| 1. |
- Deka, Pallav, et al.
(författare)
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Combined Dietary Education and High-Intensity Interval Resistance Training Improve Health Outcomes in Patients with Coronary Artery Disease
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reducing cardiovascular risk through lifestyle changes that include a heart-healthy diet and regular exercise is recommended in the rehabilitation of patients with coronary artery disease (CAD). We pilot-tested the effectiveness of a dietary-education and high-intensity interval resistance training (DE-HIIRT) program on healthy food choices and associated anthropometric variables in patients with established CAD. Methods: A total of 22 participants, aged 60.0 +/- 7.2 years, were enrolled in the study. Over 3 months, under the guidance and supervision of a physiotherapist, participants performed the resistance exercises 2x/week in a group setting (cohort of 11). Participants additionally attended three sessions of dietary education led by a dietician. Participants demonstrated their knowledge and understanding of dietary education by picking heart-healthy foods by reading food labels. Outcomes included change in diet (measured using the tricipital skinfold thickness Mediterranean Diet Adherence questionnaire (MEDAS-14) and the Food Consumption Frequency Questionnaire (FCFQ)) and anthropometric measurements (body composition, body circumference, and tricipital skinfold thickness). A paired t-test was performed to analyze the differences between the baseline and post-intervention results. Results: Participants significantly increased their consumption of vegetables (p = 0.04) and lowered their consumption of sweet snacks (p = 0.007), pastries (p = 0.02), and processed food (p = 0.05). Significant improvements in body mass index (p = 0.001), waist circumference (p = 0.0001), hip circumference (p = 0.04), and body fat (p = 0.0001) were also achieved. Conclusion: Making lifestyle changes that include both diet and exercise is essential in the management of CAD. The HIIRT program combined with dietary changes shows promise in achieving weight-loss goals in this population and needs to be further investigated with appropriate study designs.
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| 2. |
- Deka, Pallav, et al.
(författare)
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Depression mediates physical activity readiness and physical activity in patients with heart failure
- 2021
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 8:6, s. 5259 --5265
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Tidskriftsartikel (refereegranskat)abstract
- Aims Although physical activity (PA) and exercise are essential for patients with heart failure (HF), adherence to the recommended guidelines is low. Not much is known about the mediating effect of HF patients mental state with their readiness for PA and reported activity levels. The purpose of this study is to investigate the mediatory effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA in patients with HF. Methods and results In this cross-sectional study, 163 New York Heart Association Class I and II HF patients, during their clinic visit, reported on their physical limitation (PAR-Q) and psychological readiness [self-efficacy (ESES) and motivation (RM 4-FM)] for PA, depression (HADS-D), and PA (s-IPAQ). Mediation analysis was performed to test the mediating effect of depression on PA readiness (physical limitation and psychological readiness) and self-reported PA following the steps described by Baron and Kenny (1986). Hierarchical regression models were tested for their effects. The Self-Efficacy Theory and Self-Determination theory provided the theoretical platform for the study. Depression completely mediated the effect of physical limitation (beta(dep) = 268.57; P < 0.0001) and partially mediated the effect of self-efficacy on PA (beta(dep) = 344.16; P < 0.0001). Both intrinsic (P < .0001) and extrinsic motivation (P < .0001) for PA had an independent and significant effect on PA, not mediated by depression. Conclusions Patients with HF should be screened for depression throughout the trajectory of the disease as it can impact their physical and psychological readiness to perform PA.
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| 3. |
- Deka, Pallav, et al.
