cardiac rehabilitation

One of the known causes of delirium is hypoxia. Phase one cardiac rehabilitation program can improve pulmonary aerobic capacity and subsequently increase brain tissue perfusion. As a result, due to its hypoxia-reducing effects, it may be able to reduce delirium levels. The aim of this study was to determine the effect of phase one cardiac rehabilitation on the delirium level of patients after coronary artery bypass graft surgery.

This clinical trial study was performed on 60 patients in the cardiac intensive care unit of Imam Reza Hospital in Mashhad during 1398. After randomly assigning patients to two intervention and control groups, in patients in the intervention group, phase one of cardiac rehabilitation was performed. Patients in the control group received routine ward program. Delirium was measured by Nicham questionnaire in seven rounds, SPSS software version 20 was performed for analyzing data. Data were analyzed using Chi-square, independent t-test, Mann-Whitney and analysis of variance statistical tests. Pvalues less than 0.05 was considered as statistically significant.

Two groups were homogeneous in terms of contextual variables. Results of analysis variance with repeated measurement test showed a significant difference between two groups in terms of delirium. (P= 0.016) The difference between two groups on the first to fourth days was significant and daily delirium levels of two groups on different days were significantly different from each other.(P= 0/001). p

This study showed performing phase one cardiac rehabilitation effectively reduces delirium. Therefore, phase one rehabilitation can be used as an affordable and low-cost approach to prevent and reduce delirium.

Coronary artery bypass graft (CABG) is a common therapeutic intervention that is performed in patients suffering from coronary heart diseases. The aim of this study was to determine the effect of selected combined rehabilitation exercises on the expression of thrombospondin-1 (TSP-1) and interleukin-1 beta (IL-1β) genes in patients after coronary artery bypass surgery.

In this semi-experimental study, 20 male patients from Afshar Hospital (Yazd city) after coronary artery surgery were purposefully selected and available and randomly divided into two groups of combined exercise and control. Combined exercise program group performed aerobic (15-20 minutes with an intensity of 50-60% of the maximum heart rate) and resistance exercise (10-20 minutes, including three movements of the upper limbs and two movements of the lower limbs, each movement includes three sets and each set with 10 repetitions and 30 to 60 percent of a maximum repetition) for 10 weeks (30 sessions) and three sessions per week. Gene expression was measured by Real Time PCR method.. The data were analyzed using the Paired t-test and One-Way ANOVA at the P<0.05.

After the intervention period, a significant decrease in the expression of IL-1β was observed, but no significant difference was observed in the expression of TSP-1.

Combined exercises as a non-pharmacological rehabilitation intervention can be useful in patients who have undergone CABG by reducing systemic inflammation.

Exercise-based cardiac rehabilitation(CR) programs increase physiological function. However, it’s not yet clear which feature of exercise is most effective in improving important physiological performance indicators in heart patients. Therefore, the aim of this study was to compare the effects of high-intensity interval training(HIT) and moderate-intensity continuous training(MCT) on metabolic equivalent of tasks(METs), submaximal myocardial oxygen consumption(MVO2submax), and heart rate recovery(HRR) of heart patients after coronary artery bypass graft(CABG) surgery.

Twenty-four post-CABG patients (15 males and 9 females) with a mean age of 60.75±3.16 years and a mean body mass index (BMI) of 28.40±1.09 kg/m2 were randomly divided into three groups of HIT, MCT and control group (CG). The training groups (HIT and MCT) trained for eight-weeks, three-sessions per week, and 45minutes per session. The research variables (METs, MVO2submax and HRR) were measured and compared in two stages before and after eight-weeks of CR programs.

After eight-weeks of CR programs, patients in both training groups showed a significant improvement in METs, MVO2submax and HRR (P<0.05), and the HIT group showed significantly greater improvement in METs (P=0.001) and HRR (P=0.001) compared to the MCT group, as well the MCT group showed a significantly more improvement in MVO2submax (P=0.001) than the HIT group. Also, no cardiovascular adverse events related to HIT or MCT occurred during the implementation of the study.

According to the results of the present study, HIT seems to be more effective than MCT in improving METs and HRR of post-CABG patients, and is safe as well.

The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.

Methods & Materials: 

In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.

Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).

The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.

Atherosclerosis of coronary arteries is the most common heart disease and indication of coronary artery bypass graft(CABG). After CABG, patients need proper self-care and lifestyle changes to increase their quality of life. The present research aimed to the conceptual design of self-care Android software, focusing on the third phase of cardiac rehabilitation.

