Journal of Cardiopulmonary Rehabilitation最新文献

Purpose: To compare the results of treadmill exercise testing (TM) to arm-leg ergometry testing (AL) in patients with peripheral arterial disease (PAD).

Methods: Twelve men and 8 women with PAD (mean age, 62 +/- 10 years) completed a treadmill test and an arm-leg ergometer exercise test. Oxygen uptake, heart rate, rate-pressure product (x10(-3)), ratings of claudication and perceived exertion, and power were measured.

Results: Peak oxygen uptake, heart rate, and rate-pressure product were similar between TM and AL. Exercise duration was longer and the peak power higher on the AL than on the TM. Claudication pain > or =3/4 was the reason for test termination in all subjects during TM test and in 13 subjects during AL. Nine patients discontinued due to severe claudication on both tests, but the pain occurred later in AL than TM.

Conclusions: Although peak oxygen uptake was similar between the 2 exercise tests, patients with PAD exercised longer and to a higher peak power during the AL. These data suggest that the AL test may be used to evaluate peak exercise capacity in patients with PAD. The AL may also provide an alternate method for detecting PAD and coronary heart disease.

Purpose: Atherosclerosis contributes to cardiovascular mortality and morbidity even with aggressive lipid management. Our objective is to determine whether a combined pharmacological and lifestyle intervention can improve atherosclerosis.

Methods: We conducted a 2-year observational study at a specialized clinic in a tertiary care hospital. One hundred fifty-six subjects with coronary disease were enrolled in an intensive pharmacological management and lifestyle measures (including counseling and exercise training) program designed to reach specific targets. The main outcome measures were carotid intima media thickness and plaque area; brachial artery flow-mediated dilation; nitroglycerin-mediated dilation; flow-mediated dilation-nitroglycerin-mediated dilation ratio; laboratory parameters including lipids, glucose, creatinine, and homocysteine; and physical fitness.

Results: At completion, there were improvements in lipids and physical fitness. There were no overall changes in flow-mediated dilation, nitroglycerin-mediated dilation, or carotid intima media thickness in the entire cohort. However, multivariate logistic regression showed that dietary and exercise variables, such as increasing fiber intake and reducing body weight and body fat percentage, were independent predictors of improvements in endothelial function and carotid plaque burden.

Conclusions: Even in the setting of intensive pharmacological therapy, lifestyle interventions, including exercise training and dietary changes, are important determinants of improved endothelial function and atherosclerosis.

Purpose: The primary goal of pulmonary rehabilitation (PR) is for patients to achieve and maintain their maximum level of independence and functioning in the community. Traditional PR uses a predominantly aerobic/endurance approach to rehabilitation with little or no inclusion of exercises to increase strength. Few studies have investigated the impact of resistance training on PR despite growing evidence supporting its efficacy to improve physical function (functional fitness) in both healthy individuals and those with chronic disease. The purpose of this study was to investigate the effect of single-set resistance training on strength and functional fitness outcomes in PR patients.

Methods: Twenty PR patients, 60 to 81 years old, were randomly assigned to an 8-week endurance-based PR program (ET) or an ET plus resistance training program (RT).

Results: Strength increased in RT (P < .05) and decreased in ET for both upper and lower body. Functional fitness improved (P < .05) in 5 of 7 tests for RT compared with 2 tests for ET.

Conclusions: Single set RT can elicit significant improvements in both strength and functional fitness, which is not obtained by traditional PR alone. Our results are comparable to other studies with similar outcomes using multiple-set RT protocols. These findings may have important implications for program design, application, and adherence in PR.

Introduction: C-reactive protein (CRP) has emerged as an important indicator of risk for cardiovascular disease. The impact of gender on the relationship between CRP and other cardiovascular risk factors, however, has not been thoroughly investigated.

Methods: Ninety men and 75 women participated in this study. Age, resting systolic and diastolic blood pressure, resting heart rate, body mass index, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and hs-CRP were ascertained. Maximal oxygen consumption was obtained via treadmill testing, and aortic stiffness was measured using magnetic resonance imaging.

Results: Log hs-CRP level was significantly higher in the female subjects compared with the males subjects (0.86 +/- 0.67 mg/L vs 0.63 +/- 0.44 mg/L, respectively; P = .003). In the male group, Pearson product moment correlation analysis showed that log hs-CRP was not significantly correlated (P > .10) with any of the other variables of interest. In the female group, however, log hs-CRP was significantly correlated (P < .05) with total cholesterol (r = 0.30), low-density lipoprotein (r = 0.27), tryglycerides (r = 0.51), and body mass index (r = 0.36). Linear regression analysis determined that triglycerides and body mass index explained 30% of the variability in log hs-CRP.

Conclusions: These results indicate that the relationship between CRP and other cardiac risk factors is different between apparently healthy men and women. The prognostic characteristics of CRP and the impact of statin therapy on CRP may therefore differ between men and women. Future research should be directed toward resolving this issue.