87 research outputs found

    Bridging the gap from research to practice for enhanced health-related quality of life in people with chronic kidney disease

    Get PDF
    From Crossref journal articles via Jisc Publications RouterHistory: issued 2021-04-01, epub 2021-05-06, ppub 2021-05-06Article version: VoRPublication status: PublishedPelagia Koufaki - ORCID: 0000-0002-1406-3729 https://orcid.org/0000-0002-1406-3729Improving the health status of people with chronic kidney disease (CKD) through physical activity (PA) or exercise interventions is challenging. One of the gaps in the process of translating the general public PA activity guidelines as well as the CKD-specific guidelines into routine clinical practice is the lack of systematic recording and monitoring of PA and physical function attributes, which can also be used to develop individualized and measurable plans of action to promote PA for health. We aim to present an overview of key considerations for PA, physical function and health-related quality of life (HRQoL) evaluation in people with CKD, with the aim of encouraging health professionals to integrate assessment of these outcomes in routine practices. Physical inactivity and impaired physical function, sometimes to the extent of physical and social disability levels, and subsequently lower perceived HRQoL, are highly prevalent in this population. Enhanced PA is associated with better physical function that also translates into multiple health benefits. Breaking the vicious circle of inactivity and physical dysfunction as early as possible in the disease trajectory may confer huge benefits and enhanced life satisfaction in the longer term. With this in mind, the importance of PA/exercise interventions in CKD to improve HRQoL is also summarized.14pubpubSupplement_

    Relationship between declining GFR and measures of cardiac and vascular autonomic neuropathy.

    Get PDF
    Cardiac and vascular autonomic neuropathy contributes to increased morbidity and mortality in patients with chronic kidney disease. The aim of this study was to analyze the effects of a decline in GFR on heart rate variability (HRV) and nocturnal blood pressure dipping

    Transtelephonic Electrocardiographic Transmission in the Preparticipation Screening of Athletes

    Get PDF
    Transtelephonic electrocardiographic transmission (TET) is the most widespread form of telecardiology since it enables clinicians to assess patients at a distance. The purpose of this study was to assess the efficacy and effectiveness of TET either by fixed telephone line (POTS) or by mobile phone in the preparticipation screening of young athletes. A total of 506 players, aged 20.5 ± 6.2 years, from 23 soccer clubs in the prefecture of Thessaloniki, Greece, were physically examined in their playfields by a general practitioner (GP) and had their ECG recorded. In 142 cases, and on the judgment of the GP, the ECG was transmitted via POTS and/or global system for mobile communications (GSM) to a specialised medical centre where it was evaluated by a cardiologist. The mean total time for recording, storing, and transmitting the ECG was four minutes per subject. It was found that the success rate for transmission at first attempt was similar for both fixed and mobile networks, that is, 93% and 91%, respectively. The failure rate in the GSM network was correlated to the reception level at the site of transmission. Only in about half (n = 74) of the transmitted ECGs did the cardiologist confirm “abnormal” findings, although in 16, they were considered to be clinically insignificant. Consequently, 58 athletes were referred for further medical examination. Our results indicate that TET (either by fixed telephone line or by mobile phone) can ensure valid, reliable, and objective measurements, and significantly contribute to the application of medical screening in a great number of athletes. Therefore, it is recommended as an alternative diagnostic tool for the preparticipation screening of athletes living in remote areas

    Exploring the feasibility, acceptability, and safety of a real-time cardiac telerehabilitation and tele coaching programme using wearable devices in people with a recent myocardial infarction

    Get PDF
    Background:Cardiac rehabilitation (CR) constitutes the recommended nonpharmacological approach for cardiac patients with cardiovascular disease such as people following a recent (i.e., &lt; 4 week) myocardial infarction (MI). Recent evidence suggests that cardiac telerehabilitation may be as effective as traditional (i.e., in person) CR in people following a recent MI. Nevertheless, the feasibility, acceptability, and safety of such an exercise programme has yet to be examined. Methods: Forty-four (11 women, 33 men) people following a recent MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 24-week CR programme thrice per week. All patients performed the baseline, and 24 weeks follow up measurements where feasibility, acceptability, and safety were assessed. Results: Eligibility and recruitment rates were found to be 61.5% and 42%, respectively. Compliance to the thrice weekly, 24-week exercise programme for the online- and gym-based groups were 91.6% and 90.9%, respectively. There were no dropouts during the exercise programmes, however four participants, two from each group, were lost to follow up at 6 months. The average percentage of peak HR (% HRpeak) for the online group was 66.6% ± 4.5 and for the gym-based group was 67.2% ± 5. The average RPE and affect during exercise was for both groups 12 ± 1 (“somewhat hard”) and 3 ± 1 (“good”), respectively. During the 6-month exercise intervention period for both groups, the exercise-induced symptoms were minimal to none. The user suitability evaluation questionnaire revealed that the online real time telerehabilitation and tele coaching programme was enjoyable (4.85 ± 0.37) and did not induce general discomfort (1.20 ± 0.41). Conclusion: Our cardiac telerehabilitation programme seems to be feasible, acceptable, safe, and enjoyable for people with a recent MI. Our participants had an overall positive experience and acceptability of the cardiac telerehabilitation and tele coaching using wearable devices. Trial registration: ClinicalTrial.gov, ID NCT06071273, 10/02/2023, retrospectively registered.</p

    Right Ventricular Morphology and Function after Exercise Training in People with Systemic Sclerosis: A Randomized Controlled Pilot Study.

