,TBI or severe TBI.(2)A majority of the systematic reviews include a small number of clinical trials and the modest numbers of patients,largely due to the uncertainty of the effectiveness.(3)The quality of most trials reported in the systematic reviews is more or less questionable.(4)In addition,lots of other complex factors together may lead to the inconclusive results demonstrated in the Cochrane Systematic Reviews.Conclusions:For clinical physicians,to translate these conclusions into practice with caution is essential.Basic medication and nursing care deserve additional attention as well and can be beneficial.For researchers,high quality trials with perfect design and comprehensive consideration of various factors are urgently required.

  8. [Analysis of the Cochrane Review: Interventions for Improving Upper Limb Function after Stroke. Cochrane Database Syst Rev. 2014,11:CD010820].

    Science.gov (United States)

    Sousa Nanji, Liliana; Torres Cardoso, André; Costa, João; Vaz-Carneiro, António

    2015-01-01

    Impairment of the upper limbs is quite frequent after stroke, making rehabilitation an essential step towards clinical recovery and patient empowerment. This review aimed to synthetize existing evidence regarding interventions for upper limb function improvement after Stroke and to assess which would bring some benefit. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effects and PROSPERO databases were searched until June 2013 and 40 reviews have been included, covering 503 studies, 18 078 participants and 18 interventions, as well as different doses and settings of interventions. The main results were: 1- Information currently available is insufficient to assess effectiveness of each intervention and to enable comparison of interventions; 2- Transcranial direct current stimulation brings no benefit for outcomes of activities of daily living; 3- Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy, mental practice, mirror therapy, interventions for sensory impairment, virtual reality and repetitive task practice; 4- Unilateral arm training may be more effective than bilateral arm training; 5- Moderate-quality evidence showed a beneficial effect of robotics on measures of impairment and ADLs; 6- There is no evidence of benefit or harm for technics such as repetitive transcranial magnetic stimulation, music therapy, pharmacological interventions, electrical stimulation and other therapies. Currently available evidence is insufficient and of low quality, not supporting clear clinical decisions. High-quality studies are still needed. PMID:26667856

  9. Oral health research priorities on the Cochrane Library (Poster ID P2-023)

    OpenAIRE

    Clarkson JE, Worthington HV, Weldon JC

    2015-01-01

    Background: It was necessary for the Cochrane Oral Health Group (Cochrane OHG) to identify the most clinically important titles to maintain on the Cochrane Library, due to limited capacity and funding restraints. This will enable us also to fulfill the first two goals of the Cochrane Strategy to 2020 by producing high quality, useful, accessible evidence. Objectives: To identify a core portfolio of priority reviews for maintenance by Cochrane OHG. Methods: We categorised 234 registered titles...

  10. Assessing bias in osteoarthritis trials included in Cochrane reviews

    DEFF Research Database (Denmark)

    Hansen, Julie B; Juhl, Carsten Bogh; Boutron, Isabelle;

    2014-01-01

    INTRODUCTION: The validity of systematic reviews and meta-analysis depends on methodological quality and unbiased dissemination of trials. Our objective is to evaluate the association of estimates of treatment effects with different bias-related study characteristics in meta-analyses of intervent...... quality in OA Cochrane reviews and explore the effect estimates behind possible bias. Since our study does not collect primary data, no formal ethical assessment and informed consent are required. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42013006924)......., placebo or no intervention control will be considered eligible. Bias will be assessed with the risk of bias tool, used according to the Cochrane Collaboration's recommendations. Furthermore, center status, trial size and funding will be assessed. The primary outcome (pain) will be abstracted from the...

  11. 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

  12. Conservative treatment of acute knee osteoarthritis:A review of the Cochrane Library

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Objective: To analyze conservative treatment of knee pain in patients with osteoarthritis. Methods: A Cochrane Library search related to knee osteoartritis was analyzed. Five main strategies for the conservative treatment of knee osteoartritis have been reviewed:medical treatment, physical medicine and rehabilitation, intra-articular injections, and acupuncture. Results: Regarding medical treatment, non-steroidal antiinflammatory drugs (ibuprofen, diclofenac, arthrotec, celecoxib, naproxen, rofecoxib) were superior to acetaminophen. The benefits of tramadol or tramadol/paracetamol, non-tramadol opioids, glucosamine, diacerine, and doxycicline were small. Herbal topical treatment with preparations from medical plants seemed to improve pain. Concerning oral herbal therapy, Piascidine ad extracts of Boswellia serrata had a short-term effect on osteoarthritis symptoms. Regarding physical medicine and rehabilitation, there was limited evidence that a brace had additional beneficial effect compared with medical treatment alone. Land-based therapeutic exercise and aquatic exercise had at least a small short term benefit. Thera-peutic ultrasound may be beneficial (low quality of evidence). The effectiveness of transcutaneous electrostimulation for pain relief has not been demonstrated. Electrical stimulation therapy may provide significant improvements. Regarding intra-articular in-jections, viscosupplementation seemed to be an effective treatment for pain relief in the short-term (months). The short-term (weeks) benefit of intra-articular corticosteroids in the management of knee osteoarthritis has been demonstrated. The benefits of acupuncture were small. Self-management education programs resulted in no or small benefits on pain relief. Conclusions: Five main strategies for the conservative treatment of knee osteoarthritis exist that must be used before indicating surgical treatment:medical treatment, physical medicine and rehabilitation, intra-articular injections

  13. 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

  14. 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

  15. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther;

    2012-01-01

    people with hip fracture, homeless people with mental illness, adults with multiple sclerosis, stroke, aquired brain injury, chronic arthropathy, chronic pain, low back pain, and fibromyalgia. Whereas evidence was not found for adults with amyetrophic lateral schlerosis, and neck and shoulder pain...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care for......Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...

  16. 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. 

  17. 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

  18. Pulmonary Rehabilitation

    Science.gov (United States)

    ... programs are certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. These programs can be found on the AACVPR ... at 1-800-586-4872. American Association of Cardiovascular and Pulmonary Rehabilitation ... ...

  19. Stroke Rehabilitation

    Science.gov (United States)

    ... relearn skills they lose because of the damage. Rehabilitation can help them relearn those skills. Stroke can ... Problems with thinking and memory Emotional disturbances Stroke rehabilitation involves many kinds of health professionals. The goal ...

  20. 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 ...

  1. Cardiac complications of radiation therapy to the chest organs in cancer patients: the problems of early diagnosis, follow up and rehabilitation. A case discussion

    International Nuclear Information System (INIS)

    The original findings shown the character and range of complications in the cardiovascular system at radiation therapy both using a gamma-therapy unit and a linear accelerator. The questions of development of standards of diagnosis and treatment of cardiac complications of radiation therapy are discussed. A case is described

  2. Stress Management Training May Help Cardiac Rehab Patients

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_157876.html Stress Management Training May Help Cardiac Rehab Patients When added ... March 21, 2016 (HealthDay News) -- The addition of stress management training can make cardiac rehabilitation programs more effective, ...

  3. Exercise Rehabilitation in Pediatric Cardiomyopathy

    OpenAIRE

    Somarriba, Gabriel; Extein, Jason; Miller, Tracie L.

    2008-01-01

    Children with cardiomyopathy carry significant risk of morbidity and mortality. New research and technology have brought about significant advancements to the diagnosis and clinical management of children with cardiomyopathy. However, currently heart transplantation remains the standard of care for children with symptomatic and progressive cardiomyopathy. Cardiovascular rehabilitation programs have yielded success in improving cardiac function, overall physical activity, and quality of life i...

  4. Change in Profile of Entrants in a Brazilian Large Cardiovascular Rehabilitation Service

    OpenAIRE

    Pietro Felice Tomazini Nesello; Guilherme Foletto; Eduardo Pflug Comparsi; Olga Sergueevna Tairova

    2015-01-01

    BACKGROUND: There are references regarding physical activity and cardiovascular disease since the nineteenth century. New evidences support that cardiac rehabilitation is closely related to therapeutic success after major coronary events. Although the benefits of cardiac rehabilitation programs are well established, referencing and enrolment in such services remain low. AIM: The aim of this paper is to describe the profile changes throughout the years in a large cardiac rehabilitation ser...

  5. 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

  6. Coronary Rehabilitation

    OpenAIRE

    Dworkind, Michael

    1986-01-01

    This paper describes a team approach to coronary rehabilitation in a tertiary care hospital and the unique role of the family physician in a shared, multi-disciplinary service for in- and out-patients. Primary care physicians facilitate and supplement the work of the coronary-unit team in establishing an optimal rehabilitative program for MI patients and their families.

  7. [Analysis of the Cochrane Review: Antihistamines for the Common Cold. Cochrane Database Syst Rev. 2015;11:CD009345].

    Science.gov (United States)

    Sterrantino, Carmel; Duarte, Gonçalo; Costa, João; Vaz-Carneiro, António

    2016-03-01

    The common cold is an acute, self-limiting inflammation of the mucosa of the upper airways, which may involve one or all the sinuses, nasopharynx, oropharynx and larynx. It is common to have at least one episode per year. Common cold symptoms, which may include sore throat, sneezing, nasal congestion, runny nose, headache, malaise and mild fever usually disappear within a few days without treatment. The causative agent of most colds is rhinovirus. Although not associated with mortality, common cold is associated with significant morbidity. There is no vaccine or cure for common cold and, therefore, their treatment is centered on relieving the symptoms. This Cochrane review aimed to synthesize the existing evidence about the clinical benefit of antihistamines, used as monotherapy, compared with placebo or no treatment in children and adult patients with common cold. A total of 18 randomized clinical trials with 4342 participants were included. Main results were: 1) Antihistamines have a small (days one and two) beneficial effect in the short term on the severity of overall symptoms in adult patients, although this effect is not present in the medium to long term; 2) antihistamines were not associated with a clinically significant beneficial effect on the individual symptoms (nasal congestion, rhinorrhea, and sneezing); 3) Antihistamines are not associated with an increased risk of adverse effects; 4) No conclusion can be made about the effectiveness of antihistamines in pediatric populations. Our interpretation of the results is that the available evidence is insufficient to support the prescription or buying OTC antihistamines to relieve the symptoms of common cold without allergic component. PMID:27285091

  8. 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....

  9. 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....

  10. Updated method guidelines for cochrane musculoskeletal group systematic reviews and metaanalyses

    DEFF Research Database (Denmark)

    Ghogomu, Elizabeth A T; Maxwell, Lara J; Buchbinder, Rachelle;

    2014-01-01

    The Cochrane Musculoskeletal Group (CMSG), one of 53 groups of the not-for-profit, international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. It is important that authors conducting CMSG reviews and the readers of our...

  11. Agreement between reported use of interventions for liver diseases and research evidence in Cochrane systematic reviews

    DEFF Research Database (Denmark)

    Kürstein, Pia; Gluud, Lise L; Willemann, Marlene; Olsen, Kim R; Kjellberg, Jakob; Sogaard, Jes; Gluud, Christian

    2005-01-01

    This study evaluates the agreement between reported use of interventions for patients with liver diseases and research evidence in Cochrane systematic reviews.......This study evaluates the agreement between reported use of interventions for patients with liver diseases and research evidence in Cochrane systematic reviews....

  12. Stroke Rehabilitation

    Science.gov (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lose because of ... damage. Rehabilitation can help them relearn those skills. Stroke can cause five types of disabilities: Paralysis or ...

  13. VESTIBULAR REHABILITATION

    Directory of Open Access Journals (Sweden)

    Maksim Valer'evich Zamergrad

    2009-06-01

    Full Text Available Vestibular disorders are a frequent abnormality that physicians of various specialties have to encounter. Vestibular and equilibrium disorders are particularly common in elderly patients. In this case they are frequently a cause of falls and various injuries. Vestibular rehabilitation is the most important component of treatment for vestibular and equilibrium disorders. The paper considers the basic mechanisms of vestibular compensation, discusses vestibular rehabilitation procedures by doing routine exercises and by using various biofeedback crunches. In particular, it describes the principle of operation of a posturography platform, a SwayStar system for the diagnosis and therapy of vestibular disorders, and a Brainport device for vestibular rehabilitation. The current methods for drug stimulation of vestibular compensation are discussed. Vestibular rehabilitation used in the complex therapy of equilibrium disorders is stressed to considerably enhance therapeutic effectiveness, to cause a reduction in the risk of falls, and to increase quality of life in patients with vestibular disorders

  14. [Pulmonary rehabilitation].

    Science.gov (United States)

    Senjyu, Hideaki

    2016-05-01

    Pulmonary rehabilitation commenced in Japan in 1957. However, the development of pulmonary rehabilitation took a long time due to the lack of the necessary health and medical services. Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors. The benefits of pulmonary rehabilitation include a decrease in breathlessness and an improvement in exercise tolerance. It is important that the gains in exercise tolerance lead to an increase in daily physical activity. PMID:27254948

  15. Stroke rehabilitation.

    Science.gov (United States)

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

    2011-05-14

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. PMID:21571152

  16. Pulmonary rehabilitation

    OpenAIRE

    Spruit, Martijn A.

    2001-01-01

    Pulmonary rehabilitation is a therapy that offers benefits to patients with chronic obstructive pulmonary disease that are complementary to those obtained by pharmacotherapy. The main objective of pulmonary rehabilitation is to restore muscle function and exercise tolerance, reverse other nonrespiratory consequences of the disease, and help patients to self-manage chronic obstructive pulmonary disease and its exacerbations and symptoms. To do so, a multidisciplinary program tailored to the pa...

  17. Burn Rehabilitation

    OpenAIRE

    Koray Aydemir; Mehmet Ali Taşkaynatan

    2011-01-01

    Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The t...

  18. Atypical chest pain in a rehabilitation setting: a case study

    OpenAIRE

    Oliva, Joseph S

    2001-01-01

    This case represents an individual who develops chest pain in a rehabilitation setting. It provides a description of possible assessments and investigations to screen for cardiovascular health. A thorough history and investigation can present a challenge in determining a definite diagnosis. Chiropractors who encounter patients in a rehabilitation program that develop chest pain must address the cardiac versus non-cardiac nature of the condition.

  19. 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

  20. Rehabilitation following hip arthroscopy - A systematic review

    Directory of Open Access Journals (Sweden)

    Jeffrey S Grzybowski

    2015-05-01

    Full Text Available CONTEXT: Rehabilitation following hip arthroscopy is an integral component of the clinical outcome of the procedure. Given the increase in quantity, complexity, and diversity of procedures performed, a need exists to define the role of rehabilitation following hip arthroscopy.OBJECTIVES: 1 To determine the current rehabilitation protocols utilized following hip arthroscopy in the current literature, 2 to determine if clinical outcomes are significantly different based on different post-operative rehabilitation protocols; and 3 to propose the best-available evidence-based rehabilitation program following hip arthroscopy.DATA SOURCES: Per PRISMA guidelines and checklist, Medline, SciVerse Scopus, SportDiscus, and Cochrane Central Register of Controlled Trials were searched.STUDY SELECTION: Level I-IV evidence clinical studies with minimum two-year follow-up reporting outcomes of hip arthroscopy with post-operative rehabilitation protocols described were included. DATA EXTRACTION: All study, subject, and surgery parameters were collected. All elements of rehabilitation were extracted and analyzed. Descriptive statistics were calculated. Study methodological quality was analyzed using the Modified Coleman Methodology Score (MCMS.RESULTS: 18 studies were included (2,092 subjects; 52% male, mean age 35.1 +/- 10.6 years, mean follow-up 3.2 +/- 1.0 years. Labral tear and femoroacetabular impingement were the most common diagnoses treated and labral debridement and femoral/acetabular osteochondroplasty the most common surgical techniques performed. Rehabilitation protocol parameters (weight-bearing, motion, strengthening, and return-to-sport were poorly reported. Differences in clinical outcomes were unable to be assessed given heterogeneity in study reporting. Time-, phase-, goal-, and precaution-based guidelines were extracted and reported.CONCLUSIONS: The current literature of hip arthroscopy rehabilitation lacks high-quality evidence to support a

  1. The updated Cochrane review 2014 on GnRH agonist trigger

    DEFF Research Database (Denmark)

    Kol, Shahar; Humaidan, Peter; Alsbjerg, Birgit; Engmann, Lawrence; Benadiva, Claudio; García-Velasco, Juan A; Fatemi, Human; Andersen, Claus Yding

    2015-01-01

    Cochrane reviews are powerful tools, internationally recognized as the highest standard in evidence-based health care. A Cochrane analysis makes use of precise, reproducible criteria in the selection of studies for review. In the context of a previous Cochrane review (2010) on the subject of...... chance of pregnancy in fresh autologous IVF and intracytoplasmic injection treatment cycles. We argue that the new review repeats previous errors by compiling data from studies that were not comparable as different luteal phase protocols were used. From the clinical point of view, the luteal support used...

