Annals of Physical and Rehabilitation Medicine 58 (2015) 117–118
Available online at
ScienceDirect www.sciencedirect.com
Editorial
Improving scientific production in cardiovascular rehabilitation: A reasonable challenge for the Annals?
The increasing prevalence of cardiovascular diseases makes cardiovascular rehabilitation (CR) an important field in the practical aspects of the Physical Medicine, in terms of the number of patients referred. Considering the recent evolution in the Annals of Physical and Rehabilitation Medicine (PRM), which now publishes exclusively in English [1], it seems interesting to make an assessment of its contributions to this domain over the last two years, and consequently to envisage proposals for future issues. 1. Various CR themes were tackled First of all and logically, the validation of innovative training programmes accounted for the majority of published articles. This theme gave the Annals of PRM the opportunity to present some of the latest studies on the specific effects of eccentric [2] and isokinetic training [3] during the CR. Certain specific effects of CR were studied, in particular, its impact on health-related quality of life [4]. The results of original studies were reported: the impact of CR on ventricular repolarisation indices [5] and on left atrial function [6]. Then, submaximal field tests, especially walking tests, which are being used more and more often during CR to assess functional capacities, have given rise to numerous publications, either systematic review [7], or concerning their value in predicting mortality [8], or the metabolic equivalence [9] of the 6-minute walk test. More and more often, exercise training is proposed in disabilities other than those related to cardiovascular disease. For example, several articles assessed the effects of specific training in various chronic diseases, such as respiratory failure [10], chronic pain [11] and Parkinson’s disease [12]. Technological progress has led to new situations in which exercise training can be useful. For example, a left ventricular assistance device now provides the opportunity to extend exercise training to several chronic disabilities, including those due to severe neurological disorders. A case report published by the Annals of PRM of a hemiplegic patient was informative and suitable for rehabilitation teams that can be confronted with this situation [13]. Finally, the characteristics of exercise tolerance in neuromuscular diseases were studied, and showed the usual peripheral (muscular) limit [14]. Peripheral vascular diseases, namely arterial, venous or lymphatic disorders, can responds to CR. A synthesis of the contribution of rehabilitation in patients with lymphoedema was http://dx.doi.org/10.1016/j.rehab.2015.04.005 1877-0657/ß 2015 Elsevier Masson SAS. All rights reserved.
proposed [15]. Compression therapy is frequently used in chronic venous and lymphatic disorders and a comparative study to measure exerted interface pressures was conducted to better understand the impact of different types of bandages [16]. Prosthetics equipment after amputations of the lower limbs is linked to CR by the common arterial aetiology and the need to associate exercise training and therapeutic education. The results of functional assessments of a prosthetic innovation (a new hip joint for hip-disarticulated patients) were presented to readers of the Annals [17]. Furthermore, a review of the literature on postamputation therapeutic education was published [18]. 2. Various article types are published In fact, practically all types of medical publications are represented: 9 observational studies [4–6,8,9,11,14,16,17], 4 systematic reviews [7,12,15,18], 3 controlled ( randomisation) trials [2,3,10], and 1 case report [13]. The nationalities of the involved authors are diverse. However, there is a very strong predominance of the French nationality: France (64), Tunisia (6), Turkey (6), United Kingdom (4), Canada (3), Lebanon (3), Norway (3), Austria (2), Cyprus (1), Germany (1), Romania (1), Spain (1), and Sweden (1). 3. Improving healthcare and bibliometry ranking in CR These are two virtuous objectives, and the first often depends on the second! Through its holistic approach, Physical Medicine can make an enormous contribution to the development of the CR and, as already underlined, original studies have been published by the Annals of PRM. However, several aspects have to be improved: as mentioned in an earlier editorial [19], we have to make an effort to improve the reporting of our research, by respecting international guidelines, specifically CONSORT (CONsolidated Standards of Reporting Trials) statement, which is endorsed for the randomised trials by prominent medical journals. Moreover, the percentage of controlled studies in the Annals is strikingly insufficient, in particular compared with observational works which are easier to produce, and thus have less decisive results; generally, we have to increase the number of patients included in our studies, particularly by favouring multicentre research programmes;
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Editorial / Annals of Physical and Rehabilitation Medicine 58 (2015) 117–118
we must be more attractive to foreign teams (in particular nonEuropean) working in the field of CR; future developments in CR should encourage specific studies: telerehabilitation and telemonitoring, therapeutic education, the customisation of training programmes, the validation of new functional tests, stance assistive devices (e.g., powered exoskeleton), prosthetics (e.g., osseointegration), dedicated programmes for peripheral vascular disease (too often neglected). . .
