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Eduard Gappmaier Sima F. Tavazoie Michael G. Jacketta 《Cardiopulmonary Physical Therapy Journal》2013,24(3):5-13
Purpose
Large therapeutic rolls (LTR) and balls are popular rehabilitation tools and have also been advertised as cardiovascular training devices. The aim of this study was to determine if individuals of varying fitness levels would reach aerobic training levels by evidence-based standards as described in American College of Sports Medicine (ACSM) publications.Methods
Fourteen volunteers performed a maximal exercise test and on subsequent days, two submaximal exercise tests on the LTR (LTR-A and -B). LTR-A consisted of four 5-minute stages of exercise at progressive intensity levels. LTR-B included 20 minutes of continuous exercise. Oxygen consumption (VO2) and heart rate (HR) during exercise on the LTR were compared with ACSM recommended standards.Results
The average (range) peak intensity achieved during LTR-A was 66.8% (51.7-82.7%) of maximal VO2 reserve (VO2R) and 82.9% (70.7%-91.2%) of maximal heart rate (HRmax). During LTR-B, HR and VO2 of all participants was maintained at moderate exercise intensity and averaged 56% of VO2R and 78% of HRmax during the 20 minute exercise period.Conclusions
These findings suggest that individuals with a wide range of aerobic fitness are able to reach and maintain aerobic training levels with appropriate exercise on a large therapeutic roll or ball.Key Words: large therapeutic roll, Swiss Ball, aerobic exercise, exercise intensity 相似文献2.
Pamela R. Bosch Joseph Poloni Andrew Thornton James V. Lynskey 《Cardiopulmonary Physical Therapy Journal》2012,23(2):13-29
Purpose
To determine if 30 minutes of Nintendo Wii Sports boxing provides cardiorespiratory benefits and contributes to the daily exercise recommendations for healthy young adults.Methods
Twenty healthy 23- to 27-year-olds participated in two sessions to measure maximum heart rate (HRmax) via a treadmill test and heart rate (HR) response to 30 minutes of Wii Sports boxing. Heart rate in beats per minute (bpm) was measured continuously, and exercise intensity during each minute of play was stratified as a percentage of HRmax. Mixed designs analysis of variance (ANOVA) and Pearson product moment correlations were used to analyze the data.Results
Mean (SD) HR response to boxing was 143 (15) bpm or 77.5% (10.0%) of HRmax. The mean HR response for experienced participants was significantly lower than inexperienced participants, P = .007. The ANOVA revealed a significant interaction between experience and time spent at various intensities, P = .009. Experienced participants spent more time in light to vigorous intensities, inexperienced participants in moderate to very hard intensities. Fitness was not correlated with mean HR response to boxing, P = .49.Conclusion
Thirty minutes of Nintendo Wii Sports boxing provides a moderate to vigorous aerobic response in healthy young adults and can contribute to daily recommendations for physical activity.Key Words: exergaming, cardiorespiratory training, active video games 相似文献3.
Lissa M. Spencer Jennifer A. Alison Zoe J. McKeough 《Cardiopulmonary Physical Therapy Journal》2013,24(3):30-35
Purpose
To determine the opinions and attitudes toward exercise in people with chronic obstructive pulmonary disease (COPD) who had completed a randomised controlled trial of 12-months maintenance exercise.Methods
Participants were eligible for recruitment to the maintenance exercise study if they had COPD and had completed an 8-week pulmonary rehabilitation program. They were randomized into an Intervention Group (IG) that consisted of once weekly, supervised hospital-based maintenance exercise plus home exercise for 12 months or a Control Group that undertook unsupervised home maintenance exercise for 12 months. At the end of the 12 months, participants completed a survey consisting of 23 questions using a visual analogue scale (VAS) of 100 mm.Results
Forty-eight participants completed the 12 month study and 36 participants (75%) completed the survey [IG mean (SD): age 65 (8) years, FEV1 58 (20) % predicted; CG: age 66 (8) years, FEV1 67 (17) % predicted]. No between group difference was found for the importance of exercise, the benefits of the program or the importance of support from the physiotherapist. However, the IG reported exercising more regularly, having more enjoyment of being involved in the maintenance exercise program, greater benefit in general well-being, and better physical fitness.Conclusions
At the completion of the 12 month exercise study, the survey results showed that all participants reported positive attitudes towards both supervised and unsupervised maintenance exercise programs, with the IG reporting greater benefits.Key Words: COPD, survey, maintenance exercise program 相似文献4.