  2. Profiles in medical courage: evidence-based medicine and Archie Cochrane

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2012-08-01

    Full Text Available Archibald (Archie Cochrane is often credited with being the inspiration for evidence-based medicine. His influential 1971 book, “Effectiveness and Efficiency”, strongly criticized the lack of reliable evidence behind many common healthcare practices. His call for a collection of systematic reviews led to the creation of The Cochrane Collaboration, named in honor of him. Archie Cochrane's life was a tortuous one, which included psychoanalysis, service in two wars, and studies of pneumoconiosis, tuberculosis and healthcare delivery. In this profile of medical courage we explore not only his thoughts on healthcare but his extraordinary background that shaped his ideas.

  3. 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.

  4. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  5. Respuesta hemodinámica con el entrenamiento en resistencia y fuerza muscular de miembros superiores en rehabilitación cardiaca Hemodynamic response to training in resistance and muscular strength of upper limbs in cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Diana M Camargo

    2007-08-01

    de 1,92 ± 2,49 lb (pAntecedentes: training of muscular strength in patients with cardiovascular events was totally contraindicated because of the risk of incrementing the systolic and diastolic arterial pressure values, as well as the submission to a myocardial overload. Objective: evaluate the hemodynamic response (heart rate, arterial pressure during the resistance to muscular strength training in patients assisting to a heart rehabilitation program. Design: quasi experimental prospective study. Setting: resistance training to muscular strength in upper limbs to patients during stage II of cardiac rehabilitation was realized. Subjects: 175 patients were included. 135 men and 40 women with mean age 58.79 years with coronary disease, with or without revascularization procedures, valvular surgery, syncope and surgical correction of congenital heart disease. Procedure: previous aerobic training (treadmill or static bicycle, muscular strength evaluation was realized through maximal repetition and the strength training was initiated at 30%-50% of this, in a three different exercise circuit in upper limbs, 10 repetitions in three series with a twice a week frequency. Besides, monitoring of heart frequency, electrocardiogram by telemetry (V5, arterial pressure recording before, during and after the session, and subjective perception of the effort by the Borg scale were made, and signs and symptoms of intolerance to the activity or decompensation were observed. For the statistical analysis, measures of central tendency with the cardiovascular changes were used and in order to compare the change in muscular strength, a paired t test with significance level 0.05 was utilized. Results: mean muscular strength with maximal repetition evidenced a significant increase of 1.92 ± 2.49 lb (p<0.001 in the general population, with an increment of 2.03 ± 2.57 lb (p<0.001 in men and of 1.46 ± 2.1 lb (p<0.001 in women. The muscular resistance training was realized with a mean load of

  6. Impact of including Korean randomized controlled trials in Cochrane reviews of acupuncture.

    Directory of Open Access Journals (Sweden)

    Kun Hyung Kim

    Full Text Available OBJECTIVE: Acupuncture is commonly practiced in Korea and is regularly evaluated in clinical trials. Although many Cochrane reviews of acupuncture include searches of both English and Chinese databases, there is no information on the value of searching Korean databases. This study aimed to investigate the impact of searching Korean databases and journals for trials eligible for inclusion in existing Cochrane acupuncture reviews. METHODS: We searched 12 Korean databases and seven Korean journals to identify randomised trials meeting the inclusion criteria for acupuncture reviews in the Cochrane Database of Systematic Reviews. We compared risk of bias assessments of the Korean trials with the trials included in the Cochrane acupuncture reviews. Where possible, we added data from the Korean trials to the existing meta-analyses in the relevant Cochrane review and conducted sensitivity analyses to test the robustness of the results. RESULTS: Sixteen Korean trials (742 participants met the inclusion criteria for eight Cochrane acupuncture reviews (125 trials; 13,041 participants. Inclusion of the Korean trials provided data for 20% of existing meta-analyses (24 out of 120. Inclusion of the Korean trials did not change the direction of effect in any of the existing meta-analyses. The effect size and heterogeneity remained mostly unchanged. In only one meta-analysis did the significance change. Compared to the studies included in the Cochrane acupuncture reviews, the risk of bias in the Korean trials was higher in terms of outcome assessor blinding and allocation concealment. CONCLUSIONS: Many Korean studies contributed additional data to the existing meta-analyses in Cochrane acupuncture reviews. Although inclusion of these studies did not alter the results of the meta-analyses, comprehensive searches of the literature are important to avoid potential language bias. The identification and inclusion of eligible Korean trials should be considered for

  7. Agreement between Cochrane Neonatal reviews and clinical practice guidelines for newborns in Denmark a cross sectional study

    DEFF Research Database (Denmark)

    Brok, Jesper; Greisen, Gorm; Madsen, Lars P; Tilma, Karen; Faerk, Jan; Børch, Klaus; Garne, Ester; Christensen, Henrik T; Stanchev, Hristo; Jacobsen, Thorkild; Nielsen, Jens P; Henriksen, Tine Brink; Gluud, Christian

    2007-01-01

    OBJECTIVE: To assess agreement between Cochrane Neonatal Group reviews and clinical practice guidelines in Denmark. DESIGN: Retrospective analysis of clinical guidelines for newborn infants. Materials:All Cochrane neonatal reviews and Danish local clinical guidelines for newborn infants. MAIN OUT...

  8. Rehabilitation costs

    International Nuclear Information System (INIS)

    The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates

  9. Acupuncture for neurological disorders in the Cochrane reviews:Characteristics of included reviews and studies

    Institute of Scientific and Technical Information of China (English)

    Deren Wang; Weimin Yang; Ming Liu

    2011-01-01

    OBJECTIVE: To summarize Cochrane reviews of acupuncture for neurological disorders, and characteristics of included reviews and studies.DATA SOURCES: A computer-based online search of the Cochrane Library (Issue 7 of 12, July 2010) was performed with the key word "acupuncture" and systematic evaluations for acupuncture for neurological disorders were screened.STUDY SELECTION: Systematic reviews on acupuncture in the treatment of neurological disorders were included, and the characteristics of these reviews were analyzed based on methods recommended by the Cochrane collaboration.MAIN OUTCOME MEASURES: Basic characteristics, methodological quality, main reasons for excluding trials, results and conclusions of Cochrane reviews were assessed.RESULTS: A total of 18 Cochrane systematic reviews were included, including 13 completed reviews and five research protocols. The 13 completed reviews involved 111 randomized controlled trials, including 43 trials (38.7%) conducted in China, 47 trials (42.3%) using sham-acupuncture or placebo as control, 15 trials (13.5%) with relatively high quality, 91 trials (81.9%) reporting data on follow-up. Primary outcomes used in the Cochrane reviews were reported by 65 trials (58.6%), and adverse events were reported in 11 trials (9.9%). Two hundred and eighty three trials were excluded. Two reviews on headache suggested that acupuncture is a valuable non-drug treatment for patients with chronic or recurrent headache, and has better curative effects on migraine compared with preventative drug treatment. CONCLUSION: Of the Cochrane reviews on acupuncture in the treatment of neurological disorders, two reviews evaluating the efficacy of acupuncture in treating headaches drew positive conculsions, while other reviews did not obtain positive conclusions due to a small sample size or low methodological quality. The methodological quality of acupuncture trials needs further improvement.

  10. What to Expect during Cardiac Rehabilitation

    Science.gov (United States)

    ... exercise are walking (outside or on a treadmill), cycling, rowing, or climbing stairs. Your rehab team will ... exercises to your plan. Follow a Heart Healthy Diet Your rehab team will help you create and ...

  11. Economics methods in Cochrane systematic reviews of health promotion and public health related interventions

    Directory of Open Access Journals (Sweden)

    McDaid David

    2006-11-01

    Full Text Available Abstract Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as

  12. Rehabilitation and older people.

    OpenAIRE

    Young, J.

    1996-01-01

    Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.

  13. Are the Cochrane group registers comprehensive? A case study of Japanese psychiatry trials

    Directory of Open Access Journals (Sweden)

    McGuire Hugh

    2002-04-01

    Full Text Available Abstract Background Language bias is a form of publication bias and constitutes a serious threat to meta-analyses. The Cochrane Controlled Trials Register is one attempt to remedy this and now contains more than 300,000 citations. However we are still unsure if it provides comprehensive coverage, particularly for non-English trials. Methods We have recently established a comprehensive register of Japanese trials of psychotropic drugs through extensive personal contacts, electronic searches and handsearches. We examined two Cochrane psychiatry group registers against this Japanese database. Results The Japanese register contained 56 reports of randomized controlled trials (RCTs of antidepressants for depression but the Cochrane Depression, Anxiety and Neurosis group register contained 18, with an overlap of only nine. The Japanese register contained 61 reports of RCTs of neuroleptics for schizophrenia and the Cochrane Schizophrenia group register contained 36, with an overlap of only six. Taking account of some duplicate publications, only a quarter to a third of all relevant Japanese RCTs were retrievable from the Cochrane group registers. Conclusions Similar, or worse, yields may be expected with RCTs conducted in other East Asian countries, and in other fields of medicine. What evidence there is suggests that this situation may lead to a systematic over estimate of treatment effect.

  14. An enhanced version of Cochran-Armitage trend test for genome-wide association studies.

    Science.gov (United States)

    Ghodsi, Mansi; Amiri, Saeid; Hassani, Hossein; Ghodsi, Zara

    2016-09-01

    Genome-wide association studies the evaluation of association between candidate gene and disease status is widely carried out using Cochran-Armitage trend test. However, only a small number of research papers have evaluated the distribution of p-values for the Cochran-Armitage trend test. In this paper, an enhanced version of Cochran-Armitage trend test based on bootstrap approach is introduced. The achieved results confirm that the distribution of p-values of the proposed approach fits better to the uniform distribution, and it is thus concluded that the proposed method, which needs less assumptions in comparison with the conventional method, can be successfully used to test the genetic association. PMID:27617223

  15. Balance (or Vestibular) Rehabilitation

    Science.gov (United States)

    ... for the Public / Hearing and Balance Balance (or Vestibular) Rehabilitation Audiologic (hearing), balance, and medical diagnostic tests help indicate whether you are a candidate for vestibular (balance) rehabilitation. Vestibular rehabilitation is an individualized balance ...

  16. Divine intervention? A Cochrane review on intercessory prayer gone beyond science and reason

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Hróbjartsson, Asbjørn; Gøtzsche, Peter C

    2009-01-01

    We discuss in this commentary a recent Cochrane review of 10 randomised trials aimed at testing the religious belief that praying to a god can help those who are prayed for. The review concluded that the available studies merit additional research. However, the review presented a scientifically...... unsound mixture of theological and scientific arguments, and two of the included trials that had a large impact on the findings had problems that were not described in the review. The review fails to live up to the high standards required for Cochrane reviews....

  17. Reduceret saltindtagelse og forebyggelse af kardiovaskulær sygdom - en gennemgang af en Cochrane review

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben

    2012-01-01

    In a Cochrane review on reduced dietary salt for the prevention of cardiovascular disease the results of one study showed that salt restriction increased mortality. In normotensive and hypertensive patients, who were analysed separately, an insignificant reduction in cardiovascular events was found....... If the studies were analysed together, a significant reduction of cardiovascular events was found. The authors of the Cochrane review concluded that "there is still insufficient power to exclude clinically important effects of reduced dietary salt on in normotensives and hypertensives". We find...... that this conclusion is somewhat backwards. We consider salt restriction to be an important tool for improving population health....

  18. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Psychological Realities After Spinal Cord Injury Psychology of Spinal Cord Injury Rehabilitation Psychology of Spinal Cord Injury Rehabilitation How Psychologists Help ...

  19. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Psychological Realities after Spinal Cord Injury Psychology of Spinal Cord Injury Rehabilitation Psychology of Spinal Cord Injury Rehabilitation How Psychologists Help ...

  20. Rehabilitation practice patterns for patients with heart failure: the Asian perspective.

    Science.gov (United States)

    Sun, Xing-Guo

    2015-01-01

    More countries around world have begun to use cardiac rehabilitation in patients diagnosed with chronic heart failure (HF). Asia is the largest continent in the world and, depending on its economy, culture, and beliefs, a given Asian country differs from Western countries as well as others in Asia. The cardiac rehabilitation practice patterns for patients with HF are somewhat different in Asia. In addition to the formal pattern of Western practice, it also includes special techniques and skills, such as Taiji, Qigong, and Yoga. This article describes cardiac rehabilitation patterns for patients with HF in most Asian countries and areas. PMID:25432478

  1. The use of the virtual reality as intervention tool in the postoperative of cardiac surgery

    OpenAIRE

    Lucas de Assis Pereira Cacau; Géssica Uruga Oliveira; Luana Godinho Maynard; Amaro Afrânio Araújo Filho; Walderi Monteiro da Silva Junior; Manoel Luiz Cerqueria Neto; Angelo Roberto Antoniolli; Valter J. Santana-Filho

    2013-01-01

    INTRODUCTION: Cardiac surgery has been the intervention of choice in many cases of cardiovascular diseases. Susceptibility to postoperative complications, cardiac rehabilitation is indicated. Therapeutic resources, such as virtual reality has been helping the rehabilitational process. The aim of the study was to evaluate the use of virtual reality in the functional rehabilitation of patients in the postoperative period. METHODS: Patients were randomized into two groups, Virtual Reality (VRG, ...

  2. Rehabilitation Nursing: Applications for Rehabilitation Nursing

    OpenAIRE

    Aysegül Koç

    2012-01-01

    Rehabilitation nursing is a specialist form of rehabilitation requiring specialist nursing. Furthermore, as in many areas ofnursing, nurses in this field recognize that there is a need to increase the quality of and provide the most up-to-date carefor their patients and patients’ families. To achieve high levels of competence, neurological rehabilitation nurses need tobe aware of the existing body of research in this field. Effective hospital and community rehabilitation services areincreasin...

  3. Propofol for sedation during colonoscopy- A survey of a Cochrane review

    DEFF Research Database (Denmark)

    Høj, Anders Thorsmark

    2010-01-01

    The Cochrane collaboration metaanalysis of propofol use during colonoscopy found a faster patient recovery, higher patient satisfaction and unchanged complication rate compared to traditional sedatives. Patient groups consisted mostly of ASA I-II-patients, therefore the study is inconclusive with...

  4. Sedation med propofol til koloskopi. Gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Høj, Anders Thorsmark; Vilmann, Peter

    2010-01-01

    The Cochrane collaboration metaanalysis of propofol use during colonoscopy found a faster patient recovery, higher patient satisfaction and unchanged complication rate compared to traditional sedatives. Patient groups consisted mostly of ASA I-II-patients, therefore the study is inconclusive with...

  5. Medikamentel behandling af cancerrelateret traethed--en gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Pedersen, Lise; Palshof, Torben

    2009-01-01

    The data and the conclusions of the Cochrane review of drug therapy for the management of cancer related fatigue (CRF) is analysed and summarized in this report. Overall, data is weakened substantially by a high degree of heterogeneity that stems primarily from the fact that fatigue is a subjective...

  6. Life Cycle of Cochrane Reviews%Cochrane系统评价的制作周期

    Institute of Scientific and Technical Information of China (English)

    Philippa Middleton

    2004-01-01

    ObjectiveTo calculate the typical time taken to complete protocols and reviews, to track how often reviews are updated and compare with Collaboration policies, to feed back any gaps in documentation of dates to individual Cochrane Collaborative Review Groups, and to suggest changes to presentation of reviews and to editorial processes.MethodsData were extracted either from The Cochrane Library or a specially constructed database to calculate the age of reviews and protocols, and the frequency of updating of reviews. Issue 1, 2003, with 1 596 reviews and 1 200 protocols, was used as the index issue.ResultsMedian number of issues between a protocol and its completed review being published on The Cochrane Library is 5 (1.25 years). 65% of protocols have appeared on The Cochrane Library for no longer than two years, but the number of protocols more than two years old is probably increasing. One-third of reviews have been substantively updated, but generally only once and often within several months of the first publication of the review. The number of out-of-date reviews is probably increasing. ConclusionsWhile the stage between publishing a protocol and the completed review is usually completed in no longer than two years, the number of out-of-date reviews and protocols requires continuing attention. How up-to-date a review is depends on when the evidence base was last searched and when additional relevant evidence has been integrated into the review. This needs to be reflected in the information provided to readers of Cochrane Reviews and some alternative ways of presenting the components of this information are given. More accurate and complete reporting will also allow the Collaboration to track progress against policy.