This descriptive research has been carried out in two main phases and a total of six steps in order to assess the informational and functional needs of self-care software and design its conceptual model. After searching in reliable scientific sources and guidelines and checking the available Persian software, through the content validity index questionnaire of Lavshe, Welts and Bassel, 23 people from the medical staff with a history of caring for heart patients participated in the step of determining the requirements and the results were analyzed using SPSS Software. Descriptive analysis was done. Finally, the software model was prepared using integrated modeling language and th mind map was drawn.

Sixty two items were identified in 6 general categories (personal information, medical records, interventions, personal health record, essential information, emergency communication). In the phase of determining the requirements by the experts, 52 items were accepted and 10 items were included in the conceptual model of the application program with minor changes and revisions.

Using mobile health in self-care and cardiac rehabilitation will be a suitable solution in order to increase treatment, follow-up and optimal continuation of self-care in patients. By having different functions, this tool can facilitate lifestyle change and help patients in secondary prevention of cardiovascular events and improve their health.

Nowadays, due to technological advances and sedentary or inactive lifestyle, non-communicable diseases have caused many health problems such as cardiovascular diseases. This study aims to examine the effect of two methods of aerobic training and concurrent training for cardiac rehabilitation on selected hemodynamic and biomechanical factors in older men with coronary artery disease.

This is a quasi-experimental causal-comparative study using the pre-test/post-test design. Participants were 24 older men with coronary artery disease, randomly divided into three groups of aerobic training, concurrent  training, and control. They first underwent cardiac assessment using the echo Doppler device as well as sports performance test. Then, they were referred to the biomechanics laboratory of the Physical Medicine Center to start cardiac rehabilitation training. After 8 weeks of training, they underwent post-test assessments. The mean and standard deviation were used to describe the data. The Shapiro-Wilk test was used to check the normality of data distribution and the Levene’s test was used to determine the homogeneity of variances. The paired t-test was used to assess between-group differences and independent t-test was used for assessing differences between pretest and post-test scores of the groups. The significance level was set at 0.05.

Significant improvement was reported in functional capacity, left ventricular ejection fraction (LVEF), and resting heart rate after both aerobic and concurrent training methods (P<0.05), but no significant difference in diastolic blood pressure and systolic blood pressure were observed (P>0.05). The improvements were more in the concurrent  training group.

Both cardiac rehabilitation methods (aerobic and concurrent  training) can improve functional capacity, LVEF, and resting heart rate of older mean with coronary artery disease, where concurrent  training is more effective.

Cardiovascular disease especially atherosclerosis is one of the leading causes of death in the world. One of the important mechanisms for the prevention and treatment of this disease is the reverse transfer of cholesterol. The purpose of this study is to investigate the effect of a cardiac rehabilitation course on some key factors in reverse cholesterol transfer including expression of (Liver X receptor gene; LXR) lipid profile and (Tumor necrosis factor; TNFα) serum level in coronary bypass patients.Twenty-four male subjects who underwent bypass surgery were divided into two equal groups of central stability training group and mobilization voluntarily groups. The experimental group performed aerobic resistance training for eight weeks (3 sessions per week) and the control group did not. Blood samples including TNFα factors, lipids, cholesterol and LXR gene were taken 48 hours before the start of the first training session and also 48 hours after the last training session while all subjects were fasting a blood sample was taken to evaluate the desired variables. LXR gene was measured by Real-Time-PCR. Independent and paired t-test and Shapiro-Wilk tests were used to analyze the data at a significant level of 0.05.Eight weeks of cardiac rehabilitation program led to an increase in HDL, a decrease in LDL cholesterol and αTNF, and an increase in the expression of the LXR gene in the experimental group compared to the control group.Cardiac rehabilitation by improving the lipid profile and increasing the expression of LXR gene has a great effect on increasing cholesterol transfer process and reducing inflammatory factors including TNFα. which has a positive effect on the prevention of atherosclerosis and ischemia.

Myocardial infarction is one of the most important ischemic cardiopathies (1). Despite progressive improvement in medical therapy and standard care, Exercise-based rehabilitation programs have been shown to improve the exercise capacity of patients with myocardial infarction through a multifactorial effect (2). In this context, high-intensity interval exercise is a growing field of research (3). Many studies have shown that High-intensity interval training (HIIT) has more protective effects on myocardial tissue than aerobic exercise (6). Therefore, this study aimed to investigate the effect of a period of low-volume, high-intensity interval aerobic exercise on heart structural and functional indicators in patients with myocardial infarction.

In this semi-experimental study with pretest–A post testdesign,20 patients with documented MI (without regular exercise history) volunteered to participate in the research randomly in two control groups (n=10) and exercise group (n=10).The subjects trained for 3 d/week for 12 weeks (one session on a treadmill and another session on an exercise bike), under the supervision of an expert physician and exercise physiologistspecialists. We asked the control group patients not to engage in any other leisure exercise during the study.The rationale formixing bike and treadmill was to avoid the osteoarticular effects of two treadmill days by considering the HIIT program. We calculated the optimizedexercise zone using the Karvonen formula, which calculates the exercise heart rate as a percentage of the heart rate reserve, added to the resting heart rate (11).The training intensity was adjusted by constantly changing the treadmill's speed and incline or the bike's power and speed to ensure that we performed all training sessions with the target heart rate (HR)(9). Training intensity was controlled by monitoring participants’ heart rate (HR) using a Polar HR monitor (Polar Electro OY, Finland). Heart rate, blood pressure, and perceived exertion were evaluated using the Borg Scale (6 to 20 points) before, during, and after each session (12). We measured the structural and functional indices of the heart using an echocardiography device in baseline conditions and after 12 weeks of training. We performed all examinations at rest in the left lateral decubitus position according to the guidelines of the American Society of Echocardiography (16). We analyzed data using paired t-test and independent t-test.All statistical tests were performed with SPSS software version 28.0 (IBM SPSS, Inc, Armonk, NY). Values of p <0.05 were considered statistically significant.

End-diastolic diameter, end-diastolic volume, injection fraction, left ventricular stroke volume, and peak oxygen consumption of the training group wassignificantly increased compared to the baseline conditions and compared to the control group (P<0.05) and Resting heart rate, systolic and diastolic blood pressure showed a significant decrease (P<0.05).But there was no significant change in the thickness of the posterior wall at the end of the diastoleof the left ventricle.

The main results of this study showed that the HIITtraining protocol withthe lowvolume produced positive and significant changes in systolic blood pressure, diastolic blood pressure, resting heart rate and VO2 peak, which shows a positive training response in these patients. But we found no improvement in the control group and only systolic and diastolic blood pressure remained unchanged. Also, in the parameters of resting heart rate, systolic and diastolic blood pressure and VO2 peak, a significant difference was found between the HIIT group and the control group, which is related to the improvement of physical activity level and functional capacity. These findings show the effectiveness of a low-volume HIIT program in improving clinically important parameters. The results of the present study showed that left ventricular end-diastolic volume, left ventricular ejection fraction (EF) and stroke volume (SV) increased significantly after HIIT exercises compared to the control group. Recent studies have shown that physiological adaptations of the left ventricle following exercise are divided into three general sections: 1) physiological hypertrophy of existing myocytes, which is associated with increased production of specific growth factors; 2) activation of cardiac stem cells, which increase the number and their differentiation leads to myocytes and vascular cells and 3) accumulation of new heart cells called new myocytes and vascular cells (32, 33). These cellular changes depend on the intensity and duration of exercise, which is associated with increased contractile muscle mass, cardiac function, and decreased wall tension. Therefore, since the results of the present study show an improvement in left ventricular function index  in patients with MI following low volumes of HIIT training, it is likely that low volume of HIIT volumes could be stimulated the above mechanisms and play an important role in improving cardiovascular function. The results of the present study showed that the end-diastolic diameter of the left ventricle increased significantly in the HIIT group compared to the control group. Therefore, it can be said that 12 weeks of low-volume HIIT training has led to an increase in blood volume and venous return (because of skeletal muscle pumping and venous contraction), which according to Frank-Starling's law, increases ventricular stretch and ventricular contractility. It has led to an increase in injection fraction, which ultimately causes an increase in stroke volume and a decrease in resting heart rate, and one reason for the significant increase in VO2 peak after 12 weeks of low-volume HIIT training may be the increase in blood volume and ventricular end-diastolic diameter. Be left, because these two mechanisms cause an increase in the number of mitochondria and their enzyme contents, capillary density and better blood flow in active muscles and heart muscles (38). Also, the results showed that the average thickness of the posterior wall of the left ventricle at the end of diastole in the HIIT group had a slight and non-significant increase. Reports show that aerobic activity causes a volume load on the heart, an increase in the heart chambers, especially the left ventricle, and a relative increase in the ventricular walls of the heart (39). Perhaps the reason for the non-significant changes in the thickness of the posterior wall at the end of left ventricular diastole in this study was the rapid filling of the left ventricle during ventricular diastole or the small volume of the exercise program, because the volume of the exercise program was not enough to cause obvious structural changes. In summary,interval aerobic training with low volume and high intensity improves the structure and function of the left ventricle, but we need more training volume to achieve more obvious structural changes in the left ventricle of patients with MI.

