| 1. |
- Bäck, Maria, 1978, et al.
(author)
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Effects of high frequency exercise in patients before and after percutaneous coronary intervention
- 2008
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7, s. 307-313
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Journal article (peer-reviewed)abstract
- Background: The aim of this study was to evaluate the effects of high frequency exercise for patients before and after an elective percutaneous coronary intervention (PCI), with special reference to maximal aerobic capacity, muscle function, health related quality of life (HRQoL), waist–hip ratio (WHR) and restenosis. Methods: A randomised, controlled study was performed in Sweden between 2004 and 2006 in thirty-seven patients (five women) with stable coronary artery disease (CAD), age 63.6±6.9 years, randomised to either high frequency exercise or control group. The patients in the training group performed three endurance resistance exercises and trained on a cycle ergometer 30 min, 5 times a week for 8 months at 70% of VO2max. Results: Patients in the training group significantly improved their maximal aerobic capacity (15 (9–46) vs. 8 (0–18)% p≤0.05), shoulder flexion (p≤0.01), shoulder abduction (p≤0.01) and heel-lift (p≤0.05) compared to the control group. There were no significant differences between the groups in HRQoL, WHR and restenosis. Conclusion: High frequency exercise in patients treated with PCI seems to improve maximal aerobic capacity and muscle function, which may reduce the risks of further progression of atherosclerosis. However, further larger studies are needed to fully investigate the effects of exercise in patients with PCI.
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| 2. |
- Cider, Åsa, 1960, et al.
(author)
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Cardiorespiratory effects of warm water immersion in elderly patients with chronic heart failure
- 2005
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In: Clin Physiol Funct Imaging. ; 25:6, s. 313-7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Hydrotherapy might be included in the rehabilitation of patients with chronic heart failure (CHF), but little is known about the acute cardiorespiratory reaction in warm water. The aim of this study was to assess the acute cardiorespiratory effect of immersion in warm water, in a clinical setting, in elderly patients with CHF compared with healthy age and sex matched persons. METHODS: Twelve patients (three females) with CHF, NYHA II-III, age 64 +/- 6 years, and 12 healthy subjects were studied. Cardiorespiratory changes, on land and in a temperature-controlled swimming pool (33-34 degrees C) were assessed during rest and exercise, in a sitting position, using continuous gas analyses. RESULTS: There were no significant differences, land versus water, in carbon dioxide production, total ventilation, respiratory frequency, respiratory exchange ratio, heart rate or blood pressure in either of the groups. A significant difference was found in oxygen uptake, at rest, land versus water in patients with CHF in comparison with healthy subjects (-0.2 +/- 0.4 versus +0.3 +/- 0.6 ml kg(-1) min(-1), P < 0.01). Oxygen kinetics (tau) increased significantly (P = 0.01) in both groups during exercise in water. CONCLUSION: Hydrotherapy was well tolerated and the vast majority of the cardiorespiratory responses, during warm water immersion in a clinical setting, are similar in patients with CHF compared with healthy subjects. However, further larger studies, are needed to better understand the physiological reactions during hydrotherapy.
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| 3. |
- Cider, Åsa, 1960
(author)
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Exercise in patients with chronic heart failure. With emphasis on peripheral muscle training, hydrotherapy and type 2 diabetes mellitus
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Chronic heart failure (CHF) is not uncommon in developed countries with a growing ageing population. CHF is a chronic syndrome, which markedly impact negatively on the patient s life situation. Considerable impaired physical function and reduced health related quality of life is often present. Type 2 diabetes mellitus is a frequent comorbidity in patients with CHF and results in an even greater impairment of physical function. Exercise is physiologically beneficial for patients with these conditions, however little is known about the effect of peripheral muscle training, and hydrotherapy has never earlier been studied in these patients. The aim of this thesis was to evaluate: 1). the chronic effect of peripheral muscle training in patients with CHF, 2). the chronic effect of hydrotherapy in patients with CHF withor without type 2 diabetes mellitus, 3). the acute cardiorespiratory reaction during warm water immersion in patients with CHF and in healthy subjects. Peripheral muscle training during five months was evaluated using ergospirometry, clinical and isokinetic muscle function tests and health related quality of life questionnaires. Twenty-four patients were randomised to either peripheral muscle training or control group. Peripheral muscle training resulted in a significantly improved anaerobic threshold and muscle endurance. The effect of eight weeks hydrotherapy (combined peripheral muscle training and aerobic exercise in warm water) was assessed in two studies, one where 25 randomised older patients with CHF and in another study where 20 patients with the combination of CHF and type 2 diabetes mellitus were evaluated. Exercise capacity, muscle function and health related quality of life was assessed. A test for metabolic function was added in patients with type 2 diabetes mellitus. Hydrotherapy resulted, in both studies, in a significant improved exercise capacity, walking distance and muscle function as well as a decreased HbA1c in type 2 diabetes mellitus. In some items, health related quality of life improved within the training group, both in patients with and without type 2 diabetes mellitus. The cardiorespiratory reaction during warm water immersion was studied in 12 patients with CHF and in 12 healthy subjects using gas analysis and with echocardiography in 13 patients with CHF and 13 healthy subjects. Patients with CHF had a lower oxygen uptake in warm water, at rest compared to healthy subjects. Hemodynamics increased during warm water immersion i.e. ejection fraction increased significantly in patients with CHF and stroke volume and cardiac output increased significantly in healthy subjects. Conclusion: Peripheral muscle training improves muscle function in patients with CHF and hydrotherapy improves exercise capacity and muscle function in patients with CHF, with or without type 2 diabetes mellitus. Moreover, immersion in warm water and hydrotherapy result immediately in an improved heamodynamic function in patients with CHF. These training regimens can therefore be included in the rehabilitation programme for patients with CHF, with or without type 2 diabetes mellitus. A smorgasbord with different exercise regimens might increase the possibility for patients with pronounced disability to remain physically active.
