Purpose: The purpose of this study was to investigate the exercise effect of two types of training with a recumbent cycle ergometer on ankle muscle strength (dorsiflexor strength, DFS; dorsiflexor strength/weight, DFS/kg; plantar flexor strength, PFS; and plantar flexor strength/weight, PFS/kg) in healthy male subjects. Methods: Twenty-three healthy males (27.91 ± 8.66 yr) were randomly allocated into two groups (high-intensity interval training (HIIT), and aerobic exercise training (AET) after the first measurement. The subjects were trained for 24 sessions (40 min/rep, three times/week) and ankle strength was measured for a second time. Two-way mixed model analysis of variance (ANOVA) was used to identify significant differences between changes in ankle muscle strength between before and after training (within factors) in the HIIT and AET groups (between factors). The statistical significance level was set at α = 0.05. Results: In both HIIT and AET groups, all variables of ankle muscle strength were significantly increased after training compared to before training (p = 0.001). However, there were no differences in all variables of ankle strength between the HIIT and AET group (p > 0.05). Conclusion Both types (HIIT and AET) of recumbent cycle exercise training could be effective training methods to increase ankle muscle strength in healthy individuals, and the HIIT type with high intensity and low frequency pedaling could be recommended more to strengthen ankle muscles.

PURPOSE: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society.METHODS: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%).RESULTS: The relative peak VO₂ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio (VCO₂/VO₂, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO₂ slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak VO₂ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by VCO₂/VO₂ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization.CONCLUSION: The maximal aerobic capacity, especially the relative peak VO₂, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.
Blood Pressure ; Exercise Test ; Hand ; Heart Failure ; Heart Rate ; Heart ; Humans ; Logistic Models ; Male

The final degrees of education for the third and fourth authors were mutually misplaced.

PURPOSE: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). METHODS: Forty seven patients with CHF (males 33, females 14, age 61.3±9.8 years) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. RESULTS: The NHE group significantly showed lower peak VO2 and a higher VE/VCO2 slope than the MIHE (p < 0.05) and HIHE (p < 0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. CONCLUSION: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.
Blood Pressure ; Female ; Hand ; Heart Diseases ; Heart Failure* ; Heart Rate ; Heart* ; Hemodynamics ; Humans ; Rehabilitation ; Self Care

OBJECTIVES: To identify the current status of smartphone usage and to describe the needs for smartphone-based cardiac telerehabilitation of cardiac patients. METHODS: In 2016, a questionnaire survey was conducted in a supervised ambulatory cardiac rehabilitation (CR) program in a university affiliated hospital with the participation of heart failure or heart transplantation patients who were smartphone users. The questionnaire included questions regarding smartphone usage, demands for smartphone-based disease education, and home health monitoring systems. Results were described and analyzed according to principal diagnosis. RESULTS: Ninety-six patients (66% male; mean age, 53 ± 11 years), including 56 heart failure and 40 heart transplantation patients, completed the survey (completion rate, 95%). The median daily smartphone usage time was 120 minutes (interquartile range, 60–300), and the most frequently used smartphone function was text messaging (61.5%). Of the patients, 26% stated that they searched for health-related information using their smartphones more than 1 time per week. The major source of health-related information was Internet browsing (50.0%), and the least sought source was the hospital's website (3.1%). Patients with heart failure expressed significantly higher needs for disease education on treatment plan, home health monitoring of blood pressure, and body weight (χ2 = 5.79, 6.27, 4.50, p < 0.05). Heart transplantation patients expressed a significant need for home health monitoring of body temperature (χ2 = 5.25, p < 0.05). CONCLUSIONS: Heart failure and heart transplantation patients show high usage of and interest in mobile health technology. A smartphone-based cardiac telerehabilitation program should be developed based on high demand areas and modified to suit to each principal diagnosis.
Blood Pressure ; Body Temperature ; Body Weight ; Diagnosis ; Education ; Heart Failure ; Heart Transplantation ; Humans ; Internet ; Male ; Mobile Applications ; Needs Assessment ; Rehabilitation ; Smartphone ; Telemedicine ; Telerehabilitation* ; Text Messaging

OBJECTIVES: C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea. METHODS: A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors. RESULTS: The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality. CONCLUSIONS: Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.
C-Reactive Protein* ; Cardiovascular Diseases ; Female ; Humans ; Inflammation ; Korea ; Male ; Mortality* ; Proportional Hazards Models ; Republic of Korea ; Risk Factors ; Rural Population ; Uncertainty

