Journal of Cardiopulmonary Rehabilitation and Prevention

Long-Term Physical Activity Behavior Change in Pulmonary Rehabilitation: Promoting Motivation
Tappan RS, Danilovich MK and Conroy DE
Exploring Information Needs and Educational Preferences of Individuals Referred to Cardiac Rehabilitation Before Program Start
Delgado Bomtempo AP, Konidis R, Aultman C, Barry-Hickey D and Ghisi GLM
To explore information needs and educational preferences of individuals referred to cardiac rehabilitation (CR) before program start.
Impact of COVID-19 on Exercise-Based Pulmonary Rehabilitation: What Lessons Have We Learned?
Borghi-Silva A, Goulart CDL, Silva RN, Back GD, Camargo PF, Trimer R, Teles SN and Sampaio LMM
The Coronavirus Disease 2019 (COVID-19) pandemic had a major global impact on health care, including the delivery, modality, and importance of outcomes in pulmonary rehabilitation (PR). This review discusses the impact of the pandemic on PR and the changes that were required to maintain its delivery. This article reviews the current evidence on PR during the COVID-19 pandemic period, focusing on delivery models, modalities, outcomes, perspectives, and barriers. A search of the MEDLINE, Embase, and SciELO databases and the Cochrane Library on this topic was conducted between December 1, 2019 and August 1, 2023. Studies were reviewed and relevant topics were included in this narrative. Rehabilitation of patients with severe acute COVID-19 and symptoms of long COVID has been challenging. The number of rehabilitation programs worldwide is still low, and community-based programs are still rare. Integrated programs with a multidisciplinary approach and exercise therapy with individualized prescription based on symptoms have been an interesting strategy. Telerehabilitation and outpatient rehabilitation are both effective in the treatment of patients with chronic obstructive pulmonary disease. However, the uptake of PR remains considerably low, and technological barriers for patients and lack of technological resources in low-income countries affect the delivery of these services in much of the world.
Alternative Modes of Delivery in Pulmonary Rehabilitation: A Critical Appraisal of the Literature
Machado A, Burtin C and Spruit MA
This review presents an overview of the safety and efficacy of alternative modes of pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease (COPD).
Research Priorities in Pulmonary Rehabilitation: The Urgent Need to Increase the Portfolio of Rehabilitation Options for Chronic Lung Disease
Benzo R and Benzo M
Pulmonary rehabilitation (PR) plays a crucial role in improving outcomes for individuals with chronic respiratory diseases. The most outstanding challenge in PR is the low referral, uptake, and adherence that is dramatically low in the post-hospitalization period in rural, minority, and low-income populations. Research efforts to increase the portfolio of PR through the testing and implementation of new and effective options for home-based and community-based programs are potential research targets. Other potential foci of research efforts are the pursuit of behavior-change techniques to achieve a lifestyle change during PR and the referral process to increase uptake and adherence rates. Creating new rehabilitation options for chronic lung disease that can reach more people may require expanding the definition of PR for chronic lung disease to one more flexible and perhaps concordant with the World Health Organization's definition of rehabilitation as "a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment." While efforts to augment access to conventional PR are warranted, it is time to devote research efforts to reach many more individuals with chronic lung disease, particularly minorities, rural, and low-income individuals that currently have no access to any rehabilitation, a social injustice that requires action. This manuscript outlines suggested future directions in rehabilitation research with the pursuit of evidence to support feasible and effective programs that may increase the rehabilitation portfolio to accommodate most individuals with chronic lung disease.
