1,721,045 research outputs found
Functional electrical stimulation for chronic heart failure: A meta-analysis
No full textINTRODUCTION:
We conducted a meta-analysis of randomized, controlled trials of combined electrical stimulation versus conventional exercise training or placebo control in heart failure patients.
METHODS:
A systematic search was conducted of Medline (Ovid) (1950-September 2011), Embase.com (1974-September 2011), Cochrane Central Register of Controlled Trials and CINAHL (1981-September 2011). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, exercise training and functional electrical stimulation (FES).
RESULTS:
FES produced inferior improvements in peak VO2 when compared to cycle training: mean difference (MD) -0.32 ml.kg(-1).min(-1) (95% C.I. -0.63 to -0.02 ml.kg(-1).min(-1), p=0.04), however FES elicited superior improvements in peak VO2: MD 2.30 ml.kg(-1).min(-1) (95% C.I. 1.98 to 2.62 ml.kg(-1).min(-1), p<0.00001); and six minute walk distance to sedentary care or sham FES; MD 46.9 m (95% C.I. 22.5 to 71.3m, p=0.0002). There was no difference in change in quality of life between cycling and FES, but FES elicited significantly larger improvements in Minnesota Living with Heart Failure score than placebo or sham treatment; MD 1.15 (95% C.I. 0.69 to 1.61, p<0.00001). Moreover, the total FES intervention hours were strongly correlated with change in peak VO2, (r=0.80, p=0.02).
CONCLUSIONS:
Passive or active exercise is beneficial for patients with moderate to severe heart failure, but active cycling, or other aerobic/resistance activity is preferred in patients with heart failure who are able to exercise, and FES is the preferred modality in those unable to actively exercise. The benefits of FES may however, be smaller than those observed in conventional exercise training. Aggregate hours of electrical stimulation therapy were associated with larger improvements in cardio-respiratory fitness
Efficacy of inspiratory muscle training in chronic heart failure patients: A systematic review and meta-analysis
No full textINTRODUCTION:
Inspiratory muscle training (IMT) offers an alternative to exercise training (ExT) in the most severely deconditioned heart failure patients who are unable to exercise. We conducted a meta-analysis to determine magnitude of change in peak VO2, six minute walk distance (6MWD), Quality of Life measured by the Minnesota Living with Heart Failure Questionnaire (MLWHFQ), maximal inspiratory pressure (PI max) and ventilatory equivalent for carbon dioxide (VE/VCO2 slope) with IMT.
METHODS:
A systematic search was conducted of randomized, controlled trials of IMT therapy in CHF patients using Medline (Ovid) (1950-February 2012), Embase.com (1974-February 2012), Cochrane Central Register of Controlled Trials and CINAHL (1981-February 2012). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, inspiratory or respiratory muscle training, exercise training
RESULTS:
The eleven included studies contained data on 287 participants: 148 IMT participants and 139 sham or sedentary control. Compared to control groups, CHF patients undergoing IMT showed a significant improvement in peak VO2 (+1.83 ml kg(-1) min(-1), 95% C.I. 1.33 to 2.32 ml kg(-1) min(-1), p<0.00001); 6 MWD (+34.35 m, 95% C.I. 22.45 to 46.24 m, p<0.00001); MLWHFQ (-12.25, 95% C.I. -17.08 to -7.43, p<0.00001); PImax (+20.01, 95% C.I. 13.96 to 26.06, p<0.00001); and VE/VCO2 slope (-2.28, 95% C.I. -3.25 to -1.30, p<0.00001).
CONCLUSIONS:
IMT improves cardio-respiratory fitness and quality of life to a similar magnitude to conventional exercise training and may provide an initial alternative to the more severely de-conditioned CHF patients who may then transition to conventional ExT
Intermittent versus continuous exercise training in chronic heart failure: A meta-analysis
No full textINTRODUCTION:
We conducted a meta-analysis of randomized, controlled trials of combined strength and intermittent aerobic training, intermittent aerobic training only and continuous exercise training in heart failure patients.
METHODS:
A systematic search was conducted of Medline (Ovid) (1950-September 2011), Embase.com (1974-September 2011), Cochrane Central Register of Controlled Trials and CINAHL (1981-September 19 2011). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, exercise training, interval training and intermittent exercise training.