This programme is ambitious, but the Editorial Board of the Annals of PRM is openly committed to following this path! Disclosure of interest The author declares that he has no conflicts of interest concerning this article. References [1] Pe´rennou D, Thevenon A. Six years of bilingual edition for The Annals of PRM are coming to an end. Ann Phys Rehabil Med 2014;57:555–7. [2] Besson D, Joussain C, Gremeaux V, Morisset C, Laurent Y, Casillas JM, et al. Eccentric training in chronic heart failure: feasibility and functional effects. Results of a comparative study. Ann Phys Rehabil Med 2013;56:30–40. [3] Ghroubi S, Elleuch W, Abid L, Abdenadher M, Kammoun S, Elleuch MH. Effects of a low-intensity dynamic-resistance training protocol using an isokinetic dynamometer on muscular strength and aerobic capacity after coronary artery bypass grafting. Ann Phys Rehabil Med 2013;56:85–101. [4] Weberg M, Hjermstad MJ, Hilmarsen CW, Oldervoll L. Inpatient cardiac rehabilitation and changes in self-reported health related quality of life – a pilot study. Ann Phys Rehabil Med 2013;56:342–55. [5] Drigny J, Gremeaux V, Guiraud T, Gayda M, Juneau M, Nigam A. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med 2013;56:356–70. [6] Deniz Acar R, Bulut M, Ergu¨n S, Yesin M, Alıcı G, Akc¸akoyun M. Effect of cardiac rehabilitation on left atrial functions in patients with acute myocardial infarction. Ann Phys Rehabil Med 2014;57:105–13. [7] Casillas JM, Hannequin A, Besson D, Benaı¨m S, Krawcow C, Laurent Y, et al. Walking tests during the exercise training: specific use for the cardiac rehabilitation. Ann Phys Rehabil Med 2013;56:561–75.
[8] Ingle L, Cleland JG, Clark AL. The relation between repeated 6-minute walk test performance and outcome in patients with chronic heart failure. Ann Phys Rehabil Med 2014;57:244–53. [9] Morard MD, Bosquet L, Laroche D, Joussain C, Besson D, Deley G, et al. Are first ventilatory threshold and 6-minute walk test heart rate interchangeable? A pilot study in healthy elderlies and cardiac patients. Ann Phys Rehabil Med 2015;58:92–7. [10] Tout R, Tayara L, Halimi M. The effects of respiratory muscle training on improvement of the internal and external thoraco-pulmonary respiratory mechanism in COPD patients. Ann Phys Rehabil Med 2013;56:193–211. [11] Doury-Panchout F, Me´tivier JC, Fouquet B. VO2max in patients with chronic pain: the effect of a 4-week rehabilitation program. Ann Phys Rehabil Med 2014;57:1–10. [12] Tambosco L, Percebois-Macadre´ L, Rapin A, Nicomette-Bardel J, Boyer FC. Effort training in Parkinson’s disease: a systematic review. Ann Phys Rehabil Med 2014;57:79–104. [13] Bradai N, Andriantsifanetra C, Charlanes A, Scouarnec C, Cleophax C, Leprince P, et al. Rehabilitation of a hemiplegic patient with cardiac assistive device. Ann Phys Rehabil Med 2014;57:138–42. [14] Rapin A, Etosse´ A, Tambosco L, Nicomette J, Percebois-Macadre´ L, Mouret P, et al. Aerobic capacities and exercise tolerance in neuromuscular diseases: a descriptive study. Ann Phys Rehabil Med 2013;56:420–33. [15] Fialka-Moser V, Korpan M, Varela E, Ward A, Gutenbrunner C, Casillas JM, et al. The role of physical and rehabilitation medicine specialist in lymphoedema. Ann Phys Rehabil Med 2013;56:396–410. [16] Rimaud D, Convert R, Calmels P. In vivo measurement of compression bandage interface pressures: the first study. Ann Phys Rehabil Med 2014;57:394–408. [17] Gailledrat E, Moineau B, Seetha V, DeAngelis MP, Saurel B, Chabloz P, et al. Does the new Helix 3D hip joint improve walking of hip disarticulated amputees? Ann Phys Rehabil Med 2013;56:411–8. [18] Pantera E, Pourtier-Piotte C, Bensoussan L, Coudeyre E. Patient education after amputation: systematic review and experts’ opinions. Ann Phys Rehabil Med 2014;57:143–58. [19] Rannou F. Enhancing Annals value through quality. Ann Phys Rehabil Med 2014;57:553–4.
Jean-Marie Casillas Inserm U1093, Poˆle Re´e´ducation-Re´adaptation, CHU de Dijon, 21000 Dijon, France E-mail address: [email protected] (J.-M. Casillas) Received 17 April 2015 Accepted 17 April 2015
Available online at
ScienceDirect www.sciencedirect.com
Editorial
Improving scientific production in cardiovascular rehabilitation: A reasonable challenge for the Annals?
