SPC365

The Road to Strength: Functional Progress After Rehabilitation

Session: Sessão de Posters 35 - Medir o que importa na reabilitação cardíaca
Speaker: Fábio Viveiros

Congress: CPC 2026
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Fabio Viveiros; Marta Vilela; Matilde Reis; Mariana Ferreira; Madalena Carvalho; Inês Aguiar-Ricardo; Pedro Alves da Silva; Nelson Cunha; Fausto J. Pinto
<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction:</strong></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Increasing evidence supports that greater muscle strength is associated with reduced cardiovascular mortality and morbidity, yet its relationship with physical activity and cardiopulmonary performance during cardiac rehabilitation (CR) remains insufficiently explored .&nbsp;</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Objective:</strong></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">&nbsp;To analyze the evolution of muscle strength in patients undergoing a phase II CR program and to investigate the correlation between muscle strength, functional capacity assessed by cardiopulmonary exercise testing (CPET), and other functional measures.</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Prospective, single-center observational study including patients enrolled in a phase II CR program from 2016 to 2024. The evaluation involved standardized assessments: 6-Minute Walk Test (6MWT), International Physical Activity Questionnaire (IPAQ), Timed Up and Go (TUG), and FICSIT Balance Test, along with clinical and CPET data. Muscle strength was assessed through upper and lower limb testing, including bilateral grip strength. Statistical analyses included Pearson correlation and pre-/post-program comparisons.</span></span></span></p>

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<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results:</strong></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">&nbsp;A total of 446 patients were included (80% men, mean age 61.1 &plusmn; 11.4 years), with multiple cardiovascular risk factors such as hypertension (66.8%), diabetes (28.2%), dyslipidemia (70.4%), and a history of smoking (61.1%). The most prevalent etiology was ischemic cardiomyopathy (85.2%), with 43.1% presenting single-vessel coronary disease.</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Post-CR, significant improvements were observed in: Functional capacity by 6MWT (444.6 &plusmn; 95.8 m to 541.8 &plusmn; 102.9 m; p&lt;0.001); Physical activity by IPAQ (median 231 to 1406; p&lt;0.001); TUG (from 9.3 [8.2-10.8] to 7.9 [6.9-9.0] seconds; p&lt;0.001); FICSIT (from 18.1 &plusmn; 6.0 to 23.5 &plusmn; 6.4; p&lt;0.001); Muscle strength of upper and lower limbs (p&lt;0.001 for both); Bilateral grip strength (left: 31.4 &plusmn; 9.3 to 34.2 &plusmn; 10.3, p&lt;0.001; right: 32.8 &plusmn; 9.6 to 35.5 &plusmn; 10.6, p&lt;0.001).</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">&nbsp;</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Moderate, statistically significant correlations were found between upper and lower limb muscle strength and exercise duration during CPET (r=0.4&ndash;0.5, p&lt;0.001), as well as peak oxygen uptake (VO2 peak) (r=0.4, p&lt;0.001).</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Patients with poor functional capacity post-CR (VO2 &lt; 18 mL/kg/min) exhibited significantly lower values across all assessed measures compared to those who achieved &ge;18 mL/kg/min, emphasizing the role of VO2 peak as a key discriminator of overall functional status.</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">&nbsp;</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong></span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Phase II CR is associated with marked improvements in muscle strength, functional capacity, and exercise performance. Moderate correlations between muscle strength and CPET parameters&mdash;especially VO2 peak&mdash; suggesting that increased muscle strength contributes to better cardiorespiratory performance. Routine muscle strength assessment may support individualized interventions and help identify patients at higher functional risk</span></span></span></p>