S Y Chen

Publications (13)26.49 Total impact

• Article: Cardiac rehabilitation in a pediatric patient with heart retransplantation. A single case study.

  K V Chang, H H Chiu, S S Wang, C Lan, S Y Chen, N K Chou, M H Wu, J S Lai
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  ABSTRACT: Background: Cardiac rehabilitation (CR) after heart transplantation is known to benefit physical capacity in adults, but the advantages of CR on pediatric patients with heart retransplantation remain undetermined. Aim. The purpose of the present study was to report the effect of structured CR for a boy receiving heart transplantations twice. Design. Single case study. Setting. Inpatient and outpatient rehabilitation department Population: A pediatric patient underwent heart transplantation due to dilated cardiomyopathy at 13.6 year-old and retransplantation owing to severe cardiac allograft vasculopathy at 16.2 year-old. Methods: CR was arranged after both transplantations. Bicycle or treadmill exercises were conducted three times weekly with the intensity adjusted to the ventilatory threshold. Serial cardiopulmonary exercise tests were performed to evaluate the sequential cardiorespiratory function changes using the peak oxygen uptake ( ·VO2peak) as the primary outcome. Results: The patient had undergone 10 times of exercise tests during rehabilitation. The ·VO2peak increased from 12.27 to 15.63 mL·kg-1·min-1 within 6 months after the primary transplantation. However, the ·VO2peak dropped intensively after a rejection episode and failed to improve since the development of cardiac allograft vasculopathy. Following retransplantation, the ·VO2peak appeared worse initially but increased gradually with rehabilitation. One year subsequent to retransplantation, the ·VO2peak reached 17.7 mL·kg-1·min-1 with a 7.22 mL·kg-1·min-1 improvement compared with his baseline value. Conclusion: Structured CR improves aerobic capacity of a pediatric patient with heart retransplantation. Clinical Rehabilitation Impact. CR is safe and beneficial for pediatrics with heart retransplantation. Cardiopulmonary exercise testing can be considered as an adjuvant tool for detecting rejection or cardiac allograft vasculopathy in pediatric heart transplantation recipients.
  European journal of physical and rehabilitation medicine 03/2013; · 1.40 Impact Factor
• Article: The effect of early cardiac rehabilitation on health-related quality of life among heart transplant recipients and patients with coronary artery bypass graft surgery.

  C-J Hsu, S-Y Chen, S Su, M-C Yang, C Lan, N-K Chou, R-B Hsu, J-S Lai, S-S Wang
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  ABSTRACT: To investigate the effect of an early postoperative outpatient cardiac rehabilitation program to health-related quality of life among heart transplantation recipients (HTR) and patients with coronary artery bypass graft (CABG) surgery. The study included 45 clinically stable HTR (age: 47 ± 14 years; 36 men, 9 women) and 34 patients with CABG (age: 57.2 ± 12.5 years; 27 men, 7 women). HTR started rehabilitation 70 ± 33 days after transplantation; patients with CABG started training 36 ± 18 days after surgery. Patients participated in a 12-week supervised exercise training program three times per week. Each training session comprised 10 minutes of warm-up, 25 to 30 minutes of cycling or treadmill walking, and 10 minutes of cooldown. The exercise intensity was set at 50% to 80% of peak oxygen uptake (V̇O(2peak)) according to the patient's condition. The health-related quality of life of subjects was evaluated by the Medical Outcomes Trust 36-item health survey (SF-36) at baseline and upon the completion of rehabilitation. At baseline, the HTR group showed lower V̇O(2peak) than the CABG group, but the health-related quality of life was similar between the two groups. After training, both groups exhibited an increase of 3.6 mL·kg(-1)·min(-1) in V̇O(2peak) and improvement of physical component in health-related quality of life. The HTR group showed a significant increase of SF-36 scores in physical functioning (59.7 ± 18.9 to 77.0 ± 14.0), physical role (21.1 ± 34.1 to 38.3 ± 37.9), bodily pain (57.4 ± 24.3 to 73.6 ± 21.5), social functioning (63.6 ± 23.4 to 72.8 ± 22.1), emotional role (59.2 ± 43.7 to 76.3 ± 37.4), and mental health (67.1 ± 17.9 to 73.4 ± 14.6). The CABG group only exhibited increased scores in physical functioning (60.0 ± 22.9 to 73.4 ± 18.0), physical role (19.1 ± 24.9 to 27.9 ± 38.3), bodily pain (57.1 ± 20.0 to 70.3 ± 16.1), and social functioning (54.0 ± 21.3 to 69.9 ± 21.1). Early postoperative cardiac rehabilitation significantly improved physical capacity and quality of life among heart transplant recipients and patients with CABG. Additionally, HTR showed greater improvement in health-related quality of life than patients with CABG regardless of lower physical capacity.
  Transplantation Proceedings 09/2011; 43(7):2714-7. · 1.00 Impact Factor
• Source

  Available from: ntu.edu.tw

  Article: Rates and characteristics of lower limb amputations in Taiwan, 1997.

  S Y Chen, W C Chie, C Lan, M C Lin, J S Lai, I N Lien
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  ABSTRACT: This study aims to describe the national incidence rate and characteristics of lower limb amputations (LLA) in 1997 from an island-wide database of the national health insurance programme in Taiwan. Some 117,647 discharge records from a sampled database (1 in 20) of the National Health Insurance Research Database were analysed. This study included records (n=171) containing LLA procedures. The LLA procedure rates were obtained by multiplying the number of identified procedures by 20 as the numerator and mid-year total population of Taiwan in 1997 as the denominator. Each procedure was further analysed according to the demographic characteristics of the patients, cause and level of amputation. Summarised gender ratios of LLA procedure rates were obtained by Poisson regression analysis. The crude LLA procedure rate was 18.1 per 100,000 population per year and the crude major LLA procedure rate was 8.8 per 100,000 population per year in Taiwan in 1997. The major cause of LLA procedures was peripheral vascular disease (72%), and the toe was most frequently amputated (48%). The LLA procedure rates, which increased logarithmically with age of patients, were significantly higher in men with a summarised male to female rate ratio of 1.65. The age-standardised LLA procedure rate in Taiwan was lower than that reported in the United States, Finland, the Netherlands, the United Kingdom (Leeds, Middlesborough, and Newcastle), but higher than Spain, Italy, and Japan. The trend of an increasing proportion of PVD-related LLA procedures will prompt the health professionals to develop strategies for LLA prevention.
  Prosthetics and Orthotics International 05/2002; 26(1):7-14. · 0.95 Impact Factor
• Article: The relationship between exercise performance and peripheral circulation in patients with peripheral arterial occlusive disease.

  S Y Chen, Y T Wu, S S Wang
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  ABSTRACT: The exercise performance of patients with peripheral arterial occlusive disease was often impaired. The relationship of exercise performance, daily physical activity, and peripheral circulation was studied. Twenty-five patients with peripheral arterial occlusive disease were recruited; their exercise performance was evaluated with a maximal graded exercise test. A habitual physical activity questionnaire was used to quantify the physical activity level. Measurement of peripheral circulation included the assessment of macrocirculation (ankle-brachial pressure index, calf blood flow by impedance plethysmograph) and microcirculation (cutaneous blood flow, cutaneous temperature, transcutaneous oxygen tension, and cutaneous blood flow responses to iontophoresis). Pearson's product correlation coefficient and multiple linear regression were used in data analysis. Results showed that age, sports index in habitual physical activity questionnaire, and ankle-brachial pressure index were significantly correlated with maximal walking time. Age and sports index were the two major determinants for their exercise performance and accounted for a 61.5% variability.
  Angiology 05/2001; 52(4):253-8. · 1.51 Impact Factor
• Article: Energy expenditure of wheeling and walking during prosthetic rehabilitation in a woman with bilateral transfemoral amputations.

  Y J Wu, S Y Chen, M C Lin, C Lan, J S Lai, I N Lien
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  ABSTRACT: To compare the energy expenditure of locomotion by wheelchair with that required for prosthetic ambulation in a person with bilateral transfemoral (TF) amputations. Observational, single patient, descriptive. An 80-meter long rectangular hallway in a rehabilitation unit. A 41-year-old woman with bilateral TF amputations that were performed 79 days before her admission to the rehabilitation unit. The oxygen uptake, oxygen cost, heart rate, speed, cadence, and stride length of walking measured during a 4-month course of prosthetic rehabilitation. Five locomotion conditions were evaluated: (1) wheelchair propulsion, (2) walking with short-leg prostheses (stubbies) and a walker, (3) long-leg prostheses and a walker, (4) long-leg prostheses without knee mechanism and axillary crutches, and (5) long-leg prostheses with right polycentric knee and left locked knee and axillary crutches. A portable and telemetric system was used to measure the metabolic parameters. An arm ergometry graded exercise test was performed at the end of rehabilitation. Oxygen cost (range, 466%--707% of that of wheeling) and heart rate (range, 106%--116% of that of wheeling) were higher during walking with various combinations of prostheses and walking aids. The speed of prosthetic walking was only 24% to 33% of that of wheeling. Our patient preferred using a wheelchair to prosthetic walking after discharge. People with bilateral TF amputations require very high cardiorespiratory endurance to fulfill the energy demand during prosthetic rehabilitation. The high energy cost of prosthetic walking will limit its application in daily activities.
  Archives of Physical Medicine and Rehabilitation 03/2001; 82(2):265-9. · 2.28 Impact Factor
• Article: Heart rate responses and oxygen consumption during Tai Chi Chuan practice.

  C Lan, S Y Chen, J S Lai, M K Wong
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  ABSTRACT: Tai Chi Chuan (TCC) is a popular Chinese conditioning exercise, however, its exercise intensity remains controversial. The objective of this study was to determine the exercise intensity of Yang TCC by measuring heart rate (HR) responses and oxygen consumption (VO2) during practice. Fifteen men aged 39.9 +/- 9.5 yrs (range 26-56 yrs) participated in this study. Subjects had practiced classical Yang TCC for 5.8 +/- 2.4 years. HR responses and VO2 were measured during practice of TCC by using a K4 telemetry system. Blood lactate was measured before and immediately after TCC practice. Additionally, breath-by-breath measurement of cardiorespiratory function and sequential determination of blood lactate were performed during the incremental exercise of leg cycling. Measurements obtained during the TCC practice and exercise testing were compared to determine the exercise intensity of TCC. While performing TCC, the mean HR of subjects was 140 +/- 10 bpm, and the mean VO2 was 21.4 +/- 1.5 mL x kg(-1) min(-1). Compared with the data of the exercise test, the HR during practice was 58% of the heart rate range. Meanwhile, the VO2 during TCC practice was 55% of the VO2peak. Additionally, the level of blood lactate immediately after TCC practice was 3.8 mM, which reflected the level of lactate during TCC, approximated the onset of blood lactate accumulation (OBLA). The results demonstrate that TCC is an exercise with moderate intensity, and is aerobic in nature.
  The American Journal of Chinese Medicine 02/2001; 29(3-4):403-10. · 1.98 Impact Factor
• Article: Comparisons of cutaneous blood flow reactivity to norepinephrine and sodium nitroprusside between patients with heart transplantation and healthy subjects.

  Y T Wu, S Y Chen, N K Chou, S S Wang
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  ABSTRACT: Heart transplant patients are reported to have impaired regulation of the microvasculature. The purpose of this study was to investigate the cutaneous blood flow and its reactivity to sodium nitroprusside (vasodilator, Nipride 0.1%) and norepinephrine (vasoconstrictor, Levophed 0.1%) in patients after heart transplantation in comparison to normal healthy individuals. Eighteen patients after heart transplantation and 16 healthy, nonsmoking individuals served as subjects of the study. Sodium nitroprusside and norepinephrine were introduced by iontophoresis to the skin of the right and left forearms, respectively. After measuring cutaneous blood flow reactivity in the pre-exercise state by laser Doppler flowmetry, subjects were then asked to close and open their fists for 2 min. The same measurements were repeated after exercise. Comparisons between the groups were carried out by the Wilcoxan signed rank test. The Mann Whitney U-test was used for comparison between pre-exercise and post-exercise states. The results demonstrated that sodium nitroprusside significantly increased forearm cutaneous perfusion at rest but produced only a mild increase after exercise. This reactivity was significantly lower after exercise with no significant differences between groups. Norepinephrine decreased cutaneous blood flow at rest. The transplant patients were significantly less sensitive to norepinephrine before but not after exercise. The changes in norepinephrine reactivity with exercise were significantly different between groups (p < 0.05).
  Clinical Transplantation 02/2001; 15(1):63-7. · 1.67 Impact Factor
• Article: Disability-adjusted life years for breast cancer patients in Taiwan.

