Implantable cardioverter defibrillator (ICD) is the most effective measure to prevent sudden cardiac death. However, ICD patients frequently have problems such as decline of exercise tolerance and quality of life, anxiety and depression after operation, which require cardiac rehabilitation (CR). A considerable amount of studies have proved that CR is an effective secondary prevention measure for patients with cardiovascular disease. Its safety and effectiveness have been supported by evidence-based medicine research, which can prevent the recurrence of cardiovascular events, reduce the readmisson rate, and promote healthy behavior and active lifestyle formation of patients, so as to improve the quality of life of patients. This review mainly summarized the necessity, safety, exercise program and economic benefits of CR in ICD patients.
ObjectiveTo explore the effects of different exercise methods on serum short-chain fatty acids (SCFA) in type 2 diabetic mice, determine the best exercise method to improve SCFAs in type 2 diabetic mice, and provide a theoretical basis for the preventive intervention for patients with early diabetes.MethodsAccording to different exercise methods, 48 8-week-old male db/db type 2 diabetic mice were randomly divided into four groups, including aerobic exercise group, resistance exercise group, combined resistance- aerobic exercise (referred to as combined exercise) group, and the control group; with 10 mice in each group and another 2 as the substitutes. The mice were fed in the same manner in each group. The control group did not perform exercise intervention, the aerobic exercise group performed weightless running exercise, the resistance exercise group performed tail weight-bearing ladder exercise, and the combined exercise group alternated aerobic exercise and resistance exercise. Blood glucose and body weight were measured before and 8 weeks after the intervention. The content of serum SCFAs in mice was determined by gas chromatography-mass spectrometry.ResultsA total of 40 mice completed the experiment successfully. Before the exercise intervention, there was no significant difference in blood glucose or weight among the groups (P>0.05). After 8 weeks of exercise intervention, the blood glucose and weight in each exercise group were significantly lower than those in the control group (P<0.05), and the blood glucose and weight in the combined exercise group were significantly lower than those in the aerobic exercise group and the resistance exercise group (P<0.05). The contents of SCFA were higher in the aerobic exercise group, resistance exercise group, and combined exercise group than those in the control group (P<0.05); the contents of acetic acid and butyric acid in the combined exercise group were better than those in the aerobic exercise group (P<0.05), and the contents of propanoic acid and valeric acid in the combined exercise group were better than those in the resistance exercise group (P<0.05).ConclusionsDifferent exercise methods can improve the SCFA content in serum of type 2 diabetic mice. Compared with aerobic exercise and resistance exercise, combined exercise has the best effect in improving SCFA.
Objective
To evaluate the efficiency and security of physical exercise with low intensity against malnutrition and sarcopenia in patients with cirrhosis.
Methods
Between December 2014 and October 2015, 37 patients with cirrhosis were divided into two groups according to their willings, with 19 in the exercise group and 18 in the control group. Endurance of the exercise for 3 months were recorded. Mid-arm circumference, " up and go” time, width of portal vein and Child-Pugh score were compared before and after the research between the two groups.
Results
Three months later, the mid-arm circumference and the " up and go” time of the exercise group [(33.99±2.15) cm, (9.17±0.35) s] were better than those before the exercise [(32.09±2.58) cm, (9.77±0.46) s] and those in the control group [(31.93±2.04) cm, (9.76±0.30) s], and the differences above were all statistically significant (P<0.05). The change of the width of portal vein was positively correlated with pre-exercise body mass index in overweight patients (r=0.93, P=0.007).
Conclusions
Physical exercise with low intensity is safe and effective against malnutrition and sarcopenia in patients with cirrhosis. Overweitht patiens or malnutrition at the early stage may benefit more.
