Fatigue during and after cardiac rehabilitation

Geffen, Myrna E. van; Hoeve, Nienke ter; Sunamura, Madoka; Stam, Henk J.; Domburg, Ron T. van; Berg-Emons, Rita J G van den

doi:10.2340/16501977-1967

Cited by 17 publications

(22 citation statements)

References 23 publications

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“…Preliminary studies suggested feasibility of a rehabilitation program after a VTE episode [ 23 ]. Whether such programs have the potential to decrease fatigue, as is the case in patients with coronary artery disease, need to be studied prospectively [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk

et al. 2015

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ObjectiveThis study aimed to examine perception, knowledge and concerns developed by patients and their family as regards venous thromboembolism (VTE) risk.MethodsWe conducted a qualitative study. Participants were: (1) patients with unprovoked VTE with either factor V Leiden mutation or G20210A prothrombin gene mutation or not; and (2) their first-degree relatives. Interviews took place mostly at Brest University Hospital. Participants produced narratives of the patient’s illness, stressing their perception of the disorder, its mechanisms, etiology, circumstances and risk factors. Interviews were audiotaped and transcribed verbatim. On an ongoing basis, central themes were identified and data from narratives were categorized by these themes.ResultsA total of ten patients and 25 first-degree relatives were interviewed. Analyses of patient’s narratives suggested 4 main themes: (1) concerns about initial symptoms and suspicion of VTE. The longer the duration of the initial phase, the more likely anxiety took place and persisted after diagnosis; (2) underestimation of potential life-threatening episode once being managed in emergency; (3) possible biographical disruption with inability to cope with the event; and (4) secondary prevention attitudes motivated by remains of the episode and favoring general prevention attitudes. Analyses of the first-degree relatives narratives suggested 3 main themes: (1) common interpretation of the VTE episode shared within the family; (2) diverse and sometimes confusing interpretation of the genetic status; and, (3) interpretation of clinical signs linked to VTE transmission within the family.ConclusionsConstruction of the risk of VTE is based on patient’s initial experience and shared within the family. Collection of narratives illustrates the gap between these perceptions and current medical knowledge. These results support the need to collect the perceptions of the VTE episode and its consequences, as a prerequisite to any health education process.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk

et al. 2015

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“…Our population-based study was conducted in a rehabilitation centre, where subjects with CHF underwent a comprehensive intervention, based on a thorough patient assessment followed by patient-tailored therapies, which in clude, but are not limited to, exercise training, education, and behaviour changes. However, exercise remains the cornerstone of a rehabilitation programme for patients with heart disease (28)(29)(30)(31)(32). The results of the current study showed an exceptionally high prevalence of DISH among patients with CHF undergoing a programme of in-hospital rehabilitation, particularly in obese and older individuals.…”

Section: Discussionmentioning

confidence: 55%

Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation: A decision tree analysis

