Randomized Controlled Trial of Cardiac Rehabilitation Using the Balance Exercise Assist Robot in Older Adults with Cardiovascular Disease

Overview

Journal J Cardiovasc Dev Dis

Specialty Cardiology & Vascular Diseases

Date 2024 May 24

PMID 38786955

Authors

Akihiro Hirashiki

Atsuya Shimizu

Takahiro Kamihara

Manabu Kokubo

Kakeru Hashimoto

Ikue Ueda

Kenji Sato

Koki Kawamura

Naoki Itoh

Toyoaki Murohara

Hitoshi Kagaya

Izumi Kondo

Affiliations

Soon will be listed here.

Abstract

Background: Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional resistance training in older adults with cardiovascular disease (CVD).

Methods: Ninety patients (mean age: 78 years) hospitalized due to worsening CVD were randomized to cardiac rehabilitation (CR) Group R (conventional resistance training) or Group B (training using BEAR). After appropriate therapy, patients underwent laboratory testing and functional evaluation using the timed up-and-go test (TUG), short physical performance battery (SPPB), and functional independence measure (FIM) just before discharge and 4 months after CR. The rates of CVD readmission, cardiac death, and fall-related fractures were monitored.

Results: BEAR had no adverse effects during exercise. At 4 months, TUG and SPPB improved significantly in both groups, with no significant difference between them. FIM motor and the Geriatric Nutritional Risk Index were significantly improved in Group B versus Group R. There was no significant difference in cardiac events and fall-related fractures between the two groups.

Conclusion: CR with BEAR is safe and comparable to conventional resistance training for improving balance in older adults with CVD.

References

Lee K, Davis M, Marcotte J, Pressler S, Liang J, Gallagher N . Falls in community-dwelling older adults with heart failure: A retrospective cohort study. Heart Lung. 2020; 49(3):238-250. DOI: 10.1016/j.hrtlng.2019.12.005. View

Bohannon R . Reference Values for Knee Extension Strength Obtained by Hand-Held Dynamometry from Apparently Healthy Older Adults: A Meta-Analysis. J Frailty Aging. 2017; 6(4):199-201. DOI: 10.14283/jfa.2017.32. View

Nishimura R, Otto C, Bonow R, Carabello B, Erwin 3rd J, Guyton R . 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129(23):e521-643. DOI: 10.1161/CIR.0000000000000031. View

Hashimoto K, Hirashiki A, Ozaki K, Kawamura K, Sugioka J, Tanioku S . Benefits of a Balance Exercise Assist Robot in the Cardiac Rehabilitation of Older Adults with Cardiovascular Disease: A Preliminary Study. J Cardiovasc Dev Dis. 2022; 9(6). PMC: 9224750. DOI: 10.3390/jcdd9060191. View

Ross R . ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003; 167(10):1451; author reply 1451. DOI: 10.1164/ajrccm.167.10.950. View

Graham J, Ostir G, Fisher S, Ottenbacher K . Assessing walking speed in clinical research: a systematic review. J Eval Clin Pract. 2008; 14(4):552-62. PMC: 2628962. DOI: 10.1111/j.1365-2753.2007.00917.x. View

Ozaki K, Kondo I, Hirano S, Kagaya H, Saitoh E, Osawa A . Training with a balance exercise assist robot is more effective than conventional training for frail older adults. Geriatr Gerontol Int. 2017; 17(11):1982-1990. DOI: 10.1111/ggi.13009. View

Guralnik J, Simonsick E, Ferrucci L, Glynn R, Berkman L, Blazer D . A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994; 49(2):M85-94. DOI: 10.1093/geronj/49.2.m85. View

Bozkurt B, Coats A, Tsutsui H, Abdelhamid M, Adamopoulos S, Albert N . Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal.... J Card Fail. 2021; . DOI: 10.1016/j.cardfail.2021.01.022. View

10.

Inoue S, Otaka Y, Kumagai M, Sugasawa M, Mori N, Kondo K . Effects of Balance Exercise Assist Robot training for patients with hemiparetic stroke: a randomized controlled trial. J Neuroeng Rehabil. 2022; 19(1):12. PMC: 8796441. DOI: 10.1186/s12984-022-00989-6. View

11.

Barbaccia V, Bravi L, Murmura F, Savelli E, Vigano E . Mature and Older Adults' Perception of Active Ageing and the Need for Supporting Services: Insights from a Qualitative Study. Int J Environ Res Public Health. 2022; 19(13). PMC: 9265376. DOI: 10.3390/ijerph19137660. View

12.

Reina-Couto M, Pereira-Terra P, Quelhas-Santos J, Silva-Pereira C, Albino-Teixeira A, Sousa T . Inflammation in Human Heart Failure: Major Mediators and Therapeutic Targets. Front Physiol. 2021; 12:746494. PMC: 8543018. DOI: 10.3389/fphys.2021.746494. View

13.

Mijnarends D, Meijers J, Halfens R, Ter Borg S, Luiking Y, Verlaan S . Validity and reliability of tools to measure muscle mass, strength, and physical performance in community-dwelling older people: a systematic review. J Am Med Dir Assoc. 2013; 14(3):170-8. DOI: 10.1016/j.jamda.2012.10.009. View

14.

Kamiya K, Sato Y, Takahashi T, Tsuchihashi-Makaya M, Kotooka N, Ikegame T . Multidisciplinary Cardiac Rehabilitation and Long-Term Prognosis in Patients With Heart Failure. Circ Heart Fail. 2020; 13(10):e006798. DOI: 10.1161/CIRCHEARTFAILURE.119.006798. View

15.

Heidenreich P, Bozkurt B, Aguilar D, Allen L, Byun J, Colvin M . 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022; 145(18):e895-e1032. DOI: 10.1161/CIR.0000000000001063. View

16.

Sze S, Pellicori P, Kazmi S, Rigby A, Cleland J, Wong K . Prevalence and Prognostic Significance of Malnutrition Using 3 Scoring Systems Among Outpatients With Heart Failure: A Comparison With Body Mass Index. JACC Heart Fail. 2018; 6(6):476-486. DOI: 10.1016/j.jchf.2018.02.018. View

17.

Satake S, Shimada H, Yamada M, Kim H, Yoshida H, Gondo Y . Prevalence of frailty among community-dwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatr Gerontol Int. 2017; 17(12):2629-2634. DOI: 10.1111/ggi.13129. View

18.

Podsiadlo D, Richardson S . The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39(2):142-8. DOI: 10.1111/j.1532-5415.1991.tb01616.x. View

19.

Weintraub R, Semsarian C, Macdonald P . Dilated cardiomyopathy. Lancet. 2017; 390(10092):400-414. DOI: 10.1016/S0140-6736(16)31713-5. View

20.

Ottenbacher K, Hsu Y, Granger C, Fiedler R . The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil. 1996; 77(12):1226-32. DOI: 10.1016/s0003-9993(96)90184-7. View