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| 4. |
- Cider, Åsa, 1960
(author)
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Fysisk träning vid hjärtsvikt
- 2005
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In: Vård vid hjärtsvik. Redaktör Strömberg A. - Lund : Studentlitteratur.
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Book chapter (other academic/artistic)
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| 5. |
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| 6. |
- Cider, Åsa, 1960, et al.
(author)
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Immersion in warm water induces improvement in cardiac function in patients with chronic heart failure
- 2006
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In: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 8:3, s. 308-13
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Journal article (peer-reviewed)abstract
- BACKGROUND: The effects of immersion and training of patients with chronic heart failure (CHF) in warm water has not been thoroughly investigated. The aim of this study was to assess the acute hemodynamic response of immersion and peripheral muscle training in elderly patients with CHF. METHODS: Thirteen CHF patients and 13 healthy subjects underwent echocardiography on land and in a temperature-controlled swimming pool (33-34 degrees C). RESULTS: Rest. Heart rate decreased (CHF, p=0.01; control, p=0.001) and stroke volume increased (CHF, p=0.01; control, p=0.001) during water immersion in both groups, with no change in systolic or diastolic blood pressure. Ejection fraction (p<0.05) and transmitral Doppler E/A ratio (p=0.01) increased in the CHF group, with no changes in left ventricular volumes. The healthy subjects had similar responses, but also displayed an increase in cardiac output (p<0.01) and left ventricular volumes (p<0.001). Exercise. Cardiac output and systolic blood pressure increased significantly in water, in both groups. CONCLUSION: A general increase in early diastolic filling was accompanied by a decrease in heart rate, leading to an increase in stroke volume and ejection fraction in most patients with CHF during warm water immersion. These beneficial hemodynamic effects might be the reason for the previously observed good tolerability of this exercise regime.
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| 7. |
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| 8. |
- Cider, Åsa, 1960, et al.
(author)
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Rehabilitering vid hjärtkärlsjukdom
- 2006
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In: ”Rehabiliteringsmedicin, Teori och praktik” Studentlitteratur 2006. - Lund : Studentlitteratur. ; , s. 323-328
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Book chapter (other academic/artistic)
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| 9. |
- Cider, Åsa, 1960, et al.
(author)
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Reliability of clinical muscular endurance tests in patients with chronic heart failure
- 2006
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In: Eur J Cardiovasc Nurs. ; 5:2, s. 122-6
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Journal article (peer-reviewed)abstract
- BACKGROUND: In clinical praxis it is important to be able to assess the effect of rehabilitation in patients with chronic heart failure (CHF). There is therefore a need for simple clinical tests that are objective, reliable and valid measures. AIM: The aim of this study was to examine the reliability of three muscle endurance tests for patients with CHF and to compare the results to a healthy control group. METHOD: The study included 20 patients (7 women) with CHF and 20 healthy persons. Dynamic endurance of the shoulder and calf muscle was measured as well as static shoulder endurance. All three tests were performed twice, within 5-10 days. RESULTS: The reliability (rs) of the tests for the patients with CHF was between 0.90-0.99 and for the healthy persons between 0.79-0.98. There was also a significant difference in dynamic endurance in shoulder flexion and in heel-rise left leg test between patients with CHF and healthy persons. CONCLUSION: Tests of dynamic and static endurance of the shoulder muscle and dynamic calf muscle endurance are reliable assessment tools for use in clinical practice. Patients with CHF have reduced isotonic muscular endurance compared with healthy persons.
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| 10. |
- Grüner Sveälv, Bente, 1956, et al.