  7. Converting systematic reviews to Cochrane format: a cross-sectional survey of Australian authors of systematic reviews

    Directory of Open Access Journals (Sweden)

    McDonald Steve

    2003-01-01

    Full Text Available Abstract Background Despite the growing reputation and subject coverage of the Cochrane Database of Systematic Reviews, many systematic reviews continue to be published solely in paper-based health care journals. This study was designed to determine why authors choose to publish their systematic reviews outside of the Cochrane Collaboration and if they might be interested in converting their reviews to Cochrane format for publication in the Cochrane Database of Systematic Reviews. Methods Cross-sectional survey of Australian primary authors of systematic reviews not published on the Cochrane Database of Systematic Reviews identified from the Database of Abstracts of Reviews of Effectiveness. Results We identified 88 systematic reviews from the Database of Abstracts of Reviews of Effectiveness with an Australian as the primary author. We surveyed 52 authors for whom valid contact information was available. The response rate was 88 per cent (46/52. Ten authors replied without completing the survey, leaving 36 valid surveys for analysis. The most frequently cited reasons for not undertaking a Cochrane review were: lack of time (78%, the need to undergo specific Cochrane training (46%, unwillingness to update reviews (36%, difficulties with the Cochrane process (26% and the review topic already registered with the Cochrane Collaboration (21%. (Percentages based on completed responses to individual questions. Nearly half the respondents would consider converting their review to Cochrane format. Dedicated time emerged as the most important factor in facilitating the potential conversion process. Other factors included navigating the Cochrane system, assistance with updating and financial support. Eighty-six per cent were willing to have their review converted to Cochrane format by another author. Conclusion Time required to complete a Cochrane review and the need for specific training are the primary reasons why some authors publish systematic reviews

  8. 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 ...

  9. Telerehab III: a multi-center randomized, controlled trial investigating the long-term effectiveness of a comprehensive cardiac telerehabilitation program. Rationale and study design.

    OpenAIRE

    Frederix, Ines; Hansen, Dominique; Coninx, Karin; Vandervoort, Pieter; Van Craenenbroeck, Emeline; Vrints, Christiaan; Dendale, Paul

    2015-01-01

    Background Telerehabilitation has been proposed as an adjunct/alternative to standard center-based cardiac rehabilitation. Two recent systematic reviews showed non-inferiority and/or superiority of this remote approach for cardiac rehabilitation. However, these trials focused only on one core component of cardiac rehabilitation and telemonitoring, rather than implementing a more comprehensive approach. The aim of Telerehab III is to investigate the long-term effectiveness of the addition of a...

  10. Cardiac surgery outcomes.

    Science.gov (United States)

    Halpin, Linda S; Barnett, Scott D; Beachy, Jim

    2003-01-01

    Accrediting organizations and payers are demanding valid and reliable data that demonstrate the value of services. Federal agencies, healthcare industry groups, and healthcare watchdog groups are increasing the demand for public access to outcomes data. A new and growing outcomes dynamic is the information requested by prospective patients in an increasingly consumer-oriented business. Patients demand outcomes, and resources are developing to meet these demands. Physicians are increasingly confronted with requests for information about their mortality and morbidity rates, malpractice suits, and disciplinary actions received. For example, in Virginia, prospective patients have access to data provided by the nonprofit group Virginia Health Information. After numerous resolutions by the Virginia Senate since 1999, the prospective Virginia medical consumer now has access to several annual publications: Virginia Hospitals: A Consumer's Guide, 1999 Annual Report and Strategic Plan Update, and the 1999 Industry Report: Virginia Hospitals and Nursing Facilities. Consumers have access to cardiac outcomes data stratified by hospital, gender, and cardiac service line (cardiac surgery, noninvasive cardiology, and invasive cardiology). This is particularly relevant to IHI because Virginia Health Information specifically targets cardiac care. IHI has a sizable investment in cardiovascular outcomes and has found outcomes measurement and research are key to providing quality care. IHI's goal is to move from an outcomes management model to a disease management model. The hope is to incorporate all aspects of the patient's continuum of care, from preoperative and diagnostic services through cardiac interventions to postoperative rehabilitation. Furthermore, every step along the way will be supported with functional status and quality of life assessments. Although these goals are ambitious and expensive, the return on investment is high. PMID:14618772

  11. What efficacy measures are clinically relevant and should be used in Cochrane Reviews of acute migraine trials?

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer

    2015-01-01

    BACKGROUND: Cochrane Reviews are methodologically of high quality but the clinical relevance of analysed efficacy measures (EMs) should also be assessed. METHODS: The clinical relevance of EMs used in one systematic Cochrane review of oral zolmitriptan for migraine headache was evaluated. RESULTS...

  12. Saving the Time of the Library User through Subject Access Innovation: Papers in Honor of Pauline Atherton Cochrane.

    Science.gov (United States)

    Wheeler, William J., Ed.

    This book contains the following papers in honor of Pauline Atherton Cochrane on subject access issues in library and information science: (1) "Obstacles in Progress in Mechanized Subject Access and the Necessity of a Paradigm Change" (Robert Fugmann); (2) "On MARC and the Nature of Text Searching: A Review of Pauline Cochrane's Inspirational…

  13. 77 FR 65545 - Mr. Jesse S. Capel and Mr. Hilton J. Cochran; EWP LLC; Notice of Transfer of Exemption

    Science.gov (United States)

    2012-10-29

    ... Energy Regulatory Commission Mr. Jesse S. Capel and Mr. Hilton J. Cochran; EWP LLC; Notice of Transfer of Exemption 1. By application filed on July 30, 2012 and supplemented on August 14, 2012, Mr. Jesse S. Capel and Mr. Hilton J. Cochran and EWP LLC informed the Commission that its exemption from licensing...

  14. 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

  15. Baekkenbundstraening til gravide og barslende kvinder--en gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Brostrøm, Søren; Due, Ulla; Lose, Gunnar

    2010-01-01

    Urinary and anal incontinence are prevalent in pregnant and parturient women. Pelvic floor muscle training is frequently employed for prevention and treatment. A recent Cochrane review is discussed. Fifteen studies with a total of 6,181 women were included. Pregnant women without urinary incontin...... incontinence experienced a reduction of the risk of developing urinary incontinence in later pregnancy or post partum. Peripartum patients with urinary and anal incontinence experienced a reduction of their symptoms following training....

  16. Evidence for perinatal and child health care guidelines in crisis settings: can Cochrane help?

    Directory of Open Access Journals (Sweden)

    Barnes Hayley

    2010-03-01

    Full Text Available Abstract Background It is important that healthcare provided in crisis settings is based on the best available research evidence. We reviewed guidelines for child and perinatal health care in crisis situations to determine whether they were based on research evidence, whether Cochrane systematic reviews were available in the clinical areas addressed by these guidelines and whether summaries of these reviews were provided in Evidence Aid. Methods Broad internet searches were undertaken to identify relevant guidelines. Guidelines were appraised using AGREE and the clinical areas that were relevant to perinatal or child health were extracted. We searched The Cochrane Database of Systematic Reviews to identify potentially relevant reviews. For each review we determined how many trials were included, and how many were conducted in resource-limited settings. Results Six guidelines met selection criteria. None of the included guidelines were clearly based on research evidence. 198 Cochrane reviews were potentially relevant to the guidelines. These reviews predominantly addressed nutrient supplementation, breastfeeding, malaria, maternal hypertension, premature labour and prevention of HIV transmission. Most reviews included studies from developing settings. However for large portions of the guidelines, particularly health services delivery, there were no relevant reviews. Only 18 (9.1% reviews have summaries in Evidence Aid. Conclusions We did not identify any evidence-based guidelines for perinatal and child health care in disaster settings. We found many Cochrane reviews that could contribute to the evidence-base supporting future guidelines. However there are important issues to be addressed in terms of the relevance of the available reviews and increasing the number of reviews addressing health care delivery.

  17. Empirical Likelihood Confidence Intervals under the Rao-Hartley-Cochran Sampling Design

    OpenAIRE

    Berger, Yves G.

    2014-01-01

    The Hartley-Rao-Cochran (RHC) sampling design (Rao et al., 1962) is a popular unequal probability sampling design. We show how empirical likelihood confidence intervals can be derived under this sampling design. Berger and De La Riva Torres (2012) proposed an empirical likelihood approach which can be used for point estimation and to construct confidence intervals under complex sampling designs. We show how this approach can be adjusted for the RHC sampling design. The proposed approach i...

  18. Conservative treatment of acute knee osteoarthritis: A review of the Cochrane Library

    Directory of Open Access Journals (Sweden)

    Emerito Carlos Rodriguez-Merchan

    2016-05-01

    Conclusions: Five main strategies for the conservative treatment of knee osteoarthritis exist that must be used before indicating surgical treatment: medical treatment, physical medicine and rehabilitation, intra-articular injections, acupuncture, and self-management education programs.

  19. Recommendations by Cochrane Review Groups for assessment of the risk of bias in studies

    Directory of Open Access Journals (Sweden)

    Gøtzsche Peter C

    2008-04-01

    Full Text Available Abstract Background Assessing the risk of bias in individual studies in a systematic review can be done using individual components or by summarizing the study quality in an overall score. Methods We examined the instructions to authors of the 50 Cochrane Review Groups that focus on clinical interventions for recommendations on methodological quality assessment of studies. Results Forty-one of the review groups (82% recommended quality assessment using components and nine using a scale. All groups recommending components recommended to assess concealment of allocation, compared to only two of the groups recommending scales (P Conclusion We found that recommendations by some groups were not based on empirical evidence and many groups had no recommendations on how to use the quality assessment in reviews. We suggest that all Cochrane Review Groups refer to the Cochrane Handbook for Systematic Reviews of Interventions, which is evidence-based, in their instructions to authors and that their own guidelines are kept to a minimum and describe only how methodological topics that are specific to their fields should be handled.

  20. Modular Interactive Tiles for Rehabilitation – Evidence and Effect

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop

    2010-01-01

    We developed modular interactive tiles to be used for playful physiotherapy, which is supposed to motivate patients to engage in and perform physical rehabilitation exercises. We report on evidence for elderly training. We tested the modular interactive tiles for an extensive period of time (4...... the playful use of modular interactive tiles engaging and motivating for them to perform the rehabilitation. Also, test data suggest that some playful exercises on the tiles demand an average heart rate of 75% and 86% of the maximum heart rate....... years) in daily use in a hospital rehabilitation unit e.g. for cardiac patients. Also, the tiles were tested for performing physical rehabilitation of stroke patients both in hospital, rehabilitation centre and in their private home. In all test cases qualitative feedback indicate that the patients find...

  1. Endothelial dysfunction after non-cardiac surgery

    DEFF Research Database (Denmark)

    Søndergaard, E S; Fonnes, S; Gögenur, I

    2015-01-01

    BACKGROUND: More than 50% of patients with increased troponin levels after non-cardiac surgery have an impaired endothelial function pre-operatively. Non-invasive markers of endothelial function have been developed for the assessment of endothelial dysfunction. The aim of this paper was to...... systematically review the literature to evaluate the association between non-cardiac surgery and non-invasive markers of endothelial function. METHODS: A systematic search was conducted in MEDLINE, EMBASE and Cochrane Library Database according to the PRISMA guidelines. Endothelial dysfunction was described only...... with non-invasive measurements done both pre- and post-operatively and published in English. All types of non-cardiac surgery and both men and women of all ages were included. RESULTS: We found 1722 eligible studies in our search, and of these, five studies fulfilled our inclusion and exclusion...

  2. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available Experts \\ The Basics of Spinal Cord Injury Rehabilitation Topics Adult Injuries Spinal Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics ...

  3. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available Experts \\ The Basics of Spinal Cord Injury Rehabilitation Topics Adult Injuries Spinal Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of Spinal Cord ...

  4. Basics of SCI Rehabilitation

    Science.gov (United States)

    Experts \\ The Basics of Spinal Cord Injury Rehabilitation Topics Adult Injuries Spinal Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of Spinal Cord ...

  5. 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)

  6. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available Experts \\ The Basics of Spinal Cord Injury Rehabilitation Topics Adult Injuries Spinal Cord Injury 101 Spinal Cord Injury 101 The Basics of Spinal Cord Injury Rehabilitation The Basics of ...

  7. Armenia - Rural Road Rehabilitation

    Data.gov (United States)

    Millenium Challenge Corporation — The key research questions guiding our design of the RRRP evaluation are: • Did rehabilitating roads affect the quality of roads? • Did rehabilitating roads improve...

  8. Overview of Rehabilitation

    Science.gov (United States)

    ... closely monitors the progress. The goals may be changed if people become unwilling or unable (financially or ... Limb Amputation Rehabilitation for Speech Disorders Rehabilitation for Blindness NOTE: This is the Consumer Version. CONSUMERS: Click ...

  9. The effects of cardiac tertiary prevention program after coronary artery bypass graft surgery on health and quality of life

    OpenAIRE

    Azam Mosayebi; Shaghayegh Haghjooy Javanmard; Mohsen Mirmohamadsadeghi; Reza Rajabi; Samaneh Mostafavi; Marjan Mansourian

    2011-01-01

    Objectives: Cardiac tertiary prevention programs intend to support the recovery course following coronary artery bypass grafting (CABG). We investigated the effects of attendance at cardiac rehabilitation (CR) programs following CABG on patients′ mortality, morbidity and health related quality of life. Methods: Eighty patients who underwent CABG were selected in a way that half of them had attended a cardiac rehabilitation program and the other half had not. Health related quality of life ...

  10. Syrepumpehæmmerbehandling ved ulcusblødning - en gennemgang af en cochrane-analyse

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Schaffalitzky de Muckadell, Ove B

    2014-01-01

    Treatment with proton pump inhibitors (PPI) is shown to improve the outcome of peptic ulcer bleeding (PUB). A recent Cochrane review evaluated different regimes of PPI-treatment in the management of PUB. The current evidence suggests that treatment with high-dose PPI (cumulative PPI-dose > 600 mg...... doses of PPI are equally efficacious to high-dose treatment. As the current evidence is strongest for high-dose treatment for patients with serious PUB it is recommended to use high-dose PPI treatment in patients treated with endoscopic therapy. This is in line with the national recommendations in...

  11. How useful are systematic reviews for informing palliative care practice? Survey of 25 Cochrane systematic reviews

    Directory of Open Access Journals (Sweden)

    Hadley Gina

    2008-08-01

    Full Text Available Abstract Background In contemporary medical research, randomised controlled trials are seen as the gold standard for establishing treatment effects where it is ethical and practical to conduct them. In palliative care such trials are often impractical, unethical, or extremely difficult, with multiple methodological problems. We review the utility of Cochrane reviews in informing palliative care practice. Methods Published reviews in palliative care registered with the Cochrane Pain, Palliative and Supportive Care Group as of December 2007 were obtained from the Cochrane Database of Systematic Reviews, issue 1, 2008. We reviewed the quality and quantity of primary studies available for each review, assessed the quality of the review process, and judged the strength of the evidence presented. There was no prior intention to perform any statistical analyses. Results 25 published systematic reviews were identified. Numbers of included trials ranged from none to 54. Within each review, included trials were heterogeneous with respect to patients, interventions, and outcomes, and the number of patients contributing to any single analysis was generally much lower than the total included in the review. A variety of tools were used to assess trial quality; seven reviews did not use this information to exclude low quality studies, weight analyses, or perform sensitivity analysis for effect of low quality. Authors indicated that there were frequently major problems with the primary studies, individually or in aggregate. Our judgment was that the reviewing process was generally good in these reviews, and that conclusions were limited by the number, size, quality and validity of the primary studies. We judged the evidence about 23 of the 25 interventions to be weak. Two reviews had stronger evidence, but with limitations due to methodological heterogeneity or definition of outcomes. No review provided strong evidence of no effect. Conclusion Cochrane reviews

  12. Cancer rehabilitation in Denmark

    DEFF Research Database (Denmark)

    Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine

    2008-01-01

    A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this...

  13. Construção e validação do "CADE-Q" para educação de pacientes em programas de reabilitação cardíaca Construction and validation of the CADE-Q for patient education in cardiac rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Gabriela Lima de Melo Ghisi

    2010-06-01

    reduce the risk of cardiac complications. OBJECTIVE: Building and validating a tool to assess and describe coronary patients' awareness in cardiac rehabilitation programs, with the purpose of education. METHODS: For the construction, we analyzed articles and field studies to submit items to multidisciplinary team associated to cardiac rehabilitation. After this analysis, we generated the version tested in a pilot study. The tool, named CADE-Q (Questionnaire for Coronary Patient Education was applied in 155 patients aged 61 ± 9 (min = 36, max = 86 in response to cardiac rehabilitation programs. Out of the 155 patients, 114 were men. Internal consistency was measured by Cronbach's alpha coefficient. Reproducibility was tested by the intraclass correlation coefficient (ICC and construct validity was performed by exploratory factor analysis. The analysis compared the total scores as a function population characteristics and rehabilitation groups (private and public. RESULTS: The final version has 19 questions with 4 alternatives, with 4 quadrants of awareness. Cronbach's alpha was 0.68 and ICC was 0.783. The factor analysis revealed 6 factors, covering three areas of awareness, which demonstrates the multifactorial nature of the instrument. The population characteristics as a function of the total score showed significant differences depending on the socioeconomic status variables (type of rehabilitation, household income and education level. CONCLUSION: CADE-Q has proper validity and reliability to be used in the Brazilian population in future research.

