{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:10:55Z","timestamp":1760238655183,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: The coronavirus disease 2019 (COVID-19) pandemic has restricted people\u2019s activities and necessitated the discontinuation of cardiac rehabilitation (CR) programs for outpatients. In our hospital, CR for outpatients had to be discontinued for 3 months. We investigated the influence of this discontinuation of CR on physical activity, body composition, and dietary intake in cardiovascular outpatients. Method: Seventy-eight outpatients who restarted CR were investigated. We measured body composition, balance test, stage of locomotive syndrome, and food frequency questionnaire (FFQ) results at restart and 3 months later. We also investigated the results of examination that were obtained before discontinuation. Results: With regard to baseline characteristics, the percentage of male was 62.7% (n = 49), and average age and body mass index were 74.1 \u00b1 8.5 years and 24.9 \u00b1 7.0 kg\/m2, respectively. Stage of locomotive syndrome and the results of FFQ did not change significantly. The one-leg standing time with eyes open test significantly worsened at restart (p &lt; 0.001) and significantly improved 3 months later (p = 0.007). With regard to body composition, all limb muscle masses were decreased at restart and decreased even further 3 months later. Conclusions: Discontinuation of CR influenced standing balance and limb muscle mass. While the restart of CR may improve a patient\u2019s balance, more time is required for additional daily physical activities. The recent pandemic-related interruption of CR should inspire the development of alternatives that could ensure the continuity of CR in a future crisis.<\/jats:p>","DOI":"10.3390\/jcdd9060194","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T09:51:11Z","timestamp":1655545871000},"page":"194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Discontinuation of Cardiac Rehabilitation in Elderly Outpatients Due to the COVID-19 Pandemic"],"prefix":"10.3390","volume":"9","author":[{"given":"Noriyuki","family":"Mouri","sequence":"first","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7966-5977","authenticated-orcid":false,"given":"Yasunori","family":"Suematsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuiko","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Shirosaki","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaomi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakiko","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rie","family":"Tazawa","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanta","family":"Fujimi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"},{"name":"Division of Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-ichiro","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fukuoka University Hospital, Fukuoka 814-0180, Japan"},{"name":"Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka 814-0180, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"113667","DOI":"10.1016\/j.physbeh.2021.113667","article-title":"Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic","volume":"244","author":"Nikolaidis","year":"2022","journal-title":"Physiol. Behav."},{"key":"ref_3","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"11","author":"Dibben","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"35S","DOI":"10.1093\/jn\/nxac025","article-title":"Self-reported impacts of the COVID-19 pandemic on diet-related behaviours and food security in five countries: Results from the International Food Policy Study 2020","volume":"152","author":"Acton","year":"2022","journal-title":"J. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.afos.2018.09.004","article-title":"Locomotive syndrome in Japan","volume":"4","author":"Ishibashi","year":"2018","journal-title":"Osteoporos. Sarcopenia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s12018-016-9208-2","article-title":"Locomotive Syndrome: Definition and Management","volume":"14","author":"Nakamura","year":"2016","journal-title":"Clin. Rev. Bone Miner. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Eto, M., and Miyauchi, S. (2018). Relationship between occlusal force and falls among community-dwelling elderly in Japan: A cross-sectional correlative study. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0805-4"},{"key":"ref_8","unstructured":"(2022, March 31). JCS\/JACR 2021 Guideline on Rehabilitation in Patients with Cardiovascular Disease. Available online: https:\/\/www.j-circ.or.jp\/cms\/wp-content\/uploads\/2021\/03\/JCS2021_Makita.