Predictors of shuttle walking test performance in patients with cardiovascular disease

Objective: The incremental shuttle walking test (ISWT) is used to estimate cardiorespiratory fitness, but data from healthy individuals suggest that demographic and anthropometric measures account for much of the variance in test performance. The aim of this study was to determine whether anthropometric, demographic and selected gait measures also predict ISWT performance (i.e. distance walked) in patients with cardiovascular disease. Design: Observational study. Setting: A community-based cardiac rehabilitation centre (Cohort 1) and a hospital outpatient cardiac rehabilitation programme (Cohort 2). Participants: Sixteen patients with clinically stable cardiovascular disease (Cohort 1) and 113 patients undergoing cardiac rehabilitation (Cohort 2). Interventions: Patients in Cohort 1 performed the ISWT on two occasions. Anthropometric data and walking and turning variables were collected. Linear regression analyses were used to identify the predictors of test performance. The authors subsequently attempted to validate the equation created by comparing predicted and actual ISWT values in a larger (n= 113) validation sample (Cohort 2). Main outcome measures: Distance walked during ISWT, step length and height. Results: No gait or turning measures were significantly associated with ISWT performance. Distance walked correlated most strongly with step length (r= 0.83, P< 0.05) and height (r= 0.74, P< 0.05). Given the similarity of these correlations and the rarity of step length assessment in clinical practice, ISWT performance was predicted using patient's height; this explained 55% of the variance in ISWT performance. Height was also the best predictor in Cohort 2, explaining 17% of test variance (P< 0.01). Body mass index explained an additional 3% of variance (P< 0.05) in ISWT performance. Conclusions: Routine clinical measures, particularly patient's height, are predictive of ISWT performance. The findings of the present study are in partial agreement with similar studies performed in healthy individuals, and it remains unclear whether the ISWT performance of patients with cardiovascular disease is influenced by the same factors as the ISWT performance of healthy individuals. © 2013

Characteristics of the nuclear (18S, 5.8S, 28S and 5S) and mitochondrial (12S and 16S) rRNA genes of Apis mellifera (Insecta: Hymenoptera): structure, organization, and retrotransposable elements

As an accompanying manuscript to the release of the honey bee genome, we report the entire sequence of the nuclear (18S, 5.8S, 28S and 5S) and mitochondrial (12S and 16S) ribosomal RNA (rRNA)-encoding gene sequences (rDNA) and related internally and externally transcribed spacer regions of Apis mellifera (Insecta: Hymenoptera: Apocrita). Additionally, we predict secondary structures for the mature rRNA molecules based on comparative sequence analyses with other arthropod taxa and reference to recently published crystal structures of the ribosome. In general, the structures of honey bee rRNAs are in agreement with previously predicted rRNA models from other arthropods in core regions of the rRNA, with little additional expansion in non-conserved regions. Our multiple sequence alignments are made available on several public databases and provide a preliminary establishment of a global structural model of all rRNAs from the insects. Additionally, we provide conserved stretches of sequences flanking the rDNA cistrons that comprise the externally transcribed spacer regions (ETS) and part of the intergenic spacer region (IGS), including several repetitive motifs. Finally, we report the occurrence of retrotransposition in the nuclear large subunit rDNA, as R2 elements are present in the usual insertion points found in other arthropods. Interestingly, functional R1 elements usually present in the genomes of insects were not detected in the honey bee rRNA genes. The reverse transcriptase products of the R2 elements are deduced from their putative open reading frames and structurally aligned with those from another hymenopteran insect, the jewel wasp Nasonia (Pteromalidae). Stretches of conserved amino acids shared between Apis and Nasonia are illustrated and serve as potential sites for primer design, as target amplicons within these R2 elements may serve as novel phylogenetic markers for Hymenoptera. Given the impending completion of the sequencing of the Nasonia genome, we expect our report eventually to shed light on the evolution of the hymenopteran genome within higher insects, particularly regarding the relative maintenance of conserved rDNA genes, related variable spacer regions and retrotransposable elements