  14. Hepato-biliary clinical trials and their inclusion in the Cochrane Hepato-Biliary Group register and reviews

    DEFF Research Database (Denmark)

    Klingenberg, Sarah Louise; Nikolova, Dimitrinka; Alexakis, Nicholas; Als-Nielsen, Bodil; Colli, Agostino; Conte, Dario; D'Amico, Gennaro; Davidson, Brian; Fingerhut, Abe; Fraquelli, Mirella; Gluud, Christian Nyfeldt; Gurusamy, Kurinchi; Keus, Frederik; Khan, Saboor; Koretz, Ronald; van Laarhoven, Cornelis; Liu, Jianping; Myers, Robert; Pagliaro, Luigi; Simonetti, Rosa; Sutton, Robert; Thorlund, Kristian

    2011-01-01

    The Cochrane Hepato-Biliary Group (CHBG) is one of the 52 collaborative review groups within The Cochrane Collaboration. The activities of the CHBG focus on collecting hepato-biliary randomized clinical trials (RCT) and controlled clinical trials (CCT), and including them in systematic reviews wi...... meta-analyses of the trials. In this overview, we present the growth of The CHBG Controlled Trials Register, as well as the systematic reviews that have been produced since March 1996....

  15. Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

    OpenAIRE

    Smaïl-Faugeron, Violaine; Fron-Chabouis, Hélène; Courson, Frédéric

    2014-01-01

    Background To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implicatio...

  16. Hepato-biliary clinical trials and their inclusion in the Cochrane Hepato-Biliary Group register and reviews

    DEFF Research Database (Denmark)

    Klingenberg, Sarah Louise; Nikolova, Dimitrinka; Alexakis, Nicholas;

    2011-01-01

    The Cochrane Hepato-Biliary Group (CHBG) is one of the 52 collaborative review groups within The Cochrane Collaboration. The activities of the CHBG focus on collecting hepato-biliary randomized clinical trials (RCT) and controlled clinical trials (CCT), and including them in systematic reviews with...... meta-analyses of the trials. In this overview, we present the growth of The CHBG Controlled Trials Register, as well as the systematic reviews that have been produced since March 1996....

  17. Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews.

    Science.gov (United States)

    Costa, Marcelle Barrueco; Melnik, Tamara

    2016-01-01

    Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares são doenças psiquiátricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial é essencial para o tratamento e a prevenção de recaídas. Apresentar uma vis

  18. Cardiac sarcoidosis

    OpenAIRE

    Costello BT; Nadel J.; Taylor AJ

    2016-01-01

    Benedict T Costello,1,2 James Nadel,3 Andrew J Taylor,1,21Department of Cardiovascular Medicine, The Alfred Hospital, 2Baker IDI Heart and Diabetes Research Institute, Melbourne, VIC, 3School of Medicine, University of Notre Dame, Sydney, NSW, Australia Abstract: Cardiac sarcoidosis is a rare but life-threatening condition, requiring a high degree of clinical suspicion and low threshold for investigation to make the diagnosis. The cardiac manifestations include heart failure, conducting syst...

  19. Evaluation of evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Persson, Dennis; Nygren, Carita;

    2010-01-01

    Abstract Evidence-based practice creates practice that integrates research-driven evidence with clinical expertise and patients' preferences in clinical decision-making. Aim: The aim of this study was to investigate and evaluate the quality and applicability of scientific research in occupational...... therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000-2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were...

  20. Fish Oil and Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials

    OpenAIRE

    Xin, Wei; Wei, Wei; Lin, Zhiqin; Zhang, Xiaoxia; Yang, Hongxia; Zhang, Tao; Li, Bin; Mi, Shuhua

    2013-01-01

    Background Influence of fish oil supplementation on postoperative atrial fibrillation (POAF) was inconsistent according to published clinical trials. The aim of the meta-analysis was to evaluate the effects of perioperative fish oil supplementation on the incidence of POAF after cardiac surgery. Methods Pubmed, Embase and the Cochrane Library databases were searched. Randomized controlled trials (RCTs) assessing perioperative fish oil supplementation for patients undergoing cardiac surgery we...

  1. Acute effects of a work-related rehabilitation program on cardiovascular fitness, pain, and sleep

    OpenAIRE

    Nordstoga, Anne Lovise

    2014-01-01

    Aim: The aim of this study was to assess the short-term effects of a work-related rehabilitation program on cardiovascular fitness, musculoskeletal symptoms, and cardiac autonomic regulation during sleep, by comparing a group receiving long-stay rehabilitation (3.5 weeks) vs., a group receiving short-stay rehabilitation (4+4 days).Method: Three tests were performed on the patients enrolled for the work-related rehabilitation program: 1) Åstrand/Ryhming cycle test, 2) pressure pain threshold (...

  2. The ritualization of rehabilitation

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2013-01-01

    There is widespread and increasing political interest in devising plans to support people who have or have had cancer to recover and recommence 'normal' lives. Educating cancer patients for this purpose is a central element in cancer rehabilitation in both Europe and the United States. One of the...... challenges in intervention research pertaining to rehabilitation is how to measure and explain the effects of a particular rehabilitation program. The social processes of particular programs are often a 'closed box' and not taken into consideration methodologically or analytically. In this article, we unpack...... and explicate the 'closed box' of a particular cancer rehabilitation program in Denmark by drawing on approaches from the study of ritual. By analyzing rehabilitation as a ritual and as ritualization, we identify and conceptualize some of the transformative activities involved in cancer rehabilitation...

  3. Book Review of 'Evolutionary and Interpretive Archaeologies' Edited by Ethan E. Cochrane and Andrew Gardner

    CERN Document Server

    Gabora, Liane

    2015-01-01

    Evolutionary and Interpretive Archaeologies, edited by Ethan E. Cochrane and Andrew Gardner, grew out of a seminar at the Institute for Archaeology at University College London in 2007. It consists of 15 chapters by archaeologists who self-identify themselves as practitioners who emphasize the benefits of evolutionary or interpretive approaches to the study of the archaeological record. While the authors' theoretical views are dichotomous, the editors' aim for the book as a whole is not to expound on the differences between these two kinds of archaeology but to bring forward a richer understanding of the discipline and to highlight areas of mutual concern. Some chapters come across as a bit of a sales pitch, but the majority of the contributions emphasize how each approach can be productively used to address the goals of the other. The book seeks to contribute to a mutually beneficial and more productive discipline, and overall, it succeeds in this effort.

  4. Interventions for hirsutism excluding laser and photoepilation therapy alone: abridged Cochrane systematic review including GRADE assessments.

    Science.gov (United States)

    van Zuuren, E J; Fedorowicz, Z

    2016-07-01

    Hirsutism is a common disorder with a major impact on quality of life. The most frequent cause is polycystic ovary syndrome. Effects of interventions (except laser and light-based therapies) were evaluated, including Grading of Recommendations Assessment, Development and Evaluation assessments. Searches included Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase and five trials registers to June 2014. We included 157 randomized controlled trials (RCTs) with 10 550 participants. The majority were assessed as having a 'high risk' of bias (123 of 157). The quality of evidence was rated moderate to very low for most outcomes. Pooled data for an oral contraceptive (OCP) (ethinyl oestradiol and cyproterone acetate) compared with another OCP (ethinyl oestradiol and desogestrel) demonstrated that both treatments were effective in reducing Ferriman-Gallwey scores, but the mean difference (MD) was not statistically significant [-1·84, 95% confidence interval (CI): -3·86-0·18]. Flutamide was more effective than placebo in two studies (MD -7·60, 95% CI: -10·53 to -4·67 and MD -7·20, 95% CI: -10·15 to -4·25), as was spironolactone (MD -7·69, 95% CI: -10·12 to -5·26). Spironolactone appeared to be as effective as flutamide (two studies) and finasteride (two studies). However, finasteride and the gonadotropin-releasing analogues showed discrepant results in several RCTs. Metformin was ineffective. Cyproterone acetate combined with OCPs demonstrated greater reductions in Ferriman-Gallwey scores. Lifestyle interventions reduced body mass index but did not show improvement in hirsutism, and although cosmetic measures are frequently used, no RCTs investigating cosmetic treatments were identified. RCTs investigating OCPs in combination with antiandrogens or finasteride vs. OCP alone, or the different antiandrogens and 5α-reductase inhibitors are warranted. PMID:26892495

  5. A descriptive analysis of child-relevant systematic reviews in the Cochrane Database of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Thomson Denise

    2010-05-01

    Full Text Available Abstract Background Systematic reviews (SRs are considered an important tool for decision-making. There has been no recent comprehensive identification or description of child-relevant SRs. A description of existing child-relevant SRs would help to identify the extent of available child-relevant evidence available in SRs and gaps in the evidence base where SRs are required. The objective of this study was to describe child-relevant SRs from the Cochrane Database of Systematic Reviews (CDSR, Issue 2, 2009. Methods SRs were assessed for relevance using pre-defined criteria. Data were extracted and entered into an electronic form. Univariate analyses were performed to describe the SRs overall and by topic area. Results The search yielded 1666 SRs; 793 met the inclusion criteria. 38% of SRs were last assessed as up-to-date prior to 2007. Corresponding authors were most often from the UK (41%. Most SRs (59% examined pharmacological interventions. 53% had at least one external source of funding. SRs included a median of 7 studies (IQR 3, 15 and 679 participants (IQR 179, 2833. Of all studies, 48% included only children, and 27% only adults. 94% of studies were published in peer-reviewed journals. Primary outcomes were specified in 72% of SRs. Allocation concealment and the Jadad scale were used in 97% and 25% of SRs, respectively. Adults and children were analyzed separately in 12% of SRs and as a subgroup analysis in 14%. Publication bias was assessed in only 14% of SRs. A meta-analysis was conducted in 68% of SRs with a median of 5 trials (IQR 3, 9 each. Variations in these characteristics were observed across topic areas. Conclusions We described the methodological characteristics and rigour of child-relevant reviews in the CDSR. Many SRs are not up-to-date according to Cochrane criteria. Our study describes variation in conduct and reporting across SRs and reveals clinicians' ability to access child-specific data.

  6. Home-Based Multidisciplinary Rehabilitation following Hip Fracture Surgery: What Is the Evidence?

    OpenAIRE

    Kathleen Donohue; Richelle Hoevenaars; Jocelyn McEachern; Erica Zeman; Saurabh Mehta

    2013-01-01

    Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery. Methods. Systematic review methodology suggested by Cochrane Collboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided. Results. Five studies were included. Over the short-term,...

  7. Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews

    OpenAIRE

    Connolly, Bronwen; Brenda, O'Neill; Salisbury, Lisa; Blackwood, Bronagh

    2016-01-01

    Background Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery.Methods Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appr...

  8. Physiotherapeutic interventions and rehabilitation regimen of the surgically stabilized proximal humeral fracture – a literature review

    OpenAIRE

    Rosén, Kajsa

    2010-01-01

    Proximal humeral fractures requiring surgical stabilization remain a therapeutic challenge, and a fully functioning joint is rarely the outcome after traumatic proximal humeral fractures. A systematic review was conducted to present the current state of knowledge concerning the postoperative rehabilitation. Tree databases was searched (PubMed, PEDro and the Cochrane library), presenting 25 publications eligible for further review and assessment. The literature was evaluated using PEDro and Th...

  9. Vertigo and vestibular rehabilitation.

    OpenAIRE

    Konnur M

    2000-01-01

    The role of rehabilitation in the management of vertigo is limited to a very specific group of conditions. An Occupational therapist who is a part of the multidisciplinary team treating the vertiginous patient, with the knowledge of physiology and therapeutic benefit of vestibular rehabilitation can widen the rehabilitation spectrum for various diseases producing vertigo and dysequilibrium, to resolve or minimise these symptoms. The present article reviews the need for vestibular rehabilitati...

  10. Milrinone for cardiac dysfunction in critically ill adult patients

    DEFF Research Database (Denmark)

    Koster, Geert; Bekema, Hanneke J; Wetterslev, Jørn;

    2016-01-01

    review was performed according to The Cochrane Handbook for Systematic Reviews of Interventions. Searches were conducted until November 2015. Patients with cardiac dysfunction were included. The primary outcome was serious adverse events (SAE) including mortality at maximum follow-up. The risk of bias...... analyses displayed statistical and/or clinical heterogeneity of patients, interventions, comparators, outcomes, and/or settings and all featured missing data. DISCUSSION: The current evidence on the use of milrinone in critically ill adult patients with cardiac dysfunction suffers from considerable risks...

  11. Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

    Science.gov (United States)

    Daws, Karen; Punch, Amanda; Winters, Michelle; Posenelli, Sonia; Willis, John; MacIsaac, Andrew; Rahman, Muhammad Aziz; Worrall-Carter, Linda

    2014-11-01

    Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. PMID:25200319

  12. 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

    .01), self-care management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density......%). 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-to-treat and...

  13. Rehabilitation and Prosthetic Services

    Science.gov (United States)

    ... Therapy Mental Health Physical Medicine and Rehabilitation Services Physical Therapy Prosthetic and Sensory Aids Service Benefits Prosthetic and Sensory Aids Service General Information Prosthetic ...

  14. Physical medicine and rehabilitation

    Science.gov (United States)

    ... serious illness (such as infection, heart failure or respiratory failure ) Spinal cord injury or brain injury Children may need rehabilitation services for: Down syndrome or other genetic disorders ...

  15. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  16. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  17. Cardiac sarcoidosis

    Science.gov (United States)

    Smedema, J.P.; Zondervan, P.E.; van Hagen, P.; ten Cate, F.J.; Bresser, P.; Doubell, A.F.; Pattynama, P.; Hoogsteden, H.C.; Balk, A.H.M.M.

    2002-01-01

    Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology. Symptomatic cardiac involvement occurs in approximately 5% of patients. The prevalence of sarcoidosis in the Netherlands is unknown, but estimated to be approximately 20 per 100,000 population (3200 patients). We report on five patients who presented with different manifestations of cardiac sarcoidosis, and give a brief review on the current management of this condition. Magnetic Resonance Imaging (MRI) can be of great help in diagnosing this condition as well as in the follow-up of the response to therapy. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:25696121

  18. Efficacy and safety of landiolol for prevention of atrial fibrillation after cardiac surgery: a meta-analysis of randomized controlled trials

    OpenAIRE

    Liang LI; Ai, Qing; Lin, Ling; Ge, Pu; Yang, Changming; Zhang, Li

    2015-01-01

    Atrial fibrillation (AF) is a quite common complication during the postoperative period after cardiac surgery. Increasing studies have reported that landiolol may be effective in prevention of AF after cardiac surgery. Its efficacy and safety are seldom explored; hence we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of landiolol in prevention of AF after cardiac surgery. Databases of PubMed, Embase and Cochrane Central Register of Contro...

  19. Effectiveness of rehabilitation interventions in improving emotional and functional status in hearing or visually impaired older adults : a systematic review with meta-analyses

    NARCIS (Netherlands)

    Roets-Merken, Lieve M.; Draskovic, Irena; Zuidema, Sytse U.; van Erp, Willemijn S.; Graff, Maud J. L.; Kempen, Gertrudis I. J. M.; Vernooij-Dassen, Myrra J. F. J.

    2015-01-01

    Objective: To assess the effectiveness of non-equipment based rehabilitation interventions for older adults with an age-related hearing or visual impairment. Data sources: We searched PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Central Register of Controlled Trials. Review methods: Two autho

  20. Effectiveness of rehabilitation interventions in improving emotional and functional status in hearing or visually impaired older adults: a systematic review with meta-analyses

    NARCIS (Netherlands)

    Roets-Merken, L.M.; Draskovic, I.; Zuidema, S.U.; Erp, W.S. van; Graff, M.J.L.; Kempen, G.I.; Vernooij-Dassen, M.J.F.J.

    2015-01-01

    OBJECTIVE: To assess the effectiveness of non-equipment based rehabilitation interventions for older adults with an age-related hearing or visual impairment. DATA SOURCES: We searched PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Central Register of Controlled Trials. REVIEW METHODS: Two autho

  1. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  2. Rehabilitation in German Prisons.

    Science.gov (United States)

    Dammer, Harry R.

    1996-01-01

    Using interviews, literature reviews, and prison visits, describes three prominent features that promote rehabilitation in one country's prisons: unique environmental conditions, extensive work and training programs, and frequent use of community reintegration programs. Attributes rehabilitation success to its high priority in correctional law and…

  3. Effective Teamwork in Rehabilitation.

    Science.gov (United States)

    Bakheit, A. M. O.

