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K. Takizawa1, M. Saitoh2, K. Hori1, R. Uewaki1, J. Sakamoto1, A. Sakuyama1, K. Kon1, M. Nagayama3
1Sakakibara Heart Institute, Department of Rehabilitation, Tokyo, Japan, 2Juntendo University, Department of Physical Therapy, Faculty of Health Science, Tokyo, Japan, 3Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
Background: Malnutrition is negatively associated with physical function and clinical outcomes in patients with cardiovascular disease (CVD). However, it remains uncertain whether physical function of malnourished patients with CVD can be improved in outpatient cardiac rehabilitation (phaseⅡ CR).
Purpose: To investigate the effect of phaseⅡ CR on physical function in malnourished patients with CVD.
Methods: The present study was a single centre, retrospective study involving 270 patients (64±15 years old, 35%female) who completed a 3-month of multidisciplinary phaseII CR program. Patients were included after discharge from hospital due to cardiovascular disease with or without surgical intervention, as well as patients with chronic heart failure. The patients were divided into two groups according to nutritional status; malnourished group (n=73) and normal group (n=197) by using the global leadership initiative on malnutrition (GLIM) criteria. Changes in skeletal mass index (SMI) measured by bioelectrical impedance analysis, peak oxygen uptake (peak VO2), and isometric knee extension strength (IKES) were assessed at the beginning and the end of phaseⅡ CR. The two-way repeated measures ANOVA was used to determine the effects of phaseⅡ CR.
Results: There was a significant main effect of phaseⅡ CR on SMI (F=44.8, p ＜0.01), peak VO2 (F=52.1, p ＜0.01), and IKES (F=193.3, p ＜0.01). In the change of SMI, there was a significant interaction between groups and phaseⅡ CR (malnourished group vs. normal group: 3.5% vs. 1.4%; F=9.2, p =0.03). In terms of peak VO2 and IKES, there is no significant interaction between groups and phaseⅡ CR respectively.
Conclusion(s): Multidisciplinary phaseⅡ CR program could have a positive effect on physical function even in malnourished patients with CVD.
Implications: A comprehensive multidisciplinary program, consisting of exercise and nutritional therapy including not only dietary salt and fluid restriction but also nutrition care management could be beneficial therapeutic strategy to malnourished patients with CVD.
Funding, acknowledgements: No funding was utilised for this study.
Keywords: Malnutrition, Physical function, Cardiac rehabilitation
Topic: Cardiorespiratory
Did this work require ethics approval? Yes
Institution: Sakakibara Heart Institute
Committee: Sakakibara Heart Institute IRB
Ethics number: 19-100
All authors, affiliations and abstracts have been published as submitted.
