Adesão ao exercício físico e qualidade de vida de portadores de dispositivos cardíacos eletrônicos implantáveis / Adherence to physical exercise and quality of life of carriers of implantable deviceselectronic heart

Introdução: Dispositivos cardíacos eletrônicos implantáveis liberam estímulos elétricos para o músculo cardíaco quando este apresenta algum problema no sistema de condução. Objetivos: Verificar adesão à prática do exercício físico e correlacionar com a qualidade de vida de portadores de dispositivos cardíacos eletrônicos implantáveis. Métodos: Estudo transversal, quantitativo, descritivo, com correlação entre as variáveis, realizado no Ambulatório de Cardiologia de um hospital de ensino, com a participação de 70 portadores acompanhados pelo SUS . Foi desenvolvido por meio de um questionário com perguntas referentes à prática de exercício físico na rotina diária e seguindo a Versão Brasileira do Questionário de Qualidade de Vida-SF-36 que avalia os domínios: Capacidade funcional, Limitação por aspectos físicos, Dor, Estado geral de saúde, Vitalidade, Aspectos sociais, Limitação por aspectos emocionais e Saúde mental, no período de julho de 2021 a janeiro de 2022. Para análise estatística foram utilizados os métodos U de Mann - Whitney e correlação de Spearman. Resultados: Dos 70 portadores, 63, 2% não praticavam exercício físico regularmente, sendo a maior dificuldade os próprios problemas de saúde (48,90%), falta de interesse (17,80%), insegurança para praticar atividade física 35,7%, relataram não receber orientação por parte dos profissionais sobre esta questão 31,4%. As pontuações dos domínios foram: capacidade funcional (57,70), limitação por aspectos físicos (77,00), dor (71,75), estado geral de saúde (51,03), vitalidade (69,07), aspectos sociais (75,51), limitação por aspectos emocionais (83,23) e saúde mental (69,5), com média geral de 69,47, considerada de boa qualidade segundo os aspectos analisados. Dos que se exercitavam, constatou-se melhor qualidade de vida, visto que 92% relataram maior disposição para realizar as atividades diárias, 96% disseram que dormiam melhor, 92% disseram que ficavam doente com menor frequência e 92% que a interação social foi melhor com familiares e amigos. Conclusão: Os portadores de dispositivos cardíacos eletrônicos implantáveis, de forma geral, não aderem de forma satisfatória ao exercício físico, pois poucos praticam na sua rotina diária e a qualidade de vida foi considerada boa, de acordo com os domínios do SF-36. Entretanto, os que praticavam atividade física apresentaram maior pontuação de qualidade de vida em comparação com aqueles que não aderiram a essa prática.

Introduction: Implantable electronic cardiac devices release electrical stimuli to the heart muscle when there is a problem in the conduction system. Objectives: Verify adherence to physical exercise and correlate it with the quality of life of people with implantable electronic cardiac devices. Methods: Cross-sectional, quantitative, descriptive study, with correlation between variables, carried out in the cardiology outpatient clinic of a teaching hospital, with the participation of 70 patients monitored by the SUS. It was developed through a questionnaire with questions regarding the practice of physical exercise in the daily routine and following the Brazilian Version of the Quality of Life Questionnaire-SF-36 that evaluates the domains: Functional capacity, Limitation due to physical aspects, Pain, General health status, Vitality, Social aspects, Limitation due to emotional aspects and Health mental, from July 2021 to January 2022. For statistical analysis, the Mann U - Whitney and Spearman correlation methods were used. Results: Of the 70 patients, 63.2% did not practice physical exercise regularly, with the greatest difficulty being their own health problems (48.9%), lack of interest (17.8%), insecurity in practicing physical activity 35.7 %, reported not receiving guidance from professionals on this issue 31.4%. The domain scores were: functional capacity (57.70), limitation due to physical aspects (77.00), pain (71.75), general health status (51.03), vitality (69.07), social aspects (75.51), limitation due to emotional aspects (83.23) and mental health (69.5), with an overall average of 69.47, considered of good quality according to the aspects analyzed. Of those who exercised, there was a better quality of life, as 92% reported greater willingness to carry out daily activities, 96% said they slept better, 92% said they got sick less frequently and 92% said social interaction was better with family and friends. Conclusion: People with implantable electronic cardiac devices, in general, do not adhere satisfactorily to physical exercise, as few practices it in their daily routine and their quality of life was considered good, according to the SF-36 domains. However, those who practiced physical activity had higher quality of life scores compared to those who did not adhere to this practice.

