Older phase 2 cardiac rehabilitation patients engaged in gardening maintained physical function during the COVID-19 pandemic

Perceived COVID-19-related stress drives home gardening intentions and improves human health in Taiwan

The COVID-19 pandemic has added a layer of mental health problems and perceived stress. Home gardening is considered a good method to reduce perceived stress. The current research evidence is insufficient to understand the relationship and influencing factors between the intentions, behaviors, and benefits of home gardening during short-term COVID-19 events. Although the duration from the onset to stabilization of the outbreak lasted for only 1.5 months from May to June 2021 throughout Taiwan, the significant pandemic changes might have affected the perceived stress along with the intentions, behaviors, and benefits of home gardening. This study explored the relationship between pandemic stress and home gardening through online snowball sampling because of the strict social distancing regulations. A total of 1455 non-follow-up and internet questionnaires throughout Taiwan were collected during the wave onset, peak, easing, and stabilization stages. The questionnaire included questions on personal information, perceived pandemic stress, gardening intentions, gardening behaviors, and gardening benefits. This study showed that perceived stress increased from the pandemic onset to its peak, and decreased from the peak to stabilization stages. Home gardening intentions and behaviors also revealed similar trends. Higher pandemic-perceived stress directly increased home-gardening intentions and indirectly promoted home-gardening behaviors and benefits. Our findings indicated that home gardening is a positive element in reducing perceived stress. Lower gardening intentions and behaviors were observed when the high perceived stress was removed. This study suggests that home gardening was a valuable strategy for staying close to nature and obtaining multiple benefits during the peak pandemic period. Providing small-scale gardening activities and spaces is appropriate for obtaining gardening benefits and avoiding space abandonment after the pandemic. Providing seeds, seedlings, tools, knowledge, online home gardening programs, and small residential and food gardens is a valuable strategy for obtaining multiple benefits during the peak of the pandemic.

Second Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 (COVID-19) Outbreak

Background: We previously reported the results of a questionnaire survey of 37 cardiac rehabilitation (CR) training facilities conducted during April 2020, in Japan.

Methods and Results: We conducted a second questionnaire survey in 38 CR training facilities to explore the preventive measures against Coronavirus Disease 2019 (COVID-19) after a nationwide state of emergency was declared and to investigate differences between the 2 surveys. No significant differences were observed, except for the requirement for patients to wear surgical masks during CR (P=0.01) in the second survey. Thirty-four facilities (89%) continued CR with innovations, 61% revised their instruction manuals (vs. 46% in the first survey), and, in 39%, patients requested resumption of ambulatory CR and training videos.

Conclusions: In the second survey, 74% of facilities were unable to continue conventional group ambulatory CR; however, patients maintained their physical activity and exercise regimens and managed their illnesses with the aid of telephones and mobile devices.

Cardiovascular Disease Complicating COVID-19 in the Elderly

SARS-CoV-2, a single-stranded RNA coronavirus, causes an illness known as coronavirus disease 2019 (COVID-19). The highly transmissible virus gains entry into human cells primarily by the binding of its spike protein to the angiotensin-converting enzyme 2 receptor, which is expressed not only in lung tissue but also in cardiac myocytes and the vascular endothelium. Cardiovascular complications are frequent in patients with COVID-19 and may be a result of viral-associated systemic and cardiac inflammation or may arise from a virus-induced hypercoagulable state. This prothrombotic state is marked by endothelial dysfunction and platelet activation in both macrovasculature and microvasculature. In patients with subclinical atherosclerosis, COVID-19 may incite atherosclerotic plaque disruption and coronary thrombosis. Hypertension and obesity are common comorbidities in COVID-19 patients that may significantly raise the risk of mortality. Sedentary behaviors, poor diet, and increased use of tobacco and alcohol, associated with prolonged stay-at-home restrictions, may promote thrombosis, while depressed mood due to social isolation can exacerbate poor self-care. Telehealth interventions via smartphone applications and other technologies that document nutrition and offer exercise programs and social connections can be used to mitigate some of the potential damage to heart health.