Cardiovascular diseases are the main cause of death worldwide. Globally, 30% of deaths (approximately 17 million deaths per year) are attributable to cardiovascular diseases. In 2006 alone, the estimated total direct and indirect costs associated with the treatment of cardiovascular diseases exceeded 400 billion dollars. Currently, in Iran, insurance organizations only bear a limited part of cardiac rehabilitation costs, while taking into account the impact of these programs in secondary prevention and reducing the incidence of cardiovascular events and as a result reducing the treatment costs imposed on this Organizations will focus on covering cardiac rehabilitation programs both for the benefit of the patient and for the benefit of the insurance organizations. According to the mentioned studies and many other studies and the high and increasing prevalence of cardiovascular diseases in Iran, and on the other hand, the clinical advantages of cardiac rehabilitation in coronary artery transplant patients, including secondary prevention and preventing disease recurrence and improving the quality of life, are necessary and The importance of this research is clear. Cardiovascular diseases are the main cause of death all over the world, so the purpose of this study is to investigate the effect of eight weeks of cardiac rehabilitation on the functional indices of systolic and diastolic blood pressure, resting heart rate, vo2max and MEt functional capacity in male patients 55 Coronary artery transplant surgery up to 70 years old.

The research method is semi-experimental with a pre-test and post-test design. The statistical population of this research consisted of 120 male coronary artery transplant patients aged 55 to 70 years who referred to the Sari Heart Center. The statistical sample included 40 people who lived in Sari city and underwent coronary artery transplant surgery for at least 2 months and at most 4 months. Then they were randomly and equally divided into 2 groups of 20 people, control and therapeutic intervention of cardio sports rehabilitation. In this research, in order to measure the resting heart rate HR H before the test of two control and cardio exercise rehabilitation groups, therefore the best time to determine the heart rate in the morning after waking up is one hour after breakfast and without intense physical activity in a state of rest. For 20 minutes, the subjects of the two groups sat on a chair and were measured. All the subjects were advised to sleep early the night before and avoid any kind of stress. The systolic and diastolic blood pressures of the two groups were measured before the test using a dial sphygmomanometer. The time of assessment was two hours after breakfast, and the subjects were advised to refrain from smoking, vigorous physical activity, and drinking for one hour before any use of cigarettes. Avoid coffee and caffeinated drinks and sit quietly for 20 minutes and wear comfortable clothes. 12 hours before the test, blood lipid profile was taken from the subjects of both the control and cardiac rehabilitation groups fasting. The sample required for the test was 10 cc from the brachial vein immediately without delay for the actual values ​​after lying on the bed. 24 hours. Before the test, in consultation with a cardiologist, reduce the dose of heart and blood pressure medications such as Inderal and Atenolol. Also, asthmatic patients should carry a special spray and wear comfortable clothes and shoes for the test, and avoid caffeinated drinks and cigarettes 24 hours before. Cardio sports rehabilitation program consisted of 24 sessions 3 days a week for 2 months, which included 15 minutes of warm-up, 30 minutes of treadmill and 20 minutes of stationary bike, and 20 minutes of stationary bike and 15 minutes of cooling down. To investigate and compare pre-test and post-test variables between two groups, independent parametric t-test was used. Data analysis was done using spss software. The significance level was p<0.5.

The results showed that eight weeks of cardiac rehabilitation has an effect on the improvement of systolic blood pressure (SBP), diastolic blood pressure (DBP), improvement of heart rate and improvement of vo2max and MEt functional capacity in male patients aged 55 to 70 undergoing coronary artery bypass surgery.

The findings of the current research have shown the effect of a cardiac rehabilitation course on the improvement of hemodynamic indicators and functional capacity, considering the high prevalence of cardiovascular diseases in the country, and on the other hand, the high per capita consumption of drugs and their high costs, and the high importance of cardiac sports rehabilitation in improving The quality of life of heart patients, including coronary artery transplantation, is necessary and necessary to pay more attention to the category of cardiac rehabilitation and to build clinics and centers for it. The findings showed that cardio sports rehabilitation reduces the risk of coronary atherosclerosis by improving heart rate and as a result of heart attack and ischemic diseases. In order to control the risk factors of systolic and diastolic blood pressure in patients who have undergone coronary artery bypass graft surgery (CABG), it is suggested to periodically use cardiac rehabilitation programs for their treatment.