The increasing prevalence of cardiovascular diseases makes cardiovascular rehabilitation (CR) an important field in the practical aspects of the Physical Medicine, in terms of the number of patients referred. Considering the recent evolution in the Annals of Physical and Rehabilitation Medicine (PRM), which now publishes exclusively in English [1], it seems interesting to make an assessment of its contributions to this domain over the last two years, and consequently to envisage proposals for future issues. 1. Various CR themes were tackled First of all and logically, the validation of innovative training programmes accounted for the majority of published articles. This theme gave the Annals of PRM the opportunity to present some of the latest studies on the specific effects of eccentric [2] and isokinetic training [3] during the CR. Certain specific effects of CR were studied, in particular, its impact on health-related quality of life [4]. The results of original studies were reported: the impact of CR on ventricular repolarisation indices [5] and on left atrial function [6]. Then, submaximal field tests, especially walking tests, which are being used more and more often during CR to assess functional capacities, have given rise to numerous publications, either systematic review [7], or concerning their value in predicting mortality [8], or the metabolic equivalence [9] of the 6-minute walk test. More and more often, exercise training is proposed in disabilities other than those related to cardiovascular disease. For example, several articles assessed the effects of specific training in various chronic diseases, such as respiratory failure [10], chronic pain [11] and Parkinson’s disease [12]. Technological progress has led to new situations in which exercise training can be useful. For example, a left ventricular assistance device now provides the opportunity to extend exercise training to several chronic disabilities, including those due to severe neurological disorders. A case report published by the Annals of PRM of a hemiplegic patient was informative and suitable for rehabilitation teams that can be confronted with this situation [13]. Finally, the characteristics of exercise tolerance in neuromuscular diseases were studied, and showed the usual peripheral (muscular) limit [14]. Peripheral vascular diseases, namely arterial, venous or lymphatic disorders, can responds to CR. A synthesis of the contribution of rehabilitation in patients with lymphoedema was http://dx.doi.org/10.1016/j.rehab.2015.04.005 1877-0657/ß 2015 Elsevier Masson SAS. All rights reserved.
proposed [15]. Compression therapy is frequently used in chronic venous and lymphatic disorders and a comparative study to measure exerted interface pressures was conducted to better understand the impact of different types of bandages [16]. Prosthetics equipment after amputations of the lower limbs is linked to CR by the common arterial aetiology and the need to associate exercise training and therapeutic education. The results of functional assessments of a prosthetic innovation (a new hip joint for hip-disarticulated patients) were presented to readers of the Annals [17]. Furthermore, a review of the literature on postamputation therapeutic education was published [18]. 2. Various article types are published In fact, practically all types of medical publications are represented: 9 observational studies [4–6,8,9,11,14,16,17], 4 systematic reviews [7,12,15,18], 3 controlled ( randomisation) trials [2,3,10], and 1 case report [13]. The nationalities of the involved authors are diverse. However, there is a very strong predominance of the French nationality: France (64), Tunisia (6), Turkey (6), United Kingdom (4), Canada (3), Lebanon (3), Norway (3), Austria (2), Cyprus (1), Germany (1), Romania (1), Spain (1), and Sweden (1). 3. Improving healthcare and bibliometry ranking in CR These are two virtuous objectives, and the first often depends on the second! Through its holistic approach, Physical Medicine can make an enormous contribution to the development of the CR and, as already underlined, original studies have been published by the Annals of PRM. However, several aspects have to be improved: as mentioned in an earlier editorial [19], we have to make an effort to improve the reporting of our research, by respecting international guidelines, specifically CONSORT (CONsolidated Standards of Reporting Trials) statement, which is endorsed for the randomised trials by prominent medical journals. Moreover, the percentage of controlled studies in the Annals is strikingly insufficient, in particular compared with observational works which are easier to produce, and thus have less decisive results; generally, we have to increase the number of patients included in our studies, particularly by favouring multicentre research programmes;
118
Editorial / Annals of Physical and Rehabilitation Medicine 58 (2015) 117–118
we must be more attractive to foreign teams (in particular nonEuropean) working in the field of CR; future developments in CR should encourage specific studies: telerehabilitation and telemonitoring, therapeutic education, the customisation of training programmes, the validation of new functional tests, stance assistive devices (e.g., powered exoskeleton), prosthetics (e.g., osseointegration), dedicated programmes for peripheral vascular disease (too often neglected). . .
