56 research outputs found
Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland: a qualitative study
No full textBACKGROUND: Growing evidence raises doubts about the need for routine hip precautions after primary total hip replacements to reduce the risk of postoperative dislocation. However, hip precautions are still routinely and widely prescribed in postoperative care in Switzerland. We aimed to investigate experts’ clinical reasoning for hip precaution recommendations after total hip arthroplasty.
METHODS: Using a convenience sampling strategy, 14 semi-structured expert interviews were conducted with surgeons, physiotherapists, and occupational therapists in the vicinity of an inpatient rehabilitation clinic in Switzerland. Data analysis followed Mayring’s principle of inductive and deductive structuring content analysis.
RESULTS: Expert statements from the interviews were summarised into four main categories and 10 subcategories. Categories included statements on the incidences of dislocation and underlying risk factors; current preferences and use of hip precautions; their effect on physical function, anxiety, or costs; and patient’s adherence to the movement restrictions. Hip surgeons routinely prescribed hip precautions, although in different variations. Fear of dislocation and caution are barriers to changing current practice. Some surgeons are considering individualised prescribing based on patients’ risk of dislocation, which therapists would welcome.
CONCLUSION: A lack of clear instructions from the surgeon leads to ambiguity among therapists outside the acute hospital. A shared understanding of the need for and nature of hip precautions, guidelines from societies, or at least specific instructions from surgeons to therapists are warranted
Patient interest in mHealth as part of cardiac rehabilitation in Switzerland
No full textPURPOSE
Smartphone-based health interventions (mHealth) offer the potential to overcome barriers to accessibility of cardiac rehabilitation. We aimed (1) to examine patients’ interest in mHealth as part of the outpatient cardiac rehabilitation (phase II) and long-term aftercare (phase III) and (2) to identify the influence of sociodemographic and clinical patient characteristics on interest in mHealth.
METHODS
A questionnaire was consecutively handed out to 2041 patients concluding outpatient cardiac rehabilitation between March 2013 and December 2018 at the University Hospital Bern. Multivariate logistic models were used to identify influencing factors (age, sex, smartphone ownership, year, compliance with cardiac rehabilitation, physical fitness, body mass index, diabetes mellitus, German speaking) for mHealth interest.
RESULTS
The questionnaire was returned by 1025 patients (50.2% response rate). Seventy-one percent of the responding patients preferred the cardiac rehabilitation as offered with three weekly centre-based sessions, whereas 12% preferred and 17% considered replacing two out of the three centre-based sessions per week with mHealth. Forty-eight percent were interested in continuing exercise training using mHealth after completion of cardiac rehabilitation. Smartphone ownership was the most important indicator for patient interest in mHealth (odds ratio [OR] 2.54, 95% confidence interval [CI] 1.53–4.23), whereas age (per year) was not independently associated with mHealth interest for phase II (OR 0.99, 95% CI 0.98–1.01) and only weakly associated with phase III (OR 0.98, 95% CI 0.96–0.99).
CONCLUSION
In a Swiss urban region with easy access to cardiac rehabilitation, patients who participated in a centre-based cardiac rehabilitation programme between 2013 and 2018 showed little interest in mHealth during phase II. However, almost half of them expressed interest in continuing training with mHealth during phase III
Accurate Prediction Equations for Ventilatory Thresholds in Cardiometabolic Disease When Gas Exchange Analysis is Unavailable: Development and Validation.
No full textAIMS
To develop and validate equations predicting heart rate (HR) at the first and second ventilatory thresholds (VTs) and an optimized range-adjusted prescription for patients with cardiometabolic disease (CMD). To compare their performance against guideline-based exercise intensity domains.
METHODS
Cross-sectional study involving 2,868 CMD patients from nine countries. HR predictive equations for first and second VTs (VT1, VT2) were developed using multivariate linear regression with 975 cycle-ergometer cardiopulmonary exercise tests (CPET). 'Adjusted' percentages of peak HR (%HRpeak) and HR reserve (%HRR) were derived from this group. External validation with 1,893 CPET (cycle-ergometer or treadmill) assessed accuracy, agreement, and reliability against guideline-based %HRpeak and %HRR prescriptions using mean absolute percentage error (MAPE), Bland-Altman analyses, intraclass correlation coefficients (ICC).