Knowledge of cardiopulmonary resuscitation among Greek physiotherapists

High quality cardiopulmonary resuscitation (CPR) is crucial for influencing survival from cardiac arrest. Healthcare professionals are expected to know how to perform CPR as they may encounter emergency situations during their work. Physiotherapists, who use exercise as a therapeutic approach, should have good knowledge and skills in CPR not only to cope with possible adverse cardiac events during exercise but also because a widespread CPR application and early defibrillation can greatly reduce mortality due to heart attack. The aim of this study is to investigate knowledge of Greek physiotherapists in European Resuscitation Council guidelines for resuscitation. A secondary aim of this study was to assess and compare the knowledge score between those with and without previous training and/or lower self-confidence in CPR skills. Three hundred and fifty Greek physiotherapists who were working in hospitals and rehabilitation centres (face-to-face and e-mail contact) were randomly selected to complete an anonymous questionnaire containing demographic questions, CPR experience questions, and ten theoretical knowledge questions, based on European Resuscitation Council guidelines for resuscitation. The response ratio was 63% (n=220 physiotherapists). Respondents’ total mean score for the theoretic knowledge questions was 4.1±2 (range 1-10); 21.4% of the respondents had participated in a CPR course, while only 0.9% had previous experience in CPR performance. The group of respondents who had attended a CPR course had a significantly higher score in CPR knowledge questions and higher confidence score (p&lt;0.01). Moreover, the physiotherapists who attended refresher courses in CPR in the workplace scored significantly higher (p&lt;0.01). Our results indicate that Greek physiotherapists have knowledge gaps in the European Resuscitation Council guidelines for resuscitation. The percentage of Greek physiotherapists who had CPR certification and recertification was low, thus the CPR training should be mandatory for all working physiotherapists. ©Copyright: the Author(s), 2019

Knowledge of cardiopulmonary resuscitation among Greek physiotherapists

High quality cardiopulmonary resuscitation (CPR) is crucial for influencing survival from cardiac arrest. Healthcare professionals are expected to know how to perform CPR as they may encounter emergency situations during their work. Physiotherapists, who use exercise as a therapeutic approach, should have good knowledge and skills in CPR not only to cope with possible adverse cardiac events during exercise but also because a widespread CPR application and early defibrillation can greatly reduce mortality due to heart attack. The aim of this study is to investigate knowledge of Greek physiotherapists in European Resuscitation Council guidelines for resuscitation. A secondary aim of this study was to assess and compare the knowledge score between those with and without previous training and/or lower self-confidence in CPR skills. Three hundred and fifty Greek physiotherapists who were working in hospitals and rehabilitation centres (face-to-face and e-mail contact) were randomly selected to complete an anonymous questionnaire containing demographic questions, CPR experience questions, and ten theoretical knowledge questions, based on European Resuscitation Council guidelines for resuscitation. The response ratio was 63% (n=220 physiotherapists). Respondents’ total mean score for the theoretic knowledge questions was 4.1±2 (range 1-10); 21.4% of the respondents had participated in a CPR course, while only 0.9% had previous experience in CPR performance. The group of respondents who had attended a CPR course had a significantly higher score in CPR knowledge questions and higher confidence score (p<0.01). Moreover, the physiotherapists who attended refresher courses in CPR in the workplace scored significantly higher (p<0.01). Our results indicate that Greek physiotherapists have knowledge gaps in the European Resuscitation Council guidelines for resuscitation. The percentage of Greek physiotherapists who had CPR certification and recertification was low, thus the CPR training should be mandatory for all working physiotherapists. ©Copyright: the Author(s), 2019

Erratum to “Effects of multicomponent exercise training intervention on hemodynamic and physical function in older residents of long-term care facilities: A multicenter randomized clinical controlled trial” [J. Bodyw. Mov. Ther. 28, (October 2021) 231–237] (Journal of Bodywork & Movement Therapies (2021) 28 (231–237), (S1360859221001637), (10.1016/j.jbmt.2021.07.009))

The publisher regrets that the co-Author's names were published incorrectly. The correct details for each co-Author are: • Christina Mpea• Katerina Krinta• Argirios Peristeropoulos• Varsamo AntoniouThe publisher would like to apologise for any inconvenience caused. © 2022 Elsevier Lt

Effects of multicomponent exercise training intervention on hemodynamic and physical function in older residents of long-term care facilities: A multicenter randomized clinical controlled trial

