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17 Nov 2024
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Change in exercise capacity, physical activity and motivation for physical activity at 12 months after a cardiac rehabilitation program in coronary heart disease patients: a prospective, monocentric and observational study

A prospective observational study examining changes in exercise capacity, physical activity, and motivation for physical activity 12 months after a cardiac rehabilitation programme in patients with coronary heart disease

Recommended by ORCID_LOGO based on reviews by Géraldine Escriva-Boulley, Baraa Al-Khazraji and 1 anonymous reviewer

Exercise capacity is recognised as a strong predictor of mortality and cardiovascular morbidity in both healthy individuals and patients with coronary heart disease (Novaković et al., 2022). Accordingly, exercise-based cardiac rehabilitation is recommended as an effective secondary preventive intervention (Task Force Members et al., 2016; Anderson et al., 2016). While earlier studies generally focused on changes in exercise capacity during or immediately after rehabilitation (Uddin et al., 2016), recent research has emphasised the importance of physical activity trajectories on mortality in patients with coronary heart disease (Gonzalez-Jaramillo et al., 2022). This highlights the need to understand changes in exercise capacity and physical activity following the rehabilitation phase.

This study specifically explored changes in exercise capacity (assessed using the six-minute walking test) and physical activity (assessed using the International Physical Activity Questionnaire-Short Form) one year after a cardiac rehabilitation programme in patients with coronary heart disease. Additionally, the authors examined changes in motivation for physical activity over the 12 months following rehabilitation.

Within the limitations of its observational and monocentric nature, the study presents important findings that can inform future research, generate hypotheses, and guide the design of targeted trials aimed at improving or maintaining exercise capacity and physical activity levels after rehabilitation. The exploration of potential barriers to physical activity 12 months after rehabilitation could inform strategies to increase participation in physical activity post-rehabilitation, thereby improving survival (Moholdt et al., 2018).

This study is well-conducted and clearly presented. The authors' interpretation is balanced and consistent with the study's design and analysis. As noted by one of the reviewers, retention in cardiac rehabilitation studies is challenging, and the authors have done a commendable job in retaining participants. They have also addressed all the reviewers' concerns properly and accurately. I am pleased to recommend this preprint.

References
- Novaković M, Novak T, Vižintin Cuderman T, Krevel B, Tasič J, Rajkovič U, Fras Z, Jug B. Exercise capacity improvement after cardiac rehabilitation following myocardial infarction and its association with long-term cardiovascular events. Eur J Cardiovasc Nurs. 2022;21(1):76-84. https://doi.org/10.1093/eurjcn/zvab015
- Task Force Members, Piepoli MF, Hoes AW, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol. 2016;23(11):NP1-NP96. https://doi.org/10.1177/2047487316653709
- Anderson L, Oldridge N, Thompson DR, et al. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis. J Am Coll Cardiol. 2016;67(1):1-12. https://doi.org/10.1016/j.jacc.2015.10.044
- Uddin J, Zwisler AD, Lewinter C, et al. Predictors of exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure: A meta-regression analysis. Eur J Prev Cardiol. 2016;23(7):683-693. https://doi.org/10.1177/204748731560431
- Gonzalez-Jaramillo N, Wilhelm M, Arango-Rivas AM, Gonzalez-Jaramillo V, Mesa-Vieira C, Minder B, Franco OH, Bano A. Systematic review of physical activity trajectories and mortality in patients with coronary artery disease. J Am Coll Cardiol. 2022;79:1690-1700. https://doi.org/10.1016/j.jacc.2022.02.036
- Moholdt T, Lavie CJ, Nauman J. Sustained physical activity, not weight loss, associated with improved survival in coronary heart disease [published correction appears in J Am Coll Cardiol. 2018;71(13):1499. doi: 10.1016/j.jacc.2018.03.013]. J Am Coll Cardiol. 2018;71(10):1094-1101. https://doi.org/10.1016/j.jacc.2018.01.011​​​​
- Da Ros Vettoretto P, Bouffart AA, Gourronc Y, Baron AC, Gaumé M, Congnard F, Noury-Desvaux B, de Müllenheim PY (2024) Change in exercise capacity, physical activity and motivation for physical activity at 12 months after a cardiac rehabilitation program in coronary heart disease patients: a prospective, monocentric and observational study. HAL, ver.3, peer-reviewed and recommended by PCI Health & Movement Sciences. https://hal.science/hal-04510104v3  
Change in exercise capacity, physical activity and motivation for physical activity at 12 months after a cardiac rehabilitation program in coronary heart disease patients: a prospective, monocentric and observational studyPaul Da Ros Vettoretto, Anne-Armelle Bouffart, Youna Gourronc, Anne-Charlotte Baron, Marie Gaumé, Florian Congnard, Bénédicte Noury-Desvaux, Pierre-Yves de Müllenheim<p>Exercise capacity (EC) and physical activity (PA) are relevant predictors of mortality in patients with coronary heart disease (CHD) but the CHD-specific long-term trajectories of these outcomes after a cardiac rehabilitation (CR) program are n...Health & Disease, Physical Activity, RehabilitationFranco Milko Impellizzeri2024-03-22 10:59:07 View
06 Mar 2024
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Not fleeting but lasting: Limited influence of aging on implicit adaptative motor learning and its short-term retention

