• 성인간호학회지
• /
• 제25권5호
• /
• pp.515-526
• /
• 2013

Purpose: The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease. Methods: The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group. Results: The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom. Conclusion: The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.

• 한국산학기술학회논문지
• /
• 제17권9호
• /
• pp.464-471
• /
• 2016

본 연구는 심근경색 환자에서 젊은 환자군과 60세 이상의 노인 환자군에서 심장 재활이 심폐운동 기능에 미치는 효과를 비교하고자 하였다. 2012년에서 2015년까지 심장 재활을 실시하였던 환자 중 외래 경과 관찰중인 환자의 기록을 후향적으로 분석하였다. 총 46명 (60세 이상의 노인 18명, 28명의 60세 미만의 젊은 환자군)이 연구에 포함되었다. 대상자들은 초기 운동부하 검사 결과를 바탕으로 심장재활 치료실에서 심전도 감시 하에 유산소 운동요법을 시행하였다. 심폐기능은 심장재활 실시 전, 후로 운동부하 검사에 의해 평가되었다. 심장재활을 실시하기 전 시행한 운동 부하 검사에서 최대 산소소모량, 최대 운동시의 신진대사 해당치, 무산소 역치 지표 등이 60세 이상의 노인에서 의미 있는 운동 기능 저하가 관찰되었다(p<0.05). 심장재활 전과 후의 운동 능력을 비교하였을 때, 두 군에서 최대 운동 가능시간, 최대하 심근부담률, 최대 심박수, 안정시 심박수, 최대 산소 소모량, 최대 산소소모량 측정시의 최대 환기량, 최대 운동시의 신진대사 해당치, 무산소 역치 지표에서 통계학적으로 유의한 변화가 관찰되어(p<0.05), 심장재활 후 두 군 모두에서 운동기능의 개선의 효과가 있었다. 60세 이상 군과 60세 미만 군 두 군 사이에서 심장재활 전과 후의 운동능력 지표 변화율의 상대적인 비교 시에 최대 운동 가능시간, 최대 산소 소모량, 최대 운동시 신진대사 해당치, 무산소 역치 지표 등의 모든 운동 부하 검사 결과는 유사한 호전을 보였다. 한국에서 노인 환자의 심장재활 참여율과 전과율은 낮은 상태이다. 60세 이상의 노인 환자에서의 심장재활의 참여를 확대하는 것이 필요할 것으로 생각된다.

• 한국전문물리치료학회지
• /
• 제1권1호
• /
• pp.83-87
• /
• 1994

The purpose of this paper is to provide an overview of the clinical physical therapy program used at the University of Yonsei Rehabilitation Hospital, for the practicing university trained physical therapists who may be unfamiliar with patients who have suffered a myocardial infarction. The four primary phases of the cardiac physical therapy graded exercise program are: 1) coronary care unit program (phase I), 2) general ward program (phase II), 3) convalescence program (phase III), 4) maintenance program (phase IV). The exercise prescription defines the exercise intensity, duration, frequency, and mode of exercise a after pre- discharge low level graded exercise test(LL-GXT) or symptom limited maximum graded exercise test. A typical exercise routine consists of preparation warm-up exercise, therapeutic exercise, cool-down exercise. Physical therapy is involved in the acute care and rehabilitation of the patient after a myocardial infarction. Therefore, the physical therapist must throughly comprehened the cardiac anatomy, cycle, performance, conduction system, pathogenesis, risk factors, and exercise benefits.

• Physical Therapy Rehabilitation Science
• /
• 제4권1호
• /
• pp.17-21
• /
• 2015

Objective: In this study, we aimed to test the hypothesis that aerobic exercise might exert its cardio-protective effect by preventing oxidative stress and improving cardiac function in rat models with doxorubicin-induced cardiomyopathy. Design: Randomized controlled trial. Methods: We randomly divided experimental rats into four groups: the normal group was used as a non-cardiomyopathy normal control (n=10); the control group included non-aerobic exercise after doxorubicin-induced cardiomyopathy (n=10); the experimental group I included aerobic exercise (3 m/min) after doxorubicin-induced cardiomyopathy (n=10); and experimental group II included aerobic exercise (8 m/min) after doxorubicin-induced cardiomyopathy. Rats in the treadmill training groups underwent treadmill training, which began at 2 weeks after the first intraperitoneal injection. At the end of the exercise period, we determined the heart weight change for each rat. Changes in the levels of oxidative stress enzymes (superoxide dismutase [SOD], thiobarbituric acid-reactive substances [TBARS], and catalase) in the cardiac tissue of rats from all four groups were examined at the end of the experiment. Results: Significant cardiac myocyte injury and increase in myocardial TBARS concomitant with a reduction in myocardial SOD and catalase were observed following cardiomyopathy (p<0.05). Significant cardiac tissue and increase in myocardial TBARS along with reduction in myocardial SOD and catalase were observed following cardiomyopathy (p<0.05). Oxidative parameters were significantly improved in the aerobic exercise groups compared with the control group. Conclusions: These findings indicate that aerobic exercise effectively prevents oxidative stress in rat models with cardiomyopathy.