    1996-01-01

    This paper examines the merits of the interdisciplinary team model in rehabilitation settings and defines the organizational characteristics and operational polices that enhance the performance of a rehabilitation team. Team structure, leadership, process, decision making, communication, and the roles of team members are addressed. (CR)

  4. Psykiatrisk og psykosocial rehabilitering

    DEFF Research Database (Denmark)

    Eplov, Lene Falgaard; Korsbek, Lisa; Petersen, Lone Bente; Olander, Mette

    Psykiatrisk & psykosocial rehabilitering - en recoveryorienteret tilgang beskriver rehabilitering til mennesker med sindslidelser. Udgangspunktet er en indsats med fokus på den enkeltes egne mål og ressourcer. Bogen bidrager bl.a. med metoder og teoretiske forudsætninger for en national psykiatrisk...

  5. Rehabilitering ved spiseforstyrrelser

    DEFF Research Database (Denmark)

    Lau, Marianne Engelbrecht; Waaddegaard, Mette

    Psykiatrisk & psykosocial rehabilitering - en recoveryorienteret tilgang beskriver rehabilitering til mennesker med sindslidelser. Udgangspunktet er en indsats med fokus på den enkeltes egne mål og ressourcer. Bogen bidrager bl.a. med metoder og teoretiske forudsætninger for en national psykiatrisk...

  6. 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...

  7. Rehabilitation and multiple sclerosis

    DEFF Research Database (Denmark)

    Dalgas, Ulrik

    2011-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point...... of their lives, emphasising the importance of rehabilitation in order to maintain quality of life. An important aspect of multiple sclerosis rehabilitation is the preservation of physical functioning. Hot topics in the rehabilitation of physical function include (1) exercise therapy, (2) robot-assisted training...... and (3) pharmacological interventions. Exercise therapy has for many years been a controversial issue in multiple sclerosis rehabilitation and the advice generally given to patients was not to participate in physical exercise, since it was thought to lead to a worsening of symptoms or fatigue. However...

  8. 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

    papers on acupuncture in stroke rehabilitation appeared in journals with a particular focus on rehabilitation research, such as Stroke, Archives of Physical Medicine, Cochrane Database of Systematic Reviews and Journal of Alternative and Complementary Medicine. (2) In the ClinicalTrials.gov, three studies can be searched on acupuncture and stroke, all of which were registered and sponsored by Chinese institutions since February 2009.CONCLUSION: From our analysis of the literature and research trends, we found that acupuncture in stroke rehabilitation may offer further benefits in regenerative medicine.

  9. Diagnostic accuracy of pleural fluid NT-pro-BNP for pleural effusions of cardiac origin: a systematic review and meta-analysis

    OpenAIRE

    Swiston John; Janda Surinder

    2010-01-01

    Abstract Background Several studies have been published in the literature on the diagnostic accuracy of NT-pro-BNP for pleural effusions from heart failure in the last decade. The purpose of our study was to perform a systematic review and meta-analysis on the diagnostic accuracy of pleural fluid NT-pro-BNP for pleural effusions of cardiac origin. Methods MEDLINE, EMBASE, PapersFirst, and the Cochrane collaboration and the Cochrane Register of controlled trials were searched. All searches wer...

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

    DEFF Research Database (Denmark)

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

    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 in...... Scale. Of these, 78 (29.8%) reported that they had participated in psychosocial support, and 55 (21.0%) used antidepressants. One in fi ve patients smoked three months after MI although nearly half of the smokers had stopped after the MI. Regarding cardioprotective drugs, 714 (78.6%) used aspirin, 694...

  11. Lifestyle Factors in Hypertension Drug Research: Systematic Analysis of Articles in a Leading Cochrane Report

    Directory of Open Access Journals (Sweden)

    Dan E. Wilson

    2014-01-01

    Full Text Available Established standards for first-line hypertension management include lifestyle modification and behavior change. The degree to which and how lifestyle modification is systematically integrated into studies of first-line drug management for hypertension is of methodological and clinical relevance. This study systematically reviewed the methodology of articles from a recent Cochrane review that had been designed to inform first-line medical treatment of hypertension and was representative of high quality established clinical trials in the field. Source articles (n=34 were systematically reviewed for lifestyle interventions including smoking cessation, diet, weight loss, physical activity and exercise, stress reduction, and moderate alcohol consumption. 54% of articles did not mention lifestyle modification; 46% contained nonspecific descriptions of interventions. We contend that hypertension management research trials (including drug studies need to elucidate the benefits and risks of drug-lifestyle interaction, to support the priority of lifestyle modification, and that lifestyle modification, rather than drugs, is seen by patients and the public as a priority for health professionals. The inclusion of lifestyle modification strategies in research designs for hypertension drug trials could enhance current research, from trial efficacy to clinical outcome effectiveness, and align hypertension best practices of a range of health professionals with evidence-based knowledge translation.

  12. Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Gaetana Cognetti

    2015-03-01

    Full Text Available Introduction. Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Materials and methods. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. Results. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese was not consulted. Conclusion. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project. To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.

  13. Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial

    Science.gov (United States)

    Adams, C E; Bodart, A Y M; Sampson, S; Zhao, S; Montgomery, A A

    2016-01-01

    Objective To assess the effects of using health social media on web activity. Design Individually randomised controlled parallel group superiority trial. Setting Twitter and Weibo. Participants 170 Cochrane Schizophrenia Group full reviews with an abstract and plain language summary web page. Interventions Three randomly ordered slightly different 140 character or less messages, each containing a short URL to the freely accessible summary page sent on specific times on one single day. This was compared with no messaging. Outcome The primary outcome was web page visits at 1 week. Secondary outcomes were other metrics of web activity at 1 week. Results 85 reviews were randomised to each of the intervention and control arms. Google Analytics allowed 100% follow-up within 1 week of completion. Intervention and control reviews received a total of 1162 and 449 visits, respectively (IRR 2.7, 95% CI 2.2 to 3.3). Fewer intervention reviews had single page only visits (16% vs 31%, OR 0.41, 0.19 to 0.88) and users spent more time viewing intervention reviews (geometric mean 76 vs 31 s, ratio 2.5, 1.3 to 4.6). Other secondary metrics of web activity all showed strong evidence in favour of the intervention. Conclusions Tweeting in this limited area of healthcare increases ‘product placement’ of evidence with the potential for that to influence care. Trial registration number ISRCTN84658943. PMID:26956164

  14. Evaluación de la escala Borg de esfuerzo percibido aplicada a la rehabilitación cardiaca Instrument evaluation of Borg's perceived exertion scale in cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Natalie Burkhalter

    1996-12-01

    Full Text Available La escala Borg de esfuerzo percibido mide la gama entera del esfuerzo que el individuo percibe al hacer ejercicio. Esta escala da criterios para hacerle ajustes a la intensidad de ejercicio, o sea, a la carga de trabajo, y así pronosticar y dictaminar las diferentes intensidades del ejercicio en los deportes y en la rehabilitación médica (BORG, 1982. También se puede usar tanto en el atletismo, en la astronáutica, la industria y ambientes militares, como en las situaciones cotidianas. El concepto del esfuerzo percibido es una valoración subjetiva que indica la opinión del sujeto respecto a la intensidad del trabajo realizado (MORGAN, 1973. El sujeto que hace el ejercicio debe asignar un número del 1 al 20, para representar la sensación subjetiva de la cantidad de trabajo desempeñado. La escala es una herramienta valiosa dentro del ámbito del desempeño humano, en que a menudo la consideración importante no es tanto "lo que haga el individuo" "sino" "lo que cree que hace" (MORGAN, 1973.Borg's perceived exertion scale measures the extent of perceived exertion which a person experiences during exercise. The perceived exertion scale is used to adjust exercise intensity (workload for predictions and prescriptions of exercise intensities in sports and medical rehabilitation (BORG, 1982. In addition, Borg's scale can be used in the athletic arena, space, industry, military settings, or under everyday circumstances. The concept of perceived exertion is a subjective rating, indicating the subject's opinion about the intensity of the work being performed (MORGAN, 1973. The task of exercising subjects is to assign a number (from 1-20 to represent the subjective sensation of the amount of work being performed. This is a valuable tool in human performance setting, where an important consideration is not "what the individual is doing, but what he thinks and is doing" (MORGAN, 1973.

  15. Desenvolvimento e validação da versão em português da Escala de Barreiras para Reabilitação Cardíaca Development and validation of the Brazilian Portuguese version of the Cardiac Rehabilitation Barriers Scale

    Directory of Open Access Journals (Sweden)

    Gabriela Lima de Melo Ghisi

    2012-04-01

    Full Text Available FUNDAMENTO: As doenças cardiovasculares possuem alta incidência e prevalência no Brasil, porém a participação na Reabilitação Cardíaca (RC é limitada e pouco investigada no país. A Escala de Barreiras para Reabilitação Cardíaca (CRBS foi desenvolvida para avaliar as barreiras à participação e aderência à RC. OBJETIVO: Traduzir, adaptar culturalmente e validar psicometricamente a CRBS para a língua portuguesa do Brasil. MÉTODOS: Duas traduções iniciais independentes foram realizadas. Após a tradução reversa, ambas versões foram revisadas por um comitê. A versão gerada foi testada em 173 pacientes com doença arterial coronariana (48 mulheres, idade média = 63 anos. Desses, 139 (80,3% participantes de RC. A consistência interna foi avaliada pelo alfa de Cronbach, a confiabilidade teste-reteste pelo coeficiente de correlação intraclasse (ICC e a validade de construto por análise fatorial. Testes-T foram utilizados para avaliar a validade de critério entre participantes e não participantes de RC. Os resultados da aplicação em função das características dos pacientes (gênero, idade, estado de saúde e grau de escolaridade foram avaliados. RESULTADOS: A versão em português da CRBS apresentou alfa de Cronbach de 0,88, ICC de 0,68 e revelou cinco fatores, cuja maioria apresentou-se internamente consistente e todos definidos pelos itens. O escore médio para pacientes em RC foi 1,29 (desvio padrão = 0,27 e para pacientes do ambulatório 2,36 (desvio padrão = 0,50 (p BACKGROUND: Cardiovascular diseases show high incidence and prevalence in Brazil; however, participation in Cardiac Rehabilitation (CR is limited and has been poorly investigated in the country. The Cardiac Rehabilitation Barriers Scale (CRBS was developed to assess the barriers to participation and adherence to CR. OBJECTIVE: To translate, cross-culturally adapt and psychometrically validate CRBS to Brazilian Portuguese. METHODS: Two independent

  16. 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...

  17. Cardiac rhabdomyosarcoma

    OpenAIRE

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan

    2001-01-01

    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  18. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  19. Behandling af våd aldersrelateret makuladegeneration med vaskulaer endotel vaekstfaktorhaemmer. Gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi; Larsen, Michael

    2009-01-01

    This evaluation of a Cochrane-review including five clinical trials of good methodological quality indicates that the antiangiogenic therapeutic agents, pegaptanib and ranibizumab, are effective treatment strategies for neovascular Age-Related Macular Degeneration (AMD). The review does not inclu...

  20. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment, A Cochrane Review

    NARCIS (Netherlands)

    Angevaren, Maaike; Aufdemkampe, Geert; Verhaar, H.J.J.; Aleman, A.; Vanhees, L.E.M.J.

    2008-01-01

    Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD005381. DOI: 10.1002/14651858.CD005381.pub2. Background: Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is

  1. Single versus double intrauterine insemination in stimulated cycles for subfertile couples : a systematic review based on a Cochrane review

    NARCIS (Netherlands)

    Cantineau, AEP; Heineman, MJ; Cohlen, BJ

    2003-01-01

    BACKGROUND: The objective of this review was to determine, from the best available evidence, the difference in outcome using single versus double intrauterine insemination (IUI) in stimulated cycles for subfertile couples. METHODS: The principles of the Cochrane Menstrual Disorders and Subfertility

  2. [Social rehabilitation through sports].

    Science.gov (United States)

    Strohkendl, H

    1995-11-01

    The contribution community disabled sports is making towards comprehensive rehabilitation of people with disabilities is interpreted much too narrowly by the statutory definition of rehabilitation sports. In the member clubs of Deutscher Behinderten-Sportverband, the German disabled sports association, severely disabled individuals rediscover their potential and self-worth, which may entail self-determination, solidarity with others, and genuine social integration. Renewed awareness of the traditional values of German disabled sports as a self-help movement of those concerned, and characterization of rehabilitation as a complex learning process towards regaining personal autonomy--both call for a thorough reconsideration of ambulatory disabled sports in organizational and funding respects. PMID:8570904

  3. Cardiac arrhythmias during or after epileptic seizures.

    Science.gov (United States)

    van der Lende, Marije; Surges, Rainer; Sander, Josemir W; Thijs, Roland D

    2016-01-01

    Seizure-related cardiac arrhythmias are frequently reported and have been implicated as potential pathomechanisms of Sudden Unexpected Death in Epilepsy (SUDEP). We attempted to identify clinical profiles associated with various (post)ictal cardiac arrhythmias. We conducted a systematic search from the first date available to July 2013 on the combination of two terms: 'cardiac arrhythmias' and 'epilepsy'. The databases searched were PubMed, Embase (OVID version), Web of Science and COCHRANE Library. We attempted to identify all case reports and case series. We identified seven distinct patterns of (post)ictal cardiac arrhythmias: ictal asystole (103 cases), postictal asystole (13 cases), ictal bradycardia (25 cases), ictal atrioventricular (AV)-conduction block (11 cases), postictal AV-conduction block (2 cases), (post)ictal atrial flutter/atrial fibrillation (14 cases) and postictal ventricular fibrillation (3 cases). Ictal asystole had a mean prevalence of 0.318% (95% CI 0.316% to 0.320%) in people with refractory epilepsy who underwent video-EEG monitoring. Ictal asystole, bradycardia and AV-conduction block were self-limiting in all but one of the cases and seen during focal dyscognitive seizures. Seizure onset was mostly temporal (91%) without consistent lateralisation. Postictal arrhythmias were mostly found following convulsive seizures and often associated with (near) SUDEP. The contrasting clinical profiles of ictal and postictal arrhythmias suggest different pathomechanisms. Postictal rather than ictal arrhythmias seem of greater importance to the pathophysiology of SUDEP. PMID:26038597

  4. Getting evidence into practice: the work of the Cochrane Effective Practice and Organization of care Group (EPOC).

    Science.gov (United States)

    Mowatt, G; Grimshaw, J M; Davis, D A; Mazmanian, P E

    2001-01-01

    Policy makers and continuing educators often face difficult decisions about which educational and quality assurance interventions to provide. Where possible, such decisions are best informed by rigorous evidence, such as that provided by systematic reviews. The Cochrane Collaboration is an international organization that aims to help people make well-informed decisions about health care by preparing, maintaining, and ensuring the accessibility of systematic reviews of the benefits and risks of health care interventions. International collaborative review groups prepare Cochrane reviews for publication in The Cochrane Library, a collection of databases available on CD-ROM and the World Wide Web and updated quarterly. The Cochrane Effective Practice and Organization of Care Group (EPOC) aims to prepare and maintain systematic reviews of professional, financial, organizational, and regulatory interventions that are designed to improve professional practice and the delivery of effective health services. EPOC has 17 reviews and 20 protocols published in Issue 3, 2000, of the Cochrane Library, with further protocols in development. We also have undertaken an overview of previously published systematic reviews of professional behavior change strategies. Our specialized register contains details of over 1,800 studies that fall within the group's scope. Systematic reviews provide a valuable source of information for policy makers and educators involved in planning continuing education and quality assurance initiatives and organizational change. EPOC will attempt to keep the Journal of Continuing Education in the Health Professions informed on an ongoing basis about new systematic reviews that it produces in the area of continuing medical education and quality assurance. PMID:11291587

  5. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

    Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith;

    2009-01-01

    Refugees have often been exposed to torture in their countries of origin. A core issue is the resulting multifaceted presentation of somatic, psychological and social problems in the same individual, leading to severe activity limitations and participation restrictions. An international conference......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark, in...... December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach...

  6. 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

  7. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... in rehabilitation? How soon should people return to school or work after a spinal cord injury? What's important to know about sex and intimacy after a spinal cord injury? Why ...

  8. Neirab Rehabilitation Project

    Directory of Open Access Journals (Sweden)

    Lex Takkenberg

    2005-01-01

    Full Text Available Rehabilitation of the Neirab camp in northern Syria shows how improving the living conditions of Palestinian refugees need not invalidate their legal status, nor prejudicetheir right to return or receive compensation.

  9. Cambodia rehabilitates Kirirom

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The China Electric Power Technology Import & Export Corporation (CETIC) has signed a US$ 26M contract with Cambodia's Ministry of Industry, Mines and Energy (MIME) to rehabilitate the Kirirom 1 hydro project.

  10. Neirab Rehabilitation Project

    OpenAIRE

    Lex Takkenberg; Hala Mukhles

    2005-01-01

    Rehabilitation of the Neirab camp in northern Syria shows how improving the living conditions of Palestinian refugees need not invalidate their legal status, nor prejudicetheir right to return or receive compensation.

