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European Journal of Physical and Rehabilitation Medicine 2020 Jan 23

DOI: 10.23736/S1973-9087.20.06013-X


language: English

Group-based cardiac rehabilitation interventions. A challenge for physical and rehabilitation medicine physicians: a randomized controlled trial

Jannis V. PAPATHANASIOU 1, 2 , Ivo PETROV 3, Maria P. TOKMAKOVA 4, Donka D. DIMITROVA 5, Liubomir SPASOV 6, Nigyar S. DZHAFER 7, Dorothea TSEKOURA 8, Yannis DIONYSSIOTIS 9, Arthur S. FERREIRA 10, Agnaldo J. LOPES 10, Eugenia ROSULESCU 11, Calogero FOTI 12

1 Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria; 2 Department of Kinesitherapy, Medical University of Sofia, Sofia, Bulgaria; 3 Clinic of Cardiology and Angiology, Acibadem City Clinic Cardiovascular Center University Hospital, Sofia, Bulgaria; 4 Department of Cardiology at Medical University of Plovdiv, Plovdiv, Bulgaria; 5 Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; 6 Cardiac Surgery Clinic Lozenets, University Hospital, Faculty of Medicine, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria; 7 Department of Health Policy and Management, Faculty of Public Health, Medical University of Sofia, Sofia, Bulgaria; 8 Aretaieio Hospital, Athens Medical School, Athens, Greece; 9 First Physical Medicine & Rehabilitation Department, National Rehabilitation Center, Athens, Greece; 10 Rehabilitation Sciences Post-graduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil; 11 Department of Physical Therapy and Sports Medicine, Faculty of Physical Education and Sport, University of Craiova, Craiova, Romania; 12 Department of Physical Medicine and Rehabilitation, Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy


BACKGROUND: In recent decades, many studies are focused on different training modalities comparison in patients with cardiac diseases. High intensity aerobic interval training (HIAIT) has been considered as an alternative approach to moderate-intensity continuous training (MICT) in rehabilitation of patients with chronic heart failure (CHF).
AIM: To highlight the superiority of the modified group-based HIAIT intervention (m- Ullevaal) compared to the moderate-intensity continuous training (MICT), also to encourage physical and rehabilitation medicine (PRM) physicians to apply the m-Ullevaal intervention in routine cardiac rehabilitation (CR) practice.
DESIGN: А single-blind, prospective randomized controlled trial.
SETTING: Medical Center of Rehabilitation and Sports Medicine, Plovdiv, Bulgaria outpatients were enrolled.
POPULATION: One hundred and twenty subjects of both genders, mean age of 63.73 ± 6.68 years, with stable CHF, NYHA classes II to IIIB, were randomly assigned to m-Ullevaal group (N=60) or to MICT (N. =60) group. Both CR protocols were conducted throughout a 12 week period.
METHODS: Functional exercise capacity (FEC), assessed with six-minute walk test (6MWT), and peak oxygen uptake (VO2 peak), left ventricular ejection fraction (LVEF), m- Borg’s perceived exertion scale (mBPES), and quality of life (QoL) were outcome measures evaluated.
RESULTS: Significant improvement in FEC (P<0.001), LVEF (P<0.001), mBPES and QoL (P<0.001), was observed 12 weeks after both CR interventions (T2). However, the participants performed m-Ullevaal protocol achieved a greater improvement compared to those performed MICT (P<0.001).
CONCLUSIONS: The m-Ullevaal protocol seems to be more beneficial and more effective compared to MICT. PRM physicians can efficiently apply the m-Ullevaal protocol in CHF patients rehabilitation.
CLINICAL REHABILITATION IMPACT: Group-based HIAIT interventions can be widely applied by PRM physicians in CHF patients rehabilitation.

KEY WORDS: M-Ullevaal; Moderate continuous training; Six-minute walk test; Intervention

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