This programme is ambitious, but the Editorial Board of the Annals of PRM is openly committed to following this path! Disclosure of interest The author declares that he has no conflicts of interest concerning this article. References [1] Pe´rennou D, Thevenon A. Six years of bilingual edition for The Annals of PRM are coming to an end. Ann Phys Rehabil Med 2014;57:555–7. [2] Besson D, Joussain C, Gremeaux V, Morisset C, Laurent Y, Casillas JM, et al. Eccentric training in chronic heart failure: feasibility and functional effects. Results of a comparative study. Ann Phys Rehabil Med 2013;56:30–40. [3] Ghroubi S, Elleuch W, Abid L, Abdenadher M, Kammoun S, Elleuch MH. Effects of a low-intensity dynamic-resistance training protocol using an isokinetic dynamometer on muscular strength and aerobic capacity after coronary artery bypass grafting. Ann Phys Rehabil Med 2013;56:85–101. [4] Weberg M, Hjermstad MJ, Hilmarsen CW, Oldervoll L. Inpatient cardiac rehabilitation and changes in self-reported health related quality of life – a pilot study. Ann Phys Rehabil Med 2013;56:342–55. [5] Drigny J, Gremeaux V, Guiraud T, Gayda M, Juneau M, Nigam A. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med 2013;56:356–70. [6] Deniz Acar R, Bulut M, Ergu¨n S, Yesin M, Alıcı G, Akc¸akoyun M. Effect of cardiac rehabilitation on left atrial functions in patients with acute myocardial infarction. Ann Phys Rehabil Med 2014;57:105–13. [7] Casillas JM, Hannequin A, Besson D, Benaı¨m S, Krawcow C, Laurent Y, et al. Walking tests during the exercise training: specific use for the cardiac rehabilitation. Ann Phys Rehabil Med 2013;56:561–75.
[8] Ingle L, Cleland JG, Clark AL. The relation between repeated 6-minute walk test performance and outcome in patients with chronic heart failure. Ann Phys Rehabil Med 2014;57:244–53. [9] Morard MD, Bosquet L, Laroche D, Joussain C, Besson D, Deley G, et al. Are first ventilatory threshold and 6-minute walk test heart rate interchangeable? A pilot study in healthy elderlies and cardiac patients. Ann Phys Rehabil Med 2015;58:92–7. [10] Tout R, Tayara L, Halimi M. The effects of respiratory muscle training on improvement of the internal and external thoraco-pulmonary respiratory mechanism in COPD patients. Ann Phys Rehabil Med 2013;56:193–211. [11] Doury-Panchout F, Me´tivier JC, Fouquet B. VO2max in patients with chronic pain: the effect of a 4-week rehabilitation program. Ann Phys Rehabil Med 2014;57:1–10. [12] Tambosco L, Percebois-Macadre´ L, Rapin A, Nicomette-Bardel J, Boyer FC. Effort training in Parkinson’s disease: a systematic review. Ann Phys Rehabil Med 2014;57:79–104. [13] Bradai N, Andriantsifanetra C, Charlanes A, Scouarnec C, Cleophax C, Leprince P, et al. Rehabilitation of a hemiplegic patient with cardiac assistive device. Ann Phys Rehabil Med 2014;57:138–42. [14] Rapin A, Etosse´ A, Tambosco L, Nicomette J, Percebois-Macadre´ L, Mouret P, et al. Aerobic capacities and exercise tolerance in neuromuscular diseases: a descriptive study. Ann Phys Rehabil Med 2013;56:420–33. [15] Fialka-Moser V, Korpan M, Varela E, Ward A, Gutenbrunner C, Casillas JM, et al. The role of physical and rehabilitation medicine specialist in lymphoedema. Ann Phys Rehabil Med 2013;56:396–410. [16] Rimaud D, Convert R, Calmels P. In vivo measurement of compression bandage interface pressures: the first study. Ann Phys Rehabil Med 2014;57:394–408. [17] Gailledrat E, Moineau B, Seetha V, DeAngelis MP, Saurel B, Chabloz P, et al. Does the new Helix 3D hip joint improve walking of hip disarticulated amputees? Ann Phys Rehabil Med 2013;56:411–8. [18] Pantera E, Pourtier-Piotte C, Bensoussan L, Coudeyre E. Patient education after amputation: systematic review and experts’ opinions. Ann Phys Rehabil Med 2014;57:143–58. [19] Rannou F. Enhancing Annals value through quality. Ann Phys Rehabil Med 2014;57:553–4.
Jean-Marie Casillas Inserm U1093, Poˆle Re´e´ducation-Re´adaptation, CHU de Dijon, 21000 Dijon, France E-mail address: [email protected] (J.-M. Casillas) Received 17 April 2015 Accepted 17 April 2015
