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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".