Elaboration and analysis of a risk stratification protocol based on clinical and physical parameters for the occurrence of signs and symptoms in cardiovascular rehabilitation programs

• Grant number: 20/16551-0
• Support Opportunities: Regular Research Grants
• Start date: November 01, 2021
• End date: April 30, 2024
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Luiz Carlos Marques Vanderlei
• Grantee: Luiz Carlos Marques Vanderlei
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil
• Associated researchers: David Matthew Garner ; Diego Giulliano Destro Christofaro
• Associated scholarship(s): 23/04256-1 - Elaboration and analysis of a risk stratification protocol based on clinical and physical parameters for the occurrence of signs and symptoms in cardiovascular rehabilitation programs, BP.TT; 22/01141-6 - Elaboration and analysis of a risk stratification protocol based on clinical and physical parameters for the occurrence of signs and symptoms in cardiovascular rehabilitation programs, BP.TT

Abstract

Cardiac risk stratification is an essential procedure for the correct prescription of exercise intensity and definition of the level of patient monitoring in cardiac rehabilitation programs (CRP). However, the risk stratification protocols available in the literature do not have a good predictive capacity for the occurrence of signs and symptoms, which usually precede major acute events in these programs, and still, it requires complementary medical examinations, which are often not available in clinical practice. Objective: I. To develop a cardiac risk stratification protocol based on clinical and physical variables, which are routinely evaluated by physiotherapists, and their relationship with the occurrence of signs and symptoms during rehabilitation; II. To evaluate the reproducibility and effectiveness of the new protocol; III. To evaluate the agreement between evaluators of the developed protocol. Methods: To fulfill these objectives, this project will be divided into 3 subprojects: Study 1: For the elaboration of the protocol, patients attending to a CRP will be recruited, whom will be submitted to the evaluation of cardiorespiratory parameters, quadriceps muscle strength, submaximal functional capacity, autonomic modulation, body composition and anthropometric measurements. After these evaluations, the volunteers will be accompanied by 24 rehabilitation sessions to record the occurrence of signs and symptoms. The correlation data between the variables evaluated and the appearance of signs and symptoms will be used for the elaboration of the protocol and definition of high, moderate and low risk classes; Study 2: The protocol developed in the study 1 will be applied to a new sample of patients attending CRP. After evaluations and stratification, this sample will be followed by 24 sessions and the power of the protocol to predict the occurrence of signs and symptoms according to the risk class will be assessed using the intraclass correlation coefficient and ROC curve; Study 3: The developed protocol will be used by two independent evaluators to stratify the cardiac risk of the same population for the evaluation of agreement between evaluators, which will be done using the Kappa index. (AU)