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Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

ABSTRACT: OBJECTIVE:To examine the long-term association between physical activity (PA) and psychosocial functioning following completion of cardiac rehabilitation (CR) among participants in the ENHANCED study. METHOD:ENHANCED was a 3-month clinical trial examining standard CR with and without stress management training (SMT). Participants completed the Leisure-Time Exercise Questionnaire (LTEQ), Beck Depression Inventory-II (BDI-II), and the Spielberger State-Trait Anxiety Inventory (STAI) at baseline, 3- and 12-months after randomization. Prospective associations between physical activity and psychosocial function, as well as treatment group differences, were examined using repeated measures mixed modeling. RESULTS:One hundred nineteen participants were available at 12month follow-up. During the 12-month follow-up, PA remained higher compared to baseline (P<0.001), with the majority of participants reporting that they engaged in PA on a regular basis. Depressive and anxious symptoms continued to remain lower than baseline (Ps<0.001) Higher levels of PA at 12-month follow-up were associated with lower depressive (P=0.032) and anxious (P=0.003) symptoms. CONCLUSIONS:Higher physical activity levels following CR are associated with lower depressive and anxious symptoms. Encouraging patients to sustain higher levels of PA may promote both cardiovascular and mental health.

SUBMITTER: Smith PJ

PROVIDER: S-EPMC5726411 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

Smith Patrick J PJ Sherwood Andrew A Mabe Stephanie S Watkins Lana L Hinderliter Alan A Blumenthal James A JA

General hospital psychiatry 20171101

<h4>Objective</h4>To examine the long-term association between physical activity (PA) and psychosocial functioning following completion of cardiac rehabilitation (CR) among participants in the ENHANCED study.<h4>Method</h4>ENHANCED was a 3-month clinical trial examining standard CR with and without stress management training (SMT). Participants completed the Leisure-Time Exercise Questionnaire (LTEQ), Beck Depression Inventory-II (BDI-II), and the Spielberger State-Trait Anxiety Inventory (STAI) ...[more]

PMID: 29122147

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Project description:BackgroundInfectious mononucleosis after primary infection with Epstein-Barr virus (EBV-IM) has been linked to the development of myalgic encephalomyelitis/chronic fatigue-syndrome (ME/CFS) in children, adolescents, and young adults. Here, we present clinical phenotypes and follow-up data from a first German cohort of young people with ME/CFS following EBV-IM.Methods12 adolescents and 13 young adults were diagnosed with IM-triggered ME/CFS at our specialized tertiary outpatient service by clinical criteria requiring post-exertional malaise (PEM) and a history of confirmed EBV primary infection as triggering event. Demographic information, laboratory findings, frequency and severity of symptoms, physical functioning, and health-related quality of life (HRQoL) were assessed and re-evaluated 6 and 12 months later.ResultsYoung adults displayed more severe symptoms as well as worsening of fatigue, physical and mental functioning, and HRQoL throughout the study, compared to adolescents. After one year, 6/12 (54%) adolescents no longer met the diagnostic criteria for ME/CFS while all young adults continued to fulfill the Canadian consensus criteria. Improvement in adolescents was evident in physical functioning, symptom frequency and severity, and HRQoL, while young adults showed little improvement. EBV serology and EBV DNA load did not correlate with distinct clinical features of ME/CFS, and clinical chemistry showed no evidence of inflammation. Remarkably, the median time from symptom onset to ME/CFS diagnosis was 13.8 (IQR: 9.1-34.9) months.ConclusionsME/CFS following EBV-IM is a severely debilitating disease often diagnosed late and with limited responses to conventional medical care, especially in adults. Although adolescents may have a better prognosis, their condition can fluctuate and significantly impact their HRQoL. Our data emphasize that biomarkers and effective therapeutic options are also urgently needed to improve medical care and pave the way to recovery.

Project description:BackgroundAdverse neurodevelopmental sequelae are reported among children who undergo early cardiac surgery to repair congenital heart defects (CHD). APOE genotype has previously been determined to contribute to the prediction of these outcomes. Understanding further genetic causes for the development of poor neurobehavioral outcomes should enhance patient risk stratification and improve both prevention and treatment strategies.MethodsWe performed a prospective observational study of children who underwent cardiac surgery before six months of age; this included a neurodevelopmental evaluation between their fourth and fifth birthdays. Attention and behavioral skills were assessed through parental report utilizing the Attention Deficit-Hyperactivity Disorder-IV scale preschool edition (ADHD-IV), and Child Behavior Checklist (CBCL/1.5-5), respectively. Of the seven investigated, three neurodevelopmental phenotypes met genomic quality control criteria. Linear regression was performed to determine the effect of genome-wide genetic variation on these three neurodevelopmental measures in 316 subjects.ResultsThis genome-wide association study identified single nucleotide polymorphisms (SNPs) associated with three neurobehavioral phenotypes in the postoperative children ADHD-IV Impulsivity/Hyperactivity, CBCL/1.5-5 PDPs, and CBCL/1.5-5 Total Problems. The most predictive SNPs for each phenotype were: a LGALS8 intronic SNP, rs4659682, associated with ADHD-IV Impulsivity (P=1.03 × 10(-6)); a PCSK5 intronic SNP, rs2261722, associated with CBCL/1.5-5 PDPs (P=1.11 × 10(-6)); and an intergenic SNP, rs11617488, 50 kb from FGF9, associated with CBCL/1.5-5 Total Problems (P=3.47 × 10(-7)). 10 SNPs (3 for ADHD-IV Impulsivity, 5 for CBCL/1.5-5 PDPs, and 2 for CBCL/1.5-5 Total Problems) had p<10(-5).ConclusionsNo SNPs met genome-wide significance for our three neurobehavioral phenotypes; however, 10 SNPs reached a threshold for suggestive significance (p<10(-5)). Given the unique nature of this cohort, larger studies and/or replication are not possible. Studies to further investigate the mechanisms through which these newly identified genes may influence neurodevelopment dysfunction are warranted.

Dataset Information

Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

Publications

Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

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