SPC365

The impact of COVID-19 era in phase III Cardiac Rehabilitation programs: How was body composition affected in trained cardiovascular patients?

Session: Posters - J. Preventive Cardiology
Speaker: Madalena Lemos Pires

Congress: CPC 2021
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Posters
FP Number: ---
Authors: Madalena Lemos Pires; Mariana Borges; Rita Pinto; Gonçalo de sá; Inês Ricardo; Nelson Cunha; Pedro Alves da Silva; Mariana Liñan Pinto; Catarina Sousa Guerreiro; Fausto j. Pinto; Ana Abreu; Helena Santa-Clara

<p style="text-align:justify"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Introduction: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">It has been well established that multidisciplinary cardiovascular rehabilitation (CR)&nbsp;programs promote changes in body composition in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and readjusted to a home-based model</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&nbsp;where multidisciplinary interventions (e.g., supervising exercise training intensities and eating habits) were more difficult to be performed. The impact that COVID-19 era had on body composition in trained CVD patients who were attending long-term CR programs has yet to be discussed.</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> </span></span></p>

<p style="text-align:justify"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong>Purpose: </strong>To analyse the body composition of previously trained CVD patients who had their phase III centre-based CR program suspended due to COVID-19 pandemic and compare it with previous assessments. </span></span></p>

<p style="text-align:justify"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong>Methods</strong>: 87 CVD patients (mean age 62.9 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 9.1</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">, 82.8% male) were attending 3x/week a phase III centre-based CR program and were evaluated annually. After 7 months of suspension (due to COVID-19), 57.5% (n=50) patients returned from a CR home-based model to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition of 36 participants (mean age 64.4 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">7.9, 88.9% male) was assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Height and body weight were measured and used to calculate body mass index (BMI). Dual energy x-ray absorptiometry was used to measure whole-body fat and appendicular lean mass (ALM). Paired sample T-tests were used for data analysis. </span></span></p>

<p style="text-align:justify"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong>Results:</strong> From M1 to M2, no differences were found in whole-body fat and ALM percentage but, from M2 to M3, there was a significant increase in the percentage of whole-body fat (M2: 31.60 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 6.75%</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> vs M3: 32.74 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 6.92%</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">, p=0.018) and a significant decrease in the percentage of ALM (M2: 28.80 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 3.50%</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> vs M3: 28.23 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 3.63%</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">, p=0.004). The mean BMI of the 36 patients in M3 was 28.34 </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&plusmn; 3.84 kg/m<sup>2 </sup>(44.44% overweight, 33.33% obese) and no changes were found between moments. </span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">After the CR centre-based suspension due to COVID-19, we observed an increase of whole-body fat and a decrease in ALM in previously trained CVD patients. These results should emphasize the need to keep developing and improving digital home-based CR models, with a multidisciplinary approach, when face-to-face models are not available or possible to be implemented. More efforts should be made to enhance digital alternatives including supervision and remote control of vital signs, exercise intensities and eating habits, to guarantee safety and patients adherence.</span></span></p>