Rehab Centers: High-Intensity Cardiac Rehabilitation Training of a Police Officer for His Return to Work and Sports After Coronary Artery Bypass Grafting.

High-intensity cardiac rehabilitation training of a police officer for his return to work and sports after coronary artery bypass grafting.

Filed under: Rehab Centers

Proc (Bayl Univ Med Cent). 2013 Jan; 26(1): 39-41
Adams J, Berbarie RF

A 39-year-old male police officer with coronary artery disease enrolled in our cardiac rehabilitation (CR) program after coronary artery bypass grafting. He wanted to return not only to his job but also to playing ice hockey and outdoor soccer, and his responses to a self-assessment scale confirmed that he identified strongly as an athlete. On the basis of this unique profile, the CR staff designed an occupation- and sport-specific exercise program that was symptom limited and enabled the patient to train safely, but earlier and at a higher intensity than is typically allowed in conventional CR programs. The exercises were selected to replicate the various combinations of muscular strength, agility, and cardiovascular endurance required by the patient’s police work and two competitive team sports. He completed the high-intensity training with no clinically significant adverse symptoms.
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Lessons learned from study of depression in cardiovascular patients in an acute-care heart and vascular hospital.

Filed under: Rehab Centers

Proc (Bayl Univ Med Cent). 2013 Jan; 26(1): 6-9
Davis M, Brennan JM, Vish N, Adams J, Muldoon M, Renbarger T, Garner J

Depression is highly prevalent in patients with cardiovascular disease, but questions about the effectiveness of screening and intervention remain unanswered. To evaluate the effects of proactive intervention at an acute-care heart and vascular hospital, patients who reported depressive symptoms on admission were randomized to an active, counseling-based depression intervention plus standard care (referral to a primary or psychiatric care physician) or to standard care alone. Despite early termination of patient enrollment because of lower-than-expected recruitment rates, the project had a positive impact. By involving and educating staff, the investigators raised awareness and improved the process of identifying and helping depressed patients. The lessons in study design and execution gained from this experience will help ensure success in future studies of this condition.
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The influence of non-modifiable illness perceptions on attendance at cardiac rehabilitation.

Filed under: Rehab Centers

Eur J Cardiovasc Nurs. 2013 Feb 4;
Blair J, Angus NJ, Lauder WJ, Atherton I, Evans J, Leslie SJ

Background:Despite the established benefits of cardiac rehabilitation (CR) attendance rates remain variable. Physical barriers to attendance have been extensively investigated but relatively less is known about the relationship between attendance at CR and psychosocial variables such as illness perceptions and social isolation.Aim:To examine the influence of socio-demographic factors, illness perceptions and social isolation on patient attendance at cardiac rehabilitation.Methods:All individuals offered CR over a two-year period were invited to take part in a postal survey. The survey collected socio-demographic data and included completion of the Friendship Scale, to assess social isolation, and the Brief Illness Perceptions Questionnaire. Parametric and non-parametric statistical tests were used as appropriate.Results:One hundred and twenty-eight (47%) questionnaires were returned. Non-attendees reported higher total illness perception scores and those who attributed their illness to non-modifiable factors were significantly less likely to attend CR (p = 0.042). Attendees reported lower levels of social isolation; however, this finding was not statistically significant. No differences were found between attendees and non-attendees in terms of their age, gender, educational status or proximity to cardiac rehabilitation centre.Conclusion:Psychosocial barriers, specifically illness perceptions and attributions, were found to be significant with patients who did not attend CR reporting more negative illness perceptions. Distance to CR was not a significant factor influencing attendance. Early screening of perceived causal attributions may help to identify those who would benefit from early and targeted intervention to increase participation in CR. Future prospective studies would permit testing of screening approaches and early interventions.
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