The pneumonia severity index (PSI) and CURB-65 are widely used tools for the prediction of community-acquired pneumonia (CAP). This study was conducted to evaluate validation of severity scoring system including the PSI and CURB-65 scores of Korean CAP patients. In the prospective CAP cohort (participated in by 14 hospitals in Korea from January 2009 to September 2011), 883 patients aged over 18 yr were studied. The 30-day mortalities of all patients were calculated with their PSI index classes and CURB scores. The overall mortality rate was 4.5% (40/883). The mortality rates per CURB-65 score were as follows: score 0, 2.3% (6/260); score 1, 4.0% (12/300); score 2, 6.0% (13/216); score 3, 5.7% (5/88); score 4, 23.5% (4/17); and score 5, 0% (0/2). Mortality rate with PSI risk class were as follows: I, 2.3% (4/174); II, 2.7% (5/182); III, 2.3% (5/213); IV, 4.5% (11/245); and V, 21.7% (15/69). The subgroup mortality rate of Korean CAP patients varies based on the severity scores and CURB-65 is more valid for the lower scores, and PSI, for the higher scores. Thus, these variations must be considered when using PSI and CURB-65 for CAP in Korean patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cohort Studies ; Community-Acquired Infections/*mortality ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia/*mortality ; Prospective Studies ; Republic of Korea ; *Severity of Illness Index ; Young Adult

In 2008, the Korean Centers for Disease Control and Prevention (KCDC) initiated Korean Community Health Survey (KCHS), the first nationwide survey to provide data that could be used to plan, implement, monitor and evaluate community health promotion and disease prevention program. This community-based cross-sectional survey has been conducted by 253 community health centers, 36 community universities and 1,500 interviewers. The KCHS standardized questionnaire is developed jointly by KCDC staff, a working group of health indicators standardization subcommittee and 16 metropolitan cities and provinces with 253 regional sites. The KCHS was administered by trained interviewers and the quality control of KCHS was improved by introduction of computer-assisted personal interview in 2010. The questionnaire was reviewed annually so that revised and/or new questions could be added based on public health policy. The additional questions included the fixed and rotating cores, emerging issues and optional modules. The standardized questionnaire of KCHS covered a wide variety of health topics, which could be used to assess the prevalence of personal health behaviors related to causes of disease. The KCHS data allows that the differences of health issues among provinces can be directly compared. Furthermore, the provinces can use these data for their own cost-effective health interventions to improve health promotion and disease prevention.
Centers for Disease Control and Prevention (U.S.) ; Community Health Centers ; Cross-Sectional Studies ; Health Behavior ; Health Promotion ; Health Surveys ; Humans ; Organothiophosphorus Compounds ; Prevalence ; Public Health ; Quality Control ; Surveys and Questionnaires

Cleft Palate ; Dyspnea ; Floors and Floorcoverings ; Humans ; Infant, Newborn ; Male ; Mouth ; Osteogenesis, Distraction ; Pierre Robin Syndrome ; Songbirds ; Tracheostomy

The purpose of this study was to investigate the physiological effects of forward and backward walking training on lower extremity muscle strength before and after exhausting exercise. Fourteen healthy male adults were randomly divided into backward walking (BW, n=7) and forward walking (FW, n=7) training groups. Each group took part in pre-test consisted of knee extensor and flexor isokinetic peak torque (PT), total work (TW), electromyography (EMG) before and after exhausting exercise. Exhausting exercise was used to measure lower extremity endurance, which is incremental treadmill running using the Bruce protocol. The BW and FW training groups participated in a 6 weeks training program, consisted of 3 sessions per week for a total of 18 sessions. After finishing the training program, the post-test was performed using the same method. BW training group showed significant increases in knee extensor/flexor PT (4.6%/13.9%), TW (17.34%), EMG (35.9%) before exhausting exercise and PT (23.9%/18.8%), TW (46.7%), EMG (59.8%) after exhausting exercise. But FW training group did not show a significant increase in knee extensor/flexor PT (0.1%/3.2%), TW (1.8%), EMG (10.9%) before exhausting exercise and PT (2%/1%), TW (5.6%), EMG (17.2%) after exhausting exercise. BW training has positive effects on lower extremity muscle strength, especially muscle endurance that is important to prevent muscle weakness during competitive sports.
Adult ; Electromyography ; Humans ; Knee ; Lower Extremity ; Male ; Muscle Strength ; Muscle Weakness ; Muscles ; Running ; Sports ; Torque ; Walking