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Norha J, Sjöros T, Garthwaite T, Laine S, Saarenhovi M, Kallio P, Laitinen K, Houttu N, Vähä-Ypyä H, Sievänen H, Löyttyniemi E, Vasankari T, Knuuti J, Kalliokoski KK, Heinonen IHA. Effects of reduced sedentary time on resting, exercise and post-exercise blood pressure in inactive adults with metabolic syndrome - a six-month exploratory RCT. J Hum Hypertens 2024; 38:314-321. [PMID: 38267651 PMCID: PMC11001575 DOI: 10.1038/s41371-024-00894-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/26/2024]
Abstract
Evidence on the long-term effects of reducing sedentary behaviour (SB) on blood pressure (BP) is scarce. Therefore, we performed a sub-analysis of the BP effects of a six-month intervention that aimed at reducing SB by 1 h/day and replacing it with non-exercise activities. Sixty-four physically inactive and sedentary adults with metabolic syndrome (58% female, 58 [SD 7] years, BP 143/88 [16/9] mmHg, SB 10 [1] h/day) were randomised into intervention (INT, n = 33) and control (CON, n = 31) groups. Resting BP and BP at each stage during and after a graded maximal bicycle ergometer test were measured before and after the intervention. SB, standing, moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) were measured in six-second intervals at baseline and during the whole six-month intervention using hip-worn accelerometers. The analyses were adjusted for BP medication status. The intervention resulted in a 40 min/day reduction in SB and concomitant 20 min/day increase in MVPA. Resting systolic BP was lower in the CON group before and after the intervention. No group x time interactions were observed in resting BP or BP during exercise at submaximal or maximal intensities, or during recovery. The changes in LPA and MVPA were inversely correlated with the changes in BP during light-to-moderate intensity exercise. An intervention that resulted in a 40 min/day reduction in SB for six months was not sufficient at influencing BP at rest, during or after exercise in adults with metabolic syndrome. However, successfully increasing LPA or MVPA might lower BP during light-to-moderate-intensity activities.
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Affiliation(s)
- Jooa Norha
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
| | - Tanja Sjöros
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Taru Garthwaite
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Saara Laine
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Maria Saarenhovi
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Petri Kallio
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre and Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Kirsi Laitinen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Noora Houttu
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juhani Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Kari K Kalliokoski
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka H A Heinonen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
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Vasankari S, Mahlamäki V, Hartikainen J, Vasankari V, Tokola K, Vähä-Ypyä H, Anttila V, Husu P, Sievänen H, Vasankari T, Halonen J. Elective Cardiac Procedure Patients Have Low Preoperative Cardiorespiratory Fitness. Int J Sports Med 2024; 45:63-70. [PMID: 37640058 PMCID: PMC10776211 DOI: 10.1055/a-2161-4137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 08/28/2023] [Indexed: 08/31/2023]
Abstract
Preoperative cardiorespiratory fitness may influence the recovery after cardiac procedure. The aim of this study was to investigate the cardiorespiratory fitness of patients scheduled for elective cardiac procedures, using a six-minute walk test, and compare the results with a population-based sample of Finnish adults. Patients (n=234) awaiting percutaneous coronary intervention or coronary angiography, coronary artery bypass grafting, aortic valve replacement or mitral valve surgery performed the six-minute walk test. VO2max was calculated based on the walk test. The patients were compared to a population-based sample of 60-69-year-old Finnish adults from the FinFit2017 study. The mean six-minute walk test distances (meters) and VO2max (ml/kg/min) of the patient groups were: 452±73 and 24.3±6.9 (coronary artery bypass grafting), 499±84 and 27.6±7.2 (aortic valve replacement), 496±85 and 27.4±7.3 (mitral valve surgery), and 519±90 and 27.3±6.9 (percutaneous coronary intervention or coronary angiography). The population-based sample had significantly greater walk test distance (623±81) and VO2max (31.7±6.1) than the four patient groups (all p-values<0.001). All patient groups had lower cardiorespiratory fitness than the reference population of 60-69-year-old Finnish adults. Particularly the coronary artery bypass grafting group had a low cardiorespiratory fitness, and therefore might be prone to complications and challenging rehabilitation after the operation.