The Obesity Paradox in Pulmonary Rehabilitation: Relevance and Implications to Clinical Practice
Yohannes AM, Dransfield MT and Morris PE
Pulmonary rehabilitation (PR) increases exercise capacity, reduces dyspnea, and improves quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). Patients requiring PR can present with multiple comorbidities. One of the most common comorbidities is obesity. The prevalence of obesity in patients with COPD is increasing at an alarming rate. To date the efficacy of PR to ameliorate obesity in patients with COPD is unclear. Obesity in patients with COPD is associated with increased morbidity and mortality compared to patients without obesity. However, the benefits of obesity paradox in lower mortality rate health-related QoL and health care utilization remain unclear. This review discusses the challenges of prescribing PR to patients with obesity and COPD. In addition, the definition of and the potential challenges and benefits of the obesity paradox in patients with COPD will be discussed. Treatment strategies that include combining PR with lifestyle management, individually tailored nutritional advice, pharmacotherapy, and surgery need to be tested in prospective, randomized controlled trials. The challenges of providing complex care, prioritizing patient needs, and future directions will also be discussed for patients with obesity and COPD.
A Review of Cardiovascular Effects of Marijuana Use
Rezkalla SH and Kloner RA
Cannabinoids exert their effects on body tissues via cannabinoid 1 (CB1) and cannabinoid 2 (CB2) receptors. Receptors are present in brain, myocardium, vascular endothelium, platelets, and adipose tissues. Under normal physiologic conditions, endocannabinoid effects are minimal. The use of exogenous cannabis leads to endothelial dysfunction and increases vascular thrombosis via CB1 receptor stimulation. On the other hand, CB2 receptors may have a beneficial anti-inflammatory response.
Effect of Exercise-Based Cardiac Rehabilitation on Patients With Chronic Heart Failure After Transcatheter Aortic Valve Replacement: A Randomized Controlled Trial
Song J, Chen X, Wang B, Cheng Y and Wang Y
The objective of this study was to assess the effect of exercise-based cardiac rehabilitation (CR) with individualized exercise prescription in patients with chronic heart failure (HF) undergoing transcatheter aortic valve replacement (TAVR) in a randomized controlled trial.
The Psychosocial Benefits of Cardiac Rehabilitation Among Cancer Survivors
Oselinsky KM, Gupta SK, Tiboni H and Goldstein CM
An Introduction to the Journal of Cardiopulmonary Rehabilitation and Prevention's Special Issue on Pulmonary Rehabilitation
Stevens D, Babu AS and Bauldoff G
Contemporary Performance Measurement in Pulmonary Rehabilitation
Jewell DV and Gavic-Ott A
Patterns of Adherence to Home Blood Pressure Monitoring Among Older Adults With Ischemic Heart Disease: An Analysis From the RESILIENT Trial of Mobile Health Cardiac Rehabilitation
Kovell LC, Bothwick V, McCabe P, Juraschek SP, Meng Y, Revoori R, Pena S, Schoenthaler A, Adhikari S and Dodson JA
Hypertension (HTN) is common and represents a major modifiable risk factor for ischemic heart disease in older adults. While home blood pressure monitoring (HBPM) is important in HTN management, patterns of HBPM engagement in older adults undergoing mobile health cardiac rehabilitation (mHealth-CR) are unknown. We aimed to identify patterns of adherence to HBPM in a cohort of older adults undergoing mHealth-CR to optimize HBPM use in the future.
History of Pulmonary Rehabilitation: An International Perspective
Bhat A, Lee AL and Carlin BW
Pulmonary Rehabilitation for Diseases Other Than COPD
Menson KE and Dowman L
Review the current literature regarding pulmonary rehabilitation (PR) for non-chronic obstructive pulmonary disease (COPD) diagnoses and what the evidence is regarding expected outcomes based on disease manifestations. Literature search was performed using PubMed database from March 2024 to June 2024. Terms included "pulmonary rehabilitation" and "exercise training" in conjunction with key words "interstitial lung disease (ILD)," "idiopathic pulmonary fibrosis," "asthma," "bronchiectasis," "post-acute sequalae of SARS-CoV-2 (PASC)," "long COVID," "pulmonary hypertension (PH)," and "lung cancer." Results were filtered for English language, randomized controlled trial, clinical trial, observational trial, meta-analysis, and guidelines. Emphasis was placed on more recent publications since prior reviews, where applicable. The abundance of literature involved ILD, where studies have demonstrated significant improvements in exercise capacity, health-related quality of life (HRQoL), and dyspnea, despite heterogeneity of diseases; benefits are similar to those seen with COPD. Those with milder disease have more sustained benefits longer term. Patients with asthma benefit in severe disease, lower exercise activity, elevated body mass index, or when comorbid conditions are present, and breathing exercises can improve symptoms of breathlessness. Patients with PASC have a multitude of symptoms and lack benefits in HRQoL measurements; PR improves performance on post-COVID-19 functional status scale, a more comprehensive measurement of symptoms. Those with bronchiectasis benefit from PR when airflow limitation or exacerbations are impacting symptoms and HRQoL. Those with stable PH can improve their exertional capacity without change in disease severity. PR reduces perioperative complications in those with lung cancer and preserve fitness during treatment.
