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• Cardiopulmonary exercise testing predicts postoperative outcome in patients undergoing gastric bypass surgery

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  Cardiopulmonary exercise testing predicts postoperative outcome in patients undergoing gastric bypass surgery

  Author(s)

  P.J. Hennis, P.M. Meale, R.A. Hurst, A.F. O’Doherty, J. Otto, M. Kuper, N. Harper, P.A. Sufi, D. Hearth, H.E. Montgomery, M.P.W. Grocott
  Date
  2012-10-25
  Source
  British Journal of Anaesthesia, Volume 109, Issue 4, pp 566-571 (2012)

  Background For several types of non-cardiac surgery, the cardiopulmonary exercise testing (CPET) derived variables anaerobic threshold (AT), peak oxygen consumption ( peak), and ventilatory equivalent for CO2 ( ) are predictive of increased postoperative risk: less physically fit patients having a greater risk of adverse outcome. We investigated this relationship in patients undergoing gastric bypass surgery.
  Methods All patients (<190 kg) who were referred for CPET and underwent elective gastric bypass surgery at the Whittington Hospital NHS Trust between September 1, 2009, and February 25, 2011, were included in the study (n=121). Fifteen patients did not complete CPET. CPET variables ( peak, AT, and ) were derived for 106 patients. The primary outcome variables were day 5 morbidity and hospital length of stay (LOS). The independent t-test and Fisher's exact test were used to test for differences between surgical outcome groups. The predictive capacity of CPET markers was determined using receiver operating characteristic (ROC) curves. Results The AT was lower in patients with postoperative complications than in those without [9.9 (1.5) vs 11.1 (1.7) ml kg−1 min−1, P=0.049] and in patients with a LOS>3 days compared with LOS≤3 days [10.4 (1.4)vs 11.3 (1.8) ml kg−1 min−1, P=0.023]. ROC curve analysis identified AT as a significant predictor of LOS>3 days (AUC 0.640, P=0.030). The peak and were not associated with postoperative outcome.
  Conclusions AT, determined using CPET, predicts LOS after gastric bypass surgery

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• Combining perceptual regulation and exergaming for exercise prescription in low-active adults with and without cognitive impairment

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  Combining perceptual regulation and exergaming for exercise prescription in low-active adults with and without cognitive impairment

  Author(s)

  Liam McAuliffe, Gaynor C. Parfitt, Roger G. Eston, Caitlin Gray, Hannah A. D. Keage and Ashleigh E. Smith

  Date

  2018-01-30

  Source

  BMC Sports Science, Medicine and Rehabilitation

  Background
  Exercise adherence in already low-active older adults with and without mild cognitive impairment (MCI) remains low. Perceptual regulation and exergaming may facilitate future exercise behaviour by improving the affective experience, however evidence that this population can perceptually regulate is lacking. To explore this, we investigated 1) perceptual regulation of exercise intensity during either exergaming or regular ergometer cycling and 2) explored affective responses.

  Methods
  Thirty-two low active older adults (73.9 ± 7.3 years, n = 16, 8 females) with or without MCI (70.9 ± 5.5 years, n = 16, 11 females) participated in a sub-maximal fitness assessment to determine ventilatory threshold (VT) and two experimental sessions (counterbalanced: exergaming or regular ergometer cycling). Experimental sessions consisted 21-min of continuous cycling with 7-min at each: RPE 9, 11 and 13. Oxygen consumption (VO2), heart rate (HR), and affect (Feeling Scale) were obtained throughout the exercise.

  Results
  VO2 (p < 0.01) and HR (p < 0.01) increased linearly with RPE, but were not significantly different between exercise modes or cognitive groups. At RPE 13, participants worked above VT in both modes (exergaming: 115.7 ± 27.3; non-exergaming 114.1 ± 24.3 VO2 (%VT)). Regardless of cognitive group, affect declined significantly as RPE increased (p < 0.01). However on average, affect remained pleasant throughout and did not differ between exercise modes or cognitive groups.

  Conclusions
  These results suggest low-active older adults can perceptually regulate exercise intensity, regardless of cognition or mode. At RPE 13, participants regulated above VT, at an intensity that improves cardiorespiratory fitness long-term, and affect remained positive in the majority of participants, which may support long-term physical activity adherence.

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• Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events

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  Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events

  Author(s)

  Richard V. Milani, Carl J.Lavie MD, Mark M. Cassidy MD

  Date

  1996-10-01

  Source

  American Heart Journal, Volume 132, Issue 4, October 1996, pages 726 – 732

  To evaluate the effect of cardiac rehabilitation and exercise training on depression after major cardiac events, we studied 338 consecutive patients in whom a major cardiac event had occurred 4 to 6 weeks previously and who were participating in phase II cardiac rehabilitation consisting of 36 sessions over a 3-month period. Depressive symptoms and other behavioral characteristics and quality-of-life parameters were analyzed by validated questionnaire. Depression was prevalent in patients with coronary heart disease, occurring in 20% of the patients evaluated. At baseline, depressed patients had lower exercise capacity, reduced high-density lipoprotein cholesterol level, and higher triglyceride levels; had lower scores for mental health, energy or fatigue, general health, pain, overall function, well-being, and total quality of life; and had greater scores for somatization, anxiety, and hostility than those of nondepressed patients. After cardiac rehabilitation, depressed patients had marked improvements in depression scores and other behavioral parameters (anxiety, somatization, and hostility) and quality of life. Depressed patients also showed improved exercise capacity, percentage of body fat, and levels of triglycerides and high-density lipoprotein cholesterol. Depressed patients exhibited statistically greater improvements in certain behavioral and quality-of-life parameters than did nondepressed patients. Two thirds of the patients who were initially depressed resolved their symptoms by study completion. In conclusion, depression is reduced in patients with symptomatic coronary heart disease patients enrolled in cardiac rehabilitation. Greater emphasis is needed to ensure that depressed patients are referred to and attend formal cardiac rehabilitation programs after major cardiac events.

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