Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position Paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation)

Mureddu, Gian Francesco; Ambrosetti, Marco; Venturini, Elio; Rovere, Maria Teresa La; Mazza, Antonio; Pedretti, Roberto F.E.; Sarullo, Filippo M.; Fattirolli, Francesco; Faggiano, Pompilio; Giallauria, Francesco; Vigorito, Carlo; Angelino, Elisabetta; Brazzo, Silvia; Ruzzolini, Matteo

doi:10.4081/monaldi.2020.1439

Cited by 26 publications

(31 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The Ti-To home-based program, designed to overcome the barriers to exercise in an area with an aging index almost double the Europe mean value [19,34], simply relying on the telephonic monitoring passed the test during the COVID-19 epidemic. Even if social frailty, i.e., reduced connections to society and little social activity, may be correlated with reduced physical function [35,36], the program was able to ensure stable or improved function in a population with disability that was exposed to strict movement restrictions. However, the reduced sample size is a limitation of this observation.…”

Section: Discussionmentioning

confidence: 99%

Don’t stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic

et al. 2021

View full text Add to dashboard Cite

We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions. We selectively studied 83 patients (age 72 ± 11, males n = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circamonthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre-and post-lockdown as well as body weight (BW), blood pressure (BP), and anklebrachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved (p < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Don’t stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The role of inspiratory muscle training as an adjunct to pulmonary rehabilitation should also be considered and the importance here is eloquently described in the context of COVID-19 and future pandemics by Severin et al 28 There is additional evidence to support the use of cardiac rehabilitation in COVID-recovered patients whose underlying cardiac conditions have been exacerbated. 29 Beyond this, there is an ongoing need to continue rehabilitation services for those with non-COVID-related indications for referral, with added protective measures to prevent viral spread among these high-risk individuals.…”

Section: The Need For Bespoke Cardiorespiratory Rehabilitation Programentioning

confidence: 99%

The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network

Faghy

Arena

Stoner

et al. 2021

Progress in Cardiovascular Diseases

View full text Add to dashboard Cite

COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.

show abstract

“…In contrast, social isolation during the pandemic may result in HF destabilizations and adverse events due to changes in dietary habits such as processed food and lifestyle behaviours (decreased physical activity levels) 54 as well as quarantine-induced stress resulting in depression, social isolation, and behavioural addiction disorders. 55 To improve patient access and confidence in attending care facilities, it has been demonstrated that relocating HF services to isolated areas of admission or peripheral specialty units has prevented transmission of COVID-19 in advanced HF and cardiac transplantation patients and needs to be considered more widely to protect and promote outpatient visits. 56 For example, colour-coded zones have been implemented in an HF unit in Milan, Italy, to ensure isolation of infected, suspected, and no-symptom patients.…”

Section: Heart Failure Hospitalizationmentioning

confidence: 99%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.

show abstract

Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position Paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation)

Cited by 26 publications

References 59 publications

Don’t stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic

Don’t stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic

The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Contact Info

Product

Resources

About