| 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. |
- 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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| 8. |
- Verheijden Klompstra, Leonie, 1982-, et al.
(författare)
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Physical activity enjoyment, exercise motivation, and physical activity in patients with heart failure : A mediation analysis
- 2022
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Ingår i: Clinical Rehabilitation. - : Sage Publications Ltd. - 0269-2155 .- 1477-0873. ; 36:10, s. 1324-1331
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine whether physical activity enjoyment mediated the association between motivation and physical activity in patients with heart failure. Design and setting A cross-sectional study at the cardiology clinic in the university hospital in Valencia, Spain Subjects A total of 134 patients with heart failure. Main measurements Physical activity was assessed with the International Physical Activity Questionnaire, motivation was assessed with the Exercise Motivation Index and Physical Activity Enjoyment was assessed with the Physical Activity Enjoyment Scale. Analysis Mediation analysis using Hayes PROCESS macro (Model 4) for SPSS. Results The mean age of the sample was 70 +/- 14 years, 47 patients were female (35%), and 87 patients were in New York Heart Association I/II (67%). A positive relationship was found between exercise motivation and physical activity (t = 4.57, p < .01) and physical activity enjoyment (t = 11.52, p < .01). Physical activity enjoyment was found to positively affect physical activity (t = 3.50, p < .01). After controlling for physical activity enjoyment, the effect of exercise motivation on physical activity changed from a significant to non-significant (t = 1.33, p = .89), indicating that enjoyment completely mediated the relationship between motivation and physical activity. Overall, 25% of the variation in physical activity was explained by the mediation model. Conclusions Physical activity enjoyment mediates the relationship between exercise motivation and physical activity in patients with heart failure. This means that even highly motivated heart failure patients may not be physically active if they do not enjoy the physical activity.
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