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Affiliation(s)
- Sini Vasankari
- Clinical Medicine, University of Turku Faculty of Medicine, Turku,
Finland
| | - Visa Mahlamäki
- Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - Juha Hartikainen
- Heart Center, Kuopio University Hospital, Kuopio, Finland
- Clinical Medicine, University of Eastern Finland – Kuopio
Campus, Kuopio, Finland
| | - Ville Vasankari
- Neurosurgery, Helsinki University Central Hospital, Helsinki,
Finland
| | - Kari Tokola
- UKK Institute, UKK Institute, Tampere, Finland
| | | | - Vesa Anttila
- Heart Center, TYKS Turku University Hospital, Turku,
Finland
| | | | | | - Tommi Vasankari
- UKK Institute, UKK Institute, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere,
Finland
| | - Jari Halonen
- Heart Center, Kuopio University Hospital, Kuopio, Finland
- Clinical Medicine, University of Eastern Finland – Kuopio
Campus, Kuopio, Finland
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3
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Aaltonen S, Urjansson M, Varjonen A, Vähä-Ypyä H, Iso-Markku P, Kaartinen S, Vasankari T, Kujala UM, Silventoinen K, Kaprio J, Vuoksimaa E. Accelerometer-measured physical activity and sedentary behavior in nonagenarians: Associations with self-reported physical activity, anthropometric, sociodemographic, health and cognitive characteristics. PLoS One 2023; 18:e0294817. [PMID: 38055660 DOI: 10.1371/journal.pone.0294817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Research on device-based physical activity in the oldest-old adults is scarce. We examined accelerometer-measured physical activity and sedentary behavior in nonagenarians. We also investigated how the accelerometer characteristics associate with nonagenarians' self-reported physical activity, anthropometric, sociodemographic, health and cognitive characteristics. METHODS Nonagenarians from a population-based cohort study (N = 38, mean age 91.2) used accelerometers during the waking hours for seven days. They also participated in a health survey and cognitive telephone interview. The Wald test and Pearson and polyserial correlations were used to analyze the data. RESULTS The participants' average day consisted of 2931 steps, 11 minutes of moderate-to-vigorous physical activity and 13.6 hours of sedentary time. Physical activity bouts less than 3 minutes per day and sedentary time bouts of 20-60 minutes per day were the most common. No sex differences were found. Many accelerometer-measured and self-reported physical activity characteristics correlated positively (correlations ≥0.34, p-values <0.05). The low levels of many accelerometer-measured physical activity characteristics associated with low education (correlations ≥0.25, p-values <0.05), dizziness (correlations ≤-0.42, p-values <0.01) and fear of falling (correlations ≤-0.45, p-values <0.01). Fear of falling was also associated with accelerometer-measured sedentary behavior characteristics (correlations -0.42 or ≥0.43). CONCLUSIONS Nonagenarians were mostly sedentary and low in physical activity, but individual variability existed. Accelerometer-measured and self-reported physical activity had a good consistency. Education, dizziness and fear of falling were consistently related to accelerometer-measured characteristics in nonagenarians.