  11. Effects of exercise rehabilitation on blood pressure of patients after myocardial infarction

    OpenAIRE

    Mehdi Kargarfard; Reza Rouzbehani; Fatema Basati

    2010-01-01

    Objectives: Supervised exercise cardiac rehabilitation programs have been suggested to all patients specially patients with post-myocardial infarction (MI) for many years. However, limited in-formation is available on the usefulness of exercise rehabilitation programs in chronic MI. The aim of this study was to evaluate the outcome of supervised exercise training on MI patients by measur-ing both physical and physiological factors. Methods: This was a semi-experimental randomized study. It...

  12. Comparison of two models of hospital rehabilitation in patients after coronary artery bypass grafting

    OpenAIRE

    Karaszewski, Daniel

    2014-01-01

    Introduction Taking into consideration the rise in ischemic heart disease and the increasing number of performed cardiac surgery procedures, attempts have been made to prepare an optimal rehabilitation program enabling the effective improvement of patient condition in the shortest possible time-frame that would be of most benefit for the patients [1, 2]. Aim of the study Aim of the study was to compare the therapeutic efficacy of two rehabilitation models (I – a modified model, and II – the s...

  13. Rehabilitation of cancer patients.

    OpenAIRE

    Pandey M; Thomas B

    2001-01-01

    With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent ...

  14. Pulmonary Rehabilitation in Emphysema

    OpenAIRE

    Ries, Andrew L.; Make, Barry J; Reilly, John J.

    2008-01-01

    Pulmonary rehabilitation is an established treatment for patients with chronic lung disease. Benefits include improvement in exercise tolerance, symptoms, and quality of life, with a reduction in the use of health care resources. As an adjunct to surgical programs, such as lung volume reduction surgery, pulmonary rehabilitation plays an important role not just in preparing patients for surgery and facilitating recovery but also in selecting patients and ensuring informed choices about treatme...

  15. Biofeedback in rehabilitation

    OpenAIRE

    Giggins, Oonagh M; Persson, Ulrik McCarthy; Caulfield, Brian

    2013-01-01

    This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-tim...

  16. Rehabilitation in cerebral palsy.

    OpenAIRE

    Molnar, G. E.

    1991-01-01

    Cerebral palsy is the most frequent physical disability of childhood onset. Over the past four decades, prevalence has remained remarkably constant at 2 to 3 per 1,000 live births in industrialized countries. In this article I concentrate on the rehabilitation and outcome of patients with cerebral palsy. The epidemiologic, pathogenetic, and diagnostic aspects are highlighted briefly as they pertain to the planning and implementation of the rehabilitation process.

  17. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper; Hansen, John; Nielsen, Gitte; Spindler, Helle; Dinesen, Birthe

    2016-01-01

    AND METHODS: The analysis was carried out together with a randomized controlled trial with 151 patients during 2012-2014. Costs of the intervention were estimated with a health sector perspective following international guidelines for CU. Quality of life was assessed using the 36-Item Short Form...... Health Survey. RESULTS: The rehabilitation activities were approximately the same in the two groups, but the number of contacts with the physiotherapist was higher among the intervention group. The mean total cost per patient was €1,700 higher in the intervention group. The quality-adjusted life......BACKGROUND: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR...

  18. Cardiac conduction system

    Science.gov (United States)

    The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals ... to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle ...

  19. Z dokazi podprta rehabilitacija - kako učinkovita je elektroterapija?: Evidence based rehabilitation - how effective is electrotherapy?:

    OpenAIRE

    Jamnik, Helena

    2011-01-01

    Electrotherapy is a therapeutic modality very often used in physical medicine and rehabilitation. This review article investigates evidence on benefit of different types of electrotherapy via literature search of MEDLINE, PEDRO and Cochrane Collaboration up to January 2011. The literature supports evidence of effectiveness in cases of iontophoresis for tendinopathies (level of evidence II-III), TENS for neck pain (level III-IV), TENS for diabetic painfulneuropathy (level II), TENS for pain af...

  20. Rehabilitation Role Perceptions and Vocational Interests of Undergraduate Rehabilitation Students

    Science.gov (United States)

    Kelz, James W.; Fullerton, John

    1972-01-01

    This study focused on how undergraduate rehabilitation students perceive the ideal person in rehabilitation services and related these perceptions to vocational interests as measured by the Strong Vocational Interest Blank. (Author)

  1. [Treatment and rehabilitation of dysphagia following cerebrovascular disease].

    Science.gov (United States)

    López-Liria, Remedios; Fernández-Alonso, Melodie; Vega-Ramírez, Francisco A; Salido-Campos, M Ángeles; Padilla-Góngora, David

    2014-03-16

    INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation and acupuncture. CONCLUSIONS. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people's social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner. PMID:24610693

  2. [Cochrane EPOC group: closing the gap between quality assurance and organization of care research and front line professionals].

    Science.gov (United States)

    Moja, P L; Castelli, B; McCauley, L; Grilli, R; Auxilia, F

    2005-01-01

    Keeping physicians informed on an ongoing basis is a new challenge for continuing medical education and quality assurance. In Italy over the last 5 years interest in evidence based literature is growing. This is demonstrated by the launch of an Italian edition of Clinical Evidence and by the growing number of guidelines and systematic reviews produced by Italian authors and institutions. However, there is some uncertainty concerning the familiarity of Italian policy makers and public health physicians with the evidence-based resources, including also how to access them. This article attempts to close this gap, by describing the activities of the Cochrane Collaboration and, within it, of the Cochrane Effective Practice and Organisation of Care Group (EPOC), both aim to prepare and maintaining SR of health care interventions. Specifically, the EPOC group develops systematic reviews of professional, financial, organisational and regulatory interventions that are designed to improve professional practice and the delivery of effective health services. EPOC has 31 reviews and 24 protocols published in Issue 4, 2004 of the Cochrane Library and has developed standard methods to assist people, such as quality criteria for study design specific to health services research. The EPOC specialized register contains details of over 2200 studies that fall within the group's scope. Systematic reviews provide a valuable and efficient source of information for policy makers and health care professionals aimed at implementing effective and efficient strategies to encourage medical behavioural change and deliver of high quality services. PMID:16523717

  3. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features ... facility. Who Needs to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may ...

  4. Rehabilitation courses for road users.

    NARCIS (Netherlands)

    2010-01-01

    Rehabilitation courses are educational measures directed at deviant driving behaviour of car drivers. The Netherlands has four rehabilitation courses: EMA (Educational Measure Alcohol and traffic), LEMA (Lighter version of EMA), EMG (Educational Measure Behaviour and traffic) and ASP (Alcohol Interl

  5. Rehabilitative and Assistive Technology: Overview

    Science.gov (United States)

    ... Clinical Trials Resources and Publications Rehabilitative and Assistive Technology: Overview Skip sharing on social media links Share this: Page Content Rehabilitative and assistive technology refers to tools, equipment, or products that can ...

  6. Social inequality in cancer rehabilitation

    DEFF Research Database (Denmark)

    Holm, Lise Vilstrup; Hansen, Dorte Gilså; Larsen, Pia Veldt;

    2013-01-01

    of rehabilitation. Individual information on cohabitation status, education, income and labour market status was retrieved from national registers. Logistic regression analyses were used to explore associations between socioeconomic status and rehabilitation outcomes. Results. A total of 3439 patients responded (70...

  7. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  8. O impacto do CPAP na reabilitação cardíaca de pacientes com ICC: relato de caso El impacto del CPAP en la rehabilitación cardíaca de pacientes con ICC: caso clínico The impact of continuous positive airway pressure (CPAP on the cardiac rehabilitation of patients with congestive heart failure: case report

    Directory of Open Access Journals (Sweden)

    Murillo Frazão de Lima e Costa

    2010-07-01

    Full Text Available A insuficiência cardíaca congestiva é uma patologia que limita a função física do paciente. Neste estudo foi analisada uma paciente, realizando um programa de reabilitação cardíaca associado à pressão positiva contínua nas vias aéreas, aferindo-se antes do estudo e após 6 semanas, o teste de caminhada de 6 minutos (TC6M, questionário de qualidade de vida e ecocardiograma. A paciente aumentou a distância no TC6M de 152,5 m para 520,44 m. O questionário Minnesota reduziu de 62 para 18. A fração de ejeção subiu de 33% para 36%. Na paciente estudada a conduta melhorou o desempenho físico e a qualidade de vida.La insuficiencia cardíaca congestiva es una patología que limita la función física del paciente. En este estudio fue analizada una paciente, realizando un programa de rehabilitación cardíaca asociado a la presión positiva continua en las vías aéreas, realizando antes del estudio y después de 6 semanas, el test de caminata de 6 minutos (TC6M, cuestionario de calidad de vida y ecocardiograma. La paciente aumentó la distancia en el TC6M de 152,5 m a 520,44 m. El cuestionario Minnesota redujo de 62 a 18. La fracción de eyección subió de 33% a 36%. En la paciente estudiada la conducta mejoró el desempeño físico y la calidad de vida.Congestive heart failure is a pathology that limits the patient's physical function. This study analyzed one patient who was submitted to a cardiac rehabilitation program associated to Continuous Positive Airway Pressure (CPAP, by assessing the results of the six-minute walk test (6MWT and a questionnaire on the quality of life and performing an echocardiographic assessment before the study and after six weeks. The distance walked by the patient increased from 152.5 m to 520.44 m at the 6MWT. The Minnesota questionnaire score decreased from 62 to 18. Ejection fraction increased from 33% to 36%. Therefore, the management chosen for this case improved the patient's physical performance

  9. Rehabilitation in vestibular system diseases

    Directory of Open Access Journals (Sweden)

    Maksim Valeryevich Zamergrad

    2013-03-01

    Full Text Available 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, inadequate mobility, anxiety, and depression decelerate vestibular compensation whereas early activation, mobility, and betaserc use accelerate it.

  10. [Rehabilitation after periprosthetic fractures].

    Science.gov (United States)

    Schmitt-Sody, M; Valle, C

    2016-03-01

    Periprosthetic fractures of the upper and lower extremities not only represent a challenge for surgeons but also for the rehabilitation team. The sometimes multimorbid patients have often undergone several surgical operations and need special planning and cooperation between an interdisciplinary team in order to achieve the best possible functional result and social reintegration. A structured rehabilitation planning after surgical treatment is a prerequisite for the patient to return to life as normal as possible. The aim is always rapid mobilization to achieve independence in activities of daily living. Special attention should be paid to postoperative immobilization and weight bearing. PMID:26923872

  11. Games for Rehabilitation

    DEFF Research Database (Denmark)

    Petersson, Eva; Brown, David

    This anthology on games for rehabilitation contains a serious chapters on game methods and apps or research that compares game systems or modified games or interface devices (Wii, Eyetoy, Kinect, DDR) applied across all areas of clinical care and clinically focused research.......This anthology on games for rehabilitation contains a serious chapters on game methods and apps or research that compares game systems or modified games or interface devices (Wii, Eyetoy, Kinect, DDR) applied across all areas of clinical care and clinically focused research....

  12. Pulmonary rehabilitation and severe exacerbations of COPD: solution or white elephant?

    Directory of Open Access Journals (Sweden)

    William D-C. Man

    2015-10-01

    Full Text Available Hospitalisations for severe exacerbations of chronic obstructive pulmonary disease are associated with significant physical and psychological consequences including an increase in symptom severity, severe reductions in physical activity, a deleterious effect on skeletal muscle, impaired exercise tolerance/ability to self-care, decline in quality of life, and increased anxiety and depression. As these consequences are potentially amenable to exercise training, there is a clear rationale for pulmonary rehabilitation in the peri/post-exacerbation setting. Although a 2011 Cochrane review was overwhelmingly positive, subsequent trials have shown less benefit and real-life observational studies have revealed poor acceptability. Qualitative studies have demonstrated that the patient experience is a determining factor while the presence of comorbidities may influence referral, adherence and response to pulmonary rehabilitation. Systematic reviews of less supervised interventions, such as self-management, have shown limited benefits in the post-exacerbation setting. The recent update of the Cochrane review of peri-exacerbation pulmonary rehabilitation showed that benefits were associated with the “comprehensive” nature of the intervention (the number of sessions received, the intensity of exercise training and education delivered, and the degree of supervision but implementation is demanding. The challenge is to develop interventions that are deliverable and acceptable around the time of an acute exacerbation but also deliver the desired clinical impact.

  13. Auditory stimulation and cardiac autonomic regulation

    Directory of Open Access Journals (Sweden)

    Vitor E. Valenti

    2012-08-01

    Full Text Available Previous studies have already demonstrated that auditory stimulation with music influences the cardiovascular system. In this study, we described the relationship between musical auditory stimulation and heart rate variability. Searches were performed with the Medline, SciELO, Lilacs and Cochrane databases using the following keywords: "auditory stimulation", "autonomic nervous system", "music" and "heart rate variability". The selected studies indicated that there is a strong correlation between noise intensity and vagal-sympathetic balance. Additionally, it was reported that music therapy improved heart rate variability in anthracycline-treated breast cancer patients. It was hypothesized that dopamine release in the striatal system induced by pleasurable songs is involved in cardiac autonomic regulation. Musical auditory stimulation influences heart rate variability through a neural mechanism that is not well understood. Further studies are necessary to develop new therapies to treat cardiovascular disorders.

  14. Bruce NGS rehabilitation program

    International Nuclear Information System (INIS)

    The paper summarizes the status at the time of writing of the program to rehabilitate the 4-unit Bruce A Nuclear Generating Station. The aim of the program was to restore the target 85% capacity factor by repair and proactive maintenance

  15. Outpatients in Neurological Rehabilitation.

    Science.gov (United States)

    Barnes, M. P.; Skeil, D. A.

    1996-01-01

    This paper describes the multidisciplinary approach used at a neurological rehabilitation clinic in England. Analysis of questionnaire responses from outpatients indicated general support for the multidisciplinary approach, though a significant minority felt intimidated by the large number of professionals seen simultaneously. Patients also…

  16. Rehabilitation in Japan, 1988.

    Science.gov (United States)

    Japanese Society for Rehabilitation of the Disabled, Tokyo.

    The scope of Japan's rehabilitation services for persons with disabilities is reviewed and discussed from the perspective of social and demographic change in that country. An introductory chapter on the current situation in Japan looks at characteristics of the land, the people, the government, industry and the economy, and the culture. The second…

  17. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Fertility After Spinal Cord Injury Coping with a New Injury Coping with a New Injury Adjusting to Social Life in a Wheelchair ... The Basics of Pediatric SCI Rehabilitation Transitions for Children with Spinal Cord Injury Transitions for Children with ...

  18. [Quality in rehabilitation].

    Science.gov (United States)

    Jäckel, W H

    2010-12-01

    Particularly in the context of introduction of quality assurance programmes 15 years ago, "quality" became a central issue for rehabilitation, and its importance is bound to grow in the years to come. After giving a general definition of quality, this article deals more closely with 3 aspects of quality: quality development, quality assurance, and data on quality. Quality development in rehabilitation centres demands an atmosphere that supports change, encourages creativity, courage, transparency and involvement, and reduces fear. The creation of such an atmosphere is, in particular, the responsibility of a centre's management. Routine interviews regarding patient as well as employee satisfaction, and the use of strategic planning and management systems have proven successful instruments in the practice of quality development. Compared with other sectors of the health system, quality assurance in rehabilitation is marked by its comprehensive approach, intense patient orientation, scientific underpinning, and nationwide implementation. Regarding the benefits of these programmes for the health system at large, however, no clear scientific proof is available yet. Data gained from quality assurance programmes on the whole show a high amount of patient satisfaction, good quality of structures and processes as well as an improvement of the patients' health status. Between centres, however, there are marked differences of quality in a number of cases, and long-term effectiveness could be improved in some indications. Finally, suggestions are offered concerning further development of quality in rehabilitation as well as of the quality assurance programmes. PMID:21140318

  19. Token Economies in Rehabilitation

    Science.gov (United States)

    Walls, Richard T.; Nicholas, Heather

    1973-01-01

    Behavior modification has become a widely known practice in rehabilitation during the past decade. A medium of exchange or token is typically used to facilitate transactions and can be traded for backup reinforcers later on. This review of the use of token economies focuses on groups of individuals usually considered target rehabilitation…

  20. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... in rehabilitation? How soon should people return to school or work after a spinal cord injury? What's important to know about sex and intimacy after a spinal cord injury? Why are adaptive sports so helpful after a spinal cord injury? What's ...

  1. Fra revalidering til rehabilitering

    DEFF Research Database (Denmark)

    Danneris, Sophie; Olesen, Søren Peter

    samfundsmæssige udfordringer og forpligtelser forbundet med investeringssynsvinklen og med en vellykket rehabiliterings-/revalideringsindsats, uafhængigt af ordvalget. Artiklen indfanger to sammenhængende iagttagelser. Den første er, at den socialpolitiske investeringssynsvinkel, der synes at stikke næsen frem...

