Relationship between Greenness and Health Indicators in Urban Patients with Heart Failure

The environment has a significant impact on a person’s general well-being. Distance to green space has been found to be an important factor influencing health. Urban green spaces enhance people’s quality of life and physical and mental health. According to recent research, living near green space may reduce one’s risk of developing cancer, cardiovascular and respiratory diseases, as well as other harmful health issues. In this study, the health data was collected in 2007– 2009 in Kaunas, Lithuania. The study participants (144) randomly were divided into two groups, control, and trained groups. Long-term aerobic physical training was applied to the exposure group. General clinical, echocardiography, and spiroergometry parameters were evaluated for the study participants. Greenness was estimated from satellite-derived normalized difference vegetation index (NDVI) in zones with radii of 1 km, 1.5 km, and 2 km surrounding the participants’ residences. To assess the effect of greenness on the effects of rehabilitation, changes in health indicators during a period of 6 months in the groups of low/high greenness environment were presented separately for participants in control and training group. For this purpose, the paired t-test was used. For changes in patient characteristics, the effect of greenness within a radius of 1.5 km was stronger, also the effect within a radius of 1 km was similar. It was discovered that in the trained group, people who lived in high greenness experienced the best increases in the distance walked over the course of six minutes (6 MWT) and a decrease in the mean heart rate. Spiroergometry indication improvements were notable and more pronounced for residents of high greenness areas. After 6 months, a decrease in echocardiographic indicators was found when living in low greenness. Living in low greenness was found to raise diastolic blood pressure and reduce 6 MWT in the control group. Only the control group’s ejection fraction was non-significant alterations in the low greenness environment. It can be concluded that greater greenness, according to NDVI, may lead to better rehabilitation outcomes for heart failure patients undergoing an aerobic exercise training program

The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention : randomized control trial

Background: To evaluate the short- and mid-term effect of a specially tailored resistance and balance training provided in addition to usual cardiac rehabilitation (CR) care program in older patients after valve surgery/intervention. Methods: Single-center (inpatient CR clinic in Lithuania) randomized controlled trial. Two hundred fifty-two patients were assessed for eligibility on the first day of admittance to CR early after (14.5?±?5.9?days) valve surgery/intervention between January 2018 and November 2019. Participants were coded centrally in accordance with randomization 1:1 using a computerized list. Control group (CG) patients were provided with usual care phase-II-CR inpatient multidisciplinary CR program, while intervention group (IG) patients received additional resistance and balance training (3 d/wk). Patients participated in a 3-month follow-up. Main outcome measures were functional capacity (6?min walk test (6MWT, meters), cardiopulmonary exercise testing), physical performance (Short Physical Performance Battery (SPPB, score) and 5-m walk test (5MWT, meters/second)), strength (one repetition maximum test for leg press), physical frailty (SPPB, 5MWT). Results: One hundred sixteen patients (76.1?±?6.7?years, 50% male) who fulfilled the study inclusion criteria were randomized to IG (n?=?60) or CG (n?=?56) and participated in CR (18.6?±?2.7?days). As a result, 6MWT (IG 247?±?94.1 vs. 348?±?100.1, CG 232?±?102.8 vs. 333?±?120.7), SPPB (IG 8.31?±?2.21 vs. 9.51?±?2.24, CG 7.95?±?2.01 vs. 9.08?±?2.35), 5MWT (IG 0.847?±?0.31 vs. 0.965?±?0.3, CG 0.765?±?0.24 vs 0.879?±?0.29) all other outcome variables and physical frailty level improved significantly (p?<?0.05) in both groups with no significant difference between groups. Improvements were sustained over the 3-month follow-up for 6MWT (IG 348?±?113 vs. CG 332?±?147.4), SPPB (IG 10.37?±?1.59 vs CG 9.44?±?2.34), 5MWT (IG 1.086?±?0. 307 vs CG 1.123?±?0.539) and other variables. Improvement in physical frailty level was significantly more pronounced in IG (p?<?0.05) after the 3-month follow-up. Conclusion: Exercise-based CR improves functional and exercise capacity, physical performance, and muscular strength, and reduces physical frailty levels in patients after valve surgery/intervention in the short and medium terms. SPPB score and 5MWT were useful for physical frailty assessment, screening and evaluation of outcomes in a CR setting. Additional benefit from the resistance and balance training could not be confirmed

Clinical Study The Effect of Park and Urban Environments on Coronary Artery Disease Patients: A Randomized Trial