Introducción: Los dispositivos cardíacos electrónicos implantables liberan estímulos eléctricos al músculo cardíaco cuando hay un problema en el sistema de conducción. Objetivos: Verificar la adherencia al ejercicio físico y correlacionarlo con la calidad de vida de personas portadoras de dispositivos cardíacos electrónicos implantables. Métodos: Estudio descriptivo, cuantitativo, transversal, con correlación entre variables, realizado en el ambulatorio de cardiología de un hospital universitario, con la participación de 70 pacientes acompañados por el SUS. Fue desarrollado a través de un cuestionario con preguntas sobre la práctica de ejercicio físico en la rutina diaria y siguiendo la Versión Brasileña del Cuestionario de Calidad de Vida-SF-36 que evalúa los dominios: Capacidad funcional, Limitación por aspectos físicos, Dolor, Estado de salud general, Vitalidad, Aspectos sociales, Limitación por aspectos emocionales y Salud mental, de julio de 2021 a enero de 2022. Para el análisis estadístico se utilizó el método de correlación Mann U - Whitney y Spearman. Resultados: De los 70 pacientes, el 63,2% no practicaba ejercicio físico regularmente, siendo la mayor dificultad sus propios problemas de salud (48,9%), desinterés (17,8%), inseguridad para practicar actividad física 35,7%, refirió no recibir orientación. de profesionales sobre este tema el 31,4%. Las puntuaciones de los dominios fueron: capacidad funcional (57,70), limitación por aspectos físicos (77,00), dolor (71,75), estado de salud general (51,03), vitalidad (69,07), aspectos sociales (75,51), limitación por aspectos emocionales (83,23) y salud mental (69,5), con una media global de 69,47, considerada de buena calidad dentro de los aspectos analizados. De quienes hacían ejercicio hubo una mejor calidad de vida, pues el 92% reportó mayor disposición para realizar las actividades diarias, el 96% dijo que dormía mejor, el 92% dijo que se enfermaba con menos frecuencia y el 92% dijo que la interacción social con familiares y amigos era mejor. Conclusión: Las personas con dispositivos cardíacos electrónicos implantables, en general, no adhieren satisfactoriamente al ejercicio físico, ya que pocos lo practican en su rutina diaria y su calidad de vida fue considerada buena, según los dominios del SF-36. Sin embargo, quienes practicaban actividad física presentaban puntuaciones más altas en calidad de vida en comparación con quienes no adherían a esa práctica.

Capacidad funcional, fuerza y calidad de vida luego de un programa de entrenamiento para insuficiencia cardíaca. Ensayo clínico aleatorizado

RESUMEN Introducción: la insuficiencia cardiaca es considerada la patología del milenio, cuya mortalidad va en aumento y sus efectos se reflejan en la calidad de vida. Objetivo: identificar los cambios en la capacidad funcional, fuerza y calidad de vida luego de un programa de entrenamiento para pacientes con insuficiencia cardíaca. Métodos y materiales: ensayo controlado aleatorizado en un periodo de 3 años con una muestra de 920 pacientes con falla cardiaca distribuidos en 3 grupos: solo ejercicio aeróbico (GC), ejercicio aeróbico más entrenamiento para miembros superiores (GE1), ejercicio aeróbico más entrenamiento de miembros inferiores (GE2). Se realizaron mediciones de capacidad aeróbica, frecuencia cardiaca máxima, antropometría, depresión y ansiedad (test HADS), parámetros clínicos y hemodinámicos y la escala Minnesota Living with Heart Failure Questionnaire y la New York Heart Association. Las pruebas se realizaron antes y después de 24 sesiones de entrenamiento de 60 minutos, 3 veces por semana durante dos meses. Resultados: en la fuerza prensil el GE1 tuvo una gran mejoría en comparación con el GE2 (31±6,4 vs 28±5,0; p= 0,001) y GC (31±6,4 vs 24±9,2; p=0,001)y la calidad de vida mejorósignificativamente en los grupos experimentales en comparación con el grupo control (GC:49,1±8,8 vs GE1:40,5±4,5; p=0,0001) (GC:49,1±8,8 vs GE2:34,5±6,9; p=0,0001) (G1:40,5±4,5 vs GE2:34,5±6,9; p=0,0001). Además, se mejoraron variables como la capacidad funcional, depresión, ansiedad, antropometría y fracción de eyección. Conclusiones: en pacientes con insuficiencia cardiaca se recomienda el uso de ejercicicos de fuerza muscular, los cuales aumentan la capacidad funcional, calidad de vida y mejoran variables asociadas como, la depresión y ansiedad. Trial registration: Clinicaltrials.gov NCT03913780.