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Gayle L. Flo Robb W. Glenny Peter J. Kudenchuk Cynthia M. Dougherty 《Cardiopulmonary Physical Therapy Journal》2012,23(3):16-22
Purpose
Performing exercise tests in patients with an implantable cardioverter defibrillator (ICD) presents specific challenges because of susceptibility to ventricular arrhythmias during maximal levels of exertion. The purpose of this paper is to outline the exercise testing protocol from the Anti-Arrhythmic Effects of Exercise after an ICD trial and to report baseline test results and safety outcomes using the protocol.Methods and Results
Maximal cardiopulmonary exercise testing was performed to assess levels of physical fitness as part of a randomized trial of walking exercise in patients with ICDs. Subjects were randomized after baseline testing to aerobic exercise plus usual care or usual care alone. A modified Balke treadmill exercise test was used and specific ICD programming procedures were implemented to avoid unnecessary shocks, which included programming off ventricular tachycardia (VT) therapies during testing. To date, 161 baseline tests have been performed. One ventricular fibrillation (VF) cardiac arrest occurred following completion of an exercise test and three tests were stopped by the investigators due to nonsustained ventricular tachycardia. Eleven subjects were not able to achieve maximum exercise, defined as reaching an anaerobic threshold (AT) at baseline testing. There have been no deaths as a result of exercise testing.Conclusions
Symptom-limited maximal exercise testing can be performed safely and effectively in patients with ICDs for both primary and secondary prevention indications. Specific strategies for ICD programming and preparation for treating ventricular arrhythmias needs to be in place before exercise testing is performed.Key Words: implanted cardioverter defibrillator, exercise testing, treadmill protocol 相似文献6.
Michael J. Shoemaker Amy B. Curtis Eric Vangsnes Michael G. Dickinson 《Cardiopulmonary Physical Therapy Journal》2012,23(3):5-15
Purpose
The purpose of the present review was to use existing, published data to provide an estimate of the amount of change in six-minute walk test distance (Δ6MWT) that represents a clinically meaningful change in individuals with chronic heart failure (CHF).Methods
The present review included two separate literature searches of the CINAHL and Medline databases for articles that: (1) reported the intraclass correlation coefficient (ICC) of the 6MWT in individuals with CHF, and (2) used the 6MWT along with either aerobic capacity or health-related quality of life (HRQL) as study endpoints in randomized controlled trials (RCTs) of exercise-based intervention for individuals with CHF. The ICCs were used to calculate the minimum detectable difference (MDD) at the 95% confidence interval for each included study. The Δ6MWT associated with aerobic capacity and HRQL within-group effect sizes for the intervention and control groups in each included RCT was analyzed using receiver operating characteristic (ROC) curves.Results
Thirteen articles reported the ICC for the 6MWT. The mean (standard deviation) MDD calculated based on these data was 43.1(16.8) m. Eighteen RCTs measured the 6MWT and either aerobic capacity and/or HRQL. A Δ6MWT of 40–45 m was associated with at least moderate aerobic capacity and HRQL effect sizes in the intervention groups. The Δ6MWT thresholds that discriminated between intervention and control groups using ROC curves revealed the following sensitivity/specificity for the respective thresholds: 19 m, 94.4/83.3%, 32 m, 83.3/94.4%, and 48 m 44.4/100% (AUC = .935, p = .009, CI95% .855, 1.015).Conclusions
A Δ6MWT of approximately 45 m appears to exceed measurement error and be associated with significant changes in either aerobic capacity and/or HRQL.Key Words: heart failure, six-minute walk test, clinically meaningful change, minimum detectable difference 相似文献7.
