Jurnal 2 PDF
Jurnal 2 PDF
Jurnal 2 PDF
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Please cite this article in press as: Papathanasiou J, et al., The effect of group-based cardiac rehabilitation models on the quality of life
and exercise capacity of patients with chronic heart failure, Hellenic Society of Cardiology (2017), http://dx.doi.org/10.1016/
j.hjc.2017.04.003
+ MODEL
2 Letter to the Editor
Figure 1 Patient flow diagram. HIAIT m-Ullevaal: high-intensity aerobic interval training; MICT: moderate-intensity continuous
training.
The modified Borg scale9 and beats per minute music the relation between change in QoL (MLHFQ score) and
pieces were used to adjust the exercise intensity of each change in 6MWD. Unless otherwise stated, data are pre-
training interval. Each interval of m-Ullevall CR model sented as mean standard deviation (SD), with a signifi-
lasted for 5 and 10 min, while the overall duration of the cance level of p <0.001.
session was 40 min. The members of CR team offered 12
consultations to the participants regarding symptom 2. Results
management of CHF, medication issues, and dietary
recommendations.8
The MLHFQ scores significantly improved after 12 weeks of
Thirty-seven (nZ37) subjects of our study were ran-
CR interventions in both exercise groups. However, the
domized to perform MICT on electromagnetically braked
improvement in MLHFQ score was significantly greater in
cycle ergometers (Pure Bike R 4.1, Tunturi, Netherlands).
the m-Ullevaal group than in the MICT group (-17.26% vs.
During each MICT training session, the subjects were
-6.42%, p<0.001). A 10-point difference between groups
encouraged to achieve HRmax of 90%. The functional ca-
in MLHFQ scores was observed after 12 weeks (7- and 3-
pacity was evaluated by the 6-min walk test (6MWT), which
point improvement in the m-Ullevaal and MICT groups,
has been widely used as an effective and necessary tool in
respectively). A significant increase was found in the dis-
modern CR.10 It was performed in a 30-m marked corridor in
tance covered assessed through 6MWT in the m-Ullevaal
the Medical Center for Rehabilitation and Sports Medicine I
and MICT groups (63 m, 14.53% vs. 44 m, 10.6%, respec-
(Plovdiv, Bulgaria). All included subjects were requested
tively, p<0.001). A significant inverse correlation was
to complete the translated Bulgarian version of the Min-
observed between changes in MLHFQ score and changes in
nesota Living with Heart Failure questionnaire (MLHFQ)
6MWTD (rZ0. 35), indicating changes in QoL related to
at baseline (T1) and after 24 training sessions (after 12
improved functional capacity. Detailed results are pre-
weeks; T2).11
sented in Table 1.
The training sessions were supervised by the members of
the CR team (cardiologist, PRM physician, physiotherapist,
and nurse) of the Medical Center for Rehabilitation and 3. Discussion
Sport Medicine I (Plovdiv, Bulgaria).8 Data were analyzed
with Statistical Package SPSS version 17.0 (SPSS Inc., Chi- The improvement in MLHFQ scores achieved in both CR
cago, IL, USA). We used the graphical assessment of groups may be associated with the poor MLHFQ scores at
normality and Kolmogorov-Smirnov (K-S) test. Independent- baseline, which were lower than the MLHFQ scores from
sample t-test and Mann-Whitney U-test were used to eval- other studies with similar design and, consequently, pro-
uate unrelated observations between groups and correla- vide a large gap for further improvement. We speculate
tion analysis (Pearson’s correlation coefficient) to assess that the low scores achieved in MLHFQ by the Bulgarian
Please cite this article in press as: Papathanasiou J, et al., The effect of group-based cardiac rehabilitation models on the quality of life
and exercise capacity of patients with chronic heart failure, Hellenic Society of Cardiology (2017), http://dx.doi.org/10.1016/
j.hjc.2017.04.003
+ MODEL
Letter to the Editor 3
Table 1 MLHFQ and Functional Capacity (6MWT) in both CR groups before and after CR interventions (mean SD).
Training Groups HIAIT (m-Ullevaal) MICT
Variable Baseline (T1) Follow up (T2) Difference P Baseline (T1) Follow up (T2) Difference P
T2-T1 (%) T2-T1 (%)
MLHFQ 37.376.66 30.926.54 - 17.263.78 <0.001 38.278.44 35.818.56 - 6.423.06 <0.001
6MWT (m) 443.242.9 506.339.3 14.54,7 <0.001 436.541.9 480.243.9 102.6 <0.001
patients with CHF can be associated, on the one hand, with References
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Please cite this article in press as: Papathanasiou J, et al., The effect of group-based cardiac rehabilitation models on the quality of life
and exercise capacity of patients with chronic heart failure, Hellenic Society of Cardiology (2017), http://dx.doi.org/10.1016/
j.hjc.2017.04.003
+ MODEL
4 Letter to the Editor
Petya Kasnakova
*Corresponding author. Jannis Papathanasiou, MD, PhD,
Department of Rehabilitation, Medical College, Medical
Department of Kinesitherapy, Faculty of Public Health,
University of Plovdiv, Bulgaria
Medical University of Sofia, Bulgaria, Department of Medi-
cal Imaging, Allergology & Physiotherapy, Medical Univer-
Zaharias Tsakris sity of Plovdiv, Bulgaria
Department of Kinesitherapy, Faculty of Public Health, Tel.: þ359889101178; fax: þ35932940606.
Medical University of Sofia, Bulgaria E-mail address: giannipap@yahoo.co.uk (J. Papathanasiou)
Department of Medical Imaging, Allergology &
Physiotherapy, Mediccal University of Plovdiv, Bulgaria 2 February 2017
Available online XXX
Please cite this article in press as: Papathanasiou J, et al., The effect of group-based cardiac rehabilitation models on the quality of life
and exercise capacity of patients with chronic heart failure, Hellenic Society of Cardiology (2017), http://dx.doi.org/10.1016/
j.hjc.2017.04.003