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Affiliation(s)
- Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Mia Urjansson
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Anni Varjonen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Paula Iso-Markku
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
- HUS Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Physical Medicine and Rehabilitation, HUS Hyvinkää Hospital, Hyvinkää, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
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Wu KA, Kunte S, Rajkumar S, Venkatraman V, Kim G, Kaplan S, Anwar-Hashmi SO, Doberne J, Nguyen TC, Lad SP. Digital Health for Patients Undergoing Cardiac Surgery: A Systematic Review. Healthcare (Basel) 2023; 11:2411. [PMID: 37685445 PMCID: PMC10487407 DOI: 10.3390/healthcare11172411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Digital health interventions have shown promise in improving patient outcomes and experiences in various healthcare settings. However, their effectiveness in the context of cardiac surgery remains uncertain. This systematic review aims to evaluate the existing evidence on the use of digital health interventions for patients undergoing cardiac surgery. A comprehensive search of PubMed MEDLINE, Elsevier EMBASE, Elsevier Scopus databases, and ClinicalTrials.gov was conducted to identify relevant studies published up to the present. Studies that examined the effects of digital health interventions, including mobile applications and web-based interventions, on perioperative care and patient outcomes in cardiac surgery were included. The data were extracted and synthesized to provide a comprehensive overview of the findings. The search yielded 15 studies composed of 4041 patients, analyzing the feasibility and implementation of mobile or internet applications for patients undergoing cardiac surgery. The studies included the use of mobile applications (ManageMySurgery, SeamlessMD, mHeart, Telediaglog, ExSed, Soulage Tavie, Heart Health application, and Mayo Clinic Health Connection) and web-based interventions (Heartnet and Active Heart). The findings indicated that these digital health interventions were associated with improved patient engagement, satisfaction, and reduced healthcare utilization. Patients reported finding the interventions helpful in their recovery process, and there was evidence of enhanced symptom monitoring and timely intervention. The completion rates of modules varied depending on the phase of care, with higher engagement observed during the acute phase. Interest in using digital health applications was expressed by patients, regardless of age, gender, or complexity of the cardiac defect. The results demonstrated that web-based interventions resulted in improvements in mental health, quality of life, and eHealth literacy. This systematic review highlights the potential benefits of digital health interventions in the context of cardiac surgery. Further research, including randomized controlled trials, is needed to establish the effectiveness, feasibility, and generalizability of digital health interventions in cardiac surgery.
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Affiliation(s)
- Kevin A. Wu
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Sameer Kunte
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Shashank Rajkumar
- Department of Neurosurgery, Yale University, New Haven, CT 06510, USA
| | - Vishal Venkatraman
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Grace Kim
- Department of Surgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Samantha Kaplan
- Medical Center Library & Archives, Duke University School of Medicine, Durham, NC 27710, USA
| | - Syed Omar Anwar-Hashmi
- Department of Surgery, Loyola University Chicago’s Stritch School of Medicine, Maywood, IL 60153, USA
| | - Julie Doberne
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27707, USA
| | - Tom C. Nguyen
- Division of Adult Cardiothoracic Surgery, Department of Surgery, UCSF Health, San Francisco, CA 94143, USA
| | - Shivanand P. Lad
- Department of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA
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Moulton C, Grazioli E, Antinozzi C, Fantini C, Cerulli C, Murri A, Duranti G, Ceci R, Vulpiani MC, Pellegrini P, Nusca SM, Cavaliere F, Fabbri S, Sgrò P, Di Luigi L, Caporossi D, Parisi A, Dimauro I. Online Home-Based Physical Activity Counteracts Changes of Redox-Status Biomarkers and Fitness Profiles during Treatment Programs in Postsurgery Female Breast Cancer Patients. Antioxidants (Basel) 2023; 12:antiox12051138. [PMID: 37238004 DOI: 10.3390/antiox12051138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/06/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Breast cancer (BC) is one of the most commonly diagnosed types of cancer in women. Oxidative stress may contribute to cancer etiology through several mechanisms. A large body of evidence indicates that physical activity (PA) has positive effects on different aspects of BC evolution, including mitigation of negative effects induced by medical treatment. With the aim to verify the capacity of PA to counteract negative effects of BC treatment on systemic redox homeostasis in postsurgery female BC patients, we have examined the