Community-Based Aerobic Exercise Program for Primary Prevention of Cardiovascular Disease in Adults With Visual or Auditory Impairments: A Feasibility Study.

OBJECTIVE: To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments. METHODS: The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion. RESULTS: Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD. CONCLUSION: In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.

Estimation of energy expenditure of Nordic walking: a crossover trial.

BACKGROUND: Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg- 1·min- 1) of NW. METHODS: This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3-5 km·h- 1) and grade (0-7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW. RESULTS: Oxygen uptake (+ 15.8%), minute ventilation (+ 17.0%), heart rate (+ 8.4%), and systolic blood pressure (+ 7.7%) were higher in NW than in W (P < .05). NW resulted in increased muscle activity in all of the upper limb muscles (P < .05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P < .05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade. CONCLUSION: NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg- 1·min- 1. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.

Accuracy of Wearable Devices for Measuring Heart Rate During Conventional and Nordic Walking.

INTRODUCTION: Nordic walking is being used increasingly as an exercise method in many clinical disorders. To apply Nordic walking in cases of fragile or deconditioned patients, monitoring of exercise intensity such as heart rate (HR) measurement is required. The accuracy of wearable HR monitors during Nordic walking has not yet been reported. OBJECTIVE: To compare the accuracy of an electrocardiography (ECG)-based HR monitor (Polar H7) and a photoplethysmography (PPG)-based HR monitor (Fitbit Charge 2) during conventional and Nordic walking. DESIGN: Accuracy was assessed by comparing the HR values obtained using the wearable devices with those obtained via 12-lead ECG as a reference. SETTING: Laboratory setting. PARTICIPANTS: Fifteen male volunteers age 23.7 ± 3.0 years. INTERVENTIONS: None. MAIN OUTCOMES MEASURES: HR was simultaneously recorded via 12-lead ECG, the Polar H7, and the Fitbit Charge 2 during conventional and Nordic walking. Agreement between the devices was assessed by calculating Lin's concordance correlation coefficient (rc ), the mean absolute difference, and the limit of agreement (LoA) from Bland-Altman plots. RESULTS: Regarding HR values including Nordic and conventional walking, there was a better agreement between the Polar H7 and the reference (rc = 0.96) than between the Fitbit Charge 2 and the reference (rc = 0.84). For the Polar H7, the mean absolute difference from the reference did not differ significantly between the walking methods; for the Fitbit Charge 2, the mean absolute difference was significantly higher during Nordic walking than during conventional walking (6.60 vs. 3.68 bpm, P < .001). The Fitbit Charge 2 had a wider LoA than did the Polar H7 during both walking methods. CONCLUSION: ECG-based wearable devices may be better than PPG-based devices for monitoring HR during Nordic walking. However, both types of devices may adequately monitor HR during conventional walking.

Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study.

OBJECTIVE: To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed. METHODS: Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65-74 years) and old-old (≥75 years) female subjects were compared. RESULTS: Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05). CONCLUSION: We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.