ABSTRACT
Resistance training has been used for the treatment of patients with peripheral artery disease (PAD). However, cardiovascular responses during this type of exercise have not been fully elucidated in these patients. OBJECTIVES: To analyze the cardiovascular responses during resistance exercise and to verify whether there are any correlations between these responses and disease severity or blood pressure levels in patients with PAD. METHODS: Seventeen PAD patients performed one set of 10 repetitions of knee extension exercise with an intensity of 50% of one repetition maximum. The responses of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were continuously monitored using the finger photoplethysmography technique. The rate-pressure product (RPP) was obtained by multiplication of SBP and HR. RESULTS: During the resistance exercises there were significant increases in SBP (126 ± 14 vs. 184 ± 20 mmHg, p<0.001), DBP (68 ± 8 vs. 104 ± 14 mmHg, p<0.001), HR (76 ± 18 vs. 104 ± 30 bpm, p<0.001) and RPP (9523 ± 2115 vs. 19103 ± 6098 mmHg x bpm, p<0.001). A negative correlation was observed between relative change (Δ) in SBP and SBP at rest (r =-0.549, p=0.022). On the other hand, there was no relationship between Δ SBP and the ankle-brachial index (r=0.076, p=0.771). CONCLUSION: Increases in cardiovascular variables were observed during resistance exercise in PAD patients. The highest increases occurred in patients with lower SBP levels at resting...
O treinamento de força vem sendo utilizado para o tratamento de pacientes com doença arterial periférica (DAP). No entanto, as respostas cardiovasculares durante a realização desse tipo de exercício ainda não são claras nesses pacientes. OBJETIVOS: Analisar as respostas cardiovasculares durante a realização do exercício de força e verificar se existe alguma correlação entre essas respostas e a severidade da doença e o nível de pressão arterial em pacientes com DAP. MÉTODOS: Dezessete pacientes com DAP realizaram uma série de dez repetições com intensidade de 50% de uma repetição máxima do exercício extensão do joelho. As respostas da pressão arterial sistólica (PAS) e diastólica (PAD), e da frequência cardíaca (FC) foram continuamente registradas pela técnica de fotopletismografia de dedo. O duplo produto (DP) foi obtido pela multiplicação da PAS pela FC. RESULTADOS: Durante a realização do exercício de força, houve aumento significante dos seguintes parâmetros: PAS (126 ± 14 vs. 184 ± 20 mmHg; p < 0,001); PAD (68 ± 8 vs. 104 ± 14 mmHg; p < 0,001); FC (76 ± 18 vs. 104 ± 30 bpm; p < 0,001), e DP (9523 ± 2115 vs. 19103 ± 6098 bpm x mmHg; p < 0,001). Foi observada correlação negativa entre o delta (Δ) relativo da PAS com a PAS de repouso (r = -0,549; p = 0,022). Por outro lado, não foi observada relação entre o Δ relativo da PAS e o índice tornozelo braço (r = 0,076; p = 0,771). CONCLUSÃO: Foram observados aumentos das variáveis cardiovasculares durante o exercício de força em pacientes com DAP. Os maiores aumentos ocorreram nos pacientes com menor nível de PAS em repouso...
Subject(s)
Humans , Male , Female , Middle Aged , Peripheral Arterial Disease/diagnosis , Exercise , Hospitals, Private/classification , Hospitals, Public/methods , Intermittent Claudication , Arterial Pressure , Heart Rate , Risk FactorsABSTRACT
The present study was conducted to know the various reasons for patient dissatisfaction at various places and explanations of service providers for patient dissatisfaction. 400 patients selected from all departments and key service providers at Government Medical College Hospital, Miraj. 364 (91%) patients had one/ more dissatisfaction/s to report. Of the 37 types of dissatisfaction reported, 10 were found to be of serious nature viz. cursory clinical examination (56%), lack of counseling (40%), inadequate privacy during clinical examination (14.28%), lack of explanation regarding drug schedule (43%), unsatisfactory emergency management (32.95%), occurrence of post-operative surgical complications (28.82%), discharged without relief (6.18%) and illegal demand of money, etc. Most of these were ‘acts of omission’ on part of service providers. In terms of legal liability, the ‘service-provider’ constitutes a ‘collective responsibility’ with respect to application of law.