Browsing by Subject "Activity"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Cardiac Rehabilitation for Patients With Heart Failure: JACC Expert Panel
    (Elsevier, 2021) Bozkurt, Biykem; Fonarow, Gregg C.; Goldberg, Lee R.; Guglin, Maya; Josephson, Richard A.; Forman, Daniel E.; Lin, Grace; Lindenfeld, JoAnn; O'Connor, Chris; Panjrath, Gurusher; Piña, Ileana L.; Shah, Tina; Sinha, Shashank S.; Wolfel, Eugene; ACC’s Heart Failure and Transplant Section and Leadership Council; Medicine, School of Medicine
    Cardiac rehabilitation is defined as a multidisciplinary program that includes exercise training, cardiac risk factor modification, psychosocial assessment, and outcomes assessment. Exercise training and other components of cardiac rehabilitation (CR) are safe and beneficial and result in significant improvements in quality of life, functional capacity, exercise performance, and heart failure (HF)-related hospitalizations in patients with HF. Despite outcome benefits, cost-effectiveness, and strong practice guideline recommendations, CR remains underused. Clinicians, health care leaders, and payers should prioritize incorporating CR as part of the standard of care for patients with HF.
  • Thumbnail Image
    Item
    Using Clinical Scales and Digital Measures to Explore Falls in Patients with Lewy Body Dementia
    (Karger, 2023-06-21) Battioui, Chakib; Man, Albert; Pugh, Melissa; Wang, Jian; Dang, Xiangnan; Zhang, Hui; Ardayfio, Paul; Munsie, Leanne; Hake, Ann Marie; Biglan, Kevin; Neurology, School of Medicine
    Introduction: PRESENCE was a phase 2 clinical trial assessing the efficacy of mevidalen, a D1 receptor positive allosteric modulator, for symptomatic treatment of Lewy body dementia (LBD). Mevidalen demonstrated improvements in motor and non-motor features of LBD, global functioning, and actigraphy-measured activity and daytime sleep. Adverse events (AEs) of fall were numerically increased in mevidalen-treated participants. Methods: A subset of PRESENCE participants wore a wrist actigraphy device for 2-week periods pre-, during, and posttreatment. Actigraphy sleep and activity measures were derived per period and analyzed to assess for their association with participants' reports of an AE of fall. Prespecified baseline and treatment-emergent clinical characteristics were also included in the retrospective analysis of falls. Independent-samples t test and χ2 test were performed to compare the means and proportions between individuals with/without falls. Results: A trend toward more falls was observed with mevidalen treatment (31/258 mevidalen-treated vs. 4/86 in placebo-treated participants: p = 0.12). Higher body mass index (BMI) (p < 0.05), more severe disease measured by baseline Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part II (p < 0.05), and a trend toward improved Alzheimer's Disease Assessment Scale-Cognitive Subscale 13 (ADAS-Cog13) (p = 0.06) were associated with individuals with falls. No statistically significant associations with falls and treatment-emergent changes were observed. Conclusion: The association of falls with worse baseline disease severity and higher BMI and overall trend toward improvements on cognitive and motor scales suggest that falls in PRESENCE may be related to increased activity in mevidalen-treated participants at greater risk for falling. Future studies to confirm this hypothesis using fall diaries and digital assessments are necessary.