ORCID Profile
0000-0002-2060-8852
Current Organisation
Northumbria University
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2017
Publisher: Elsevier BV
Date: 09-2023
Publisher: Public Library of Science (PLoS)
Date: 05-07-2023
DOI: 10.1371/JOURNAL.PONE.0286757
Abstract: Prehabilitation interventions are being delivered across surgical specialities to improve health risk behaviours leading to better surgical outcomes and potentially reduce length of hospital stay. Most previous research has focused on specific surgery specialities and has not considered the impact of interventions on health inequalities, nor whether prehabilitation improves health behaviour risk profiles beyond surgery. The aim of this review was to examine behavioural Prehabilitation interventions across surgeries to inform policy makers and commissioners of the best available evidence. A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to determine the effect of behavioural prehabilitation interventions targeting at least one of: smoking behaviour, alcohol use, physical activity, dietary intake (including weight loss interventions) on pre- and post-surgery health behaviours, health outcomes, and health inequalities. The comparator was usual care or no treatment. MEDLINE, PubMed, PsychINFO, CINAHL, Web of Science, Google Scholar, Clinical trials and Embase databases were searched from inception to May 2021, and the MEDLINE search was updated twice, most recently in March 2023. Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Outcomes were length of stay, six-minute walk test, behaviours (smoking, diet, physical activity, weight change, and alcohol), and quality of life. Sixty-seven trials were included 49 interventions targeted a single behaviour and 18 targeted multiple behaviours. No trials examined effects by equality measures. Length of stay in the intervention group was 1.5 days shorter than the comparator (n = 9 trials, 95% CI -2.6 to -0.4, p = 0.01, I 2 83%), although in sensitivity analysis prehabilitation had the most impact in lung cancer patients (-3.5 days). Pre-surgery, there was a mean difference of 31.8 m in the six-minute walk test favouring the prehabilitation group (n = 19 trials, 95% CI 21.2 to 42.4m, I 2 55%, P .001) and this was sustained to 4-weeks post-surgery (n = 9 trials, mean difference = 34.4m (95%CI 12.8 to 56.0, I 2 72%, P = 0.002)). Smoking cessation was greater in the prehabilitation group before surgery (RR 2.9, 95% CI 1.7 to 4.8, I 2 84%), and this was sustained at 12 months post-surgery (RR 1.74 (95% CI 1.20 to 2.55, I 2 43%, Tau 2 0.09, p = 0.004)There was no difference in pre-surgery quality of life (n = 12 trials) or BMI (n = 4 trials). Behavioural prehabilitation interventions reduced length of stay by 1.5 days, although in sensitivity analysis the difference was only found for Prehabilitation interventions for lung cancer. Prehabilitation can improve functional capacity and smoking outcomes just before surgery. That improvements in smoking outcomes were sustained at 12-months post-surgery suggests that the surgical encounter holds promise as a teachable moment for longer-term behavioural change. Given the paucity of data on the effects on other behavioural risk factors, more research grounded in behavioural science and with longer-term follow-up is needed to further investigate this potential.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.ATHEROSCLEROSIS.2018.01.009
Abstract: Increased arterial stiffness is linked to increased risk of cardiovascular disease and mortality. Studies have reported conflicting results regarding the relationship between arterial stiffness and time spent in sedentary behavior (SB) and physical activity (PA). The objective of this systematic review and meta-analysis was to assess the relationship between objectively measured light PA (LPA), moderate to vigorous PA (MVPA), and SB with the gold standard measurement of arterial stiffness, carotid-femoral pulse wave velocity (cfPWV). PubMed, Scopus, and Web of Science were searched for relevant studies published until November 2016. Studies reporting the correlation of objectively measured PA and SB with cfPWV in human adults >18 years old were included in this analysis. Correlation coefficients (CCs) were converted to Z scores via Fisher's z values for the analysis of summary effects, using a random-effects model. Twelve studies were included in the systematic review. The meta-analysis showed a negative correlation between cfPWV and LPA (CC -0.16 95% CI: -0.29 to -0.03 p=0.02) and MVPA (CC -0.16 95% CI: -0.26 to -0.06 p<0.01), and a positive relationship between cfPWV and SB (CC 0.23 95% CI: 0.12 to 0.35 p<0.01). Time spent in light and moderate physical activities is associated with lower arterial stiffness, while time spent in SB is related to higher arterial stiffness. It suggests that PA at any intensity is favorable for arterial stiffness, whereas SB leads to increased arterial stiffness. Considering that cfPWV has an independent prognostic value, these associations may have important clinical implications.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2015
Publisher: FapUNIFESP (SciELO)
Date: 12-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-02-2020
Abstract: Meta‐analyses have shown that isometric handgrip training ( IHT ) can reduce brachial systolic and diastolic blood pressure ( BP ) by /4 mm Hg, respectively. However, whether IHT promotes these effects among patients with peripheral artery disease, who exhibit severe impairment in cardiovascular function, is currently unknown. This study aimed to evaluate the effects of IHT on the cardiovascular function of patients with peripheral artery disease. A randomized controlled trial with peripheral artery disease patients assigned to either the IHT or control group was conducted. The IHT group performed 3 sessions per week, for 8 weeks, of unilateral handgrip exercises, consisting of 4 sets of isometric contractions for 2 minutes at 30% of maximum voluntary contraction and a 4‐minute interval between sets. The control group received a compression ball in order to minimize the placebo effects, representing sham training. The primary outcome was brachial BP . The secondary outcomes were central BP , arterial stiffness parameters, cardiac autonomic modulation, and vascular function. The IHT program reduced diastolic BP (75 [10] mm Hg preintervention versus 72 [11] mm Hg postintervention), with no change in the control group (74 [11] mm Hg preintervention versus 74 [11] mm Hg postintervention), with this between‐group difference being significant ( P =0.04). Flow‐mediated dilation improved in the IHT group (6.0% [5.7] preintervention versus 9.7% [5.5] postintervention), with no change in the control group (7.6% [5.5] preintervention versus 7.4% [5.1] postintervention), with this between‐group difference being significant ( P =0.04). There was no change in other measured variables over the intervention period. IHT reduced brachial diastolic BP and improved local vascular function in patients with peripheral artery disease. URL : www.clinicaltrials.gov/ . Unique identifier: NCT 02742220.
