Submaximal 2-day cardiopulmonary exercise testing to assess exercise capacity and post-exertional symptom exacerbation in people with long COVID.

Long COVID has a complex pathology and a heterogeneous symptom profile that impacts quality of life and functional status. Post-exertional symptom exacerbation (PESE) affects one-third of people living with long COVID, but the physiological basis of impaired physical function remains poorly understood. Sixty-eight people (age (mean ± SD): 50 ± 11 years, 46 females (68%)) were screened for severity of PESE and completed two submaximal cardiopulmonary exercise tests separated by 24 h.

Tailoring interval training in stroke rehabilitation: The role of peak velocity.

Stroke rehabilitation demands innovative approaches to address the diverse physical limitations and functional goals of stroke survivors. Traditional interval training paradigms, such as high-intensity interval training (HIIT) and sprint interval training (SIT), often fall short of meeting the specific needs of this population due to their reliance on sustained or maximal efforts. Peak velocity interval training (PVIT) on the other hand, is an adaptable protocol tailored to optimize gait recovery in stroke survivors.

Cultural influences on choosing to move more and sit less.

Low levels of physical activity (PA) and prolonged periods of sedentary time significantly increase the risk of developing non-communicable diseases. Individuals who minimally increase their PA levels can experience significant reductions in risk of morbidity and mortality. Despite regular public messaging cycles and PA promotional campaigns highlighting these observations, the number of individuals meeting the PA recommendations has been underwhelming and stagnant for decades.

Effectiveness of home-based cardiac rehabilitation interventions delivered via mHealth technologies: a systematic review and meta-analysis.

Background: Centre-based cardiac rehabilitation (CBCR) is underused due to low referral rates, accessibility barriers, and socioeconomic constraints. mHealth technologies have the potential to address some of these challenges through remote delivery of home-based cardiac rehabilitation (HBCR). This study aims to assess the effects of mHealth HBCR interventions compared with usual care and CBCR in patients with heart disease.

Volume of Aerobic Exercise to Optimize Outcomes in Cardiac Rehabilitation: An Official Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation.

Exercise training is a core component of cardiac rehabilitation (CR) programming. Exercise and, more broadly, physical activity are critical elements to secondary prevention of cardiovascular disease. The central components of the exercise prescription are well-defined and include frequency (how many bouts of exercise per week), intensity (how hard to exercise), time (duration of exercise session), type (modality of exercise), and progression (rate of increase in the dose of exercise).

Profiling the persistent and episodic nature of long COVID symptoms and the impact on quality of life and functional status: a cohort observation study.

Background: Post-viral issues following acute infection with coronavirus disease 2019 (COVID-19), referred to widely as long COVID, are associated with episodic, persistent, and disabling symptoms affecting quality of life and functional status. Evidence demonstrates a significant impairment and long disease course, but there remains limited empirical data to profile and determine the fluctuating symptom profile of long COVID.

Methods: We devised a 16-week, multicentre prospective cohort observation study to profile changes in patient-reported outcomes, and biological, physiological, psychological, and cognitive parameters following diagnosis and/or referral to an established long COVID clinic.

Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation.

The science of cardiac rehabilitation and the secondary prevention of cardiovascular disease has progressed substantially since the most recent American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation update on the core components of cardiac rehabilitation and secondary prevention programs was published in 2007. In addition, the advent of new care models, including virtual and remote delivery of cardiac rehabilitation services, has expanded the ways that cardiac rehabilitation programs can reach patients. In this scientific statement, we update the scientific basis of the core components of patient assessment, nutritional counseling, weight management and body composition, cardiovascular disease and risk factor management, psychosocial management, aerobic exercise training, strength training, and physical activity counseling.

How to interpret a cardiorespiratory fitness assessment - Key measures that provide the best picture of health, disease status and prognosis.

