114 research outputs found

    Changes in derived measures from six-minute walk distance following home-based exercise training in congestive heart failure: A preliminary report

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    The response of derived parameters from six-minute walk distance (6MWD), like 6MW work (6MWW), to exercise training and its correlation with quality of life (QoL) in congestive heart failure (CHF) is not known. A secondary analysis from a randomized controlled trial on 30 patients (23 males; mean age 57.7 ± 10.4 years; mean ejection fraction 31 ± 10%) with CHF in NYHA class I–IV who completed an eight-week home-based exercise training program found a significant improvement in 6MWW (p < 0.05), with similar correlations between 6MWD and 6MWW with QoL. 6MWW does not appear to provide additional benefit to 6MWD in cardiac rehabilitation for CHF

    Virgin coconut oil and its potential cardioprotective effects

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    Emphasis on diet to improve the cardiovascular (CV) risk profile has been the focus of many studies. Recently, virgin coconut oil (VCO) has been growing in popularity due to its potential CV benefits. The chemical properties and the manufacturing process of VCO make this oil healthier than its copra-derived counterpart. This review highlights the mechanism through which saturated fatty acids contribute to CV disease (CVD), how oils and fats contribute to the risk of CVD, and the existing views on VCO and how its cardioprotective effects may make this a possible dietary intervention in isolation or in combination with exercise to help reduce the burden of CVDs

    Protocol-guided phase-1 cardiac rehabilitation in patients with ST-Elevation myocardial infarction in a rural hospital

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    Aims: Phase-1 Cardiac Rehabilitation (CR) is an important part in the treatment of patients with ST-Elevation Myocardial Infarction (STEMI). Lack of literature in the rural Indian setting led to the design of this study. Setting and Design: Secondary care rural hospital, non-randomized experimental study. Materials and Methods: Fifteen historical controls and 15 prospectively enrolled patients between January 2007 and December 2007. The prospectively enrolled patients received the phase-1, exercise-based, protocol-guided CR. At discharge, the six-minute walk test (6MWT) distance, Borg′s Rating of Perceived Exertion (RPE) after the 6MWT, time to return to baseline parameters after the 6MWT, and complications were assessed. Statistical Analysis used: Independent t-test and the Mann Whitney test. Results: Statistically significant (P < 0.01) differences in ratings of perceived exertion (RPE) and time to return to baseline parameters post the 6MWT were seen in the experimental group ((2 vs. 4 and 5.47 vs. 7.93 minutes, respectively). No significant changes in the 6MWT distance between the groups were noticed (470+151.76 m and 379+170.70 m, respectively). No adverse events during the 6MWT and the phase-1 CR were observed. Conclusion: Protocol-guided, phase-1 CR produces a much faster return of heart rate and blood pressure to baseline following the 6MWT, without producing a great rise in the RPE during the 6MWT, which suggests a training benefit among these patients. The 6MWT can be safely administered in this rural population. However, larger studies will be required to validate these results

    Effects of Combined Early In-Patient Cardiac Rehabilitation and Structured Home-based Program on Function among Patients with Congestive Heart Failure: A Randomized ontrolled Trial

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    Aims: To determine the effects of combined in-patient rehabilitation with a home-based program on function and quality of life. Setting and Design: Tertiary care, university teaching hospital, randomized controlled trial. Patients and Methods: Thirty admitted patients with congestive heart failure with New York Heart Association class II -IV. A five step individualised phase-1 cardiac rehabilitation program followed by a structured home based rehabilitation for eight weeks was given to the experimental group while the control group only received physician directed advice. Six minute walk distance was assessed at discharge and follow-up, while quality of life (SF36) was assessed at admission, discharge, and follow-up. Statistical analysis used: Independent t-test, paired t-test and repeated measures ANOVA with Bonferroni post-hoc analysis. Results: At admission patients in both the groups were comparable. After the phase-1 cardiac rehabilitation, there was a change in the six minute walk distance between control and experimental group (310 m vs. 357 m, respectively; P = 0.001). Following the eight week home-based program, there was a greater increase in six minute walk distance in the experimental group when compared to the control group (514 m vs. 429 m; P < 0.001). Quality of life as measured by the SF-36 at the end of 8-weeks showed a statistically significant difference (P < 0.05) in the experimental group for both the mental and physical components. Conclusion: Early in-patient rehabilitation followed by an eight week home based exercise program improves function and quality of life in patients with congestive heart failure

    Exercise-based evaluations and interventions for pulmonary hypertension with connective tissue disorders

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    Introduction: Exercise intolerance is a common and often significant limitation in pulmonary arterial hypertension (PAH). This intolerance greatly affects the quality of life and function of the individual with PAH, irrespective of its etiology. In PAH associated with connective tissue disorders (PAH-CTD), exercise intolerance is further amplified by the presence of coexisting musculoskeletal manifestations of CTD. The evaluation of exercise capacity and prescription for exercise training therefore becomes a challenge to the clinician. Areas covered: This review highlights factors contributing to exercise intolerance in PAH-CTD, evaluation methods of exercise capacity and an overview on exercise training and a roadmap for future research. Expert commentary: Exercise intolerance is a complex interplay of cardiovascular, pulmonary, and musculoskeletal systems. Data from cardiopulmonary exercise tests have shown predictive abilities for both diagnosis and prognosis. In its absence, the 6-min walk test can be used to provide similar information thereby making the role of exercise testing an invaluable evaluation method in PAH-CTD. Exercise training data in PAH-CTD are still sparse, though, data from PAH studies suggest potential benefit. However, more research is required in this area of testing and training for greater understanding on exercise hemodynamic, phenotypes, and training benefits.Full Tex
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