Improvement in aerobic endurance and pulmonary oxygen uptake during a six-minute walk test after participating in a combined in-person and home based (My Heart Coach) cardiac rehabilitation program
Notice bibliographique
Résumé
Abstract Background Since COVID-19, cardiac rehabilitation (CR) programs are moving towards fewer in-person sessions, therefore the need for home-based support is paramount for patient well-being and fitness benefits. Moreover, reducing the barriers for participation and ensuring better CR accessibility is important. Our research group recently developed a home-based online rehabilitation support program "My Heart Coach" which provides exercise support to people throughout their CR program. Purpose We determined aerobic endurance (6-minute walk test [6MWT] distance) and heart rate (HR) and pulmonary oxygen uptake (VO2) during and following (i.e., recovery kinetics) 6MWT in patients undertaking combined center- and home-based CR. Methods Twenty-seven patients (64±11 years, 5 female) attended assessments at baseline (BL) and after 12 weeks of combined in-person CR (exercise training 1 day/week for 8 weeks) with online MHC support. At each assessment, 6MWT was performed following American Thoracic Society guidelines1. HR and VO2 were continuously measured at rest, during, and immediately following (for 5 min) 6MWT. Rate of perceived exertion (RPE; Borg 6-20 scale) was recorded following 6MWT. Exercise HR and VO2 were determined in the last two-minutes of the 6MWT, and recovery kinetics for both variables were determined using non-linear modelling (OriginLab, 2023b) to yield the mean response time (MRT = time delay to onset of the exponential recovery + time constant of the recovery curve; Figure 1) during seated rest. The effect of the intervention was evaluated using two-tailed paired t-tests and differences considered significant when p<0.05. Results At baseline, patients walked 452±117m at an RPE of 13±2 and this improved by 63±46m after the intervention (515±131m, p<0.01) with a similar RPE (14±2, p=0.13). Resting VO2 was higher following the intervention (p<0.01) with no change in resting HR (p=0.71; Figure 2A/B). Pulmonary VO2 during 6MWT was higher after the 12-week intervention (BL: 12.4±3.2 ml/kg/min; 12wk: 14.5±4.3 ml/kg/min; p<0.01); however, exercising HR was not different between time-points (BL: 103±19 bpm; 12wk: 107±18 bpm; p=0.21; Figure 2C/D). The MRT for HR (BL: 54±23 s; 12wk: 8±16 s; p=0.35; Figure 2E) and VO2 (BL: 73±25 s; 12wk: 81±38 s; p=0.16; Figure 2F) were not significantly changed by the intervention despite greater distance covered (i.e., higher speed) at a higher exercising VO2. Conclusion A 12-week blended CR program is an effective intervention to improve aerobic endurance during a 6MWT. Our finding of a higher VO2, but not HR, during exercise despite a similar VO2 recovery kinetics suggests favorable peripheral adaptations that result in greater skeletal muscle oxygen utilization after CR participation.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».