Critical surgical and medical advances have shifted the focus of congenital heart disease (CHD) patients from survival to achievement of a greater health-related quality of life (HRQoL). HRQoL is influenced, amongst other factors, by aerobic capacity and respiratory muscle strength, both of which are reduced in CHD patients. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on respiratory muscle strength and functional capacity. Fifteen CHD patients, ages 12 to 16, with reduced aerobic capacity in cardiopulmonary exercise testing (CPET) were enrolled in a CPRP involving strength and aerobic training for three months. Measurements for comparison were obtained at the start, end, and six months after the CPRP. A significant improvement of inspiratory muscle strength was evidenced (maximum inspiratory pressure 21 cm H2O, 23%, p < 0.01). The six-minute walking test showed a statistically and clinically significant rise in walked distance (48 m, p < 0.01) and a reduction in muscle fatigue (1.7 out of 10 points, p = 0.017). These results suggest CPRP could potentially improve respiratory muscle function and functional capacity, with lasting results, in children with congenital heart disease, but additional clinical trials must be conducted to confirm this finding.
Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects’ handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects’ handgrip strength (kg) (p < 0.001), biceps brachii and quadriceps femoris strength (N) (p < 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis.
Background and Purpose: Cardiac surgery enhances cardiovascular disease (CVD) patient survival rates, and the fast‐track protocol can reduce complications, hospital length of stay (HLOS) and associated costs. However, there is no evidence on the effectiveness of unsupervised physiotherapy programmes in reducing HLOS and postoperative pulmonary complications in patients undergoing fast‐track surgery. The study aimed to determine if a pre‐surgical respiratory programme reduces intensive care unit length of stay (ICULOS) and HLOS patients undergoing fast‐track surgery, and its effects on post‐operative complications and healthcare costs.Methods: This was a retrospective observational cohort study. The patients were divided into two groups: those who followed the exercise programme (pre‐hab group) and those who did not (no pre‐hab group). The study analysed the mean of ICULOS and HLOS for each group, recorded post‐operative complications, and calculated healthcare costs using the Spanish Ministry of Health cost tables.Results: A total of 418 patients participated in the study with a mean age of 70.44 (10.87) years. The study found significant differences in HLOS (p = 0.001) and ICULOS (p = 0.003) between groups. Pre‐hab HLOS was 232.8 (221.3) hours in the hospital, whereas no pre‐hab LOS increased to 315.1 (277.9) hours. Pre‐hab ICULOS was 82.0 (129.8) hours when No pre‐hab ICULOS accounted 120.2 (190.3) hours. This reduction in hospital admissions resulted in savings of €356,107.16 in average healthcare costs for the pre‐hab group. Mortality risk (p = 0.034) was also reduced in the pre‐hab group (17.7% vs. 26.65% in the no pre‐hab group).Discussion: An unsupervised home‐based respiratory programme reduces hospital and ICU stay, healthcare costs, post‐surgical pulmonary complications, and mortality risk. The clinical application of an unsupervised home‐based pre‐habilitation programme, focussing on ventilatory exercises and costal expansion techniques, has proven effective in enhancing patient recovery post‐cardiac surgery, offering significant healthcare cost savings, and reducing the burden on hospital resources.
The aim of the present clinical trial is to evaluate the effectiveness of neuromuscular versus classical strength-resistance training as part of a cardiac rehabilitation programme in patients following acute coronary syndrome. The study is designed as a double-blinded, randomised, and controlled clinical trial. Thirty participants suffering from acute coronary syndrome who meet our inclusion criteria will be recruited by a private tertiary hospital. The intervention group will follow 20 sessions of a cardiac rehabilitation programme divided into two parts: aerobic training and neuromuscular strength-resistance training. The control group will complete the same aerobic training as well as a classical strength-resistance training workout programme. The primary outcome of the study will be the mean difference in change from baseline in the Incremental Shuttle Walking Test. The secondary outcomes will be the cardiorespiratory fitness of the patients (assessed by means of the Chester Step Test), lower-limb performance (assessed with the 30-Second Chair Stand Test and Single-Leg Squat Test), lower-limb strength (hip flexor handheld dynamometry), sexual dysfunction assessment (Sex Health Inventory for Men) and quality of life (EQ-5D-5L). This work will provide evidence for the effectiveness of a neuromuscular versus a classic strength-training programme in terms of cardiorespiratory fitness, lower-limb performance capacities and quality of life, in cardiac patients. The data obtained could lead to more effective and functional workouts which, in turn, may enhance the speed at which these patients can return to their everyday activities of life and improve the efficiency of their movement patterns and heart responses. Furthermore, patients may find neuromuscular workout routines more motivating and engaging, thus encouraging them to adopt healthier lifestyle patterns.