Determinants of Physical Functioning in Coronary Patients

Ades, Philip A.; Maloney, Anne Marie; Savage, Patrick D.; Carhart, Robert

doi:10.1001/archinte.159.19.2357

Cited by 95 publications

(72 citation statements)

References 15 publications

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“…The major reason for lack of participation was lack of physician referral. Ades and colleagues 30 reported improved physical functioning and adoption of secondary preventive measures in patients with coronary disease who participated in cardiac rehabilitation. Lindsay and colleagues 31 noted higher overall general Short Form-36 health scores in CABG patients who attended cardiac rehabilitation programs.…”

Section: Discussionmentioning

confidence: 99%

Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery

Koch

Lauer

et al. 2007

Circulation

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Background-Health-related quality-of-life instruments have become important measures of early health outcomes after cardiac surgery. The relationship between quality of life after recovery from surgery and subsequent long-term survival has not previously been explored. Our objective was to determine whether the Duke Activity Status Index (DASI) was predictive of subsequent time-related survival after recovery from cardiac surgery. Methods and Results-We examined survival status among 6305 patients who underwent isolated coronary artery bypass grafting with or without valve procedures or isolated valve procedure between May 1995 and June 1998 who had a preoperative baseline and follow-up DASI. The postoperative DASI was administered nominally at 6 and 12 months. Baseline and perioperative variables and postoperative morbid events were prospectively collected concurrently with patient care. The end point was all-cause mortality. The Social Security Death Index was queried for survival status. Cox proportional-hazards analysis was used to study the associations between DASI, a number of traditional risk factors, and survival. Median follow-up was 8.6 years. The "dose-response" relationship between baseline and follow-up DASI and risk of long-term death was established.

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Section: Discussionmentioning

confidence: 99%

Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery

Koch

Lauer

et al. 2007

Circulation

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“…Exercise training has several beneficial effects in patients with coronary artery disease (CAD): increased exercise capacity (Ades et al 1996(Ades et al , 1999Hambrecht et al 2000;O'Connor et al 1989), fewer subsequent coronary events and hospitalizations (Haskell et al 1994;Ornish et al 1998), and reduced mortality from cardiovascular causes (O'Connor et al 1989;Oldridge et al 1988). The training programs for patients with CAD entering cardiac rehabilitation are well-established and based on the traditional prescription of exercise for healthy persons in terms of mode, intensity, duration, and frequency (ACSM 1994(ACSM , 1998.…”

Section: Introductionmentioning

confidence: 99%

High versus low training frequency in cardiac rehabilitation using a systems model of training

Bris¹,

Ledermann²,

Topin

et al. 2005

Eur J Appl Physiol

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No study has reported the long term effects of cardiac rehabilitation, concerning the duration of beneficial effects of training program. The present study analyzed the influence of training session frequency on long-term beneficial effects in patients with coronary artery disease (CAD) undergoing phase 2 cardiac rehabilitation. Four patients with CAD completed 20 training sessions. Two patients were assigned to low training frequency (LTF) and two to high training frequency (HTF): three and five sessions per week(-1), respectively. The method was based on the systems model of training and required training quantification and the assessment of real exercise tolerance. Convolution of training quantity with real exercise tolerance provided the model exercise tolerance for every patient. The model parameters, the magnitude factor (k), and the time constant of decay (tau), were fitted from real and model exercise tolerances by the least squares method. LTF and HTF resulted in similar increases in exercise tolerance (12-14%). A model with one-component (fitness) allowed fitting exercise tolerance in all patients with r (2) = 0.77, 0.79, 0.84, and 0.91, respectively (p < 0.05). The addition of a second component did not improve the fit in any patient (p> 0.05). The k value was about twice as high with LTF (0.13 and 0.16 AU) than with HTF (0.05 AU for the two patients), whereas the tau value was about twice as low with LTF (37 and 41 days) than with HTF (72 and 89 days). The long term beneficial effects estimated by 4tau, were twice as long with HTF (288 and 356 days) than with LTF (148 and 164 days). We concluded that exercise tolerance was similarly increased with HTF and LTF but HTF training induced beneficial effects which were sustained twice as long.

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“…In addition to mortality benefits described in both meta-analyses and single-center studies, 20 -24 the most predictable benefit of CR is an increase in exercise tolerance, 16 along with benefits related to physical functioning. 25 Selective use of resistance training also has been shown effective in reducing measures of disability in this patient population 26,27 and may be associated with increases in peak V O 2 , although this is controversial. 28 Finally, it should be noted that the magnitude of training-induced increases in peak V O 2 has been shown to independently predict a decrease in cardiovascular mortality.…”

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confidence: 99%