[Long-term HRV analysis shows stress reduction by magnesium intake]. / Langzeit-HRV-Analyse zeigt Stressreduktion durch Magnesiumzufuhr.

BACKGROUND: Mental pressure and stress represent an ever-increasing socio-political challenge. The heart rate variability (HRV) measurement, which has its origin in the cardiac function diagnosis, gives information on the neurovegetative activity. A low HRV shows an imbalance of the sympathetic and parasympathetic efferents and thus is an indicator of stress. METHOD: A randomized, controlled, two-armed parallel study with 100 participants and a period of 90 days was performed. Main object of investigation was to what extent the mineral magnesium, which is also a high-quality natural calcium antagonist in cardiology, can influence the sympathovagal balance, when given in combination with a strength-endurance training. The effect on intracellular magnesium concentration was investigated as an additional parameter. RESULTS: In the group with daily supplementation of 400 mg of magnesium, HRV parameters clearly increased: pNN50 - an indicator of parasympathetic activity - increased. LF-HF ratio as well as stress index - low values for each represent a good balance of the vegetative nervous system - decreased. In the control group no positive changes in HRV parameters could be shown. Vagus activity, and thus the adaptive and regenerative capacity of the body, veritably increased by magnesium supplementation. No effect on the intracellular magnesium concentration could be shown in the study. CONCLUSIONS: The results of this study point out that persons with mental and physical stress can benefit from a daily intake of magnesium. This might lead to an improved physiological regulation of the sympathetic and parasympathetic efferents and, furthermore, prevent magnesium deficiency and diseases such as, for example, restlessness, irritability, lack of concentration, sleep disorder or depression.

Nutritional supplementation: is it necessary for everybody?

Mineral nutrients, vitamins, and trace elements are essential for the growth and development of a multicellular organism. Today, an adequate supply of nutrients is often unattainable solely through a well-balanced diet, so a targeted, individually designed dietary supplement regime is necessary. Nutrient deficiency, which is impossible to detect through plasma levels alone, is reliably detected through the intracellular measurement of the nutrient levels in the blood. Two case studies presented here indicate the need for supplementation as improvement in nutritional behavior could not replenish already exhausted nutrient reservoirs. Only supplementation was able to significantly boost nutrient levels and confer beneficial effects on general welfare, physical performance, and resistance to infections. Therefore, it appears that nutritional supplements are advisable for everyone, but more research is needed, especially on an intracellular level, to corroborate these findings.

New East-Westfalian Postoperative Therapy Concept: a telemedicine guide for the study of ambulatory rehabilitation of patients after cardiac surgery.

In-hospital rehabilitation can improve recovery of patients after surgery, but also contributes to the high costs of the German health system. A telemedicine-based rehabilitation used in the home as an alternative to in-hospital rehabilitation was evaluated in a pilot study. In an open trial, 170 patients performed a 3-month ambulatory rehabilitation after cardiac surgery. There were two groups (group 1 [n = 70] and group 2 [n = 100]). Group 1 participated in conventional in-hospital rehabilitation. Group 2 received ambulant rehabilitation using telemedicine. Physical performance, quality of life, (measured with a questionnaire), complications and costs were assessed and compared between the two groups. Maximal physical performance (MPP) was assessed at 6 and at 12 months after cardiac surgery. It was significantly increased by 46-54 watts in both study groups compared to their baseline value. Moreover, physical and psychological quality of life had increased in both study groups compared to baseline values. However, group 2 was the only group to show statistical significance in all categories. Fewer incidents of angina pectoris were reported within the study interval in group 2 compared to group 1 (p < 0.01). The total cost of rehabilitation was 58% lower in group 2 compared to group 1. Ambulatory rehabilitation using telemedicine improves physical performance, quality of life, is safe, and is inexpensive. Our data indicate that home-based rehabilitation is more effective than in-hospital rehabilitation for patients after cardiac surgery.

[New Eastern Westfalian Postoperative Therapeutic Concept (NOPT). A telemedically guided study for ambulatory rehabilitation of patients after cardiac surgery]. / Neues Ostwestfälisches Postoperatives Therapiekonzept (NOPT) Eine telemedizinisch betreute Studie zur ambulanten Rehabilitation von Patienten nach kardiochirurgischen Operationen.

BACKGROUND AND PURPOSE: In-hospital rehabilitation can improve recovery of patients after surgery, but also contributes to the high costs of the German health system. Therefore, the possibility of a telemedically monitored rehabilitation at home as an alternative to an in-hospital rehabilitation was evaluated in a pilot study. PATIENTS AND METHODS: In an open trial, 100 patients performed an ambulatory rehabilitation after heart surgery under coverage of telemedical monitoring for 3 months. 70 patients performed a regular conventional in-hospital rehabilitation for 3 weeks. Physical performance, quality of life (questionnaire), complications, and costs were assessed and compared between the two groups. RESULTS: 6 and also 12 months after surgery, maximal physical performance was significantly increased by 46-54 W in both study groups compared to their baseline value. Moreover, physical and psychological quality of life had increased in both study groups compared to baseline values. However, only in the ambulatory group all items had increased with statistical significance. Fewer insults of angina pectoris were reported during follow-up in the ambulatory group compared to the in-hospital group (p < 0.01). Total costs of the rehabilitation were 59% lower in the ambulatory group compared to the in-hospital group. CONCLUSION: An ambulatory rehabilitation improves physical performance, quality of life, and is safe and cheap. The data of this study indicate that rehabilitation at home can be established instead of an in-hospital rehabilitation for patients after heart surgery.