Ambrosino¹,

Scrutinio²,

Campi³

et al. 2020

J Rehabil Med

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Diffuse idiopathic skeletal hyperostosis (also known as Forestier's disease) is a systemic condition with a wide spectrum of clinical manifestations. Patients with diffuse idiopathic skeletal hyperostosis often experience pain, stiffness, loss of range of motion, and even difficulty breathing or swallowing. As a consequence, the presence of such disabling symptoms may interfere with activities of daily living and significantly reduce perceived quality of life. Moreover, the ankylosed spine in patients with diffuse idiopathic skeletal hyperostosis is prone to unstable fractures, thus exposing patients to a considerable risk of secondary spinal cord injury. This study found an exceptionally high prevalence of diffuse idiopathic skeletal hyperostosis among patients with congestive heart failure who were undergoing cardiac rehabilitation, particularly in obese and older individuals. Given the risk of spinal fractures, even after low impact trauma, and of severe disability, the presence of diffuse idiopathic skeletal hyperostosis should always be investigated in patients with congestive heart failure who report stiffness of the spine or chronic back pain, especially in those undergoing exercise-based activities. Objective: To assess the prevalence of diffuse idiopathic skeletal hyperostosis and its relationship with vascular risk factors among patients with congestive heart failure. Design: Population-based cross-sectional study. Participants: A total of 584 consecutive patients admitted to a Rehabilitative Cardiology Unit. Methods: Chi-square Automatic Interaction Detector (CHAID) decision tree analysis was used to build a predictive model. Results: The mean age (standard deviation) of the study population was 68.1 years (standard deviation 12.3), and 77.7% of the subjects were men. The overall prevalence of diffuse idiopathic skeletal hyperostosis in the cohort was 49.8%. Logistic regression analysis showed that age was a predictor of diffuse idiopathic skeletal hyperostosis (odds ratio 1.034; 95% confidence interval: 1.021-1.047, p < 0.001), with increasing odds ratios for increasing age tertiles. The CHAID prediction model identified 2 age "buckets": ≤ 69 and > 69 years. Patients > 69 years had a diffuse idiopathic skeletal hyperostosis prevalence of 60.1%, compared with 39.2% among those ≤ 69 years. Notably, body mass index was a predictor of diffuse idiopathic skeletal hyperostosis in this younger subset of patients (p = 0.028), with 2 body mass index buckets, ≤ 23.3 and > 23.3 kg/m 2 , the latter showing more than twice the prevalence of diffuse idiopathic skeletal hyperostosis (43.2% vs 20%). Conclusion: Diffuse idiopathic skeletal hyperostosis is extremely frequent among patients with congestive heart failure, with age and body mass index being the strongest predictors.

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“…8,9 To date, cardiac rehabilitation results for these outcomes have been suboptimal in patients with acute coronary syndrome. 8,10,11…”

Section: Introductionmentioning

confidence: 99%

A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society

Hoeve

Sunamura

Stam³

et al. 2019

Clin Rehabil

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Objective: In this secondary analysis of data from the OPTICARE trial, we compared the effects of two behavioral interventions integrated into cardiac rehabilitation to standard rehabilitation with regard to functional capacity, fatigue, and participation in society. Design: This is a randomized controlled trial. Setting: This study was conducted in a cardiac rehabilitation setting. Subjects: A total of 740 patients with acute coronary syndrome were recruited for this study. Interventions: Patients were randomized to (1) three months of standard rehabilitation; (2) cardiac rehabilitation plus nine months after-care with face-to-face group lifestyle counseling; or (3) cardiac rehabilitation plus nine months after-care with individual lifestyle telephone counseling. Main measures: Functional capacity (6-minute walk test), fatigue (Fatigue Severity Scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) were measured at randomization, 3, 12, and 18 months. Results: Additional face-to-face sessions resulted at 12 months in 12.49 m more on the 6-minute walk test compared to standard rehabilitation ( P = .041). This difference was no longer present at 18 months. Prevalence of fatigue decreased from 30.2% at baseline to 11.9% at 18 months compared to an improvement from 37.3% to 24.9% after standard rehabilitation (between-group difference: odds ratio = 0.47; P = .010). The additional improvements in functional capacity seemed to be mediated by increases in daily physical activity. No mediating effects were found for fatigue. No additional improvements were seen for participation in society. Additional telephonic sessions did not result in additional intervention effects. Conclusion: Extending cardiac rehabilitation with a face-to-face behavioral intervention resulted in additional long-term improvements in fatigue and small improvements in functional capacity up to 12 months. A telephonic behavioral intervention provided no additional benefits.

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Fatigue during and after cardiac rehabilitation

Abstract: Fatigue decreased during and after cardiac rehabilitation. However, the prevalence of severely fatigued patients remained high after cardiac rehabilitation. Fatigue should be identified at an early stage in order to provide additional programmes aiming to reduce severe fatigue.

Cited by 17 publications

References 23 publications

A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk

A Qualitative Study to Appraise Patients and Family Members Perceptions, Knowledge, and Attitudes towards Venous Thromboembolism Risk

Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation: A decision tree analysis

A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society

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