(author)
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Benefit of warm water immersion on biventricular function in patients with chronic heart failure
- 2009
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In: Cardiovasc Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120 .- 1476-7120. ; 7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Regular physical activity and exercise are well-known cardiovascular protective factors. Many elderly patients with heart failure find it difficult to exercise on land, and hydrotherapy (training in warm water) could be a more appropriate form of exercise for such patients. However, concerns have been raised about its safety.The aim of this study was to investigate, with echocardiography and Doppler, the acute effect of warm water immersion (WWI) and effect of 8 weeks of hydrotherapy on biventricular function, volumes and systemic vascular resistance. A secondary aim was to observe the effect of hydrotherapy on brain natriuretic peptide (BNP). METHODS: Eighteen patients [age 69 +/- 8 years, left ventricular ejection fraction 31 +/- 9%, peakVO2 14.6 +/- 4.5 mL/kg/min] were examined with echocardiography on land and in warm water (34 degrees C).Twelve of these patients completed 8 weeks of control period followed by 8 weeks of hydrotherapy twice weekly. RESULTS: During acute WWI, cardiac output increased from 3.1 +/- 0.8 to 4.2 +/- 0.9 L/min, LV tissue velocity time integral from 1.2 +/- 0.4 to 1.7 +/- 0.5 cm and right ventricular tissue velocity time integral from 1.6 +/- 0.6 to 2.5 +/- 0.8 cm (land vs WWI, p < 0.0001, respectively). Heart rate decreased from 73 +/- 12 to 66 +/- 11 bpm (p < 0.0001), mean arterial pressure from 92 +/- 14 to 86 +/- 16 mmHg (p < 0.01), and systemic vascular resistance from 31 +/- 7 to 22 +/- 5 resistant units (p < 0.0001).There was no change in the cardiovascular response or BNP after 8 weeks of hydrotherapy. CONCLUSION: Hydrotherapy was well tolerated by all patients. The main observed cardiac effect during acute WWI was a reduction in heart rate, which, together with a decrease in afterload, resulted in increases in systolic and diastolic biventricular function. Although 8 weeks of hydrotherapy did not improve cardiac function, our data support the concept that exercise in warm water is an acceptable regime for patients with heart failure.
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| 11. |
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| 12. |
- Thelandersson, Anneli, et al.
(author)
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Prone position in mechanically ventilated patients with reduced intracranial compliance.
- 2006
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In: Acta anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 50:8, s. 937-41
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Journal article (peer-reviewed)abstract
- BACKGROUND: Prone position has been used for several years to treat acute lung insufficiency, but in previous studies patients with unstable intracranial pressure (ICP) are mostly excluded. The aim of this study was to investigate if prone position is a safe and useful treatment in patients with reduced intracranial compliance. METHODS: A consecutive, prospective pilot study of 11 patients admitted to the neuro intensive care unit (NICU) due to traumatic brain injury or intracerebral haemorrhage. ICP, cerebral perfusion pressure (CPP), heart rate (HR), mean arterial blood pressure (MABP), arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial oxygen saturation (SaO(2)) and respiratory system compliance were measured before, three times during and two times after the patients were placed in the prone position. RESULTS: No significant changes were demonstrated in ICP, CPP or MABP. PaO(2) and SaO(2) were significantly increased in the prone position. HR was significantly increased in the prone position and after 10 min in the supine post-prone position and the respiratory system compliance was increased after 1 h in the supine post-prone position. CONCLUSION: Turning NICU patients from the supine to the prone position did not influence ICP, CPP or MABP, but significantly improved patient PaO(2), SaO(2) and respiratory system compliance.
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| 13. |
- Varkey, Emma, et al.
(author)
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A Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine.
- 2009
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In: Headache. - : Wiley. - 1526-4610. ; 49:4, s. 563-70
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Journal article (peer-reviewed)abstract
- Objectives.- The aim of this study was to develop and evaluate an exercise program to improve maximum oxygen uptake (VO(2 max)) in untrained patients with migraine without making their migraines worse. Patients and methods.- Twenty-six patients were studied at a headache clinic in Sweden. The exercise program, based on indoor cycling, was performed 3 times per week during 12 weeks. VO(2 max), migraine status, side effects, and quality of life were evaluated. Results.- VO(2 max) increased from 32.9 mL/kg/minute to 36.2 mL/kg/minute (P = .044). Quality of life increased and significant improvements in migraine status (attack frequency, symptom intensity, and intake of medicine) were seen. During the 12 weeks of exercise, on one occasion one patient had a migraine attack, which started immediately after training. No other side effects were reported. Conclusions.- The evaluated exercise program was well tolerated by the patients and improved their VO(2 max) with no deterioration of migraine status.
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| 14. |
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