• 대한의생명과학회지
• /
• 제17권4호
• /
• pp.321-328
• /
• 2011

This study divided a group of healthy adults aged 20 or older who had a health examination at J General Hospital in Gyeonggi Province into three groups according to the degrees of metabolic syndrome risk factors. They include the normal group (n=58), the pre-metabolic syndrome group (n=112) and the metabolic syndrome group (n=32). They were compared in exercise capacity and cardiac structure and function and impacts of exercise capacity on the cardiac diastolic function. All the groups took echocardiography to have their cardiac structures and functions examined and an exercise stress test to have their exercise capacity measured. The research findings were as follows: There were differences in exercise capacity, cardiac structure, and diastolic heart function among three groups. Between exercise capacity and diastolic heart function was found to be related. It turned out exercise capacity affected the cardiac diastolic functions. In conclusion, there were significant differences in exercise capacity between the normal group and the metabolic syndrome group and in the cardiac structure and function among the normal, metabolic syndrome, and pre-metabolic syndrome group. In addition, METs (metabolic equivalents) and heart rate recovery of exercise capacity turned out to affect cardiac diastolic functions.

• Clinical and Experimental Pediatrics
• /
• 제62권6호
• /
• pp.244-244
• /
• 2019

• The Journal of Korean Physical Therapy
• /
• 제31권5호
• /
• pp.322-327
• /
• 2019

Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

• 한국전문물리치료학회지
• /
• 제1권1호
• /
• pp.75-82
• /
• 1994

The purpose of this study is to determine cardiovascular reponses to concentric, eccentric and isometric exercise applied to the knee extensor muscle group. Exercise types studied were concentric, eccentric and isometric. The subjects were sixty healthy male volunteers who had no hypertension or cardiac disease. Heart rate, systolic and diastolic blood pressure were recorded prior to starting exercise. The subjects also performed 10RM on right lower extremity. A N-K table was used for three exercises to right knee extensors. Each exercise was selected randomly and applied to each subject 10 times in a 10 second. After each exercise, heart rate, systolic and diastolic blood pressure were recorded immediately. Findings were as follows concectric contractions had a greater effect on the increase of systolic blood pressure and heart rate than eccentric or isometric contractions. Diastolic blood pressure is influenced only by isometric contractions. Eccentric contractions have less effect on the increase of systolic blood pressure and heart rate than concentric or isometric contractions. We hope that the results of this experiment can be adapted to exercise programs for patients with cardiac disease.

• Journal of Chest Surgery
• /
• 제52권4호
• /
• pp.248-329
• /
• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• Journal of Medicine and Life Science
• /
• 제19권2호
• /
• pp.57-65
• /
• 2022

This study aimed to compare the Korean Activity Status Index (KASI) with the cardiopulmonary exercise test (CPET) among patients with acute myocardial infarction. A total of 2,268 patients (85.4% male; mean age, 59.3±10.2 years; range, 23-90 years) diagnosed with acute myocardial infarction were enrolled in the Regional Center Myocardial Infarction Registry between July 2016 and June 2019. The KASI is a tool used to measure functional capacity by asking patients about their ability to perform specific activities and then scoring their responses. In contrast, CPET is the gold standard for assessing the objective functional capacity in patients undergoing cardiac rehabilitation. Peak oxygen uptake (VO_2peak) was used to analyze the correlation. Patients who completed two consecutive KASI and CPET evaluations during their first (KASI_1, VO_2peak_1) and second visits (KASI_2, VO_2peak_2) for cardiac rehabilitation were included in the study. The mean KASI_1 and KASI_2 scores were 43.3±14.3 and 49.8±13.9, respectively, and the mean VO_2peak_1 and VO_2peak_2 scores were 25.9±8.0 and 28.5±8.3, respectively. Both the KASI scores were significantly correlated with the measured VO_2peak during each visit, with correlation coefficients of 0.385 (P<0.001) and 0.346 (P<0.001), respectively. Moreover, the KASI score and VO_2peak had a linear relationship (VO_2peak_1=0.22×KASI_1+16.5, P<0.001; VO_2peak_2=0.21×KASI_2+18.2,VO_2peak_2=0.21×KASI_2+18.2, P<0.001). This study revealed that the KASI is a valid measure for the follow-up evaluation of the functional capacity of patients. These findings suggest that VO_2peak can be predicted using the KASI score in patients who do not undergo CPET.