modulation of circulating levels of oxidative stress and inflammation markers. Moreover, we evaluated the impacts on physical fitness and mental well-being by measuring functional parameters, body mass index, body composition, health-related quality of life (QoL), and fatigue. Our investigation revealed that PA was effective in maintaining plasma levels of superoxide dismutase (SOD) activity and tGSH, as well as peripheral blood mononuclear cells' (PBMCs) mRNA levels of SOD1 and heat-shock protein 27. Moreover, we found a significant decrease in plasma interleukin-6 (≈0.57 ± 0.23-fold change, p < 0.05) and increases in both interleukin-10 (≈1.15 ± 0.35-fold change, p < 0.05) and PBMCs' mRNA level of SOD2 (≈1.87 ± 0.36-fold change, p < 0.05). Finally, PA improves functional parameters (6 min walking test, ≈+6.50%, p < 0.01; Borg, ≈-58.18%, p < 0.01; sit-and-reach, ≈+250.00%, p < 0.01; scratch right, ≈-24.12%, and left, ≈-18.81%, p < 0.01) and body composition (free fat mass, ≈+2.80%, p < 0.05; fat mass, ≈-6.93%, p < 0.05) as well as the QoL (physical function, ≈+5.78%, p < 0.05) and fatigue (cognitive fatigue, ≈-60%, p < 0.05) parameters. These results suggest that a specific PA program not only is effective in improving functional and anthropometric parameters but may also activate cellular responses through a multitude of actions in postsurgery BC patients undergoing adjuvant therapy. These may include modulation of gene expression and protein activity and impacting several signaling pathways/biological activities involved in tumor-cell growth; metastasis; and inflammation, as well as moderating distress symptoms known to negatively affect QoL.
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Affiliation(s)
- Chantalle Moulton
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Cristina Antinozzi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Cristina Fantini
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Claudia Cerulli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Arianna Murri
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Guglielmo Duranti
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Roberta Ceci
- Unit of Biochemistry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Maria Chiara Vulpiani
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Patrizia Pellegrini
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Sveva Maria Nusca
- Department of Medical-Surgical and Translational Medicine Sciences, La Sapienza University of Rome, 00185 Rome, Italy
| | - Francesco Cavaliere
- Unit of Breast Surgery, Center of Breast of Belcolle Hospital, 01100 Viterbo, Italy
| | - Simona Fabbri
- Unit of Breast Surgery, Center of Breast of Belcolle Hospital, 01100 Viterbo, Italy
| | - Paolo Sgrò
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Luigi Di Luigi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy
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Vasankari S, Hartikainen J, Vasankari V, Anttila V, Tokola K, Vähä-Ypyä H, Husu P, Sievänen H, Vasankari T, Halonen J. Objectively measured preoperative physical activity and sedentary behaviour among Finnish patients scheduled for elective cardiac procedures: baseline results from randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:130. [PMID: 35842711 PMCID: PMC9287962 DOI: 10.1186/s13102-022-00522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 06/24/2022] [Indexed: 12/02/2022]
Abstract
Background We investigated preoperative physical activity (PA) and sedentary behaviour (SB) in patients scheduled for elective cardiac procedures and compared them with population-based sample of Finnish adults. Methods Cardiac patients (n = 139) undergoing cardiac operations carried a triaxial accelerometer for seven days during the month before the procedure. Patients were categorised into four groups according to the procedure: percutaneous coronary intervention or coronary angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer data was analyzed with dedicated algorithms to determine metabolic equivalents (METs, 3.5 mL/kg/min of oxygen consumption) of PA. The intensity of PA was divided into two categories: light (LPA, 1.5–2.9 METs) and moderate-to-vigorous (MVPA, ≥ 3.0 METs), while SB represented intensity < 1.5 MET without movements. SB and PA were described as daily means and accumulation from different bout lengths. Daily standing, steps and mean and peak MET-values were calculated. The results were compared between the patient groups and against the reference group from a population-based study FinFit2017. Results Cardiac patients had fewer daily steps than the FinFit population (p = 0.01), and less SB accumulating from < 20 min bouts (p = 0.002) but more from 20 to 60 min bouts (p = 0.002). Particularly, CABG group had less daily MVPA (p = 0.002) and MVPA accumulating from > 10 min bouts (p < 0.001) than the FinFit population. Conclusions We found large differences in PA and SB between the patient groups and the FitFit population, CABG group having the worst activity profile. Also, the variation within the patient groups was wide, which should be considered to individualise the rehabilitation programs postoperatively. Trial registration clinicaltrials.gov (NCT03470246). Registered 19 March 2018, https://clinicaltrials.gov/ct2/show/NCT03470246.