RESULTS
HR predictive equations (R²: 0.77 VT1, 0.88 VT2) and adjusted %HRR (VT1: 42%, VT2: 77%) were developed. External validation demonstrated superiority over widely used guideline-directed intensity domains for %HRpeak and %HRR. The new methods showed consistent performance across both VTs with lower MAPE (VT1: 7.1%, VT2: 5.0%), 'good' ICC for VT1 (0.81, 0.82) and 'excellent' for VT2 (0.93). Guideline-based exercise intensity domains had higher MAPE (VT1: 6.8%-21.3%, VT2: 5.1%-16.7%), 'poor' to 'good' ICC for VT1, and 'poor' to 'excellent' for VT2, indicating inconsistencies related to specific VTs across guidelines.
CONCLUSION
Developed and validated HR predictive equations and the optimized %HRR for CMD patients for determining VT1 and VT2 outperformed the guideline-based exercise intensity domains and showed ergometer interchangeability. They offer a superior alternative for prescribing moderate intensity exercise when CPET is unavailable
DDX-BRO Clinical Investigation Protocol v1.5
No full textClinical Investigation Protocol v1.5 of the DDX-BRO stud
DDX-BRO Investigator Brochure v1.1
No full text<p>Investigator Brochure v1.1 of the DDX-BRO study</p>
DDX-BRO Statistical Analysis Plan v1.0
No full textStatistical Analysis Plan v1.0 of the DDX-BRO stud
Cardiorespiratory fitness, arterial stiffness and rheumatic disease
No full textObjectivesArterial stiffness is increased in patients with inflammatory rheumatic disease, independent of traditional cardiovascular (CV) risk factors. In contrast, aerobic exercise training has a beneficial effect on arterial stiffness. Our aim was to investigate the cross-sectional relationship between arterial stiffness and cardiorespiratory fitness (CRF) in patients with a rheumatic disease but without traditional cardiovascular risk factors.MethodsPulse wave velocity (PWV), augmentation index corrected to a set heart rate of 75bpm (Aix@75) and central pulse pressure (cPP) recorded by applantation tonometry were analysed as parameters for arterial stiffness. CRF was assessed as peak oxygen consumption (VO2peak) measured in a maximal cycle ergometer test. Primary regression analyses adjusted for age and sex were executed to evaluate the influence of one metabolic equivalent (MET=3.5ml/kg/min) increment in VO2peak on arterial stiffness parameters.ResultsTwenty-eight patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis were recruited. Aix@75 decreased significantly by -1.570% (95% confidence interval (CI) -2.888; -0.251) for every MET increase in VO2peak when adjusted for age and sex. PWV and cPP were not significantly influenced by increased VO2peak but tended to a decrease of -0.092 m/s (95% CI -0.286; 0.103) and -0.359mmHG (95% CI -1.665; 0.947) respectively.ConclusionThere is an inverse relationship between arterial stiffness and CRF in patients with an inflammatory rheumatic disease in the absence of traditional cardiovascular risk factors. An increased CRF has a stronger beneficial influence on Aix@75 than on PWV. Since Aix@75 represents global arterial stiffness and PWV primarily central arterial stiffness, aerobic exercise might have a particularly beneficial effect on peripheral arteries
Thimo cedrato, Genista spinosa, Ligustro
No full text1. Nome scientifico: Thymus sp.
(Laminaceae, Labiatae)
Nome attuale: Timo
2. Nome scientifico: Genista germanica L.
(Fabaceae, Leguminosae)
Nome attuale: Ginestra spinosa
3. Nome scientifico: Ligustrum vulgare L.
(Oleaceae)
Nome attuale: Ligustr
Effect of self-tailored high-intensity interval training versus moderate-intensity continuous exercise on cardiorespiratory fitness after myocardial infarction: A randomised controlled trial
No full textSetting the Exercise Intensity in Cardiovascular Rehabilitation for Patients with Cardiometabolic Disease: Is it different between males and females?
No full textFinancial support by the Special Research Fund (BOF) from Hasselt University/Belgium [BOF23DOCBL10 (J.G.P.O.M.) and BOF23KV10 (M.M.)] and from Flanders Research Foundation FWO, 1SE1222N (M.F.). This study was also supported by public research grants and scholarships from Brazilian fostering agencies: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [CAPES (Coordination for the Advancement of Higher Education Personnel)], Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq (National Council of Scientific and Technological Development)], and Fundação de Apoio a Pesquisa do Distrito Federal [FAPDF (The State Funding Agency of Distrito Federal)]
Acknowledgements We express our sincere appreciation to the laboratory staff across all participating centres, as well as to the physicians and other healthcare professionals who were involved in CPET evaluations
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