Browsing by Author "Delgado, Bruno"
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- Aerobic and resistance exercise in heart failure inpatients: a scoping reviewPublication . Lopes, Ivo; Delgado, Bruno; Costa, Patrício; Padilha, José Miguel Santos CastroExercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart failure, there is still no consensus on their prescription in patients hospitalized with acute heart failure undergoing clinical stabilization. The aim of this study is to identify the literature on exercise programs encompassing the components of aerobic and resistance training for hospitalized patients admitted for acute heart failure. A scoping review was conducted according to the proposed methodology of the Joanna Briggs Institute. Studies with adults over 18 years old, hospitalized, and diagnosed with acute heart failure who participated in aerobic and resistance exercise training programs during their hospital stay were included. Three studies met the inclusion criteria. One was a retrospective, observational analytical cohort study, in which the main outcome of the exercise program was improvement in the previous disabilities of the participants. The other two were multicenter randomized controlled studies that showed greater improvement in physical function, functional capacity, depression, quality of life, and frailty status in the intervention groups. The exercise prescriptions differed according to the principles of the exercise prescription—frequency of exercise, intensity of exercise, exercise time (duration), type (mode), exercise volume, and progression. It is too early to make recommendations based on evidence of the type structure of an exercise program with aerobic and strength-training components in this population. However, in the exercise programs of the reviewed studies, the predominance of light to moderate intensity and the importance of progressively increase the frequency and duration of the training sessions were demonstrated, with bicycle ergometers and walking being the most common types of aerobic exercises. It is recommended that investment and research in this area should continue with more methodologically robust studies.
- Impacte de um programa de exercício físico (ERIC) em contexto de internamento no doente com insuficiência cardíaca descompensada – estudo preliminarPublication . Delgado, Bruno; Lopes, Ivo; Mendes, Eugénia; Preto, Leonel; Novo, André; Gomes, BárbaraIntrodução: A insuficiência cardíaca (IC) acarreta limitação nas atividades da vida diária e consequente perda de autonomia funcional e instrumental. Representa um dos problemas de saúde mais preocupantes devido ao seu impacte económico significativo. Objetivo: Identificar o impacte de um programa de exercício físico nos doentes com IC em fase de compensação em contexto hospitalar. Métodos: Foi implementado um estudo exploratório retrospectivo no qual participaram vinte doentes que realizaram um mínimo de 3 sessões do programa ERIC. Os sinais vitais, monitorização do ECG e da perceção subjetiva de esforço (PSE) foram avaliados antes e depois de cada sessão de treino, bem como escala LCADL e os parâmetros do exercício (número de voltas na pedaleira, o número de metros caminhados no corredor e número de degraus percorridos). O estudo apresentado decorreu num período de 3 meses. Resultados: Os doentes (idade média de 64 anos) apresentaram uma variação positiva nos parâmetros de desempenho do exercício, uma variação negativa na escala LCADL (29,9-20,9) e PSE após o exercício (4,85-3,82), o que significa que melhoram a sua capacidade funcional ao longo do programa. Nenhum dos odentes apresentou eventos adversos ou treinou fora do intervalo de frequência cardíaca de segurança (valor médio de 11,2 bpm a 12,9 bpm). Conclusões: O programa ERIC demonstra segurança e melhoria da Capacidade Funcional do doente, com base na análise estatística desta amostra, Estes resultados permitem-nos inferir que o exercício poderá ser um recurso efetivo para o tratamento coadjuvante de doentes admitidos com insuficiência cardíaca descompensada. Contudo, serão necessários mais estudos com amostras maiores e com desenho do tipo randomizado.
- The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients: Results of a multicenter randomized controlled trial (ERIC-HF study)Publication . Delgado, Bruno; Novo, André; Lopes, Ivo; Rebelo, Carina; Almeida, Cecília; Pestana, Sandra; Gomes, Bárbara; Froelicher, Erika; Klompstra, LeonieObjective: To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design: A randomized controlled clinical trial with follow-up at discharge. Settings: Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments: Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome: Functional exercise tolerance was measured with a 6-min walking test at discharge. Results: In total 257 patients with DHF were included, with a mean age of 67±11 years, 84% (n=205) had a reduced ejection fraction and the hospital stay was 16±10 days. At discharge, patients in the intervention group walked further compared to the control group (278±117m vs 219±115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96±7 vs 93±12, p=0.02) and dyspnea associated to ADL (13±5 vs 17±7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p=0.02). Conclusion: The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.