    Get PDF
    Background: Vascular dysfunction and its concomitant multi-organ involvement, including cardiac involvement, affects prognosis in systemic sclerosis (SSc) patients. Regular exercise has demonstrated to be able to improve vascular function in SSc. However, the effects of an exercise program on the heart and specifically in right ventricular (RV) morphology and function in SSc have yet to be explored. The study aimed to examine whether a 3-month combined exercise program can affect RV morphology and function in SSc patients. Methods: Twenty-eight SSc patients were randomly allocated to either the exercise training (ET) or the control (CON) group. Baseline and follow-up assessments consisted of a cardiopulmonary exercise test along with both a conventional and a two-dimensional speckle tracking echocardiography (2DSTE) focused on RV morphology and function. Following the baseline assessments, Group ET participated in a supervised combined exercise program for 12 weeks, while group CON received their usual care. Results: The ET group demonstrated increases in peak oxygen consumption by 25.1% (p < 0.001), global RV free wall longitudinal systolic strain by 6.69% (p < 0.03), RV free wall longitudinal systolic strain of the basal segment by 13.5% (p < 0.001), and global RV four-chamber longitudinal systolic strain by 6.76% (p < 0.03) following the exercise program. No differences were observed in group CON. Conclusions: Combined exercise improved cardiorespiratory efficiency and indices of RV systolic function, as assessed by the 2DSTE, in SSc patients

    DE-PASS Best Evidence Statement (BESt): Determinants of self-report physical activity and sedentary behaviours in children in settings: A systematic review and meta-analyses.

    Get PDF
    Previous physical activity interventions for children (5-12yrs) have aimed to change determinants associated with self-report physical activity behaviour (PAB) and/or sedentary behaviour (SB), however, the associations between these determinants and PAB/SB in different settings are uncertain. The present study aimed to identify modifiable determinants targeted in previous PAB/SB interventions for children. Intervention effects on the determinants and their associations with self-report PAB/SB were assessed across settings.Search of relevant interventions from pre-defined databases was conducted up to July 2023. Randomized and non-randomized controlled trials with modifiable determinants were included. Data extraction and risk of bias assessments were conducted by two independent researchers. Where data could be pooled, we performed Robust Bayesian meta-analyses. Heterogeneity, publication bias and certainty of evidence were assessed. Fifteen studies were deemed eligible to be included. Thirty-seven unique determinants within four settings were identified – school, family, school with family/home, and community with(out) other settings. Ninety-eight percent of determinants belonged to individual/interpersonal determinant categories. Narratively, intervention effects on student perception of teachers’ behaviour (school), self-management, perceived barriers, external motivation, exercise intention, parental modeling on SB (school with family/home) and MVPA expectations (community) were weak to strong, however, corresponding PAB/SB change was not evident. There were negligible effects for all other determinants and the corresponding PAB/SB. Meta-analyses on self-efficacy, attitude, subjective norm and parental practice and PAB/SB in two settings showed weak to strong evidence against intervention effect, while the effect on knowledge could not be determined. Similarly, publication bias and heterogeneity for most analyses could not be ascertained. We found no concrete evidence of association between the modifiable determinants and self-report PAB/SB in any settings. This is presumably due to intervention ineffectiveness. Design of future interventions should consider to follow the systems-based approach and identify determinants unique to the context of a setting, including policy and environmental determinants. <br/

    DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

    Get PDF
    Background: Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods: A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results: Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions: Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables

    DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

    Get PDF
    Background: Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods: A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results: Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions: Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables

    Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

    Get PDF
    Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: [email protected] Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.info:eu-repo/semantics/publishedVersio

    European Society of Organ Transplantation (ESOT) Consensus Statement on Prehabilitation for Solid Organ Transplantation Candidates

    Get PDF
    Data Availability Statement: The original contributions presented in the study are included in the article/Supplementary Material (https://www.frontierspartnerships.org/articles/10.3389/ti.2023.11564/full#SM1), further inquiries can be directed to the corresponding author.Supplementary Material: The Supplementary Material for this article can be found online at: https://www.frontierspartnerships.org/articles/10.3389/ti.2023.11564/full#supplementary-materialCopyright © 2023 The Authors. There is increasingly growing evidence and awareness that prehabilitation in waitlisted solid organ transplant candidates may benefit clinical transplant outcomes and improve the patient’s overall health and quality of life. Lifestyle changes, consisting of physical training, dietary management, and psychosocial interventions, aim to optimize the patient’s physical and mental health before undergoing surgery, so as to enhance their ability to overcome procedure-associated stress, reduce complications, and accelerate post-operative recovery. Clinical data are promising but few, and evidence-based recommendations are scarce. To address the need for clinical guidelines, The European Society of Organ Transplantation (ESOT) convened a dedicated Working Group “Prehabilitation in Solid Organ Transplant Candidates,” comprising experts in physical exercise, nutrition and psychosocial interventions, to review the literature on prehabilitation in this population, and develop recommendations. These were discussed and voted upon during the Consensus Conference in Prague, 13–15 November 2022. A high degree of consensus existed amongst all stakeholders including transplant recipients and their representatives. Ten recommendations were formulated that are a balanced representation of current published evidence and real-world practice. The findings and recommendations of the Working Group on Prehabilitation for solid organ transplant candidates are presented in this article.All costs related to taskforce and workgroup meetings were covered by ESOT, without external funding
    • 

    corecore