This study aimed to investigate the hydration influence on the autonomic responses of coronary artery disease subjects in the immediate recovery period after a cardiovascular rehabilitation session, in view of the risks of a delayed autonomic recovery for this population. 28 males with coronary artery disease were submitted to: (I) Maximum effort test; (II) Control protocol (CP), composed by initial rest, warm-up, exercise and passive recovery; (III) Hydration protocol (HP) similar to CP, but with rehydration during exercise. The recovery was evaluated through the heart rate (HR) variability, HR recovery and by the rate of perceived exertion and recovery. The main results revealed that the vagal reactivation occurred at the first 30 s of recovery in HP and after the first minute in CP. A better behavior of the HR at the first minute of recovery was observed in HP. The rate of perceived exertion had a significant decrease in the first minute of recovery in HP, while in CP this occurred after the third minute. In conclusion, despite an anticipated vagal reactivation found at HP, these results should be analyzed with caution as there were no significant differences between protocols for all variables and the effect sizes were small.
The influence of fluid replacement, realized during and after the exercise on individuals with coronary artery disease (CAD) remains poorly understood. To investigate the influence of hydration on cardiac autonomic modulation, cardiorespiratory parameters and perceived exertion and discommodity, of coronary heart patients submitted to cardiac rehabilitation (CR) session. Methods: This cross-over clinical trial, will recruit 31 adults with more than 45 years old, participants of a cardiovascular rehabilitation program, with CAD diagnosis. The participants will be submitted to an experimental protocol composed of three phases: I) Maximal stress test; II) Control protocol (CP); and III) Hydration protocol (HP). The CP and HP will consist of 10 min of rest in a supine position, 15 min of warming, 40 min of treadmill exercise, 5 min of cooling down and 60 min of rest in a supine position. In the HP, the participants will be hydrated with mineral water, based on the bodyweight reduction of the CP. The water intake will be divided into eight equal portions, offered during the treadmill exercise and recovery period. On CP and HP will be evaluated linear and nonlinear indices of heart rate variability, the heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen partial saturation, perceived exertion and discommodity on specifics moments. Conclusion: The results of this study will allow us to identify if the proposed protocol will be able to positively influence the outcomes and, consequently, if could be implement in the clinical practice.
Introduction
Participants in cardiac rehabilitation programs have low adherence to their
sessions, which makes extremely important to recognize the barriers that
cause non-adherence, identifying whether the type of service and level of
adherence influence these barriers.
Methods
This is a cross-sectional observational study, in which 220 individuals
(66.80±11.59 years) of both genders who are members of public and
private exercise-based cardiac rehabilitation programs participated. The
volunteers were divided according to the level of adherence, considering
patients with low adherence (PLA) those with < 70% of attendance and high
adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac
Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital
Anxiety and Depression Scale, and Mini-Mental State Examination were
applied.
Results
Higher total barriers were found in PLA in the public service compared to PHA
in the private service (P=0.023). In the subscale “perceived need”, PHA in
the public service showed higher values than PLA and PHA in the private
service (P≤0.001). The “access” barrier was higher for PHA in the
public service when compared to PHA in the private service (P=0.024). PHA in
the public service exhibited a higher barrier regarding questions about
distance, transportation problems, cost, and time constraints.
Conclusion
The public program presents higher barriers in the questions and categories
compared to the private program, mainly the PHA. Furthermore, there are
differences in the profile of the participants regarding socioeconomic and
anxiety levels, treatment time, ethnicity, and city where they live.
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