(författare)
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High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease
- 2022
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Ingår i: Journal of the American Medical Directors Association. - : ELSEVIER SCIENCE INC. - 1525-8610 .- 1538-9375. ; 23:1, s. 60-65
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Both high-intensity interval training (HIIT) and resistance exercises (R) are used in cardiac rehabilitation in patients with coronary artery disease (CAD). However, the combined effect of an HIIT + R exercise program in older adults with CAD is not well investigated. The studys purpose was to assess the changes in anthropometric parameters, physical activity, functional capacity, physiological parameters, and quality of life (QoL) in this population following a combined HIIT + R program. Design: The study was a 2-group (n = 45 each) randomized controlled single-blinded trial. Setting and Participants: The study was done at a treatment clinic of a tertiary hospital. The mean age of participants was 69.23 +/- 4.9 years. The HIIT + R group performed 8 sessions (1/wk) of HIIT + R training. The 30 minutes of the active exercise phase consisted of ten 3-minute bouts. Each bout comprised of 1 minute of high-intensity treadmill walking at 85% to 90% maximum heart rate (MHR), followed by a low-intensity walking at 60%-70% MHR, followed by low-to moderate-intensity resistance training. The Usual Care group underwent conventional medical treatment. Measures: Anthropometric measurements [weight, body mass index (BMI), waist circumference, body fat percentage, lean body mass], physical activity (International Physical Activity Questionnaire), functional capacity (Incremental Shuttle Walking Test), physiologic measurements (blood pressure, heart rate), and QoL (36-Item Short Form Health Survey) were measured pre- and postintervention. Results: Significant group and time interaction were found for the participants in the HIIT + R Group for BMI (P =.001), body fat percentage (P =.001), waist circumference (P <.001), physical activity (P <.001), functional capacity (P <.001), and QoL (P =.001) compared with the UC Group. Significant improvement in systolic blood pressure (P =.001) was seen in the HIIT + R group. Conclusions and Implications: A combined HIIT thorn R training protocol in older adults with CAD can be useful in producing desired health outcomes. Further evaluation of longer duration exercise programs with more frequent dosing needs to be evaluated for their benefits and sustainability. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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| 4. |
- Deka, Pallav, et al.
(författare)
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Predicting maximal oxygen uptake from the 6 min walk test in patients with heart failure
- 2021
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Ingår i: ESC Heart Failure. - : WILEY PERIODICALS, INC. - 2055-5822. ; 8:1, s. 47-54
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Tidskriftsartikel (refereegranskat)abstract
- Aims A cardiopulmonary exercise (CPX) test is considered the gold standard in evaluating maximal oxygen uptake. This study aimed to evaluate the predictive validity of equations provided by Burr et al., Ross et al., Adedoyin et al., and Cahalin et al. in predicting peak VO2 from 6 min walk test (6MWT) distance in patients with heart failure (HF). Methods and Results New York Heart Association Class I-III HF patients performed a maximal effort CPX test and two 6MWTs. Correlations between CPX VO2 peak and the predicted VO2 peak, coefficient of determination (R-2), and mean absolute percentage error (MAPE) scores were calculated. P-values were set at 0.05. A total of 106 participants aged 62.5 +/- 11.5 years completed the tests. The mean VO2 peak from CPX testing was 16.4 +/- 3.9 mL/kg/min, and the mean 6MWT distance was 419.2 +/- 93.0 m. The predicted mean VO2 peak (mL/kg/min) by Burr et al., Ross et al., Adedoyin et al., and Cahalin et al. was 22.8 +/- 8.8, 14.6 +/- 2.1, 8.30 +/- 1.4, and 16.6 +/- 2.8. A significant correlation was observed between the CPX test VO2 peak and predicted values. The mean difference (0.1 mL/kg/min), R-2 (0.97), and MAPE (0.14) values suggest that the Cahalin et al. equation provided the best predictive validity. Conclusions The equation provided by Cahalin et al. is simple and has a strong predictive validity, and researchers may use the equation to predict mean VO2 peak in patients with HF. Based on our observation, equations to predict individual maximal oxygen uptake should be used cautiously.
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| 6. |
- Deka, Pallav, et al.