Examining Risk Factors Related to Cardiac Rehabilitation Cessation Among Patients With Advanced Heart Failure
Sidhu SK, Kadosh BS, Tang Y, Sweeney G, Pierre A, Whiteson J, Katz E, Reyentovich A and Dodson JA
Cardiac rehabilitation (CR) is beneficial in heart transplant and left ventricular assist device (LVAD) recipients, but patterns of attendance remain poorly understood. We describe CR adherence and cessation in this population.
Sex Differences in Changes in Cardiorespiratory Fitness and Additional Health Outcomes Following Exercise Training in Adults With Atrial Fibrillation: A Systematic Review and Meta-Analysis
Vidal-Almela S, Marçal IR, Wong J, Terada T, Nguyen BO, Joensen AM, Mills MT, Bittman J, Prud'Homme D and Reed JL
Improving cardiorespiratory fitness (CRF) through exercise training is associated with lower morbidity and mortality in patients with atrial fibrillation (AF). Smaller CRF improvements have been suggested in females than males with cardiovascular disease following exercise training. This systematic review compared changes in CRF (primary) and additional physical and mental health outcomes following exercise training between females and males with AF.
Speed of Heart Rate Recovery After Orthostatic Stress as a Modifiable Risk Factor During Cardiac Rehabilitation
Armstrong R, Murphy G, Wheen P, Brandon L, Kenny RA and Maree AO
AACVPR 39th Annual Meeting Scientific Abstract Presentations: AACVPR Research Committee
Pack Q, Hughes J, Aberegg E, Ades P, Alexander J, Bachmann J, Beckie T, Ghisi G, Goldstein C, Keteyian S, Khadanga S, Lindenauer P, Nelson R, Oehler A, Ozemek C, Rengo J, Savage P, Saval M, Schopfer D, Spranger C, Taylor B and Zuhl M
A Comparison of Rural and Urban Differences in Geographic Proximity to Outpatient Stroke Rehabilitation Services in Tennessee
Tran PM, Fogelson B, Heidel RE and Baljepally R
Great travel distances and long travel times can be barriers to outpatient stroke rehabilitation services (OSR) receipt, but there is limited information on differences in proximity to specific OSR services between urban and potentially medically underserved rural areas. Accordingly, we compared travel distance and time to the nearest service for different OSR services between rural and urban counties in Tennessee.
Remote Exercise Engagement Among Individuals With Cardiovascular Disease: A Systematic Review of Barriers and Facilitators
Bomtempo APD, Main E and Ghisi GLM
To systematically review the literature regarding barriers and facilitators to remote exercise among individuals with cardiovascular diseases (CVD).
Exploring the Promising Impact of Pulmonary Rehabilitation on Gait and Balance in Patients With COPD: A Systematic Review and Meta-Analysis
Khosravi M, Naimi SS, Shokouhyan SM, Nemati A and Abedi M
Chronic obstructive pulmonary disease (COPD) is commonly associated with respiratory difficulties, but it also presents with musculoskeletal problems. The objective of this systematic review and meta-analysis was to evaluate the effects of pulmonary rehabilitation (PR) on balance and gait in patients with COPD.