ABSTRACT Introduction: Heart failure is considered the millennium pathology, whose mortality is increasing and its effects are reflected in the quality of life. Objective: To identify changes in functional capacity, strength and quality of life after a training program in patients with heart failure. Methods and materials: Randomized controlled trial over a period of 3 years with a sample of 920 patients with heart failure distributed in 3 groups (only aerobic exercise, aerobic exercise plus training for MMSS, aerobic exercise plus MMII training). Aerobic capacity, maximum heart, anthropometry, depression and anxiety (HADS Test), clinical and hemodynamic parameters measurements and the Minnesota Living with Heart Failure Questionnaire and the New York Heart Association were performed. The tests were performed before and after 24 60-minute training sessions, 3 times a week for two months. Results: In the prehensile force the GE1 had a great improvement compared to the GE2 (31±6.4 vs 28±5.0; p= 0.001) and GC (31±6.4 vs 24±9.2; p=0.001) and the quality of life improved significantly in the experimental groups compared to the control group (GC:49.1±8.8 vs. GE1:40.5±4.5; p=0.000) (GC:49.1±8.8 vs. GE2:34.5±6.9; p=0.000) (G1:40.5±4.5 vs. GE2:34.5±6.9; p=0.000). In addition, variables such as functional capacity, depression, anxiety, anthropometry and ejection fraction were improved. Conclusions: In patients with heart failure, the use of muscular strength exercises is recommended, which increase functional capacity, quality of life and improve associated variables such as depression and anxiety. Trial registration: Clinicaltrials.gov NCT03913780.

Effect of an aerobic exercise session combined with abdominal radiofrequency on lipolytic activity in women: Randomized control trial.

BACKGROUND: Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE: To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. METHODOLOGY: The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40º C and 42º C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. RESULTS: There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). CONCLUSION: The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.

Factors Related to Changes in Activities of Daily Living among Elderly Patients with Slight Disability who were Discharged to Home / The Japanese Journal of Rehabilitation Medicine

<p>Purpose：To clarify factors related to changes in activities of daily living (ADL) among elderly patients who were discharged to home.</p><p>Methods：The subjects were 88 persons who received in-hospital musculoskeletal rehabilitation and discharged to home. Factors related to changes in functional independence measure (FIM) score were examined.</p><p>Results：The factors related to restoring the FIM score to its values before hospitalization were frequency of physical exercise at 1 week (odds ratio [OR] ＝1.41) and 1 month (OR＝1.27) after hospital discharge, restoring the FIM score at hospital discharge to its value before hospitalization (OR＝3.96), and feeling of self-efficacy (OR＝1.16) at 3 months after hospital discharge. A receiver-operating characteristic analysis revealed that the factors related to restoring the FIM score to its value before hospitalization were frequency of physical exercise (cutoff value＝1.5) at 1 week after discharge, frequency of physical exercise (cutoff value＝1.0) at 1 month after discharge, and feeling of self-efficacy (cutoff value＝31.5) at 3 months after discharge. In addition, ≥ 2 days of physical exercise per week after hospital discharge was more likely to lead to high FIM score than ＜ 2 days of physical exercise per week.</p><p>Conclusion：Our results implied that regular physical exercise soon after hospital discharge would lead to better prognosis</p>