Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan

Ogura, Asami; Izawa, Kazuhiro P.; Tawa, Hideto; Kureha, Fumie; Wada, Masaaki; Harada, Nobuo; Ikeda, Yuki; Kimura, Kaemi; Kondo, Naomi; Kanai, Masashi; Kubo, Ikko; Yoshikawa, Ryohei; Matsuda, Yuichi

doi:10.1007/s00380-021-01783-5

Cited by 13 publications

(10 citation statements)

References 34 publications

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“…Therefore, we tend to believe that the clinical relevance of diagnosed events was comparable among phases, and that patients may have experienced more frequent episodes of true HF decompensation. Indeed, the detrimental effects of the lockdown in patients with cardiovascular diseases have recently been demonstrated [ 23 ]. Our findings seem to disagree with the observations of a recent work that suggested potential beneficial effects of the lockdown in ICD patients for the reduction in real-life stressors [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Ziacchi

Calò

D’Onofrio

et al. 2022

Biology

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Aims: The utilization of remote monitoring platforms was recommended amidst the COVID-19 pandemic. The HeartLogic index combines multiple implantable cardioverter defibrillator (ICD) sensors and has proved to be a predictor of impending heart failure (HF) decompensation. We examined how multiple ICD sensors behave in the periods of anticipated restrictions pertaining to physical activity. Methods: The HeartLogic feature was active in 349 ICD and cardiac resynchronization therapy ICD patients at 20 Italian centers. The period from 1 January to 19 July 2020, was divided into three phases: pre-lockdown (weeks 1–11), lockdown (weeks 12–20), post-lockdown (weeks 21–29). Results: Immediately after the implementation of stay-at-home orders (week 12), we observed a significant drop in median activity level whereas there was no difference in the other contributing parameters. The median composite HeartLogic index increased at the end of the Lockdown. The weekly rate of alerts was significantly higher during the lockdown (1.56 alerts/week/100 pts, 95%CI: 1.15–2.06; IRR = 1.71, p = 0.014) and post-lockdown (1.37 alerts/week/100 pts, 95%CI: 0.99–1.84; IRR = 1.50, p = 0.072) than that reported in pre-lockdown (0.91 alerts/week/100 pts, 95%CI: 0.64–1.27). However, the median duration of alert state and the maximum index value did not change among phases, as well as the proportion of alerts followed by clinical actions at the centers and the proportion of alerts fully managed remotely. Conclusions: During the lockdown, the system detected a significant drop in the median activity level and generated a higher rate of alerts suggestive of worsening of the HF status.

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Section: Discussionmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Ziacchi

Calò

D’Onofrio

et al. 2022

Biology

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“…Furthermore, the onset of COVID-19 lockdown restrictions were reported to reduce activity levels, in the form of step counts, by 16% in a population of heart failure patients [ 38 ]. Furthermore, research from CR participants in Japan revealed that COVID-19 related interruptions in CR practice were negatively associated with both activity levels and hemodynamic response, relative perceived exertion during exercise as well as body weight [ 39 ]. Older patients in particular (≥ 75 years), were also at greater risk of frailty [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, research from CR participants in Japan revealed that COVID-19 related interruptions in CR practice were negatively associated with both activity levels and hemodynamic response, relative perceived exertion during exercise as well as body weight [ 39 ]. Older patients in particular (≥ 75 years), were also at greater risk of frailty [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 lockdown restrictions on cardiac rehabilitation participation and behaviours in the United Kingdom

Kirwan

Heredia

McCullough

et al. 2022

BMC Sports Sci Med Rehabil

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Background COVID-19 lockdown measures led to the suspension of centre-based cardiac rehabilitation (CR). We aimed to describe the impact of lockdown on CR behaviours and perceptions of efficacy in a sample of CR participants. Methods An online survey was conducted amongst CR participants from May to October 2020, COVID-19-related lockdown restrictions. Anthropometric data, participant-determined levels of motivation and self-perceived efficacy, CR practices etc., pre- and post-lockdown, were collected. Results The probability of practicing CR in public gyms and hospitals decreased 15-fold (47.2% pre-, 5.6% post-lockdown; OR[95% CI] 0.065[0.013; 0.318], p < 0.001), and 34-fold (47.2% pre, 2.8% post; OR[95% CI] 0.029[0.004; 0.223], p < 0.001), respectively. Amongst participants, 79.5% indicated that their CR goals had changed and were 78% less likely to engage in CR for socialization after lockdown (47.2% pre, 16.7% post; OR[95% CI] 0.220[0.087; 0.555]; p = 0.002). The probability of receiving in-person supervision decreased by 90% (94.4% pre, 16.7% post; OR[95% CI] 0.011[0.002; 0.056]), while participants were almost 7 times more likely to use online supervision (11.1% pre, 44.4% post; OR[95% CI] 6.824[2.450; 19.002]) (both p < 0.001). Fifty percent indicated that their enjoyment of CR was lower than before lockdown and 27.8% reported they would be less likely to continue with CR in the newer format. Conclusions Lockdown was associated with considerable changes in how CR was practiced, motivation levels and willingness to continue with CR. Further research is warranted to develop and improve strategies to implement in times when individuals cannot attend CR in person and not only during pandemics.

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“…First, we could not evaluate the impact on outpatient outcomes. Interruption of outpatient programs could adversely impact patients, [34][35][36] and further studies are needed to confirm this assumption. Subsequently, the results of the present study were based on nationwide data from multiple centers in Japan.…”

Section: Discussionmentioning

confidence: 99%

Implementation of Rehabilitation and Patient Outcomes During the Initial COVID-19 Pandemic

Kanazawa

Inoue

Tani

et al. 2022

PRM

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This study investigated the impact of the initial outbreak of coronavirus disease (COVID-19) on rehabilitation and functional outcomes of patients in Japanese hospitals. Methods: The study subjects were hospitals belonging to Japan's National Hospital Organization that provided inpatient care for patients with coronavirus COVID-19 during March-May 2020. We specifically focused on patients who were hospitalized for acute diseases, such as stroke, hip fracture, acute myocardial infarction, congestive heart failure, or chronic obstructive pulmonary disease, and received rehabilitation during hospitalization. Data were sourced from Japanese administrative data. The primary outcome was rehabilitation provision time in the target hospitals. The secondary outcomes were patient outcomes: rehabilitation participation time, length of hospital stay, 30-day readmission rate, and improvement of activities of daily living. Interrupted time series analysis was performed to evaluate the trend of rehabilitation provision time. Patient outcomes were compared with those for 2019. Results: The rehabilitation provision time for outpatients declined by 62% during the pandemic, while that for inpatients declined temporarily, and then increased. Compared with 2019 outcomes, rehabilitation participation time was longer and hospital stay length was shorter for stroke and hip-fracture patients, the 30-day readmission rate was increased for hip-fracture patients, and improvement of activities in daily living was less for patients with congestive heart failure who were totally dependent at admission. Other outcomes did not change. Conclusions:The findings suggest that during the initial COVID-19 pandemic, resources for rehabilitation were quickly reallocated to inpatient care, and the impact on inpatient outcomes was minimized.

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Impact of the COVID-19 pandemic on phase 2 cardiac rehabilitation patients in Japan

Cited by 13 publications

References 34 publications

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Impact of COVID-19 lockdown restrictions on cardiac rehabilitation participation and behaviours in the United Kingdom

Implementation of Rehabilitation and Patient Outcomes During the Initial COVID-19 Pandemic

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