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Affiliation(s)
- Sini Vasankari
- Derpartment of Clinical Medicine, University of Turku, Turku, Finland.
| | | | - Ville Vasankari
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Vesa Anttila
- Heart Center, Turku University Hospital, Turku, Finland
| | - Kari Tokola
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pauliina Husu
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland.,The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Halonen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
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Effects of reduced sedentary time on cardiometabolic health in adults with metabolic syndrome: A three-month randomized controlled trial. J Sci Med Sport 2022; 25:579-585. [DOI: 10.1016/j.jsams.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 12/18/2022]
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8
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Jafri SH, Hushcha P, Dorbala P, Bousquet G, Lutfy C, Klein J, Mellett L, Sonis L, Polk D, Skali H. Physical and Psychological Well-being Effects of Cardiac Rehabilitation on Patients Following Mitral Valve and Aortic Valve Procedures. J Cardiopulm Rehabil Prev 2022; 42:90-96. [PMID: 34793360 DOI: 10.1097/hcr.0000000000000609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients participating in cardiac rehabilitation (CR) following an aortic valve procedure demonstrate improvements in physical capacity and psychological well-being. The primary aim of this study is to evaluate baseline exercise capacity and psychological well-being for mitral valve patients participating in CR and to compare physical and psychological outcomes between mitral valve and aortic valve patients. METHODS The primary endpoint was improvement in 6-min walk test (6MWT) distance. Secondary endpoints included change in exercise min/wk, depression scores (Patient Health Questionnaire-9 [PHQ-9]), anxiety scores (General Anxiety Disorder-7 [GAD-7]), and overall quality of life (Dartmouth Cooperative Functional Assessment [COOP]) scores. RESULTS Between January 2015 and December 2019, 94 patients who underwent an aortic valve procedure and 46 patients who underwent mitral valve procedures were enrolled prospectively in CR. At the completion of their CR program, patients had similar improvements in their 6MWT (mitral valve: 173 ft [125, 238] vs aortic valve 197 ft [121, 295], P = .42); exercise min/wk (mitral valve: 90 min [45, 175] vs aortic valve: 80 min [40, 130], P = .44). Changes in anxiety (GAD-7), depression (PHQ-9), and COOP scores were smaller but similar between the two groups. CONCLUSIONS CR participation resulted in similar improvements in physical activity between patients undergoing mitral valve and aortic valve procedures. Psychological well-being and quality of life scores improved minimally and similarly between the two groups.