(författare)
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Technology Usage, Physical Activity, and Motivation in Patients With Heart Failure and Heart Transplantation
- 2023
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Ingår i: Computers, Informatics, Nursing. - : LIPPINCOTT WILLIAMS & WILKINS. - 1538-2931 .- 1538-9774. ; 41:11, s. 903-908
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Tidskriftsartikel (refereegranskat)abstract
- The cross-sectional study enrolled 231 patients with heart failure (n = 115; 60.87% were men; mean age, 74.34 +/- 12.70 years) and heart transplantation (n = 116; 72.41% were men; mean age, 56.85 +/- 11.87 years) who self-reported their technology usage, physical activity, and source of motivation for exercise. Patients with heart failure were significantly older (P = .0001) than patients with heart transplantation. Physical activity levels in patients with heart failure decreased as the New York Heart Association classification increased. Patients with heart failure reported significantly lower physical activity than patients with heart transplantation (P = .0008). Smartphones were the most widely used electronic device to access the Internet in both groups. Patients with heart transplantation seemed to use more than one device to access the Internet. In both groups, patients reporting more technology usage also reported higher levels of physical activity. Patients who accessed the Internet daily reported lower levels of physical activity. Whereas patients with heart failure identified encouragement by family members as a source of motivation for exercise, patients with heart transplantation reported that they were likely to exercise if motivated by their healthcare provider. Patients with heart failure and heart transplantation have unique technological and motivational needs that need consideration for mobile health-driven interventions.
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| 7. |
- Durante, Angela, et al.
(författare)
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Psychological Health Among Older Adults During and After Quarantine: A Multi-Method Study
- 2023
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Ingår i: Western Journal of Nursing Research. - : SAGE PUBLICATIONS INC. - 0193-9459 .- 1552-8456.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Depression among older adults is a growing problem. With aging being a risk factor for COVID-19 infection, depression in this population may have been exacerbated. This study aimed to describe experiences and changes in depressive symptoms and well-being of older adults during and after the COVID-19 first wave in Spain. Methods: The study used a multi-method design. Participants self-reported depressive symptoms (Geriatric Depression Scale) and well-being (Cantril Ladder of Life). Participants were asked about changes in depressive symptoms or well-being during quarantine. If a change was perceived, they were asked to describe the change. In addition, the Patient Global Impression of Change scale was used. Both quantitative and qualitative analyses were performed on the data. Results: 111 participants (mean age: 71 +/- 5 years; 76% women) completed the study. Sixty-three percent reported mild and 2% reported major depressive symptoms. Nearly half (47.7%) reported changes in depressive symptoms during the lockdown. While 37% reported feeling better during the lockdown, about 11% reported depressive symptoms were worse now compared with during the lockdown. 60% reported worsening well-being during the quarantining period. The qualitative analysis revealed 2 main themes: (1) psychological discomfort (mood deflection, fear/worries, and boredom/inactivity) and (2) social issues (inability to go out, missing family members and others). Conclusions: Worsening depressive symptoms and lowering of well-being were noticed in this sample of older adults during and post-COVID lockdowns. Evaluation of mental health in the primary care setting and providing referrals for mental health services is essential for older adults who experienced COVID-19-related lockdowns.
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| 8. |
- Marques-Sule, Elena, et al.
(författare)
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Physical Activity Readiness in Patients with Heart Failure
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:23
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the readiness for physical activity (PA) and its related factors in patients with heart failure. This cross-sectional study included 163 patients with heart failure (mean age 66 +/- 16, 50% female). The ability to safely engage in PA was assessed with the PA Readiness Questionnaire (PAR-Q). Psychological readiness was measured using two questionnaires, namely: Exercise Self-efficacy Scale and the Motivation for PA and Exercise/Working Out. A multivariate analysis of covariance was conducted to test the effect of background variables on readiness for PA. 64% (n = 105) of patients reported not being able to safely engage in PA, 80% (n = 129) reported low self-efficacy, and 45% (n = 74) were extrinsically motivated indicating external factors drove their motivation. Factors that positively influenced the PA readiness included lower age (p < 0.01), being male (p < 0.01), being married (p < 0.01), having higher education (p < 0.01), being in NYHA-class I compared with II (p < 0.01), less time since diagnosis (p < 0.01), lower BMI (p = 0.02), and not suffering from COPD (p = 0.02). Prior to recommending exercise, assessment of safety to engage in PA along with self-efficacy and motivation in patients with heart failure is essential.
