ABSTRACT
Abstract Background: In pandemic times, social isolation is of utmost importance to minimize the spread of the SARS-Cov-2 virus. At times like these, home fitness becomes extremely necessary to avoid sedentarism and decompensation in chronic disease patients. Objectives: Evaluate the engagement of rehabilitation patients to a tele- oriented exercise program at home (TOEP). Materials and Methods: 66 of 94 patients (63.8% males; 65.5±14 years old; 5.2±2.6 months in rehabilitation) agreed to take part. Subjects were grouped in three levels of functionality to guide the exercise prescription. Weekly Training Rates (WTR) were compared using the Friedman test and corrected by Dunn's test. A multivariate logistic model was designed to determine independent predictors in program engagement. Statistical significance was determined by a p<0.05. Results: TOEP provided WTR similar to the pre-quarantine values of 2.8/week (p>0.05), and 91.8% of patients took part until the end of those 5 weeks. The presence of diabetes was a predicted factor for low engagement to TOEP with relative risk of 0.41 (CI95%: 0.25 to 0.66). Conclusion: TOEP provided satisfactory engagement in rehabilitation patients. Most of them increased WTR during quarantine. Patients with diabetes displayed lower engagement to the minimum standard frequency.
ABSTRACT
Background: Cardiac rehabilitation (CR) programs play an important role in the control and prevention of new cardiac events. Aim: A survey was performed to evaluate the current situation of CR programs in Chile. Material and Methods: A questionnaire evaluating the structure of rehabilitation centers, characteristics of the rehabilitation programs and patients, management of risk factors, reimbursement methods, human resources and potential barriers for an efficient rehabilitation, was mailed to centers dedicated to CR in Chile. Results: Eight centers were contacted and seven responded. Coronary heart disease is the most common underlying disease of attended patients and CR is carried out mainly during phases II and III. All CR centers perform an initial assessment, stratify patients, plan and provide tips on physical activity and nutrition. Only three centers provide help to quit smoking. Lipid profile and blood sugar are assessed in 62% of centers. Most practitioners involved are cardiologists, nurses, physiotherapists and nutritionists, all trained in cardiopulmonary resuscitation. The main barrier for their development is the lack of patient referral from practitioners. Conclusions: Despite the recognized value of CR in the care of patients after a cardiac event, this study reveals the need for further development of such programs and improvement of patient referrals.
Subject(s)
Humans , Cardiovascular Diseases/rehabilitation , Health Personnel/statistics & numerical data , Rehabilitation Centers/standards , Cardiovascular Diseases/prevention & control , Chile , Coronary Disease/rehabilitation , Patient Care Team , Program Evaluation , Surveys and Questionnaires , Referral and Consultation , Rehabilitation Centers/organization & administration , Rehabilitation Centers/statistics & numerical data , Risk Factors , Secondary PreventionABSTRACT
The aim of this review was to gain insight into prevalence of and interventions targeted specifically at psychological distress and health-related quality of life (HRQL) after a myocardial infarction (MI). For this purpose, self-regulation theory was introduced as frame of reference. Psychological distress and a reduction in HRQL after an MI are prevalent and can, for some patients, be persistent. This can negatively influence secondary prevention efforts, adherence, return to work and progression of the underlying coronary heart disease. At the same time, the effectiveness of cardiac rehabilitation programmes in improving HRQL is inconclusive. By starting off from a theoretical framework, effective strategies can be either identified or developed. Self-regulation theory is concerned with the process of goal setting and goal attainment and offers a model for explaining well-being and quality of life. The usefulness of this theory is supported by empirical evidence. Psychological factors derived from this theoretical framework (e.g. higher order goal disturbance) are associated with psychological distress and HRQL in the short and medium term after an MI and should thus be the target of cardiac rehabilitation programmes.