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1007\/s12603-020-1501-6","article-title":"Effect of the COVID-19 Epidemic on Physical Activity in Community-Dwelling Older Adults in Japan: A Cross-Sectional Online Survey","volume":"24","author":"Yamada","year":"2020","journal-title":"J. Nutr. Health Aging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s12603-021-1634-2","article-title":"The Influence of the COVID-19 Pandemic on Physical Activity and New Incidence of Frailty among Initially Non-Frail Older Adults in Japan: A Follow-Up Online Survey","volume":"25","author":"Yamada","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e000463","DOI":"10.1136\/openhrt-2016-000463","article-title":"Home-based versus centre-based cardiac rehabilitation: Abridged Cochrane systematic review and meta-analysis","volume":"3","author":"Buckingham","year":"2016","journal-title":"Open Heart"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1001\/jamacardio.2020.5218","article-title":"Effectiveness of Home-Based Mobile Guided Cardiac Rehabilitation as Alternative Strategy for Nonparticipation in Clinic-Based Cardiac Rehabilitation Among Elderly Patients in Europe: A Randomized Clinical Trial","volume":"6","author":"Snoek","year":"2021","journal-title":"JAMA Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"853376","DOI":"10.3389\/fcvm.2022.853376","article-title":"Efficacy of a 6-Week Home-Based Online Supervised Exercise Program Conducted During COVID-19 in Patients with Post Percutaneous Coronary Intervention: A Single-Blind Randomized Controlled Trial","volume":"9","author":"Li","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e24960","DOI":"10.2196\/24960","article-title":"An Affordable, User-friendly Telerehabilitation System Assembled Using Existing Technologies for Individuals Isolated With COVID-19: Development and Feasibility Study","volume":"7","author":"Mukaino","year":"2020","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jjcc.2012.11.004","article-title":"Effect of cardiac rehabilitation on muscle mass, muscle strength, and exercise tolerance in diabetic patients after coronary artery bypass grafting","volume":"61","author":"Nishitani","year":"2013","journal-title":"J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/ggi.14339","article-title":"Skeletal muscle as a treatment target for older adults with diabetes mellitus: The importance of a multimodal intervention based on functional category","volume":"22","author":"Omura","year":"2022","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1519\/SSC.0b013e3182980d57","article-title":"Exercise to Improve Bone Mineral Density","volume":"35","author":"Calatayud","year":"2013","journal-title":"Strength Cond. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s00776-009-1371-6","article-title":"One-leg standing test for elderly populations","volume":"14","author":"Michikawa","year":"2009","journal-title":"J. Orthop. Sci."},{"key":"ref_19","unstructured":"Shumway-Cook, A., and Woollacott, M. (2000). Motor Control: Theory and Practical Applications, Lippincott, Williams and Wilkens. [2nd ed.]."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3389\/fnins.2018.00171","article-title":"Human Postural Control","volume":"12","author":"Ivanenko","year":"2018","journal-title":"Front. Neurosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jamda.2013.02.001","article-title":"Muscle strength rather than muscle mass is associated with standing balance in elderly outpatients","volume":"14","author":"Bijlsma","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bakaloudi, D.R., Jeyakumar, D.T., Jayawardena, R., and Chourdakis, M. (Clin. Nutr., 2021). The impact of COVID-19 lockdown on snacking habits, fast-food and alcohol consumption: A systematic review of the evidence, Clin. Nutr., in press.","DOI":"10.1016\/j.clnu.2021.04.020"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cosgrove, K., and Wharton, C. (2021). Predictors of COVID-19-Related Perceived Improvements in Dietary Health: Results from a US Cross-Sectional Study. Nutrients, 13.","DOI":"10.3390\/nu13062097"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Visser, M., Schaap, L.A., and Wijnhoven, H.A.H. (2020). Self-Reported Impact of the COVID-19 Pandemic on Nutrition and Physical Activity Behaviour in Dutch Older Adults Living Independently. Nutrients, 12.","DOI":"10.3390\/nu12123708"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1093\/geronb\/gbaa218","article-title":"Relationship Between Dietary Variety and Frailty in Older Japanese Women During the Period of Restriction on Outings Due to COVID-19","volume":"76","author":"Otaki","year":"2021","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1177\/2047487320916823","article-title":"Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19)","volume":"27","author":"Lippi","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Martinez-Ferran, M., de la Gu\u00eda-Galipienso, F., Sanchis-Gomar, F., and Pareja-Galeano, H. (2020). Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits. Nutrients, 12.","DOI":"10.3390\/nu12061549"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/9\/6\/194\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:34:34Z","timestamp":1760139274000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/9\/6\/194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,18]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["jcdd9060194"],"URL":"https:\/\/doi.org\/10.3390\/jcdd9060194","relation":{},"ISSN":["2308-3425"],"issn-type":[{"type":"electronic","value":"2308-3425"}],"subject":[],"published":{"date-parts":[[2022,6,18]]}}}