RESULTS:
The included studies contained an aggregate of 446 patients, 212 completed intermittent exercise training, 66 only continuous exercise training, 59 completed combined intermittent and strength training and 109 sedentary controls. Weighted mean difference (MD) in Peak VO2 was 1.04mlkg(-1)min(-1) and (95% C.I.) was 0.42-1.66 (p=0.0009) in intermittent versus continuous exercise training respectively. Weighted mean difference in Peak VO2 was -1.10mlkg(-1)min(-1) (95% C.I.) was -1.83-0.37 p=0.003 for intermittent only versus intermittent and strength (combined) training respectively. In studies reporting VE/VCO2 for intermittent versus control groups, MD was -1.50 [(95% C.I. -2.64, -0.37), p=0.01] and for intermittent versus continuous exercise training MD was -1.35 [(95% C.I. -2.15, -0.55), p=0.001]. Change in peak VO2 was positively correlated with weekly exercise energy expenditure for intermittent exercise groups (r=0.48, p=0.05).
CONCLUSIONS:
Combined strength and intermittent exercise appears superior for peak VO2 changes when compared to intermittent exercise of similar exercise energy expenditure
Exercise training in heart failure patients with preserved ejection fraction: a systematic review and meta-analysis
Full text linkGriffith Health, School of Medical ScienceFull Tex
Clinical outcomes and cardiovascular responses to exercise training in heart failure patients with preserved ejection fraction: A systematic review and meta-analysis
No full textExercise training induces physical adaptations for heart failure patients with systolic dysfunction, but less is known about those patients with preserved ejection fraction. To establish whether exercise training produces changes in peak V̇o2 and related measures, quality of life, general health, and diastolic function in heart failure patients with preserved ejection fraction. We conducted a MEDLINE search (1985 to October 10, 2014), for exercise-based rehabilitation trials in heart failure, using search terms "exercise training, heart failure with preserved ejection fraction, heart failure with normal ejection fraction, peak V̇o2, and diastolic heart dysfunction". Seven intervention studies were included providing a total of 144 exercising subjects and 114 control subjects, a total of 258 participants. Peak V̇o2 increased by a mean difference (MD) 2.13 ml·kg(-1)·min(-1) [95% confidence interval (CI) 1.54 to 2.71, P < 0.00001] in exercise training vs. sedentary control, equating to a 17% improvement from baseline. The corresponding data are provided for the following exercise test variables: V̇e/V̇co2 slope, MD 0.85 ml·kg(-1)·min(-1) (95% CI 0.05 to 1.65, P = 0.04); maximum heart rate, MD 5.60 beats per minute (95% CI 3.95 to 7.25, P < 0.00001); Six-Minute Walk Test, MD 32.1 m (95% CI 17.2 to 47.1, P < 0.0001); and indices of diastolic function: E/A ratio, MD 0.07 (95% CI 0.02 to 0.12, P = 0.005); E/E' ratio MD -2.31 (95% CI -3.44 to -1.19, P < 0.0001); deceleration time (DT), MD -13.2 ms (95% CI -19.8 to -6.5, P = 0.0001); and quality of life: Minnesota Living with Heart Failure Questionnaire, MD -6.50 (95% CI -9.47 to -3.53, P < 0.0001); and short form-36 health survey (physical dimension), MD 15.6 (95% CI 7.4 to 23.8, P = 0.0002). In 3,744 h patient-hours of training, not one death was directly attributable to exercise. Exercise training appears to effect several health-related improvements in people with heart failure and preserved ejection fraction
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Validation of a new tool for the assessment of study quality and reporting in exercise training studies
No full textINTRODUCTION:
Several established tools are available to assess study quality and reporting of randomized controlled trials; however, these tools were designed with clinical intervention trials in mind. In exercise training intervention trials some of the traditional study quality criteria, such as participant or researcher blinding, are extremely difficult to implement.
METHODS:
We developed the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) - a study quality and reporting assessment tool, designed specifically for use in exercise training studies. Our tool is a 15-point scale (5 points for study quality and 10 points for reporting) and addresses previously unmentioned quality assessment criteria specific to exercise training studies.
RESULTS:
There were no systematic differences between the summated TESTEX scores of each observer [H(2)=0.392, P=0.822]. There was a significant association between the summated TESTEX scores of the three observers, with almost perfect agreement between observers 1 and 2 [intra-class correlation coefficient (ICC)=0.93, 95% confidence interval (CI) 0.82-0.97, P<0.001], observers 1 and 3 (ICC= 0.96, 95% CI 0.89-0.98, P<0.001) and observers 2 and 3 (ICC=0.91, 95% CI 0.75-0.96, P<0.001).
CONCLUSIONS:
The TESTEX scale is a new, reliable tool, specific to exercise scientists, that facilitates a comprehensive review of exercise training trials
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