Background: Patients with reduced ejection fraction have high rates of mortality and readmission after hospitalization for heart failure. In Taiwan, heart failure disease management programs (HFDMPs) have proven effective for reducing readmissions for decompensated heart failure or other cardiovascular causes by up to 30%. However, the benefits of HFDMP in different populations of heart failure patients is unknown. Method: This observational cohort study compared mortality and readmission in heart failure patients who participated in an HFDMP (HFDMP group) and heart failure patients who received standard care (non-HFDMP group) over a 1-year follow-up period after discharge (December 2014 retrospectively registered). The components of the intervention program included a patient education program delivered by the lead nurse of the HFDMP; a cardiac rehabilitation program provided by a physical therapist; consultation with a dietician, and consultation and assessment by a psychologist. The patients were followed up for at least 1 year after discharge or until death. Patient characteristics and clinical demographic data were compared between the two groups. Cox proportional hazards regression analysis was performed to calculate hazard ratios (HRs) for death or recurrent events of hospitalization in the HFDMP group in comparison with the non-HFDMP group while controlling for covariates. Results: The two groups did not significantly differ in demographic characteristics. The risk of readmission was lower in the HFDMP group, but the difference was not statistically significant (HR = 0.36, p = 0.09). In patients with ischemic cardiomyopathy, the risk of readmission was significantly lower in the HFDMP group compared to the non-HFDMP group (HR = 0.13, p = 0.026). The total mortality rate did not have significant difference between this two groups. Conclusion: The HFDMP may be beneficial for reducing recurrent events of heart failure hospitalization, especially in patients with ischemic cardiomyopathy. Trial registration: Longitudinal case-control study ISRCTN98483065, 24/09/2019, retrospectively registered.

Introduction: Kawasaki disease (KD) is a childhood illness causing blood vessel inflammation. Children with KD have similar cardiopulmonary function to healthy children, but lower moderate-to-vigorous activity and exercise self-efficacy—possibly harming their cardiopulmonary function in adolescence. The purpose of this study is to investigate the cardiopulmonary function, exercise behaviors, exercise motivations, and self-efficacy of adolescents who once had KD. Methods: adolescents who once had KD and adolescents matched to the KD group in age and sex were enrolled. The cardiopulmonary exercise test was used to assess cardiopulmonary function. Weekly exercise behavior, exercise motivation, and self-efficacy were assessed with questionnaires. Results: this study recruited 50 and 30 participants, respectively, to the KD and control groups. The KD group had a lower ratio of VO₂/kg at the anaerobic threshold and peak to the predicted VO₂/kg at the peak (p = 0.021 and 0.043, respectively). No significant differences were found in questionnaire scores. The correlations of weekly exercise behavior scores with exercise motivation and self-efficacy scores were stronger in the KD group. Conclusions: adolescents with KD history had significantly lower aerobic metabolism capacity and peak exercise load capacity than controls. The correlations of amount of weekly exercise with exercise motivation and self-efficacy were stronger in the KD group.

The aim of this study was to investigate the association between mobility status and cardiovascular rehospitalizations in patients with heart failure undergoing cardiac rehabilitation. This retrospective cohort study included patients with heart failure undergoing cardiac rehabilitation. Mobility status was evaluated using functional ambulation categories (FAC), and each cardiovascular hospitalization was recorded by the case manager. A Poisson regression model was used to analyze the association between mobility status and cardiovascular rehospitalizations. This study included 154 patients with heart failure undergoing cardiac rehabilitation. For cardiovascular rehospitalizations within 6 months, the Poisson regression model reported that the impaired mobility group had a higher risk than the fair mobility group (incidence rate ratio (IRR) = 2.38, 95% CI 1.27–4.46, p = 0.007). For cardiovascular rehospitalizations within 12 months, the Poisson regression model also reported that the impaired mobility group had a higher risk than the fair mobility group (IRR = 1.91, 95% CI 1.16–3.13, p = 0.010). Other covariates, such as LVEF, peak oxygen consumption, and PAOD, could have impacted the risk of cardiovascular rehospitalizations. Among patients with heart failure undergoing cardiac rehabilitation, the impaired mobility group had a twofold risk of cardiovascular rehospitalizations, compared with the fair mobility group within both 6 and 12 months.

BACKGROUND: Patients with degenerative lumbar spondylolisthesis (DLS) may have low back pain (LBP), radicular pain and spinal instability. Current programs emphasize intervention of spinal stabilization exercise. However, no prospective, randomized studies have elucidated standardized treatment for DLS. OBJECTIVE: To examine the effect of spinal stabilization exercise and Biodex balance system (BBS) training in patients with DLS. METHODS: It was a prospective, clinical trial. Participants were allocated into three groups: (1) DLS-balance group treated with balance training (DLSB), (2) DLS non-balance training group (DLSNB), and (3) lumbar spondylosis without spondylolisthesis (SC). ALL patients underwent a rehabilitation program with lumbar stabilization exercises. The evaluation included the Numeric Pain Scale, the BBS, the Quebec back pain disability scale and Oswestry disability index. RESULTS: LBP was significantly different among three groups. Radicular pain was significantly different in the DLSB and SC groups. In post-hoc analysis, only the DLSB group had greater pain relief than the DLSNB group. Fall risk significantly decreased in the DLSB group. CONCLUSIONS: Lumbar stabilization exercise were beneficial for DLS. BBS could provide more pain relief than lumbar stabilization exercise alone. BBS also enhanced balance in DLS patients, thereby reducing fall risks. Findings could provide a clinical reference for designing rehabilitation programs.