Publisher: Routledge
Date: 20-01-2022
Publisher: FapUNIFESP (SciELO)
Date: 06-2011
DOI: 10.1590/S1517-86922011000300005
Abstract: O objetivo deste estudo foi verificar a relação entre a aptidão física e os indicadores de qualidade de vida de in íduos com claudicação intermitente (CI). Participaram do estudo 42 in íduos (65,2 ± 8,3 anos) com CI, de ambos os gêneros. Para a avaliação da aptidão física, foram realizados teste de esforço em esteira, para obtenção da distância de claudicação (DC) e da distância total de marcha (DTM) e o teste de uma repetição máxima no exercício extensão de joelho. Os indicadores de qualidade de vida foram avaliados por meio do Medical Outcome Study Questionnaire Short Form 36, composto por oito domínios: capacidade funcional (CF), aspectos físicos (AF), dor, estado geral de saúde, vitalidade (VI), aspectos sociais (AS), aspectos emocionais (AE) e saúde mental. Para a análise estatística foi utilizado o coeficiente de correlação de Pearson, com p 0,05. Foi observada correlação significante entre o domínio da CF com a DC e a DTM (r = 0,60, p 0,01 e r = 0,49, p 0,01, respectivamente), o domínio da AF com a DTM (r = 0,46, p 0,01), o domínio da VI e dos AS com a DC (r = 0,34, p = 0,03 e r = 0,33, p = 0,04, respectivamente) e o domínio da AE com a DC e a DTM (r = 0,43, p = 0,01 e r = 0,44, p = 0,01, respectivamente). Como conclusão, os resultados deste estudo sugerem que os indicadores da qualidade de vida nos domínios da saúde física e da saúde emocional são relacionados com a capacidade de caminhada de in íduos com CI
Publisher: BMJ
Date: 12-02-2020
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.JVN.2011.01.002
Abstract: Previous studies have demonstrated that supervised strength training (ST) or walking training (WT) improve walking capacity in patients with claudication. However, it remains unknown whether these improvements would be sustained over a subsequent unsupervised period. This article reports the findings of a study to analyze whether the improvements in walking capacity, achieved with a supervised ST or WT, would be sustained over a subsequent unsupervised therapy period in patients with claudication. Patients were initially randomized to supervised exercise consisting of ST (n = 15) or WT (n = 15) for 12 weeks. After this period, 12 patients in each group consented to be followed for an additional 12 weeks of unsupervised therapy. Initial claudication distance (ICD) and total walking distance (TWD) were measured at baseline, after the supervised period (Week 12) and after the unsupervised period (Week 24). In comparison with baseline values, both groups similarly increased ICD and TWD at Week 12. From Week 12 to Week 24, both groups similarly decreased ICD (ST: -55 ± 110 m and WT: -82 ± 142 m, P =.04) and TWD (ST: -68 ± 186 m and WT: -128 ± 112 m, P < .01). However, in both groups, ICD (ST: +126 ± 149 m and WT: +50 ± 167 m, P = .01) and TWD (ST: +104 ± 162 m and WT: +45 ± 139 m, P =.01) at Week 24 remained greater than baseline values. The conclusion is that supervised ST or WT followed by an unsupervised therapy period similarly decreased walking capacity in patients with claudication. However, after the unsupervised period, walking capacity remained at a higher level than before the onset of the supervised exercise-training period.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.AVSG.2021.06.011
Abstract: The mechanisms underlying functional impairments in symptomatic PAD patients are controversial and poorly understood. Endothelial dysfunction and arterial stiffness have been proposed as potential mechanisms related to functional impairment in symptomatic PAD patients, however, more studies are needed to confirm these associations. To analyze the association between vascular function and walking impairment in patients with peripheral arterial disease (PAD) and symptoms of claudication. This was a cross-sectional study that included 68 patients with symptomatic PAD. All patients underwent an objective (Six-minute walk test [6MWT], 4-meter walk test) and a subjective (Walking Impairment Questionnaire [WIQ]) measurement of walking impairment. Vascular parameters measured were pulse-wave velocity (PWV) and flow-mediated dilation (FMD). Multiple linear regression was performed to investigate the association among walking impairment variables with vascular function parameters. No significant associations between the claudication onset distance (PWV: b=.060, P = 0.842 FMD: b=-.192, P = 0.456), 6MWT (PWV: b=.007, P = 0..975 FMD: b=.090, P = 0.725), WIQ distance (PWV: b=.337, P = 0.117 FMD: b=-.025, P = 0.895) WIQ speed (PWV: b=.320, P = 0.181 FMD: b=-.028, P = 0.497), WIQ stairs (PWV: b=.256, P = 0.204 FMD: b=-.228, P = 0.230), 4-meter usual walk (PWV: b=-.421, P = 0.107 FMD: b=-.338, P = 0.112), 4-meter fast walk (PWV: b=-.496, P = 0.063 FMD: b=-.371, P = 0.086) and vascular function were found. In symptomatic PAD patients, vascular function is not associated to walking impairment, even when adjusting for comorbid conditions and diabetes.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Gabriel Cucato.