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Affiliation(s)
- S Hammad Jafri
- Master of Medical Sciences in Clinical Investigation Program, Harvard Medical School, Boston, Massachusetts (Dr Jafri); Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (Drs Jafri, Hushcha, Polk, and Skali and Mr Dorbala); and Cardiac Rehabilitation Program, Brigham and Women's Hospital, Foxborough, Massachusetts (Mss Bousquet, Lutfy, Klein, and Sonis and Drs Mellett, Polk, and Skali)
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9
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Chaudhari S, Ghanvatkar S, Kankanhalli A. Personalization of Intervention Timing for Physical Activity: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e31327. [PMID: 35225811 PMCID: PMC8922140 DOI: 10.2196/31327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/21/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background The use of sensors in smartphones, smartwatches, and wearable devices has facilitated the personalization of interventions to increase users’ physical activity (PA). Recent research has focused on evaluating the effects of personalized interventions in improving PA among users. However, it is critical to deliver the intervention at an appropriate time to each user to increase the likelihood of adoption of the intervention. Earlier review studies have not focused on the personalization of intervention timing for increasing PA. Objective This review aims to examine studies of information technology–based PA interventions with personalized intervention timing (PIT); identify inputs (eg, user location) used by the system for generating the PIT, the techniques and methods used for generating the PIT, the content of the PA intervention, and delivery mode of the intervention; and identify gaps in existing literature and suggest future research directions. Methods A scoping review was undertaken using PsycINFO, PubMed, Scopus, and Web of Science databases based on a structured search query. The main inclusion criteria were as follows: the study aimed to promote PA, included some form of PIT, and used some form of information technology for delivery of the intervention to the user. If deemed relevant, articles were included in this review after removing duplicates and examining the title, abstract, and full text of the shortlisted articles. Results The literature search resulted in 18 eligible studies. In this review, 72% (13/18) of the studies focused on increasing PA as the primary objective, whereas it was the secondary focus in the remaining studies. The inputs used to generate the PIT were categorized as user preference, activity level, schedule, location, and predicted patterns. On the basis of the intervention technique, studies were classified as manual, semiautomated, or automated. Of these, the automated interventions were either knowledge based (based on rules or guidelines) or data driven. Of the 18 studies, only 6 (33%) evaluated the effectiveness of the intervention and reported positive outcomes. Conclusions This work reviewed studies on PIT for PA interventions and identified several aspects of the interventions, that is, inputs, techniques, contents, and delivery mode. The reviewed studies evaluated PIT in conjunction with other personalization approaches such as activity recommendation, with no study evaluating the effectiveness of PIT alone. On the basis of the findings, several important directions for future research are also highlighted in this review.
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Affiliation(s)
- Saurabh Chaudhari
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Suparna Ghanvatkar
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
| | - Atreyi Kankanhalli
- Department of Information Systems and Analytics, School of Computing, National University of Singapore, Singapore, Singapore
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Pietiläinen E, Kyröläinen H, Vasankari T, Santtila M, Luukkaala T, Parkkola K. A Randomized Controlled Trial Protocol for Using an Accelerometer-Smartphone Application Intervention to Increase Physical Activity and Improve Health among Employees in a Military Workplace. Methods Protoc 2021; 5:mps5010001. [PMID: 35076553 PMCID: PMC8788450 DOI: 10.3390/mps5010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/12/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Physical activity is beneficial for improving health and reducing sick leave absences. This article describes a protocol for an intervention using an interactive accelerometer smartphone application, telephone counselling, and physical activity recordings to increase the physical activity of workers in the military and improve their health. Under the protocol, employees from six military brigades in Finland will be randomly assigned to intervention and control groups. The intervention group’s participants will use accelerometers to measure their daily physical activities and their quality of sleep for six months. They will receive feedback based on these measurements via a smartphone application. The intervention group’s participants will be encouraged to exercise for two hours per week during working hours, and to participate in telephone counselling. The control group’s participants will continue with their normal exercise routines, without the accelerometer or feedback. The participants of both groups will be measured at the baseline, after the intervention period, and six months after the end of the intervention. The measurements will include accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and questionnaires on sociodemographic factors, physical activities, and health. The primary outcomes will indicate changes in physical activity, physical fitness, and sick leave absences. The findings will help to develop a straightforward and cost-effective model for supporting the health and working capabilities of employees in the military and other workplaces.
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Affiliation(s)
- Emilia Pietiläinen
- Faculty of Medicine and Health Technology, Kauppi Campus, Tampere University, 33520 Tampere, Finland;
- Special Expert Unit, Centre for Military Medicine, P.O. Box 50, 00301 Helsinki, Finland
- Correspondence:
| | - Heikki Kyröläinen
- Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (VIV), 40014 Jyvaskyla, Finland;
- Department of Military Pedagogy and Leadership, National Defence University, P.O. Box 7, 00861 Helsinki, Finland; (M.S.); (K.P.)
| | - Tommi Vasankari
- Faculty of Medicine and Health Technology, Kauppi Campus, Tampere University, 33520 Tampere, Finland;
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Matti Santtila
- Department of Military Pedagogy and Leadership, National Defence University, P.O. Box 7, 00861 Helsinki, Finland; (M.S.); (K.P.)
| | - Tiina Luukkaala
- Research, Development and Innovation Center, Tampere University Hospital, 33520 Tampere, Finland;
- Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
| | - Kai Parkkola
- Department of Military Pedagogy and Leadership, National Defence University, P.O. Box 7, 00861 Helsinki, Finland; (M.S.); (K.P.)