  2. Smart portable rehabilitation devices

    Directory of Open Access Journals (Sweden)

    Leahey Matt

    2005-07-01

    Full Text Available Abstract Background The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s. Methods In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Results Laboratory tests of the devices

  3. Implementing Modular Interactive Tiles for Rehabilitation in Tanzania – a pilot study

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf; Abdalahman, Rashid

    2014-01-01

    The pilot study in the Iringa region, Tanzania, indicates how the modular interactive tiles can be used for playful physical rehabilitation for many diverse patient groups (handicapped children, stroke, cardiac, diabetic patients, etc.) in both urban and rural areas, and how it motivates the user...

  4. Rehabilitation time before disability pension

    Directory of Open Access Journals (Sweden)

    Støver Morten

    2012-10-01

    Full Text Available Abstract Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

  5. Feasibility of high-intensity interval training in cardiac rehabilitation

    OpenAIRE

    Aamot, Inger-Lise

    2013-01-01

    High-intensity interval training (at 85-95% of maximal heart rate) has been found to be a feasible, well-tolerated and time-efficient exercise mode to improve peak oxygen uptake in patients with coronary artery disease, in short term. Most exercise studies, however, are performed during laboratory conditions with strict supervision and monitoring of exercise intensity. In the clinic, the exercise is supervised but with less ability to monitor exercise intensity due to the number of participan...

  6. Cardiac perception and cardiac control. A review.

    Science.gov (United States)

    Carroll, D

    1977-12-01

    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  7. Langtidseffekt af vægtreducerende behandlinghos patienter med hypertension--en gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2011-01-01

    In eight studies included in the present Cochrane review the effects of orlistat or sibutramine versus placebo on mortality, cardiovascular mortality and adverse events were investigated in obese people with hypertension. No studies with rimonabant fulfilled the inclusion criteria. The weight loss...... was larger in the groups treated with orlistat or sibutramine compared with placebo therapy. Orlistat reduced systolic and diastolic blood pressure more than placebo, while blood pressure increased during treatment with sibutramine. The studies were too small and of too short duration to allow an...... evaluation of the effect on cardiovascular mortality and morbidity....

  8. Music Therapy for Post Operative Cardiac Patients

    DEFF Research Database (Denmark)

    Schou, Karin

    Background This study is the first controlled research study undertaken in the early phase of rehabilitation after cardiac surgery investigating the effect of a receptive music therapy method. Various forms of music therapy interventions including both active and receptive methods were reported...... to be significantly more effective than music treatment with music medicine. Music listening and receptive music therapy (such as Guided Imagery and Music) have been proposed to help patients both before heart surgery and during the recovery phase. This study therefore intended to explore both a music therapy...

  9. 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

    INTRODUCTION: Game-based interventions have been proposed as a way to improve both patient adherence to physical activity (PA) and disease-related knowledge to achieve better self-management of blood glucose levels (HbA1c). The objective of this study was to systematically review the literature 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...

  10. Maintenance of Physical Activity and Exercise Capacity After Rehabilitation in Coronary Heart Disease: A Randomized Controlled Trial

    OpenAIRE

    2014-01-01

    Background and Objectives: Physical activity is one of the core components in cardiac rehabilitation and secondary prevention programs. This study investigated the effect of an intervention based on the health action process approach (HAPA) together with family support in the maintenance of physical activity and exercise capacity in coronary heart disease after discharge from rehabilitation. Method and Materials: In this randomized controlled trial, 96 patients with coronary heart disease wer...

  11. Long-Term effects of two psychological interventions on physical exercise and self-regulation following coronary rehabilitation

    OpenAIRE

    Sniehotta, Falco F.; Scholz, Urte; Schwarzer, Ralf; Fuhrmann, Bärbel; Kiwus, Ulrich; Völler, Heinz

    2005-01-01

    In cardiac rehabilitation programs, patients learn how to adopt a healthier lifestyle, including regular, strenuous physical activity. Long-term success is only modest despite good intentions. To improve exercise adherence, a 3-group experiment was designed that included innovative psychological interventions. All 3 groups underwent a standard care rehabilitation program. Patients in the 2 treatment groups were instructed not only to produce detailed action plans but also to develop barrier-f...

  12. The value of telerehabilitation in encouraging coronary artery disease patients to stay active after the acute rehabilitation phase

    OpenAIRE

    Frederix, Ines; Hansen, Dominique; Bonne, K.; Alders, Toon; Van Driessche, Niels; Berger, Jan; DENDALE, PAUL

    2012-01-01

    Purpose. The aim of this study was to evaluate whether the addition of a motion sensor with automated feed-back by SMS to the conventional rehabilitation program could result in an increase in daily activity among coronary artery disease patients. Methods. 20 coronary artery disease patients were included in this randomised, controlled trial after admission for PCI or CABG (target population of the study n = 80). All patients were included during phase II of the cardiac rehabilitation pro...

  13. 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

  14. [Current issues in gastroeneterologic rehabilitation].

    Science.gov (United States)

    Petri, M

    2000-10-01

    In Hungary gastroenteric diseases' rehabilitation, which is one of the youngest branch of medical rehabilitation, has grown out of traditional, sanatorial care from the 70s. Its main feature that it is based on a biopsychosocial attitude towards patients as a team-work. Though it comprises traditional, medical diagnosis and treatment, medicine and medical technology are not the primary resources of gastroenteric diseases rehabilitation: it is mainly built on a friendly and co-operating relations with the patients, which helps doctors to exert their mental and intellectual influence promoting their patients recovery. Therefore, gastroenteric diseases' rehabilitation can be sharply separated from active treatment and care. The article gives full details of the possible methods of gastroenteric diseases' rehabilitation, such as diagnosis, medicinal treatment, psychotherapy, dietotherapy, physiotherapy and regimen guidance. In addition, it is emphasized that under sanatorial circumstances the effects of rehabilitation, especially of regimen guidance multiplies. Furthermore it gives numerical data about the present situation of gastroenteric diseases' rehabilitation in Hungary. Considering the data gained from the special rehabilitation hospital located in Visegrád, the article touches upon the illnesses calling for this kind of rehabilitative treatment not passing over the fact of multimorbidity, especially important in rehabilitation. PMID:11064571

  15. 75 FR 21614 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation Short-Term... single budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative... 21, 2010. Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services....

  16. 75 FR 21606 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation Training... single budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. BILLING CODE...

  17. Rehabilitation at Olympic Dam

    International Nuclear Information System (INIS)

    Rehabilitation work on areas denuded of vegetation during the exploration phase of the Olympic Dam project was used to test various methods for regeneration of vegetation cover in the arid zone. The test work carried out on drill pads and access tracks has indicated that, with adequate site preparation, natural regeneration is the most economical and effective method to ensure post-operational stability of the affected land-forms. An on-going monitoring regime, utilising a computer data base, has been set up to allow year-to-year comparison of rehabilitation effectiveness. The database also provides a catalogue of initial colonising plants and a measure of variations in species diversity with time

  18. Rehabilitation of pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

    2013-01-01

    Acquired reading problems caused by brain injury (alexia) are common, either as a part of an aphasic syndrome, or as an isolated symptom. In pure alexia, reading is impaired while other language functions, including writing, are spared. Being in many ways a simple syndrome, one would think that...... pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia in the......, tentatively conclude that Multiple Oral Re-reading techniques may have some effect in mild pure alexia where diminished reading speed is the main problem, while Tacile-Kinesthetic training may improve letter identification in more severe cases of alexia. There is, however, still a great need for well...

  19. SEFRE: Semiexoskeleton Rehabilitation System.

    Science.gov (United States)

    Chonnaparamutt, Winai; Supsi, Witsarut

    2016-01-01

    SEFRE (Shoulder-Elbow-Forearm Robotics Economic) rehabilitation system is presented in this paper. SEFRE Rehab System is composed of a robotic manipulator and an exoskeleton, so-called Forearm Supportive Mechanism (FSM). The controller of the system is developed as the Master PC consisting of five modules, that is, Intelligent Control (IC), Patient Communication (PC), Training with Game (TG), Progress Monitoring (PM), and Patient Supervision (PS). These modules support a patient to exercise with SEFRE in six modes, that is, Passive, Passive Stretching, Passive Guiding, Initiating Active, Active Assisted, and Active Resisted. To validate the advantages of the system, the preclinical trial was carried out at a national rehabilitation center. Here, the implement of the system and the preclinical results are presented as the verifications of SEFRE. PMID:27578961

  20. Training practitioners in preparing systematic reviews: a cross-sectional survey of participants in the Australasian Cochrane Centre training program

    Directory of Open Access Journals (Sweden)

    Silagy Chris

    2002-06-01

    Full Text Available Abstract Background Although systematic reviews of health care interventions are an invaluable tool for health care providers and researchers, many potential authors never publish reviews. This study attempts to determine why some people with interest in performing systematic reviews do not subsequently publish a review; and what steps could possibly increase review completion. Methods Cross-sectional survey by email and facsimile of the 179 participants in Australasian Cochrane Centre training events between 1998 and 2000. Results Ninety-two participants responded to the survey (51 percent. Response rate of deliverable surveys was 82 percent (92/112. The remainder of the participants had invalid or no contact information on file. More than 75 percent of respondents felt that the current workshops met their needs for training. The most critical barriers to completion of a Cochrane review were: lack of time (80 percent, lack of financial support (36 percent, methodological problems (23 percent and problems with group dynamics (10 percent. Conclusions Strategies to protect reviewer time and increase the efficiency of the review process may increase the numbers of trained reviewers completing a systematic review.

  1. 38 CFR 21.70 - Vocational rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Vocational rehabilitation...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Duration of Rehabilitation Programs § 21.70 Vocational rehabilitation. (a) General. The goal of...

  2. [Rehabilitation in Alzheimer's dementia].

    Science.gov (United States)

    Cicconetti, P; Fionda, A; Zannino, G; Ettorre, E; Marigliano, V

    2000-09-01

    Alzheimer's disease is a neurodegenerative disease that causes a progressive decline of cognitive and behavioural functions. The simultaneous presence of these disorders requires a treatment not only for cognitive decline, but also for behavioural symptoms, depression and caregiver's stress. Research has made many efforts to develop a wide range of treatments, different from current pharmacological therapy, which is not resolutive, owing to the absence of an exact etiopathogenetic mechanism. Since new drugs have not been shown to be really effective in slowing cognitive impairment, various forms of rehabilitative interventions have been proposed in order to treat Alzheimer's disease. Their efficacy in the improvement of cognitive functions is still not completely clear. Surely, interesting results have been obtained from studies about Reality Orientation Therapy, Occupational Therapy and Memory Training. Music therapy might provide a new form of rehabilitative intervention, especially acting on the reducing of behavioural symptoms. These alternative forms of non pharmacological treatment may have a positive effect on caregiver. The heavy emotional burden of seeing a loved one becoming confused and isolated and of having to accept new responsibilities, may be reduced by rehabilitative supports, complementary to the pharmacological therapy. Caregiver stress could be reduced in two ways: by promoting the hope that something is being done for the patient and providing free time for himself. PMID:11021168

  3. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  4. Biofeedback in rehabilitation

    Science.gov (United States)

    2013-01-01

    This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback

  5. Rehabilitation courses for road users.

    OpenAIRE

    2010-01-01

    Rehabilitation courses are educational measures directed at deviant driving behaviour of car drivers. The Netherlands has four rehabilitation courses: EMA (Educational Measure Alcohol and traffic), LEMA (Lighter version of EMA), EMG (Educational Measure Behaviour and traffic) and ASP (Alcohol Interlock Programme). Also outside the Netherlands many rehabilitation courses are organized. Participation may be voluntary or can be made compulsory, if necessary in combination with other punitive mea...

  6. Evaluation of peripheral muscle strength of patients undergoing elective cardiac surgery: a longitudinal study

    OpenAIRE

    Kelli Maria Souza Santos; Manoel Luiz de Cerqueira Neto; Vitor Oliveira Carvalho; Valter Joviniano Santana Filho; Walderi Monteiro da Silva Junior; Amaro Afrânio Araújo Filho; Telma Cristina Fontes Cerqueira; Lucas de Assis Pereira Cacau

    2014-01-01

    Introduction: Peripheral muscle strength has been little explored in the literature in the context of cardiac rehabilitation. Objective: To evaluate the peripheral muscle strength of patients undergoing elective cardiac surgery. Methods: This was a longitudinal observational study. The peripheral muscle strength was measured using isometric dynamometry lower limb (knee extensors and flexors) at three different times: preoperatively (M1), the day of discharge (M2) and hospital discharge (M...

  7. Incidence of sexual dysfunction in men after cardiac surgery in Afshar hospital, Yazd

    OpenAIRE

    Seyed Khalil Foruzan-Nia; Mohammad Hassan Abdollahi; Seyed Hossein Hekmatimoghaddam; Seyedeh Mahdiyeh Namayandeh; Mohammad Hadi Mortazavi

    2011-01-01

    Background: Successful rehabilitation of cardiac surgery patients should include consideration of their sexual activity, but there is paucity of data regarding this matter. Objective: This study determined the incidence and type of sexual dysfunction in our patients. Materials and Methods: Two hundred-seventy nine men with age under 70 years old who had coronary artery bypass graft (CABG), valvular, or other types of cardiac surgery from Dec. 2006 until Dec. 2007 were enrolled in this descrip...

  8. New tools in pulmonary rehabilitation.

    Science.gov (United States)

    Wijkstra, P J; Wempe, J B

    2011-12-01

    In patients with more severe chronic obstructive pulmonary disease (COPD), the benefits of rehabilitation might not be clear and, therefore, new treatment options have been developed to increase the benefits of rehabilitation. This review provides an overview of new approaches being developed as an addition to exercise training. In turn, the benefits of adding ventilatory support, oxygen, anabolics or neuromuscular stimulation to a rehabilitation programme will be discussed. While positive benefits for a number of these approaches have been found, many questions remain unsolved. Therefore, at present, we cannot recommend these new tools as part of the routine management of patients with COPD who start a rehabilitation programme. PMID:21828026

  9. 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.

  10. SERIES "NOVELTIES IN PULMONARY REHABILITATION" New tools in pulmonary rehabilitation

    NARCIS (Netherlands)

    Wijkstra, P. J.; Wempe, J. B.

    2011-01-01

    In patients with more severe chronic obstructive pulmonary disease ( COPD), the benefits of rehabilitation might not be clear and, therefore, new treatment options have been developed to increase the benefits of rehabilitation. This review provides an overview of new approaches being developed as an

  11. 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

  12. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  13. The Maralinga rehabilitation project

    International Nuclear Information System (INIS)

    The $108 million Maralinga Rehabilitation Project to clean-up the former British atomic test site in South Australia, the largest remediation of this type, was completed in 2000. The rehabilitation was agreed by the Commonwealth and South Australian Governments and the Maralinga Tjarujta traditional owners, following methods identified by technical experts. The rehabilitation permits unrestricted access to about 90% of the former restricted area, but excludes full time occupation of the remaining 120 square kilometers. The clean-up has largely been directed at remediating plutonium contamination caused by minor trials. The clean-up involved two components, the removal of surface soil from the more contaminated areas, and the treatment of contaminated debris pits. Over 350,000 cubic meters of soil and debris was removed over about 2 square kilometers of land, and was buried in 10-15 meter deep trenches under a capping of clean soil of at least 5 meters. Treatment of contaminated pit debris at various sites has involved in situ vitrification, a process which involves application of an electric current to heat and melt debris encasing the contaminated material in a vitric/ceramic block, and exhumation of the contaminated debris and at depths of at least 5 meters. The independent regulator to the project, the Australian Radiation Protection and Nuclear Safety Agency, has indicated that the clean-up of the test sites has met the radiological criteria laid down in the original plan. Discussions are progressing with the South Australian Government and the Maralinga Tjarujta traditional owners as to the long-term management of the site, and the possible hand back of the land from the Commonwealth to South Australia for addition to the Maralinga Tjarutja freehold lands. Copyright (2001) Material Research Society

  14. Psychosocial Recovery and Rehabilitation.

    Science.gov (United States)

    Antai-Otong, Deborah

    2016-06-01

    This article discusses a psychosocial recovery and rehabilitation recovery model that uses an intensive case management approach. The approach offers an interdisciplinary model that integrates pharmacotherapy, social skills training, cognitive remediation, family involvement, and community integration. This evidence-based plan of care instills hope and nurtures one's capacity to learn and improve function and quality of life. It is cost-effective and offers psychiatric nurses opportunities to facilitate symptomatic remission, facilitate self-efficacy, and improve communication and social cognition skills. Nurses in diverse practice settings must be willing to plan and implement innovative treatment models that provide seamless mental health care across the treatment continuum. PMID:27229282

  15. Rum Jungle rehabilitation project - update

    International Nuclear Information System (INIS)

    The Rum Jungle uranium mine project created a serious pollution and public health problem, which was exacerbated by the monsoonal climate and the dispersed nature of the site. The rehabilitation works successfully reduced the environmental pollution and transformed and beautified the original stark landscape. The project serves as a model for the management and rehabilitation of other mine sites in this climate

  16. [Coordinating schooling, care and rehabilitation].

    Science.gov (United States)

    Sarrazin, Françoise

    2014-05-01

    Close collaboration has been established between a care and rehabilitation centre and a regional special needs school. The cooperation and interdisciplinarity of the approach ensures young people with motor disabilities are supported throughout their schooling, while being provided with the necessary care and rehabilitation. PMID:24941531

  17. AIDS: Dynamics and Rehabilitation Concerns.

    Science.gov (United States)

    Wong, Henry; And Others

    1988-01-01

    The epidemic of Acquired Immune Deficiency Syndrome (AIDS) confronts the rehabilitation professional with a number of concerns. This paper reviews literature on the diagnosis, epidemiological factors, psychosocial elements, medical intervention of AIDS, and rehabilitation issues involved in serving AIDS patients. (JDD)

  18. Rehabilitation Education: A Pilot Study

    Science.gov (United States)

    Vander Kolk, Charles; Jaques, Marceline E.

    1972-01-01

    The presentation of undergraduate courses in rehabilitation could serve several purposes: (a) preparation for graduate level work; (b) training for support personnel; and (c) interdisciplinary education. This article describes a pilot study of a course in rehabilitation to investigate through pre- and post measures, attitude change, attainment of…

  19. Qualitative Research in Rehabilitation Counseling

    Science.gov (United States)

    Hanley-Maxwell, Cheryl; Al Hano, Ibrahim; Skivington, Michael

    2007-01-01

    Qualitative research approaches offer rehabilitation scholars and practitioners avenues into understanding the lives and experiences of people with disabilities and those people and systems with whom they interact. The methods used often parallel those used in counseling and appear to be well matched with the field of rehabilitation counseling.…

  20. Rehabilitation with a Future Orientation

    Science.gov (United States)

    Journal of Rehabilitation, 1975

    1975-01-01

    A question-answer interview with Carl Schleicher, cofounder and technical director of the Center for Preventive Therapy and Rehabilitation, Inc. (CEPTAR) and president and research/development director of Mankind Research Unlimited, Inc. (MRU), Washington, D. C., provides explicit information on recent developments in the rehabilitation field and…

  1. Motivational Rehabilitation using Serious Games

    Directory of Open Access Journals (Sweden)

    Antoni Jaume i Capó

    2013-11-01

    Full Text Available Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games presented in the literature. We have tested the video game with a set of users who abandoned therapy due to demotivation in the previous year. Results show that the set of users improved their balance and motivation.

  2. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  3. Physical rehabilitation of primary school children with asthma in day hospital

    Directory of Open Access Journals (Sweden)

    Statiev S. I.

    2010-06-01

    Full Text Available The paper suggests a child with asthma. They may be present functional disorders of the central nervous system and cardiac activity, frequent violations of posture, scoliosis, and this in turn worsens the condition of all internal organs and systems. There is a problem of adaptation of these children to normal life. Therefore, the study of physical rehabilitation and its features in bronchial asthma is very important. The study with sequential decision tasks, it was analyzed the effect of physical rehabilitation on the respiratory system of children with bronchial asthma.

  4. Respiratory physiotherapy and its application in preoperative period of cardiac surgery.

    Science.gov (United States)

    Miranda, Regina Coeli Vasques de; Padulla, Susimary Aparecida Trevizan; Bortolatto, Carolina Rodrigues

    2011-01-01

    Cardiac surgical procedures change respiratory mechanics, defecting in lung dysfunction. The physical therapists play an important role in the preparation and rehabilitation of individuals who are undergoing cardiac surgery, as they have a large quantity of techniques. The objective was to evaluate the effectiveness of breathing exercises with and without the use of devices, and respiratory muscle training in preoperative period of cardiac surgery in reducing postoperative pulmonary complications. Although there are controversies as to which technique to use, studies show the effectiveness of preoperative physiotherapy in the prevention and reduction of postoperative pulmonary complications. PMID:22358282

  5. Preoperative cardiac risk management

    OpenAIRE

    Vidaković Radosav; Poldermans Don; Nešković Aleksandar N.

    2011-01-01

    Approximately 100 million people undergo noncardiac surgery annually worldwide. It is estimated that around 3% of patients undergoing noncardiac surgery experience a major adverse cardiac event. Although cardiac events, like myocardial infarction, are major cause of perioperative morbidity or mortality, its true incidence is difficult to assess. The risk of perioperative cardiac complications depends mainly on two conditions: 1) identified risk factors, and 2) the type of the surgical p...

  6. Ventilation and gas exchange management after cardiac arrest.

    Science.gov (United States)

    Sutherasan, Yuda; Raimondo, Pasquale; Pelosi, Paolo

    2015-12-01

    For several decades, physicians had integrated several interventions aiming to improve the outcomes in post-cardiac arrest patients. However, the mortality rate after cardiac arrest is still as high as 50%. Post-cardiac arrest syndrome is associated with high morbidity and mortality due to not only poor neurological outcome and cardiovascular failure but also respiratory dysfunction. To minimize ventilator-associated lung injury, protective mechanical ventilation by using low tidal volume ventilation and driving pressure may decrease pulmonary complications and improve survival. Low level of positive end-expiratory pressure (PEEP) can be initiated and titrated with careful cardiac output and respiratory mechanics monitoring. Furthermore, optimizing gas exchange by avoiding hypoxia and hyperoxia as well as maintaining normocarbia may improve neurological and survival outcome. Early multidisciplinary cardiac rehabilitation intervention is recommended. Minimally invasive monitoring techniques, that is, echocardiography, transpulmonary thermodilution method measuring extravascular lung water, as well as transcranial Doppler ultrasound, might be useful to improve appropriate management of post-cardiac arrest patients. PMID:26670813

  7. 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 occupation-based cognitive rehabilitation would be beneficial for individuals with TBI for improving daily 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

  8. Drug therapy in cardiac arrest: a review of the literature.

    Science.gov (United States)

    Lundin, Andreas; Djärv, Therese; Engdahl, Johan; Hollenberg, Jacob; Nordberg, Per; Ravn-Fischer, Annika; Ringh, Mattias; Rysz, Susanne; Svensson, Leif; Herlitz, Johan; Lundgren, Peter

    2016-01-01

    The aim of this study was to review the literature on human studies of drug therapy in cardiac arrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiac arrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiac arrest were excluded. The literature search identified a total of 8936 articles. Eighty-eight articles met our inclusion criteria and were included in the review. We identified no human study in which drug therapy, compared with placebo, improved long-term survival. Regarding adrenaline and amiodarone, the drugs currently recommended in cardiac arrest, two prospective randomized placebo-controlled trials, were identified for adrenaline, and one for amiodarone, but they were all underpowered to detect differences in survival to hospital discharge. Of all reviewed studies, only one recent prospective study demonstrated improved neurological outcome with one therapy over another using a combination of vasopressin, steroids, and adrenaline as the intervention compared with standard adrenaline administration. The evidence base for drug therapy in cardiac arrest is scarce. However, many human studies on drug therapy in cardiac arrest have not been powered to identify differences in important clinical outcomes such as survival to hospital discharge and favourable neurological outcome. Efforts are needed to initiate large multicentre prospective randomized clinical trials to evaluate both currently recommended and

  9. Rehabilitation of patients with glioma.

    Science.gov (United States)

    Vargo, Mary; Henriksson, Roger; Salander, Pär

    2016-01-01

    Disabling sequelae occur in a majority of patients diagnosed with brain tumor, including glioma, such as cognitive deficits, weakness, and visual perceptual changes. Often, multiple impairments are present concurrently. Healthcare staff must be aware of the "biographic disruption" the patient with glioma has experienced. While prognostic considerations factor into rehabilitation goals and expectations, regardless of prognosis the treatment team must offer cohesive support, facilitating hope, function, and quality of life. Awareness of family and caregiver concerns plays an important role in the overall care. Inpatient rehabilitation, especially after surgical resection, has been shown to result in functional improvement and homegoing rates on a par with individuals with other neurologic conditions, such as stroke or traumatic brain injury. Community integration comprises a significant element of life satisfaction, as has been shown in childhood glioma survivors. Employment is often affected by the glioma diagnosis, but may be ameliorated, when appropriate, by addressing modifiable factors such as depression, fatigue, or sleep disturbance, or by workplace accommodations. Further research is needed into many facets of rehabilitation in the setting of glioma, including establishing better care models for consistently identifying and addressing functional limitations in this population, measuring outcomes of various levels of rehabilitation care, identifying optimal physical activity strategies, delineating the long-term effects of rehabilitation interventions, and exploring impact of rehabilitation interventions on caregiver burden. The effective elements of cognitive rehabilitation, including transition of cognitive strategies to everyday living, need to be better defined. PMID:26948361

  10. [The best of cardiac failure in 1999].

    Science.gov (United States)

    Desnos, M

    2000-01-01

    Cardiac failure has become a major but underestimated public health problem. The EPICAL study in France confirmed the severity of this condition. In addition to the neuro-hormones, the role played by inflammatory cytokines in the progression of the disease has been emphasized. The importance of the "genetic background" in the development and evolution of cardiac failure has been demonstrated (deletion or prospective polymorphism). From the therapeutic point of view, besides the hopes raised by multisite pacing, the betablockers and spironolactone have been shown to provide major functional improvement and prolonged survival, and they take their place with the angiotensin converting enzyme inhibitors in our pharmacological arsenal. Cellular transplantation is associated with encouraging pre-clinical results which open up a new field of interest. Finally, global management, including physical rehabilitation and patient education by plury-disciplinary teams, provides medical and economic benefits. The year 1999 has been particularly rich in the field of cardiac failure from the basis of fundamental research to the organisation of health care. PMID:10721444

  11. Client Motivation and Rehabilitation Counseling Outcome.

    Science.gov (United States)

    Salomone, Paul R.

    This study investigates the relationship between client motivation or lack of motivation for vocational rehabilitation services, and rehabilitation outcome. Clients who had received services at a rehabilitation center during a two year period were rated on their level of motivation for rehabilitation services using the contents of diagnostic…

  12. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae

    2015-07-01

    Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.

  13. [Work and social rehabilitation].

    Science.gov (United States)

    Vignali, J M

    2010-01-01

    On the basis of its experience, the Associazione In-Presa accepted the challenge consisting of the alienation of young people by using an educational method which makes it possible to reclaim them for rehabilitation. Children with difficult family situations, negative experience at school, damaged self-esteem, poor ability to connect with reality, are taken on a career course "as a protagonists". A tutor supports them and also closely cooperates with the entrepreneur who offered the youngsters the possibility of learning a trade and at the same time giving them the experience of a job. In 10 years over 120 young people have found steady jobs and regained the faith in themselves and in the world around them. PMID:21298876

  14. The rehabilitation of Rum Jungle

    International Nuclear Information System (INIS)

    The Rum Jungle uranium mine was operated by Territory enterprises Pty Ltd on behalf of the Commonwealth Government during the period 1952 to 1971. Environmental degredation resulting from the mining and processing activities at Rum Jungle is being addressed by the Rum Jungle Rehabilitation Project, a Commonwealth funded project being managed by the Northern Territory Government. The Rehabilitation Project was established in 1982 and it is expected that the work of rehabilitating the Rum Jungle mine site will be completed by June 1986. Monitoring will continue until 1988

  15. VOICE REHABILITATION FOLLOWING TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2015-03-01

    Full Text Available Despite continuing advances in surgical management of laryngeal malignancy, total laryngectomy is still the treatment of choice in advanced laryngeal malignancies. Considering the longevity of the patient following total laryngectomy, various measures have been adopted in order to provide voice function to the patient. Significant advancements have taken place in voice rehabilitation of post laryngectomy patients. Advancements in oncological surgical techniques and irradiation techniques have literally cured laryngeal malignancies. Among the various voice rehabilitation techniques available TEP (Tracheo oesophageal puncture is considered to be the gold standard. This article attempts to explore the various voice rehabilitation technique available with primary focus on TEP.

  16. The cardiac safety of aripiprazole treatment in patients at high risk for torsade

    DEFF Research Database (Denmark)

    Polcwiartek, Christoffer; Sneider, Benjamin; Graff, Claus;

    2015-01-01

    reviewed and cardiac safety data were extracted. Continuous and dichotomous QTc data were used in the meta-analysis. RESULTS: Preclinical studies suggested that aripiprazole has limited affinity for the delayed rectifier potassium current. TdP was reported in two case reports and SCD was reported in one...... case report and one case series. No clinical studies assessing aripiprazole's cardiac safety in patients at high risk for torsade were found. No thorough QT (TQT) study with aripiprazole was found. The meta-analysis revealed that the mean ΔQTc interval was decreased with aripiprazole and QTc...... factors. OBJECTIVES: Aripiprazole's cardiac safety has not been assessed in patients at high risk for torsade, where QTc prolongation risk is highly increased. METHODS: MEDLINE, Embase, and The Cochrane Library were searched for preclinical, clinical, and epidemiological studies. Eligible studies were...

  17. Critique of the review of 'Water fluoridation for the prevention of dental caries' published by the Cochrane Collaboration in 2015.

    Science.gov (United States)

    Rugg-Gunn, A J; Spencer, A J; Whelton, H P; Jones, C; Beal, J F; Castle, P; Cooney, P V; Johnson, J; Kelly, M P; Lennon, M A; McGinley, J; O'Mullane, D; Sgan-Cohen, H D; Sharma, P P; Thomson, W M; Woodward, S M; Zusman, S P

    2016-04-01

    The Cochrane Review on water fluoridation for the prevention of dental caries was published in 2015 and attracted considerable interest and comment, especially in countries with extensive water fluoridation programmes. The Review had two objectives: (i) to evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries, and (ii) to evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. The authors concluded, inter alia, that there was very little contemporary evidence, meeting the Review's inclusion criteria, that evaluated the effectiveness of water fluoridation for the prevention of dental caries. The purpose of this critique is to examine the conduct of the above Review, and to put it into context in the wider body of evidence regarding the effectiveness of water fluoridation. While the overall conclusion that water fluoridation is effective in caries prevention agrees with previous reviews, many important public health questions could not be answered by the Review because of the restrictive criteria used to judge adequacy of study design and risk of bias. The potential benefits of using wider criteria in order to achieve a fuller understanding of the effectiveness of water fluoridation are discussed. PMID:27056513

  18. Blunt cardiac rupture.

    Science.gov (United States)

    Martin, T D; Flynn, T C; Rowlands, B J; Ward, R E; Fischer, R P

    1984-04-01

    Blunt injury to the heart ranges from contusion to disruption. This report comprises 14 patients seen during a 6-year period with cardiac rupture secondary to blunt trauma. Eight patients were injured in automobile accidents, two patients were injured in auto-pedestrian accidents, two were kicked in the chest by ungulates, and two sustained falls. Cardiac tamponade was suspected in ten patients. Five patients presented with prehospital cardiac arrest or arrested shortly after arrival. All underwent emergency department thoracotomy without survival. Two patients expired in the operating room during attempted cardiac repair; both had significant extracardiac injury. Seven patients survived, three had right atrial injuries, three had right ventricular injuries, and one had a left atrial injury. Cardiopulmonary bypass was not required for repair of the surviving patients. There were no significant complications from the cardiac repair. The history of significant force dispersed over a relatively small area of the precordium as in a kicking injury from an animal or steering wheel impact should alert the physician to possible cardiac rupture. Cardiac rupture should be considered in patients who present with signs of cardiac tamponade or persistent thoracic bleeding after blunt trauma. PMID:6708151

  19. Rehabilitation of uranium tailings impoundments

    International Nuclear Information System (INIS)

    Under Australian environmental controls relating to the management of uranium tailings, it is no longer acceptable practice to search for a rehabilitation strategy at the end of production when the generation of tailings has ceased. The uranium projects currently in production and those being proposed are tightly regulated by the authorities. The waste management plans must consider site specific factors and must include selection of appropriate disposal sites and design for long term containment. The final encapsulation in engineered facilities must take into account the probable routes to the environment of the tailings. Rehabilitation shoud be undertaken by the mining and milling operators to standards approved by appropriate authorities. Appropriate administrative arrangements are required, by way of technical committees and financial bonds to ensure that agreed standards of rehabilitation may be achieved. Past and present experience with the rehabilitation of uranium tailings impoundments in Australia is discussed

  20. Rehabilitation Counselor Certification: Moving Forward

    Science.gov (United States)

    Saunders, Jodi L.; Barros-Bailey, Mary; Chapman, Cindy; Nunez, Patricia

    2009-01-01

    This article provides a brief history of the Commission on Rehabilitation Counselor Certification and presents recent changes and strategic goals for moving forward. Challenges and opportunities for the profession in relation to certification are also discussed. (Contains 3 tables.)