Aim. To test the hypothesis that walking in a park has a greater positive effect on coronary artery disease (CAD) patients&apos; hemodynamic parameters than walking in an urban environment. Methods. Twenty stable CAD patients were randomized into two groups: 30-minute walk on 7 consecutive days in either a city park or busy urban street. Wilcoxon signed-rank test was employed to study short-term (30 min) and cumulative changes (following 7 consecutive days of exposure) in resting hemodynamic parameters in different environments. Results. There were no statistically significant differences in the baseline and peak exercise systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), exercise duration, or HR recovery in urban versus park exposure groups. Seven days of walking slightly improved all hemodynamic parameters in both groups. Compared to baseline, the city park group exhibited statistically significantly greater reductions in HR and DBP and increases in exercise duration and HR recovery. The SBP and DBP changes in the urban exposed group were lower than in the park exposed group. Conclusions. Walking in a park had a greater positive effect on CAD patients&apos; cardiac function than walking in an urban environment, suggesting that rehabilitation through walking in green environments after coronary events should be encouraged

Evaluation of the effect of long-term training on cardiorespiratory function, chronic fatigue and quality of life of patients with stable chronic heart failure

Evaluation of the effect of long-term training on cardiorespiratory function, chronic fatigue and quality of life of patients with stable chronic heart failure Objectives of the study: 1. To evaluate the effect of additional complex rehabilitative measures to clinical state, cardiorespiratory function, left ventricle remodeling, quality of life and fatigue in patients with severe and particularly severe heart failure. 2. To assess the relationship between parameters of cardiorespiratory functions measured by various methods (two-dimensional echocardiography, spiroergometry, 6-minute walk test) in patients with moderate and severe heart failure after long-term physical training. 3. To evaluate the safety of long-term physical training for patients with moderate and severe heart failure. After 6 months aerobic staged physical training of patients with moderate and severe HF there was statistically significant changes in clinical condition: increase of NYHA HF functional class, increase of quality of life and decrease of fatigue; respiratory function: respiratory volume increased by 2.4±0.8 l/min and oxygen consumption by 2 ml/kg/min; physical capacity: physical workload increased by 18.0±3.6 W and exercise duration increased by 2.4±3.3 minutes in trained patients. Long-term physical training is safe for patients with moderate and severe HF: during study period there were significantly fewer deaths and cardiovascular hospitalizations, in comparison with the patients who were provided with medical treatment

Effect of physical training on indices of platelet aggregation and fibrinogen concentration in patients with chronic heart failure

Objective: The aim of this study was to determine the effect of long-term physical load on the changes in the fibrinogen concentration and platelet aggregation. Material and methods: Platelet aggregation was investigated in 144 patients while fibrinogen concentration in 138 patients with CHF. The patients were divided into the groups of the trained patients and the controls and were investigated as follows: on admission to the hospital (stage 1); after treatment in the hospital (stage 2); after 3 months (stage 3); after 6 months (stage 4); and after 1 year (stage 5). The indices were investigated before and after physical load. Results: It was determined that fibrinogen concentration significantly increased after physical load in all the treatment stages in both groups of the patients (P = 0.045). In the course of the treatment, fibrinogen concentration gradually decreased in the group of the trained patients (P = 0.02). Platelet aggregation investigated with ADP significantly increased after physical load in all the stages in both groups of the patients and decreased during the different investigation stages in the groups of the untrained (P = 0.02) and trained patients. Platelet aggregation investigated with ADR consistently decreased before physical load during the different investigation stages in the groups of the trained (difference is not significant) and untrained patients (P = 0.02). Conclusions: Physical training reduces fibrinogen concentration in patients with CHF. It remains unclear whether physical training can have an effect on the decrease in platelet aggregation in patients who have long-term physical training applied

The effectiveness of Kinesio Taping(R) for pain management in knee osteoarthritis: a randomized, double-blind, controlled clinical trial

Background: Kinesio Taping(R) method is a nonpharmacological alternative for pain management in musculoskeletal disorders. However, the existing evidence is insufficient to assess its full effectiveness for pain management in knee osteoarthritis (KO). Our aim was to evaluate the effectiveness of the Kinesio Taping method in reducing knee pain for KO patients. Methods: In this randomized, double blind, controlled trial, we recruited 187 patients with grade I-III KO who were allocated to either the Kinesio Taping or control group. The study was carried out in outpatient facility. Either Kinesio Taping or nonspecific taping was applied on the affected knee area for 4 weeks. Pain evaluation was performed at baseline, after 1 month of taping and after 1 further month without taping. The data on usage of painkillers were collected; Numeric Pain Rating Scale; an algometer, and Knee injury and Osteoarthritis Outcome Scores (KOOS) pain subscale were used to assess pain. Tolerance and subjective opinions toward the effectiveness of taping were evaluated. The chosen level of significance was p 70%) of both groups' patients indicated that tapes reduced the knee pain. The reported use of painkillers decreased, in addition to self-reported increase in the KOOS subscale, thereby indicating pain alleviation. All self-reported improvement remained at the 1-month follow up (p < 0.05). Significantly higher and clinically meaningful reduction of pain intensity was found in the Kinesio Taping group after the treatment month, in comparison with the control group (p < 0.05). More pain reduction was reported in the daytime for participants in the Kinesio Taping group at the follow up (p = 0.022). No changes in algometry results were observed. Conclusions: Elastic taping can safely relieve knee pain and reduce the need for pharmacological management in KO. A specific Kinesio Taping technique is clinically more beneficial for knee-pain alleviat