Graded exercise testing is a widely accepted tool for revealing cardiac ischemia and/or arrhythmias in clinical settings. Cardiopulmonary exercise testing (CPET) measures expired gases during a graded exercise test making it a versatile tool that helps reveal underlying physiologic abnormalities that are in many cases only present with exertion. It also characterizes one's health status and clinical trajectory, informs the therapeutic plan, evaluates the efficacy of therapy, and provides submaximal and maximal information that can be used to tailor an exercise intervention.

The Impact of Light Physical Activity, Sedentary Behavior and Cardiorespiratory Fitness in Extending Lifespan and Healthspan Outcomes: How Little is Still Significant? A Narrative Review.

To describe the relationship between mortality and measures of low intensity physical activity (LIPA) as well as sedentary behavior (SB), and cardiorespiratory fitness (CRF). Study selection was performed through multiple database searches from January 1, 2000 until May 1, 2023. Seven LIPA studies, 9 SB studies, and 8 studies CRF studies were selected for primary analysis.

The Impact of COVID-19 on the Social Determinants of Cardiovascular Health.

Cardiovascular disease is the leading noncommunicable disease and cause of premature mortality globally. Despite well established evidence of a cause-effect relationship between modifiable lifestyle behaviours and the onset of risk of chronic disease, preventive approaches to curtail increasing prevalence have been ineffective. This has undoubtedly been exacerbated by the response to COVID-19, which saw widespread national lockdowns implemented to reduce transmission and alleviate pressure on strained health care systems.

Long-Term Maintenance of Cardiorespiratory Fitness Gains After Cardiac Rehabilitation Reduces Mortality Risk in Patients With Multimorbidity.

Purpose: The objective of this study was to characterize the impact of multimorbidity and cardiorespiratory fitness (CRF) on mortality in patients completing cardiac rehabilitation (CR).

Methods: This cohort study included data from patients with a history of cardiovascular disease (CVD) completing a 12-wk CR program between January 1996 and March 2016, with follow-up through March 2017. Patients were stratified by the presence of multimorbidity, which was defined as having a diagnosis of ≥2 noncommunicable diseases (NCDs).

Right Ventricular Contractile Reserve: A Key Metric to Identifying When Cardiorespiratory Fitness Will Improve With Pulmonary Vasodilators.

Cardiorespiratory fitness (CRF) has been proposed as a vital sign for the past several years, supported by a wealth of evidence demonstrating its significance as a predictor of health trajectory, exercise/functional capacity, and the quality of life. According to the Fick equation, oxygen consumption (VO) is the product of cardiac output (CO) and arterial-venous oxygen difference, with the former being a primary driver of one's aerobic capacity. In terms of the dependence of aerobic capacity on a robust augmentation of CO from rest to maximal exercise, left ventricular (LV) CO has been the historic focal point.

Role of BH deficiency as a mediator of oxidative stress-related endothelial dysfunction in menopausal women.

Endothelial function (brachial artery flow-mediated dilation [FMD]) is reduced in estrogen-deficient postmenopausal women, mediated, in part, by reduced nitric oxide (NO) bioavailability, secondary to tetrahydrobiopterin (BH) deficiency and oxidative stress. FMD is increased, but not fully restored, in postmenopausal women after acute intravenous vitamin C (VITC; superoxide scavenger) or oral BH supplementation. In vitro studies demonstrate that coadministration of VITC with BH prevents endothelial nitric oxide synthase (eNOS) uncoupling and reductions in NO by peroxynitrite.

It still takes a village: Advocating healthy living medicine for communities through social justice action.

Countless individuals in the United States continue to experience effects related to the coronavirus disease 2019 (COVID-19) pandemic, such as job/business instability, the breaking down of school systems, isolation, and negative health consequences. There are, however, certain populations and communities that continue to be disproportionately affected, resulting in severe health outcomes, decreased quality of life, and alarmingly high death rates. These populations typically live in historically excluded communities and identify as persons of color.