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland
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11
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Abraham LN, Sibilitz KL, Berg SK, Tang LH, Risom SS, Lindschou J, Taylor RS, Borregaard B, Zwisler AD. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev 2021; 5:CD010876. [PMID: 33962483 PMCID: PMC8105032 DOI: 10.1002/14651858.cd010876.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The impact of exercise-based cardiac rehabilitation (CR) following heart valve surgery is uncertain. We conducted an update of this systematic review and a meta-analysis to assess randomised controlled trial evidence for the use of exercise-based CR following heart valve surgery. OBJECTIVES To assess the benefits and harms of exercise-based CR compared with no exercise training in adults following heart valve surgery or repair, including both percutaneous and surgical procedures. We considered CR programmes consisting of exercise training with or without another intervention (such as an intervention with a psycho-educational component). SEARCH METHODS We searched the Cochrane Central Register of Clinical Trials (CENTRAL), in the Cochrane Library; MEDLINE (Ovid); Embase (Ovid); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO); PsycINFO (Ovid); Latin American Caribbean Health Sciences Literature (LILACS; Bireme); and Conference Proceedings Citation Index-Science (CPCI-S) on the Web of Science (Clarivate Analytics) on 10 January 2020. We searched for ongoing trials from ClinicalTrials.gov, Clinical-trials.com, and the World Health Organization International Clinical Trials Registry Platform on 15 May 2020. SELECTION CRITERIA We included randomised controlled trials that compared exercise-based CR interventions with no exercise training. Trial participants comprised adults aged 18 years or older who had undergone heart valve surgery for heart valve disease (from any cause) and had received heart valve replacement or heart valve repair. Both percutaneous and surgical procedures were included. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. We assessed the risk of systematic errors ('bias') by evaluating risk domains using the 'Risk of bias' (RoB2) tool. We assessed clinical and statistical heterogeneity. We performed meta-analyses using both fixed-effect and random-effects models. We used the GRADE approach to assess the quality of evidence for primary outcomes (all-cause mortality, all-cause hospitalisation, and health-related quality of life). MAIN RESULTS We included six trials with a total of 364 participants who have had open or percutaneous heart valve surgery. For this updated review, we identified four additional trials (216 participants). One trial had an overall low risk of bias, and we classified the remaining five trials as having some concerns. Follow-up ranged across included trials from 3 to 24 months. Based on data at longest follow-up, a total of nine participants died: 4 CR versus 5 control (relative risk (RR) 0.83, 95% confidence interval (CI) 0.26 to 2.68; 2 trials, 131 participants; GRADE quality of evidence very low). No trials reported on cardiovascular mortality. One trial reported one cardiac-related hospitalisation in the CR group and none in the control group (RR 2.72, 95% CI 0.11 to 65.56; 1 trial, 122 participants; GRADE quality of evidence very low). We are uncertain about health-related quality of life at completion of the intervention in CR compared to control (Short Form (SF)-12/36 mental component: mean difference (MD) 1.28, 95% CI -1.60 to 4.16; 2 trials, 150 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD 2.99, 95% CI -5.24 to 11.21; 2 trials, 150 participants; GRADE quality of evidence very low), or at longest follow-up (SF-12/36 mental component: MD -1.45, 95% CI -4.70 to 1.80; 2 trials, 139 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD -0.87, 95% CI -3.57 to 1.83; 2 trials, 139 participants; GRADE quality of evidence very low). AUTHORS' CONCLUSIONS: Due to lack of evidence and the very low quality of available evidence, this updated review is uncertain about the impact of exercise-CR in this population in terms of mortality, hospitalisation, and health-related quality of life. High-quality (low risk of bias) evidence on the impact of CR is needed to inform clinical guidelines and routine practice.