Does aging affect implicit motor adaptation?

Recommended by based on reviews by Kevin Trewartha and Marit Ruitenberg
Motor adaptation to environmental perturbations (such as visuomotor rotations and force fields) is thought to be achieved through the interaction of  implicit and explicit processes [1]. However, the extent to which these processes are affected by aging is unclear, partly because of differences in experimental protocols. In this paper, Hermans et al. [2] address the question of whether the implicit component of learning is affected in older adults. 
 
Using a force-field adaptation paradigm, the authors examine implicit adaptation and spontaneous recovery in healthy young and older adults. Overall, the authors found that both total adaptation and implicit adaptation was not affected in older adults. They also found evidence that spontaneous recovery was associated with implicit adaptation, but was not affected in older adults. 
 
These results are noteworthy because they challenge some prior work in the field [3], but are also consistent with results from other experimental paradigms [4]. A main strength of the current paper is the rigor applied to testing this question. The authors provide robust, converging evidence from multiple analyses and statistical methods, and control for confounds both statistically and experimentally.
 
Readers might want to note that this is a ‘conceptual’ replication of the previous study [3], and there are some potentially important differences in experimental details, which are clearly outlined. The sensitivity of the findings to such experimental parameters needs further testing. More broadly, these results highlight the need for greater understanding of how age differences observed in other motor learning tasks [5] are reflective of deficits in learning mechanisms.
 
References
1.     Taylor, J. A., & Ivry, R. B. (2011). Flexible cognitive strategies during motor learning. PLoS computational biology, 7(3), e1001096. https://doi.org/10.1371/journal.pcbi.1001096
2.     Hermans, P., Vandevoorde, K., & Orban de Xivry, J. J. (2024). Not fleeting but lasting: Limited influence of aging on implicit adaptative motor learning and its short-term retention. bioRxiv, ver.2, peer-reviewed and recommended by PCI Health & Movement Sciences. https://doi.org/10.1101/2023.08.30.555501
3.     Trewartha, K. M., Garcia, A., Wolpert, D. M., & Flanagan, J. R. (2014). Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline. The Journal of neuroscience : the official journal of the Society for Neuroscience, 34(40), 13411–13421. https://doi.org/10.1523/JNEUROSCI.1489-14.2014
4.     Vandevoorde, K., & Orban de Xivry, J. J. (2019). Internal model recalibration does not deteriorate with age while motor adaptation does. Neurobiology of aging, 80, 138–153. https://doi.org/10.1016/j.neurobiolaging.2019.03.020
5.     Voelcker-Rehage, C. (2008). Motor-skill learning in older adults—a review of studies on age-related differences. European review of aging and physical activity 5, 5–16. https://doi.org/10.1007/s11556-008-0030-9
 
Not fleeting but lasting: Limited influence of aging on implicit adaptative motor learning and its short-term retentionPauline Hermans, Koen Vandevoorde, Jean-Jacques Orban de Xivry<p>In motor adaptation, learning is thought to rely on a combination of several processes. Two of these are implicit learning (incidental updating of the sensory prediction error) and explicit learning (intentional adjustment to reduce target erro...Sensorimotor ControlRajiv Ranganathan Marit Ruitenberg, Kevin Trewartha2023-09-02 13:23:44 View