ObjectiveTo investigate the effect of 24-week intradialytic progressive resistance exercise on hemoglobin and iron metabolism in maintenance hemodialysis (MHD) patients.MethodsFrom April to May 2019, 62 MHD patients were enrolled and randomly assigned into exercise group (n=31) and control group (n=31). Both groups of patients received regular routine hemodialysis, on that basis, patients in the exercise group completed intradialytic resistance exercise three times per week for 24 weeks. Each exercise included 8-10 muscle groups (grasping the grip ring with both hands, flexion and extension of the elbows and shoulders on the non-vascular side and lower limbs with sandbag), 3 sets of 15 repetitions with a rest of 1-2 min between 2 sets. Exercise began with a low load, the sandbag weight was gradually increased, and the Borg score was aimed to be 11-13 points after exercise. Hemoglobin, serum ferritin, transferrin saturation, serum creatinine, high-sensitivity C-reactive protein, urea clearance index, recombinant human erythropoietin (rHuEPO) dosage at baseline and after 24 weeks, as well as the cumulative iron supplement dose and hemoglobin variation of the two groups during the study period were evaluated.ResultsThere were 20 patients in the exercise group and 30 ones in the control group who completed the study. After 24 weeks of progressive resistance exercise, the medium (lower quartile, upper quartile) of the amount of rHuEPO in the exercise group decreased from 6 000 (6 000, 9 000) U/week to 6 000 (4 500, 7 125) U/week (Z=?2.599, P=0.009), while that in the control group had no statistically significant difference (Z=?1.340, P=0.180); there was no statistically difference in hemoglobin, hemoglobin coefficient of variation, serum ferritin, transferrin saturation, or 24-week cumulative iron supplementation between the two groups.ConclusionIntradialytic progressive resistance exercise can reduce the amount of rHuEPO in MHD patients, which is benefitial to optimizing the management of hemoglobin.
Objective To evaluate the effects of different ways of exercise training on elderly patients with chronic obstructive pulmonary disease ( COPD) , which focuse on the changes of cardiopulmonary exercise function and COPD symptoms. Methods 54 cases of elderly patients with stable COPD were randomly allocated to a control ( 15 cases) , a lower-limb ( 20 cases) , or a upper-Limb and lower-Limb combined exercise group ( 19 cases) . All patients received conventional medical therapy.Meanwhile, the exercise groups received training for 16 weeks. The improvements of resting spirometry,cardiopulmonary exercise test ( CPET) , and dyspnea ( Borg scale rating) were evaluated before and after the training scheme. Results There was no significant difference in resting spirometry after exercise training( P gt;0. 05) . Exercise tolerance and Borg scale were improved in both exercise groups significantly than baseline ( P gt;0. 05) and the control group ( P gt;0. 05) . VE@ 50% Vo2max was improved significantly in the combined group( 4. 81 ±0. 70 vs. 2. 49 ±1. 15, P lt; 0. 001) . Breathing reserve ( BR) was elevated in bothexercise groups than the control ( P lt; 0. 01) , and the improvement in the combined group was more significant ( 9. 79 ±1. 57 vs. - 1. 36 ±2. 82, P lt; 0. 001) . Gas exchange response ( VD /VT ) was slightly improved after rehabilitation in the combined group( P lt;0. 05) . Borg scale after rehabilitation was correlatedwith FEV1% pred, BR, and Vo2 /kg after rehabilitation[ Borg = 9. 516 - 0. 174 ×FEV1% pred - 0. 156 × (Vo2 /kg) - 0. 023 ×BR] . Conclusions Upper-limb combined with lower-limb exercise training can markedly improve the level of aerobic capacity and ventilation in elderly patients with stable COPD, and then improve the exercise tolerance.
Objective
To observe and study the effect of neuromuscular exercise (NEMEX) on pain and physical function in patients with knee osteoarthritis (KOA).
Methods
From December 2016 to December 2017, a total of 70 participants with degenerative KOA were randomly divided into the control group and the observation group, with 35 participants in each group. The participants in the observation group received 8-weeks NEMEX, and the ones in the control group received 8-week quadriceps strengthening. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the WOMAC physical functional subscale were used to measure pain and physical function before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment.
Results
The WOMAC pain scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 24.2±10.0, 23.4±9.1, 18.9±8.2, 15.0±6.3, 15.0±7.0, respectively in the observation group, and 25.6±9.8, 24.1±9.2, 20.2±8.8, 15.2±6.0, 11.4±5.3, respectively in the control group. After 1 week of treatment, neither group showed a significant change in pain than pretreatment (P>0.05), but after 2, 4, 8 weeks of treatment, both groups showed significant improvements in pain (P<0.05). There was no significant between-group difference in pain before treatment or after 1 week, 2 weeks, and 4 weeks of treatment (P>0.05), but after 8 weeks of treatment, statistically significant difference in WOMAC pain score was found between the two groups (t=2.439, P<0.05). The WOMAC physical function scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 94.3±31.0, 81.8±28.3, 68.9±22.1, 34.0±15.1, 22.0±8.0, respectively in the observation group, and 92.7±31.8, 82.6±29.3, 75.2±22.9, 52.2±20.0, 43.4±18.2 respectively in the control group. After 1 week, 2 weeks, 4 weeks and 8 weeks of treatment, both groups showed significant changes in WOMAC physical function scores than pretreatment (P<0.05). There was no statistically significant between-group difference before treatment or after 1, 2 weeks of treatment in physical function (P>0.05). The functional improvements in the observation group were significantly better than those in the control group after 4 and 8 weeks of treatment, and the differences were statistically significant (t=–4.287, –6.355; P<0.05).
Conclusion
NEMEX and quadriceps strengthening have similar effects in relieve pain in patients with KOA. And both exercises can effectively improve the physical function, and NEMEX is better than quadriceps strengthening on physical function improvement in patients with KOA.
Objective
To explore the compliance improvement of rehabilitation exercise for patients after spine surgery.
Methods
Forty-nine in-patients who underwent spinal surgery between June 1st and July 14th 2016 were selected as the control group and 50 in-patients who underwent spinal surgery between July 15th and August 30th 2016 were selected as the trial group. The control group received conventional nursing for rehabilitation exercise, and the tiral group adopted a series of quality improvement measures for rehabilitation exercise. The compliance of functional exercise, the accuracy of patients’ exercise and the satisfaction with health education of the patients were compared between the two groups.
Results
The functional exercise compliance in the trial group (complete compliance in 45 cases, partial compliance in 4 cases, non-compliance in 1 case) was higher than that in the control group (complete compliance in 9 cases, partial compliance in 34 cases, non-compliance in 6 cases) with a statistical difference (Z=–6.910, P<0.001). The functional exercise accuracy rate of patients was higher in the trial group [84.00%(168/200)] than that in the control group [53.06% (104/196)] with a statistical difference (χ2=44.060, P<0.001). The patients’ satisfaction with health education in the trial group (4.64±0.49) was higher than that in the control group (4.20±0.89) with a statistical difference (t=3.084, P=0.003).
Conclusion
The implementation of nursing quality improvement intervention can improve the compliance and accuracy rate of rehabilitation functional exercise of patients undergoing spinal surgery, and improve the satisfaction of patients, which is worth promoting.
ObjectiveTo analyze the effect of core stabilization exercise with unstable support surface on rehabilitation of patients with osteoporotic vertebral fracture.MethodsFrom January 2018 to January 2020, 66 patients with osteoporotic vertebral fractures in the Fifth Affiliated Hospital of Zhengzhou University were selected as the research objects. All patients were treated with percutaneous vertebroplasty. After operation, they were randomly divided into intervention group and control group by random number table method, with 33 cases in each group. Both groups were given routine rehabilitation intervention after operation, while the intervention group was given core stabilization exercise with unstable support surface at the same time. The vertebral height, shape, stability and gait of the two groups were compared 1 day before operation and 1 day after rehabilitation training.ResultsThere was no significant difference in gender, age, injured vertebral body, course of osteoporosis, years of education and marital status between the two groups (P>0.05). Before surgery, there was no statistically significant difference in the height ratio of the front edge of the injured vertebra, middle height ratio of the injured vertebra, back convex Cobb angle, track length when eyes were open, track length when eyes were closed, Romberg rate, track length per unit time when eyes were open, track length per unit time when eyes were closed, Romberg rate per unit time, deviation of the center of gravity on X-axis when eyes were open, deviation of the center of gravity on X-axis when eyes were closed, deviation of the center of gravity on Y-axis when eyes were open, deviation of the center of gravity on Y-axis when eyes were closed, stride length, step frequency or comfortable pace between the two groups (P>0.05). After training, the height