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      Eficacia de las diferentes modalidades de ejercicio terapéutico en rehabilitación cardiaca tras infarto de miocardio. Revisión de la literatura Translated title: Efficacy of the different therapeutic exercise modalities in cardiac rehabilitation after myocardial infarction. A review of the literature

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          Resumen

          Esta revisión valoró la eficacia de diferentes modalidades de ejercicio terapéutico en la rehabilitación tras un infarto agudo de miocardio. Se realizó una búsqueda de estudios controlados aleatorizados publicados entre 2016 y 2021 en Scopus, PubMed, CINAHL, Web of Science y Cochrane Library, utilizando los términos MeSH “ exercise therapy” y “ myocardial infarction”. Tras aplicar los criterios de selección, se incluyeron diez artículos que utilizaron programas combinados o tradicionales, realizados en el hogar o en el ámbito hospitalario, y que incluyeron entrenamiento de relajación. Se analizaron las variables tolerancia al ejercicio, parámetros cardiovasculares, medidas antropométricas y calidad de vida. En la mayoría de estudios se observaron mejoras significativas en estas variables. Se concluye que todas las modalidades de ejercicio terapéutico estudiadas son útiles en la rehabilitación cardiaca de los pacientes tras infarto de miocardio, y la modalidad que mejores resultados obtiene es el uso de programas combinados de ejercicio terapéutico.

          Abstract

          We aimed to assess the efficacy of different therapeutic exercise modalities in cardiac rehabilitation after acute myocardial infarction. A search of randomized controlled studies published between 2016 and 2021 in Scopus, PubMed, CINAHL, Web of Science and Cochrane Library was carried out using the MeSH terms “exercise therapy” and “myocardial infarction”. Ten articles met the inclusion criteria; in these studies, the used exercises were combined or traditional programs that included relaxation training, and were performed either at home or at the hospital. We examined exercise tolerance, cardiovascular parameters, anthropometric measurements, and quality of life. Significant improvements in the assessed variables were observed in most studies. We conclude that all studied therapeutic exercise modalities are useful in cardiac rehabilitation after myocardial infarction, although the best outcomes are seen for combined therapeutic exercise programs.

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          Reliability of the PEDro scale for rating quality of randomized controlled trials.

          Assessment of the quality of randomized controlled trials (RCTs) is common practice in systematic reviews. However, the reliability of data obtained with most quality assessment scales has not been established. This report describes 2 studies designed to investigate the reliability of data obtained with the Physiotherapy Evidence Database (PEDro) scale developed to rate the quality of RCTs evaluating physical therapist interventions. In the first study, 11 raters independently rated 25 RCTs randomly selected from the PEDro database. In the second study, 2 raters rated 120 RCTs randomly selected from the PEDro database, and disagreements were resolved by a third rater; this generated a set of individual rater and consensus ratings. The process was repeated by independent raters to create a second set of individual and consensus ratings. Reliability of ratings of PEDro scale items was calculated using multirater kappas, and reliability of the total (summed) score was calculated using intraclass correlation coefficients (ICC [1,1]). The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters. The ICC for the total score was.56 (95% confidence interval=.47-.65) for ratings by individuals, and the ICC for consensus ratings was.68 (95% confidence interval=.57-.76). The reliability of ratings of PEDro scale items varied from "fair" to "substantial," and the reliability of the total PEDro score was "fair" to "good."
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            Universal definition of myocardial infarction.

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              Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants

              Abstract Objectives To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age. Design Prospective population based study. Setting UK Biobank. Participants 471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease. Main outcome measure Incident (fatal and non-fatal) MI. Results 5081 participants (1463 (28.8%) of whom were women) had MI over seven years’ mean follow-up, resulting in an incidence per 10 000 person years of 7.76 (95% confidence interval 7.37 to 8.16) for women and 24.35 (23.57 to 25.16) for men. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MI in men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were associated with higher hazard ratios for MI compared with men: ratio of hazard ratios 1.09 (95% confidence interval 1.02 to 1.16) for systolic blood pressure, 1.55 (1.32 to 1.83) for current smoking, 2.91 (1.56 to 5.45) for type 1 diabetes, and 1.47 (1.16 to 1.87) for type 2 diabetes. There was no evidence that any of these ratios of hazard ratios decreased with age (P>0.2). With the exception of type 1 diabetes, the incidence of MI was higher in men than in women for all risk factors. Conclusions Although the incidence of MI was higher in men than in women, several risk factors were more strongly associated with MI in women compared with men. Sex specific associations between risk factors and MI declined with age, but, where it occurred, the higher relative risk in women remained. As the population ages and the prevalence of lifestyle associated risk factors increase, the incidence of MI in women will likely become more similar to that in men.
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                Author and article information

                Contributors
                Role: ConceptualizaciónRole: MetodologíaRole: Redacción y revisión
                Role: InvestigaciónRole: Análisis formalRole: Redacción y revisión
                Role: InvestigaciónRole: RecursosRole: Redacción y revisión
                Role: ConceptualizaciónRole: Análisis formalRole: ValidaciónRole: Redacción y revisión
                Journal
                An Sist Sanit Navar
                An Sist Sanit Navar
                assn
                Anales del Sistema Sanitario de Navarra
                Gobierno de Navarra. Departamento de Salud
                1137-6627
                2340-3527
                09 December 2022
                Sep-Dec 2022
                : 45
                : 3
                : e1021
                Affiliations
                [1 ] original Universidade de Vigo. Facultade de Fisioterapia. Campus A Xunqueira. Pontevedra. Galicia. España. normalizedUniversidade de Vigo orgnameUniversidade de Vigo orgdiv1Facultade de Fisioterapia Pontevedra, Galicia, Spain
                [2 ] original Grupo de Investigación REMOSS (Rendimiento y Motricidad del Salvamento y Socorrismo). Universidad de Vigo. Pontevedra. España. normalizedUniversidade de Vigo orgdiv1Grupo de Investigación REMOSS (Rendimiento y Motricidad del Salvamento y Socorrismo) orgnameUniversidad de Vigo Pontevedra, Spain
                [3 ] original Grupo de Investigación Fisioterapia Clínica (FS1). Instituto de Investigación Sanitaria Galicia Sur. Servicio Gallego de Salud - Universidad de Vigo. Pontevedra. España. normalizedUniversidade de Vigo orgdiv2Grupo de Investigación Fisioterapia Clínica (FS1) orgdiv1Instituto de Investigación Sanitaria Galicia Sur. Servicio Gallego de Salud orgnameUniversidad de Vigo Pontevedra, Spain
                Author notes
                [Correspondencia ] Yoana González González. E-mail: yoana@ 123456uvigo.es

                Conflictos de intereses: Los autores declaran no tener conflictos de intereses.

                Financiación: Los autores declaran no haber recibido financiación externa para la realización de este estudio.

                Author information
                http://orcid.org/0000-0003-4386-1559
                http://orcid.org/0000-0002-1787-4017
                http://orcid.org/0000-0002-5895-5868
                Article
                10.23938/ASSN.1021
                10065051
                36694986
                f7219b62-b6cf-4155-b7bb-170ae212305c

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 06 September 2021
                : 23 December 2021
                : 09 March 2022
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 46, Pages: 0
                Categories
                Revisión

                ejercicio terapéutico,infarto de miocardio,fisioterapia,enfermedad cardiovascular,rehabilitación,exercise therapy,myocardial infarction,physical therapy modalities,cardiovascular disease,rehabilitation

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