High-Frequency Ipsilesional versus Low-Frequency Contralesional Transcranial Magnetic Stimulation after Stroke:Differential Effects on Ipsilesional Upper Extremity Motor Recovery

: Stroke is a major cause of death and disability worldwide; therefore, transcranial magnetic stimulation (TMS) is being widely studied and clinically applied to improve motor deficits in the affected arm. However, recent studies indicate that the function of both arms can be affected after stroke. It currently remains unknown how various TMS methods affect the function of the ipsilesional upper extremity. : Thirty-five subacute stroke patients with upper extremity motor deficits were enrolled in this study and randomly allocated into three groups, receiving either (1) low-frequency rTMS over the contralesional hemisphere; (2) high-frequency rTMS over the ipsilesional hemisphere; or (3) no stimulation. Experimental groups received 10 rTMS sessions over two weeks alongside standard rehabilitation, and the control group received the same procedures except for rTMS. Both affected and unaffected upper extremity motor function was evaluated using hand grip strength and Functional Independence Measure (FIM) tests before and after rehabilitation (7 weeks apart). : All groups showed significant improvement in both the affected and unaffected hand grip and FIM scores ( &lt; 0.05). HF-rTMS led to a notably higher increase in unaffected hand grip strength than the control group ( = 0.007). There was no difference in the improvement in affected upper extremity motor function between the groups. The FIM score increase was lower in the control group compared to experimental groups, although not statistically significant. : This study demonstrates the positive effect of ipsilesional HF-rTMS on the improvement in unaffected arm motor function and reveals the positive effect of both LF- and HF-rTMS on the affected upper extremity motor function recovery

A Novel, individualized exercise program for patients with peripheral arterial disease recovering from bypass surgery

The effectiveness of an individual six-month-long physical exercise program in improving health-related quality of life (HRQOL) is unclear. There is some evidence that an individual exercise program can be effective for this aim. The goal of this study was to compare an individual six-month-long physical exercise program for patients with PAD (Peripheral Arterial Disease) with a traditional exercise program and find the effect of these programs on HRQOL and PAD risk factors. The study included patients who underwent femoral-popliteal artery bypass grafting surgery. Patients were divided into three groups: patients participating in an individual six-month-long physical exercise program (group I), in the standard physical activity program (group II), and in a control group (group III), with no subjects participating in rehabilitation II. Results: group I patients had a significantly (p /= 65), overweight participants, as well as among patients with diabetes mellitus and cardiovascular diseases when comparing study results with patients without these risk factors

Do Comorbidities and Daily Medication before SARS-CoV-2 Infection Play a Role in Self-Reported Post-Infection Symptoms?

This study investigated the associations between health status before SARS-CoV-2 infection and persistent symptoms after acute infection. Data were collected from participants older than 18 years and more than 28 days after acute SARS-CoV-2 infection using an online survey. Sociodemographic data, comorbidities, and daily medication before infection, as well as acute and persistent symptoms were analysed. Among the 1050 participants (mean age 41 years, 88% women, 56% with higher education, 93% working), 538 (51%) reported being healthy and 762 (73%) reported not taking any daily medication prior to infection. Positive laboratory testing was reported by 965 (92%) participants; asymptomatic infection was reported by 30 (3%); and 999 (95%) stayed at home during their acute infection. Reduced physical capacity (40%), fatigue (39%), cognitive difficulties (30–34%), altered sense of smell (24%), headache (20%), tachycardia (20%), unstable mood (19%), hair loss (17%), and insomnia (17%) were the most often reported symptoms. Those taking daily medication before infection reported increased frequency of both acute and persistent symptoms, except for decreased frequency of persistent altered smell and taste. The presence of persistent symptoms was predicted by taking daily medication before infection and by the total number of acute symptoms. Comorbidities before infection did not predict persistent symptoms. Therefore, the role of medication needs further investigation in both acute SARS-CoV-2 infection and post-COVID-19 condition