Ann Rehabil Med.  2021 Jun;45(3):204-214. 10.5535/arm.20220.

Community-Based Aerobic Exercise Program for Primary Prevention of Cardiovascular Disease in Adults With Visual or Auditory Impairments: A Feasibility Study

• Baek S
• Ha Y
• Mok J
• Lee H
• Song W

• KMID: 2517598
• DOI: http://doi.org/10.5535/arm.20220

Abstract

Objective
To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments.
Methods
The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion.
Results
Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD.
Conclusion
In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.

Keyword

Cardiac rehabilitation; Cardiovascular diseases; Community health centers; Disabled persons; Exercise

Figure

• 

  Fig. 1. Flow chart showing the enrollment process.

Reference

1. Centers for Disease Prevention and Control. Disability and health overview [Internet]. Washington, DC: Centers for Disease Prevention and Control;c2020. [cited 2021 May 1]. Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html.

2. Achieve Australia. What is a physical disability? [Internet]. North Ryde, Australia: Achieve Australia;c2019. [cited 2021 May 1]. Available from: https://achieveaustralia.org.au/ndis-overview-and-faqs/physical-disability/.

3. Centers for Disease Prevention and Control. Disability and obesity [Internet]. Washington, DC: Centers for Disease Prevention and Control;c2019. [cited 2021 May 1]. Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/obesity.html.

4. American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 10th ed. Philadelphia, PA: Wolters Kluwer;2018.

5. Pinsky JL, Jette AM, Branch LG, Kannel WB, Feinleib M. The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health. 1990; 80:1363–7.

6. Plichart M, Barberger-Gateau P, Tzourio C, Amouyel P, Peres K, Ritchie K, et al. Disability and incident coronary heart disease in older community-dwelling adults: the Three-City Study. J Am Geriatr Soc. 2010; 58:636–42.

7. Huang YY, Kung PT, Chiu LT, Tsai WC. Related factors and incidence risk of acute myocardial infarction among the people with disability: a national population-based study. Res Dev Disabil. 2015; 36C:366–75.

8. Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016; 67:1–12.

9. Brochu M, Savage P, Lee M, Dee J, Cress ME, Poehlman ET, et al. Effects of resistance training on physical function in older disabled women with coronary heart disease. J Appl Physiol (1985). 2002; 92:672–8.

10. Jeon B, Kwon S, Kim H. Health care utilization by people with disabilities: a longitudinal analysis of the Korea Welfare Panel Study (KoWePS). Disabil Health J. 2015; 8:353–62.

11. Im HW, Baek S, Jee S, Ahn JM, Park MW, Kim WS. Barriers to outpatient hospital-based cardiac rehabilitation in Korean patients with acute coronary syndrome. Ann Rehabil Med. 2018; 42:154–65.

12. Kim SH, Byun YC, Sohn CK, Lee YH, Lee MK, Lee SH, et al. The 2011 National Survey of the Disabled Persons. Sejong, Korea: Korea Institute for Health and Social Affairs;2012.

13. Hwang B, Chun SM, Park JH, Shin HI. Unmet healthcare needs in people with disabilities: comparison with the general population in Korea. Ann Rehabil Med. 2011; 35:627–35.

14. Ministry of Health and Welfare. Health and welfare statistical yearbook 2019. Sejong, Korea: Minister of Health and Welfare;2019.

15. Baek S, Ha Y, Mok J, Park HW, Son HR, Jin MS. Community-based cardiac rehabilitation conducted in a public health center in South Korea: a preliminary study. Ann Rehabil Med. 2020; 44:481–92.

16. American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 9th ed. Baltimore, MD: Lippincott Williams & Wilkins;2013.

17. Holden MK, Gill KM, Magliozzi MR. Gait assessment for neurologically impaired patients: standards for outcome assessment. Phys Ther. 1986; 66:1530–9.

18. Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JM, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2007; 115:2675–82.

19. Pinkstaff S, Peberdy MA, Kontos MC, Finucane S, Arena R. Quantifying exertion level during exercise stress testing using percentage of age-predicted maximal heart rate, rate pressure product, and perceived exertion. Mayo Clin Proc. 2010; 85:1095–100.

20. TheraBand resistance band & tubing instruction manual [Internet]. Akton, OH: Performance Health;2012. [cited 2021 May 1]. Available from: http://www.thera-bandacademy.com/resource/x-showResource.aspx?id=1461.

21. TheraBand CLX consecutive loops [Internet]. Akton, OH: Performance Health;2015. [cited 2021 May 1]. Available from: https://www.artzt.eu/media/pdf/18/75/8f/Exercise-Instruction_Thera-Band-CLX_English.pdf.

22. Sung J, On YK, Kim HS, Chae IH, Sohn DW, Oh BH, et al. Development of Korean activity scale/index (KASI). Korean Circ J. 2000; 30:1004–9.

23. Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007; 28:532–41.

24. Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, et al. South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health. 2009; 12:1187–93.

25. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999; 70:113–9.

26. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166:111–7.

27. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center;1993.

28. Syddall HE, Martin HJ, Harwood RH, Cooper C, Aihie Sayer A. The SF-36: a simple, effective measure of mobility-disability for epidemiological studies. J Nutr Health Aging. 2009; 13:57–62.

29. Lee JE, Kim HR, Shin HI. Accessibility of medical services for persons with disabilities: comparison with the general population in Korea. Disabil Rehabil. 2014; 36:1728–34.

30. Bakhshayeh S, Sarbaz M, Kimiafar K, Vakilian F, Eslami S. Barriers to participation in center-based cardiac rehabilitation programs and patients’ attitude toward home-based cardiac rehabilitation programs. Physiother Theory Pract. 2021; 37:158–68.

31. Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999; 14:270–4.

32. Faggiano P, D’Aloia A, Gualeni A, Lavatelli A, Giordano A. Assessment of oxygen uptake during the 6-minute walking test in patients with heart failure: preliminary experience with a portable device. Am Heart J. 1997; 134(2 Pt 1):203–6.