Objectives: To assess hemodynamic and physical function responses during a two-month multicomponent group exercise program (MCEP) in residents of long-term care facilities. Methods: 40 older long-term care residents were randomly allocated equally to an intervention (IG; n = 20; 80 ± 7 years) and control group (CG; n = 20; 79 ± 7 years); they all submitted to hemodynamic (blood pressure and heart rate) and functional assessments before and after the MCEP. The IG performed a twice-weekly, two-months multicomponent exercise program composed of functional mobility, balance, muscle strength, and flexibility exercises; while the CG did not perform any exercise intervention. Results: There was a statistically significant decrease in systolic blood pressure (7.25 ± 14.64 mmHg; t = 2.2; effect size = 0.34; p < 0.05) following a two-month MCEP as compared with baseline. In all functional measurements (balance, mobility) were significantly improved after the MCEP (p < 0.05). Discussion: These data indicate that a two-month MCEP can improve systolic blood pressure and functionality in older residents of long-term care facilities. © 2021 Elsevier Lt

Efficacy, efficiency and safety of a cardiac telerehabilitation programme using wearable sensors in patients with coronary heart disease: The TELEWEAR-CR study protocol

Introduction Exercise-based cardiac rehabilitation (CR) is a beneficial tool for the secondary prevention of cardiovascular diseases with, however, low participation rates. Telerehabilitation, intergrading mobile technologies and wireless sensors may advance the cardiac patients' adherence. This study will investigate the efficacy, efficiency, safety and cost-effectiveness of a telerehabilitation programme based on objective exercise telemonitoring and evaluation of cardiorespiratory fitness. Methods and analysis A supervised, parallel-group, single-blind randomised controlled trial will be conducted. A total of 124 patients with coronary disease will be randomised in a 1:1 ratio into two groups: intervention telerehabilitation group (TELE-CR) (n=62) and control centre-based cardiac rehabilitation group (CB-CR) (n=62). Participants will receive a 12-week exercise-based rehabilitation programme, remotely monitored for the TELE-CR group and standard supervised for the CB-CR group. All participants will perform aerobic training at 70% of their maximal heart rate, as obtained from cardiopulmonary exercise testing (CPET) for 20 min plus 20 min for strengthening and balance training, three times per week. The primary outcomes will be the assessment of cardiorespiratory fitness, expressed as peak oxygen uptake assessed by the CPET test and the 6 min walk test. Secondary outcomes will be the physical activity, the safety of the exercise intervention (number of adverse events that may occur during the exercise), the quality of life, the training adherence, the anxiety and depression levels, the nicotine dependence and cost-effectiveness. Assessments will be held at baseline, end of intervention (12 weeks) and follow-up (36 weeks). Ethics and dissemination The study protocol has been reviewed and approved by the Ethics Committee of the University of Thessaly (1108/1-12-2021) and by the Ethics Committee of the General University Hospital of Larissa (3780/31-01-2022). The results of this study will be disseminated through manuscript publications and conference presentations. Trial registration number NCT05019157. © 2022 BMJ Publishing Group. All rights reserved

Cardio-Oncology Rehabilitation and Telehealth: Rationale for Future Integration in Supportive Care of Cancer Survivors

The direct toxicity of cancer treatment threatens patients and survivors with an increased risk of cardiovascular disease or adverse functional changes with subsequent progression of cardiovascular complications. An accumulation of cardiovascular risk factors combined with an unhealthy lifestyle has recently become more common in cancer patients and survivors. It has been recommended to integrate a comprehensive cardiac rehabilitation model called cardio-oncology rehabilitation to mitigate cardiovascular risk. Nevertheless, cardiac rehabilitation interventions limit barriers in low utilization, further exacerbated by the restrictions associated with the COVID-19 pandemic. Therefore, it is essential to integrate alternative interventions such as telehealth, which can overcome several barriers. This literature review was designed as a framework for developing and evaluating telehealth interventions and mobile applications for comprehensive cardio-oncology rehabilitation. We identify knowledge gaps and propose strategies to facilitate the development and integration of cardio-oncology rehabilitation telehealth as an alternative approach to the standard of care for cancer patients and survivors. Despite the limited evidence, the pilot results from included studies support the feasibility and acceptability of telehealth and mobile technologies in cardio-oncology rehabilitation. This new area suggests that telehealth interventions are feasible and induce physiological and psychological benefits for cancer patients and survivors. There is an assumption that telehealth interventions and exercise may be an effective future alternative approach in supportive cancer care. Copyright © 2022 Batalik, Filakova, Radkovcova, Dosbaba, Winnige, Vlazna, Batalikova, Felsoci, Stefanakis, Liska, Papathanasiou, Pokorna, Janikova, Rutkowski and Pepera