R Scott Van Zant Kelly Jo Cape Katrina Roach Janie Sweeney 《Cardiopulmonary Physical Therapy Journal》2013,24(2):18-26
Purpose
The study purpose was to assess perceptions of physical therapists (PTs) regarding the role of physical therapy in cardiovascular disease (CVD) prevention.Methods
A 25-item survey, validated by expert cardiovascular/pulmonary (CVP) PTs, was sent electronically to 2,673 PTs. Each item represented an element of clinical practice behavior: education of CVD/risk factors (EDCVD), administration of primary CVD prevention (PRECVD), identifying underlying CVD/risk factors (IDCVD), monitoring CV status in patients with CVD (MONCVD). Responses were assigned numeric values (strongly agree = 5 to strongly disagree = 1), and mean element scores were analyzed.Results
Most of the 516 respondents were APTA Section members (34% CVP Section, 42% other Section membership) and worked in academia (53%). Items showing a high (> 95%) level of agreement included patient education of smoking (97%) and monitoring exercise intensity (99%), assessing exercise benefits (99%), clinically identifying obesity (97%) and hypertension (97%), and monitoring CV response to exercise (99%). Items failing to reach 80% overall agreement were patient education of CVD medications (79%) and blood chemistry (72%), and assessing CVD family history (75%), patient BMI (60%), and body composition (33%). Identifying underlying CVD (77.2%) was the only practice behavior failing to reach 80% agreement. Outpatient PTs agreed significantly less to all elements vs. academics, and to IDCVD vs. all PTs except home health.Conclusions
Physical therapists support most CVD prevention behaviors, but not given elements of patient education and identifying underlying CVD/risk factors.Key Words: cardiovascular disease, primary disease prevention, secondary disease prevention 相似文献8.
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Purpose
The purpose of this review is to evaluate the literature related to mobilization of the critically ill patient with an emphasis on functional outcomes and patient safety.Methods
We searched the electronic databases of PubMed, CINAHL, Medline (Ovid), and The Cochrane Library for a period spanning 2000–2011. Articles used in this review included randomized and nonrandomized clinical trials, prospective and retrospective analyses, and case series in peer-reviewed journals. Sackett''s Levels of Evidence were used to classify the current literature to evaluate the strength of the outcomes reported.Results
Fifteen studies met inclusion criteria and were reviewed. According to Sackett''s Levels of Evidence, 9 studies were level 4 evidence, one study was level 3, 4 studies were level 2, and one study was level one evidence. Ten studies pertained to patient safety/feasibility and 10 studies pertained to functional outcomes with 5 fitting into both categories.Conclusion
A search of the scientific literature revealed a limited number of studies that examined the mobilization of critically ill patients in the intensive care unit. However, literature that does exist supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes.Key Words: mobilization, exercise, intensive care unit, critical illness, physical therapy 相似文献10.
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Joseph F. Norman Bunny J. Pozehl Kathleen A. Duncan Melody A. Hertzog Steven K. Krueger 《Cardiopulmonary Physical Therapy Journal》2012,23(4):19-25
Purpose
The purpose of this study was to compare an Exercise Training Group (EX) with an Attention-Control Group (AT-C) to more specifically assess the impact of exercise training on individuals with heart failure (HF).Methods
Forty-two individuals with HF were randomized to AT-C or EX that met with the same frequency and format of investigator interaction. Baseline, 12- and 24-week measurements of B-type naturetic peptide (BNP), 6-minute walk test (6-MWT), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) were obtained.Results
BNP tended to increase in the AT-C while remaining stable in the EX over time. A clinically significant increase in 6-MWT was demonstrated by the EX but not the AT-C. The EX achieved a clinically significant change on the KCCQ at 12 weeks, with further improvement by 24 weeks, while the AT-C demonstrated a clinically significant change at 24 weeks.Conclusions
Attention alone was inadequate to positively impact BNP levels or 6-MWT distances, but did have a positive impact on quality of life after 24 weeks. Although exercise offers enhanced benefits, individuals with HF unable to participate in an exercise program may still gain quality of life benefits from participation in a peer-support group that discusses topics pertinent to HF.Key Words: heart failure, attention, exercise 相似文献12.