Attention to the quality of life of patients after coronary artery bypass graft (CABG) surgery is one of the priorities of nursing care. Although postoperative heart rehabilitation programs are performed in most centers, it does not seem to be sufficient to improve quality of life and require complementary programs. The purpose of this study was to determine the effect of yoga-based cardiac rehabilitation programs on the quality of life of patients after CABG surgery.

The present study is an experimental study that was performed in the intensive care unit of Shahid Beheshti Hospital in Shiraz in the first half of 2021. Participants were selected using convenience sampling and then randomly divided into two groups intervention and control. For the intervention group, a yoga-based cardiac rehabilitation program was performed virtually for one month. To collect data, the Ferrans, and Powers quality of life index - cardiac version was used.

There was no significant difference between the two groups in terms of demographic characteristics and quality of life scores before the intervention (P<0.05). Also, after the intervention, the difference between the mean score of quality of life between the two groups was significant (P<0.001). In the experimental group, the mean score of quality of life significantly improved from the pre-test to the post-test. but did not differ significantly in the control group. Importantly, this program affected all aspects of quality of life except mental health.

Yoga-based cardiac rehabilitation has an effect on the quality of life of patients after CABG surgery, so it is suggested that this intervention be used to help improve the lives of these patients

smoking enhances the risk of cardiac events in patients with coronary artery disease. So, it is necessary to evaluate the effects of exercise-based cardiac rehabilitation on endothelial function and functional capacity among smoker patients.

This randomized clinical trial study was conducted on 56 non-diabetic smokers with a history of percutaneous coronary intervention or coronary artery bypass graft surgery in Imam Khomeini Hospital from May to August 2015. Based on cardiac rehabilitation, patients were divided into intervention and control groups. Before rehabilitation, fasting blood sugar (FBS), lipid profile (LDL, HDL, triglyceride, and total cholesterol), and Ankle-Brachial Index (ABI) were measured for endothelial function. Besides, METs were measured based on the Duke activity status index. After 24 rehabilitation sessions (3 sessions of 1 hour each week for 2 months), all values were checked again and compared with the initial values.

The mean age of the subjects in the cardiac rehabilitation and control groups were 61.18 and 52.32, respectively. Before the intervention, there were no significant differences between the two groups in terms of the ABI variables, BMI, systolic and diastolic blood pressure, LDL, triglyceride, total cholesterol and FBS; only HDL and  METs showed significant differences. After exercise-based cardiac rehabilitation, the mean rate of ABI changes was +0.078 on the right side of the body and +0.084 on the left side of the body. In the control group, these values were 0.002 and 0.003, respectively (P=0.001). The amount of changes in increasing METs as well as decreasing body mass index (BMI), and systolic and diastolic blood pressure in the rehabilitation group were statistically significant compared to the control group. In addition, there were no significant differences in terms of FBS and lipid profiles either (P>0.05).

Two months of cardiac rehabilitation with regular exercise was associated with improved ABI as an indicator of endothelial function and prognosis of cardiovascular disease, as well as improved cardiac functional capacity among smoker patients.

Despite progressive improvement in medical therapy and standard care, Exercisebased rehabilitation programs have been shown to to have beneficial cardiovascular effects in patients with myocardial infarction through a multifactorial effect. This review study aimed to evaluate exercise-based cardiac rehabilitation strategies in patients with myocardial infarction with special focus on high intensity interval training, as a growing field of research was conducted.

This is a systematic review study on articles published, without limitation Year, by searching in reputable databases such as PabMed, Science Direct, Google Scholar, Scopus, Springer. Also in the process of searching for articles on the keywords microRNAs (miRNA) and myocardial infarction "," cardiac rehabilitation and myocardial infarction "," cardiac rehabilitation and high-intensity interval training  (HIIT) ", high-intensity interval training (HIIT) and Myocardial infarction was used.

All Ethical principles in writing this article have been observed  according to the instructions of the National Ethics Committee and the COPE regulations.

High-intensity interval training (HIIT) is a safe and effective exercise strategy to improve cardiac function in MI, and to prevent abnormal changes in mass, size, geometry, and cardiac function after MI, and Applies significant changes in molecular targets and cell pathway.

Therefore, HIIT targets myocardial necroptosis due to oxidative stress, protects the heart against adverse left ventricular regeneration after MI, and can be considered an integral part of post-MI cardiac rehabilitation programs.