Impact of personalized accurate intensity exercise on radial artery pulse wave in patients with multi-chronic diseases: a holistic functional assessment approach.

Background: The prevalence of chronic diseases continues to rise. Personalized accurate intensity exercise based on an overall functional evaluation is a useful supplement to medication therapy. The aim of this study is to provide a simple method for detecting human function and evaluating the role of individualized exercise.

Methods: This retrospective cohort study included 30 patients with chronic diseases and 30 healthy subjects. A cardiopulmonary exercise test (CPET) was performed on all participants to determine their functional state. An individualized exercise intensity was set based on the CPET results, and exercise was performed for 30 minutes at that intensity. Pulse waves were recorded for 50 seconds each before exercise and at 10, 20, and 30 minutes after exercise. This study compared pulse wave parameters before and after exercise, including radial artery pulse pressure difference (ΔYP1), upstroke time (UT), upstroke time per cardiac cycle (UTCC), diastolic time to systolic time ratio (DT/ST), reflection index (RI), stiffness index (SI), and dicrotic wave rate.

Results: Compared with healthy subjects, patients with chronic diseases were older and had greater body mass index (BMI) (P<0.001). All pulmonary function indicators of patients were significantly lower than those of healthy subjects (P<0.05). Patients had lower measured-to-estimated values for peak oxygen uptake (peak ) (P<0.001). After eliminating the influence of age differences, the two-way repeated-measures analysis of variance demonstrated significant time difference for DT/ST (P=0.001), RI (P<0.001) and SI (P=0.005). Significant group differences were observed in ΔYP1 (P=0.03), UT (P=0.03) and SI (P=0.009). Patients have a lower incidence of dicrotic waves before and after exercise (P<0.001).

Conclusions: Personalized intensity exercise can reveal nonobvious functional decline and may benefit patients with chronic diseases, as well as the importance of pulse waves in the early detection of chronic diseases and reflecting patients' cardiovascular function state.