Assessment of detraining through a six-minute walk test in patients with heart disease

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease undergoing cardiac rehabilitation (n=20). Intervention: Detraining (45-day interruption of supervised cardiac rehabilitation) vs. Post-training (after 5 months of supervised cardiac rehabilitation). Primary outcome: Distance covered in the 6-minute walk test (6MWT) in meters (p=0.02).

Q: What does this research mean for the field?

A 45-day interruption of cardiac rehabilitation significantly reduces functional capacity as measured by the six-minute walk test in patients with heart disease, though this loss can be recovered with subsequent retraining. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Vanessa Onório da Silva; Vitória Moreira Cintra; Maria de Lourdes da Silva; Joilson Meneguci; Fernando Seiji Silva; Eduardo Elias Vieira de Carvalho; Ana Paula Espíndula; Luciana Duarte Novais Silva

doi:10.1590/1516-3180.2023.0334.r1.03072024

December 20, 2024Sao Paulo Medical JournalOpen Access

Assessment of detraining through a six-minute walk test in patients with heart disease

View Full Paper

Ask AI

Bookmark

Share

Key result

A 45-day detraining period reduces 6-minute walk test distance by ~35 meters in cardiac patients.

P=0.02
n=20

Why the study?

The duration for which cardiac rehabilitation effects persist after detraining in patients with heart disease remains unclear.

Does a 45-day detraining interruption reduce functional capacity as measured by the 6-minute walk test in patients with cardiovascular disease undergoing supervised cardiac rehabilitation, and does 5 months of retraining restore it?

Key Points

To evaluate the principle of reversibility and detraining in patients with heart disease using the 6-minute walk test after a period of rest.
Retrospective cohort study conducted at a rehabilitation center in Brazil involving 20 patients with heart disease (mean age 64.05 ± 9.25 years).
Participants underwent 5 months of supervised cardiac rehabilitation, followed by an interruption period (45 days) and 5 months of retraining.
Functional capacity was assessed via the 6-minute walk test (6MWT) across post-training, post-detraining, and post-retraining phases.
In the cohort completing all phases (n = 11), distance covered decreased significantly from post-training (669.64 ± 58.80 m) to post-detraining (640.82 ± 101.23 m, P = 0.03).
No significant difference was observed between post-training and post-retraining distances (P = 0.83), while resting heart rate decreased after detraining across the initial 20 participants (P = 0.04).

Study Design

Type

Cohort (n=20)

Multicenter

No

Structured PICO

Does a 45-day detraining interruption reduce functional capacity as measured by the 6-minute walk test in patients with cardiovascular disease undergoing supervised cardiac rehabilitation, and does 5 months of retraining restore it?

P

Population

20 adults with cardiovascular disease (mean age 64.1 years, 30% female) participating in a supervised cardiac rehabilitation program in Brazil, assessed after 5 months of training, 45 days of detraining, and 5 months of retraining.

E

Exposure

Supervised cardiac rehabilitation (60 minutes per session: 10 min warm-up stretching, 30 min aerobic conditioning on treadmill or bicycle at 60–80% reserve heart rate, 10 min peripheral muscular resistance training with dumbbells/anklets, 10 min cool-down) for 5 months, followed by a 45-day detraining interruption period (advised to maintain usual activities without unsupervised training prescription), and subsequently 5 months of supervised retraining.

C

Comparator

Intra-individual comparison across three time points: post-training (at the end of 5 months of initial cardiac rehabilitation), post-detraining (after 45 days of program interruption), and post-retraining (after another 5 months of rehabilitation).

O

Outcome

Functional capacity assessed by distance covered in the 6-minute walk test (6MWT) after 5 months of training, 45 days of detraining, and 5 months of retraining.surrogate

Main Result

Absolute Event Rate: 583.6% vs 618.9%

p-value: p=0.02

Limitations

Small sample size (n = 20)
Loss of 9 participants over the 5-month retraining period due to non-adherence or absence
Retrospective single-center convenience sample
Loss of nine participants over the 5-month retraining period due to non-adherence or absence from evaluation
Retrospective study design using a convenience sample

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

A 45-day interruption in supervised cardiac rehabilitation significantly reduces functional capacity as measured by the 6-minute walk test in patients with heart disease, though lost capacity can be recovered after 5 months of retraining.

Abstract

BACKGROUND: Detraining can partially or completely reduce training-induced metabolic adaptations. However, the duration for which the rehabilitation effects persist after detraining, especially in patients with heart disease, remains unclear. OBJECTIVES: To evaluate the principle of reversibility/detraining in patients with heart disease via the 6-minute walk test (6MWT) after a period of rest. DESIGN AND SETTING: A retrospective cohort study developed at the Rehabilitation Center of the Universidade Federal do Triângulo Mineiro in Uberaba/MG, Brazil. METHODS: This clinical, retrospective longitudinal study involved 20 patients with heart disease who underwent 5 months of supervised cardiac rehabilitation (CR). The mean age of participants was 64.05 ± 9.25 years. The initial rehabilitation was followed by an interruption period and rehabilitation for another 5 months. Functional capacity was assessed using the 6MWT. RESULTS: In the specific analysis of the distance covered, values of P = 0.03 and P = 0.01 were obtained on comparing post-training (669.64 ± 58.80 meters) with post-detraining (640.82 ± 101.23 meters) and post-detraining with post-retraining (650.82 ± 96.28 meters), respectively. No significant difference was observed for the comparison between training and retraining (P = 0.83). CONCLUSION: Cardiovascular rehabilitation positively stimulates functional capacity, whereas detraining significantly reduces it. The 6MWT is effective in measuring changes in physical capacity.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Silva et al. (2024) conducted a cohort in Cardiovascular disease undergoing cardiac rehabilitation (n=20). Detraining (45-day interruption of supervised cardiac rehabilitation) vs. Post-training (after 5 months of supervised cardiac rehabilitation) was evaluated on Distance covered in the 6-minute walk test (6MWT) in meters (p=0.02). Detraining for 45 days significantly reduced 6-minute walk test distance from 618.9 m to 583.6 m (P = 0.02) in patients with heart disease.

synapsesocial.com/papers/6a776a9c576efb0ddaf75341 https://doi.org/10.1590/1516-3180.2023.0334.r1.03072024

View Full Paper

Ask AI

Bookmark

Share

Assessment of detraining through a six-minute walk test in patients with heart disease

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Assessment of detraining through a six-minute walk test in patients with heart disease

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading