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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: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.

Project description:BackgroundA large proportion of gynecological cancer survivors suffer from pain during sexual intercourse, also known as dyspareunia. Following a multimodal pelvic floor physical therapy (PFPT) treatment, a reduction in pain and improvement in psychosexual outcomes were found in the short term, but no study thus far has examined whether these changes are sustained over time.PurposeTo examine the improvements in pain, sexual functioning, sexual distress, body image concerns, pain anxiety, pain catastrophizing, painful intercourse self-efficacy, depressive symptoms and pelvic floor disorder symptoms in gynecological cancer survivors with dyspareunia after PFPT, and to explore women's perceptions of treatment effects at one-year follow-up.MethodsThis mixed-method study included 31 gynecological cancer survivors affected by dyspareunia. The women completed a 12-week PFPT treatment comprising education, manual therapy and pelvic floor muscle exercises. Quantitative data were collected using validated questionnaires at baseline, post-treatment and one-year follow-up. As for qualitative data, semi-structured interviews were conducted at one-year follow-up to better understand women's perception and experience of treatment effects.ResultsSignificant improvements were found from baseline to one-year follow-up on all quantitative outcomes (P ≤ 0.028). Moreover, no changes were found from post-treatment to one-year follow-up, supporting that the improvements were sustained at follow-up. Qualitative data highlighted that reduction in pain, improvement in sexual functioning and reduction in urinary symptoms were the most meaningful effects perceived by participants. Women expressed that these effects resulted from positive biological, psychological and social changes attributable to multimodal PFPT. Adherence was also perceived to influence treatment outcomes.ConclusionsFindings suggest that the short-term improvements following multimodal PFPT are sustained and meaningful for gynecological cancer survivors with dyspareunia one year after treatment.

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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