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| 9. |
- Marques-Sule, Elena, et al.
(författare)
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Physical Therapy Programs in Older Adults with Coronary Artery Disease : Preferences to Technology-Based Cardiac Physical Therapy Programs
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:20
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Assessing preferences in technology-based cardiac physical therapy programs in older adults with coronary artery disease (CAD) is fundamental to promoting adherence to healthy lifestyles and healthy aging. This study aimed at analyzing preferences in technology-based cardiac physical therapy programs in older adults with CAD. Additionally, a comparison by sex was performed. (2) Methods: Cross-sectional study. 70 older adults with CAD (mean age 66.73 +/- 0.77, 80% men) were evaluated. Technology use and preferences in technology-based cardiac physical therapy programs (Technology Usage Questionnaire) were assessed. (3) Results: 97.1% of the sample had Smartphones and 81.4% accessed the Internet every day, mostly with their Smartphones (75.5%). A total of 54.3% were interested in receiving rehabilitation via their Smartphone, and most of the sample considered ideas to manage stress (92.9%), healthy meal ideas and recipes (85.7%), exercise ideas (84.3%), exercise prompts (72.9%), setting goals (67.1%), exercise taught by a virtual therapist (65.7%), ideas to overcome cigarette cravings (62.9%), information on local exercise opportunities (60%), ideas to remember to take medications (57.1%), steps to achieve goals (54.3%) and eating tips for takeaways (51.7%) very useful. Additionally, men considered the technology-based advice about exercise prompts, healthy meal ideas and recipes, and ideas to manage stress more useful than women, and had more frequently a Smartphone, less frequently made phone calls, had more regular access to the Internet, and used the Internet more often. (4) Conclusions: Clinicians should encourage older adults to engage in cardiac technology-based physical therapy programs to provide meaningful exercise counselling, promote healthy lifestyle and healthy aging.
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| 10. |
- Marques-Sule, Elena, et al.
(författare)
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Well-Being, Physical Activity, and Social Support in Octogenarians with Heart Failure during COVID-19 Confinement: A Mixed-Methods Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:22
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study aimed to compare well-being and physical activity (PA) before and during COVID-19 confinement in older adults with heart failure (HF), to compare well-being and PA during COVID-19 confinement in octogenarians and non-octogenarians, and to explore well-being, social support, attention to symptoms, and assistance needs during confinement in this population. Methods: A mixed-methods design was performed. Well-being (Cantril Ladder of Life) and PA (International Physical Activity Questionnaire) were assessed. Semi-structured interviews were performed to assess the rest of the variables. Results: 120 participants were evaluated (74.16 +/- 12.90 years; octogenarians = 44.16%, non-octogenarians = 55.83%). Both groups showed lower well-being and performed less PA during confinement than before (p < 0.001). Octogenarians reported lower well-being (p = 0.02), higher sedentary time (p = 0.03), and lower levels of moderate PA (p = 0.04) during confinement. Most individuals in the sample considered their well-being to have decreased during confinement, 30% reported decreased social support, 50% increased their attention to symptoms, and 60% were not satisfied with the assistance received. Octogenarians were more severely impacted during confinement than non-octogenarians in terms of well-being, attention to symptoms, and assistance needs. Conclusions: Well-being and PA decreased during confinement, although octogenarians were more affected than non-octogenarians. Remote monitoring strategies are needed in elders with HF to control health outcomes in critical periods, especially in octogenarians.
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