ratio of the front edge of the injured vertebra [(79.26±12.15)% vs. (72.26±13.36)%], middle height ratio of the injured vertebra [(82.11±10.26)% vs. (75.64±9.56)%], back convex Cobb angle [(9.87±7.10) vs. (14.41±2.36)°], track length when eyes were closed [(1856.29±457.16) vs. (2358.48±786.45) mm], Romberg rate [(1.32±0.29)% vs. (1.87±0.54)%], track length per unit time when eyes were closed [(33.45±3.26) vs. (41.55±4.69) mm], Romberg rate per unit time [(1.41±0.30)% vs. (1.95±0.77)%], deviation of the center of gravity on X-axis when eyes were open [(11.06±1.36) vs. (16.54±2.22) mm], deviation of the center of gravity on X-axis when eyes were closed [(11.15±0.96) vs. (23.31±3.06) mm], deviation of the center of gravity on Y-axis when eyes were open [(12.57±1.84) vs. (15.56±2.06) mm], deviation of the center of gravity on Y-axis when eyes were closed [(15.69±2.05) vs. (18.96±3.56) mm], stride length [(0.57±0.12) vs. (0.49±0.10) m], step frequency [(1.09±0.29) vs. (0.94±0.20) step/s] and comfortable pace [(0.35±0.12) vs. (0.29±0.10) m/s] of the intervention group were better than those of the control group (P<0.05). There was no significant difference in the track length when eyes were open or track length per unit time when eyes were open between the two groups (P>0.05).ConclusionIn patients with osteoporotic vertebral body fractures, core stabilization exercise with unstable support surface on the basis of conventional rehabilitation interventions after surgery can effectively restore the height and shape of the vertebral body, and improve the stability and gait to a certain extent.
ObjectiveTo investigate the effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome (non-ACS) after interventional therapy.MethodsA total of 102 patients with coronary heart disease and non-ACS in our hospital from December 2018 to June 2019 were selected and randomly divided into a control group (n=51, 30 males and 21 females with an average age of 56.1±4.8 years) and a trial group (n=51, 34 males and 17 females with an average age of 55.1±4.9 years). The control group received routine treatment, while the trial group received regular supervised rehabilitation exercise on the basis of routine treatment. Patients were followed up for 6 months to compare the differences in cardiovascular risk factors (blood pressure, blood lipid, fasting blood glucose), 6-minute walking distance (6MWD), adverse lifestyle changes and treatment compliance between the two groups after treatment.ResultsThe difference of 6MWD between the two groups was statistically significant (P<0.05). In the trial group, 6MWD increased after intervention compared with that before intervention, and the difference was statistically significant (P<0.05). Comparison of total cholesterol (TC), high density liptein cholesterol (HDL-C), low density liptein cholesterol (LDL-C) and fasting blood glucose in the trial group before and after intervention showed statistically significant differences (P<0.05). The differences in TC, HDL-C and LDL-C in the control group before and after intervention were statistically significant (P<0.05). It was statistically significant in dietary compliance rate, smoking cessation rate and alcohol cessation rate between the two groups (P<0.05); the differences in the dietary compliance and drug compliance of the trial group before and after intervention were statistically significant (P<0.05).ConclusionRegular supervised rehabilitation exercise can significantly improve the exercise tolerance and cardiovascular risk factors of non-ACS patients after coronary intervention treatment, so as to improve the quality of life and long-term prognosis of non-ACS patients, which is worthy of clinical application.
Objective To systematically analyze the relevant research on the application of preoperative exercise training in the pre-rehabilitation of elderly hip fracture patients, identify the specific content, outcome indicators, and application effects of exercise intervention, in order to provide reference for medical staff to carry out relevant interventions. Methods Computer searches were conducted on domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, VIP, Cochrane Library, PubMed, Embase, Web of Science. The search period was from the establishment of the database to January 2024. The scoping review method was used to screen, summarize, and analyze the included studies. ResultsA total of 10 studies were included, including 3 randomized controlled trial, 1 quasi experimental study, 5 retrospective studies and 1 case report. Preoperative exercise preparation includes completing relevant examinations and providing sufficient pain relief. The types of exercise include adaptive training, resistance training, and aerobic exercise. Monitor the patient’s symptoms, signs, and adverse reactions throughout the exercise process. Outcome measures include physical activity and function, pain, average length of hospital stay, and perioperative complications. Conclusions Preoperative exercise training has a positive effect on elderly patients with hip fracture. Elderly patients with hip fracture should be well prepared for preoperative exercise, based on adaptive training, with resistance exercise as the main focus, while monitoring the patient’s physical signs and adverse events during exercise.