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Affiliation(s)
- Lizette N Abraham
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Kirstine L Sibilitz
- Department of Cardiology, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Selina K Berg
- Department of Cardiology, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars H Tang
- The research unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Signe S Risom
- Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- The Heart Centre, University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute for Nursing and Nutrition, University College Copenhagen, Copenhagen, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - Britt Borregaard
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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12
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Vasankari V, Halonen J, Vasankari T, Anttila V, Airaksinen J, Sievänen H, Hartikainen J. Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review. Am J Prev Cardiol 2021; 5:100146. [PMID: 34327489 PMCID: PMC8315618 DOI: 10.1016/j.ajpc.2021.100146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/05/2020] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
Comprehensive management of coronary artery disease (CAD) includes physical exercise as a part of daily lifestyle therapy. Still CAD patients generally have low physical activity (PA) and high sedentary behaviour (SB). This review summarizes the effect of exercise training and habitual PA and SB on physical fitness and quality of life (QoL) as well as on rehospitalizations and mortality in patients with stable CAD, recent acute coronary syndrome (ACS) or recent revascularization. A literature review of the influence of exercise, and PA and SB profiles in secondary prevention of CAD was performed using PubMed. All articles published between January 2001 and April 2019, meeting the inclusion criteria were considered. A total of 25 cross-sectional or prospective studies or randomized controlled trials (RCT) were included to this review. Exercise training was found to improve maximal oxygen consumption, QoL, and to reduce rehospitalizations and mortality among patients with established CAD. Remote PA interventions have not been as effective as the supervised exercise sessions in reducing the clinical endpoints. High SB, especially when combined to low PA, is associated with poor cardiorespiratory fitness and worse long-term prognosis among patients with ACS. In conclusion, exercise training and high PA are beneficial for patients with stable CAD, recent ACS or recent revascularization. High SB is associated with poor cardiopulmonary fitness and increased mortality in ACS patients. Novel tools using online applications and smart devices are promising means to offer remote guidance for PA among patients unable to participate in regular exercise sessions.
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Affiliation(s)
- Ville Vasankari
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
- Corresponding author. Heart Center, Kuopio University Hospital, PO box 100, 70029, KYS, Finland.
| | - Jari Halonen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Vesa Anttila
- Heart Center, Turku University Hospital (TUH), Turku, Finland
| | | | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Juha Hartikainen
- Heart Center, Kuopio University Hospital (KUH), Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland (UEF), Finland
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13
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New Strategy of Home-Based Exercise during Pandemic COVID-19 in Breast Cancer Patients: A Case Study. SUSTAINABILITY 2020. [DOI: 10.3390/su12176940] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The COVID-19 pandemic has posed several challenges for the oncology health care system. The need to improve patients’ Quality of Life (QoL) through exercise, which is related to survival and healing, has increased, especially during lockdowns. Technologies are often used to help with patient care as well as to monitor exercise training. This case study, developed during the pandemic period, aims to evaluate the effectiveness of a proposed home-based combined training (CT) regimen, supervised through online lessons, in increasing QoL and fatigue in breast cancer patients undergoing adjuvant therapy. Additionally, we evaluated the effect of exercise on psychological and functional parameters. Methods: Two breast cancer (BC) survivors were required to participate in 2 h/week of supervised and home-based CT for 16 weeks. Results: Improvements were found in the emotional function of QoL (10% in patient A; 70% in patient B) and in all variables of fatigue (physical fatigue 66% in patient A; 33% in patient B). Conclusion: The findings from this study revealed positive effects of CT on QoL and fatigue perception in BC women undergoing therapy. Both patients attended all training sessions with no adverse events, showing the sustainability of this training as an alternative and affordable method that is capable of improving patients’ wellbeing.
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