Sandra Billinger 《Cardiopulmonary Physical Therapy Journal》2010,21(1):22-24
Purpose: To discuss the role of the vascular system and regulation of blood flow delivery in individuals with chronic stroke. This paper will discuss mechanisms of blood flow, vascular remodeling in chronic stroke, exercise as an intervention to improve blood flow delivery, and the role of physical therapy practice in promoting exercise. Key Points: Evidence suggests that people with chronic stroke may experience reduced blood flow and decreased arterial diameter in the hemiparetic limb. These arterial changes may influence exercise performance and functional ambulation. However, exercise training can be an effective intervention for improving blood flow delivery in the hemiparetic limb. Statement of Recommendations: Physical therapists working with people post-stroke should routinely prescribe aerobic exercise training within the plan of care during stroke rehabilitation. This may minimize declines in the cardiorespiratory and vascular systems and provide greater functional capacity to perform functional activities during and after discharge from physical therapy services.Key Words: blood flow, stroke, cardiovascular, exercise 相似文献
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Christiane Perme Theresa Nalty Chris Winkelman Ricardo Kenji Nawa Faisal Masud 《Cardiopulmonary Physical Therapy Journal》2013,24(2):12-17
Introduction
There are limited data describing mobility interventions provided to patients with femoral catheters. The purpose of this study was to examine the incidence of femoral catheter related adverse effects during physical therapy (PT) sessions in a cardiovascular intensive care unit (ICU).Methods
This was a prospective, observational study and included patients with at least one femoral catheter. Data were collected after each PT session.Results
There were 77 subjects with a total of 92 femoral catheters (50 arterial, 15 central venous, and 27 dialysis) treated. A total of 210 separate PT sessions occurred with 630 mobility activities including sitting on side of bed, standing at the bedside, transfers to stretcher chair or regular chair, and walking. There were no catheter related mechanical or thrombotic complications during any of the PT sessions.Conclusions
Physical therapy sessions, including standing and walking were feasible and safe in cardiovascular ICU patients with femoral catheters who met the criteria for mobility interventions. The results from this study support the hypothesis that early mobilization in patients with femoral catheters is important to minimize functional decline and provide evidence that the presence of femoral catheters alone should not be a reason to limit progressive mobility interventions.Key Words: physical therapy, ICU, early mobilization, femoral catheter 相似文献14.
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Neeti Pathare Esther M. Haskvitz Marjane Selleck 《Cardiopulmonary Physical Therapy Journal》2012,23(4):12-18
PURPOSE
The primary purpose of this study was to investigate 6-minute walk test (6MWT) performance in young children who were normal weight (NW) and overweight (OW).METHODS
Seventy children, 5-9 years of age, participated in this study. The 6MWT was performed on an indoor walkway. Heart rate (HR), blood pressure (BP), and oxygen saturation (SaO2) were measured. A self-reported physical activity questionnaire was completed by a parent/guardian. Data were analyzed with independent t tests, ANOVA, correlation analyses, and logistic regression.RESULTS
The systolic BP values were higher in the children who were OW compared with their NW peers (resting mean 104.1 (8.9) mmHg vs. 97.5 (7.8) mmHg, P < 0.05; post-6WMT: mean 118.4 (10.78) mmHg vs. 109.9 (9.1) mmHg, P < 0.05). The SaO2 values were lower in the children who were OW compared to their NW counterparts (resting: mean 97.2 (1.1) % vs. 98.0 (1.0) %, P < 0.05; post-6WMT: mean 96.8 (1.0) % vs. 97.7 (1.0) %, P < 0.05).CONCLUSIONS
The children who were OW had higher systolic BP and lower SaO2 levels at rest and post-6WMT. More research is needed to determine if these differences contribute to children who are OW having difficulty performing exercise.Key Words: obesity, children, exercise capacity 相似文献17.
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John D. Lowman Tamara K. Kirk Diane E. Clark 《Cardiopulmonary Physical Therapy Journal》2012,23(1):30-35