  W C Chie, S Y Chen, K J Chang
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  ABSTRACT: The incidence and mortality of breast cancer in Taiwan have increased rapidly in the past several decades, but the societal impact of deaths and disabilities due to breast cancer has not been assessed. This study estimated the disability-adjusted life years (DALYs) for breast cancer patients during 1994, and compared the results with similar data from other areas of the world. DALYs for breast cancer patients in Taiwan were calculated using the equation developed by Murray and Lopez. The incidence and mortality of breast cancer and the population structure were obtained from national statistics maintained by the Department of Health and the Ministry of the Interior. The age-specific mean survival time for breast cancer patients was estimated using the exponential distribution from incidence-mortality linkage of the incidence file at National Taiwan University Hospital and the National Mortality File maintained by the Department of Health. There were 11,963 years of life lost (YLL) due to breast cancer during 1994, 2677 years lived with disability (YLD), and 14,640 DALYs. The YLL and DALYs per 1000 population (1.17 and 1.44) were in the middle of the world spectrum, while the YLD value per 1000 population (0.26) was closer to those of developed countries. The proportion of DALYs contributed by younger patients (< 45 years) was higher than in developed countries and similar to those in developing countries other than Sub-Saharan Africa. The DALYs per 1000 population of women younger than 45 years of age in Taiwan were also higher than those in India, China, other regions of Asia and Islands, Sub-Saharan Africa, and the Middle Eastern Crescent. The disability portion (YLD) of the DALYs for breast cancer patients in Taiwan was higher than in other regions of the world. Moreover, patients younger than 45 years contributed a higher proportion of DALYs than in developed countries. The DALY value per 1000 population younger than 45 years of age was also higher than in developing countries. These results suggest that health professionals should focus more attention on programs for education, screening, and treatment of younger women.
  Journal of the Formosan Medical Association 02/2001; 100(1):20-5. · 1.13 Impact Factor
• Article: Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study.

  C Lan, J S Lai, S Y Chen, M K Wong
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  ABSTRACT: To evaluate the training effect of a Tai Chi Chuan (TCC) program on knee extensor muscular strength and endurance in elderly individuals. Before-after trial. Community setting. Forty-one community dwelling subjects aged 61.1 +/- 9.8 years undertook a TCC program. Nine dropped out during the study. Pretraining and posttraining measurements were obtained from 15 men and 17 women. Subjects participated in a 6-month TCC program. Each session consisted of 20 minutes of warm-up, 24 minutes of structured TCC training, and 10 minutes of cool-down exercises. Peak torque of dominant and nondominant knee extensors was tested at speeds of 60 degrees , 180 degrees , and 240 degrees/sec concentrically and eccentrically. Muscular endurance of the knee extensor was tested at the speed of 180 degrees /sec. In the group of men, concentric knee extensor peak torque increased by 15.1% to 20.0% and eccentric peak torque increased by 15.1% to 23.7%. The group of women also showed increases, ranging from 13.5% to 21.8% in concentric peak torque, and 18.3% to 23.8% in eccentric peak torque. In addition, the knee extensor endurance ratio increased by 9.6% to 18.8% in the men and 10.1% to 14.6% in the women. TCC training may enhance muscular strength and endurance of knee extensors in elderly individuals.
  Archives of Physical Medicine and Rehabilitation 06/2000; 81(5):604-7. · 2.28 Impact Factor
• Article: The effect of Tai Chi on cardiorespiratory function in patients with coronary artery bypass surgery.

  C Lan, S Y Chen, J S Lai, M K Wong
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  ABSTRACT: This study prospectively evaluated the training effect of a 1-yr Tai Chi Chuan (TCC) program for low-risk patients with coronary artery bypass surgery (CABS) after a postoperative outpatient (phase II) cardiac rehabilitation program. Twenty patients with mean age of 56.5+/-7.4 yr completed this study. The TCC group included nine men who practiced classical Yang TCC with an exercise intensity of 48-57% heart rate range (HRR). The control group included 11 men whom were recommended to do a home-based self-adjusted exercise program with similar intensity of phase II cardiac rehabilitation. Graded exercise tests were performed before and after 1 yr of training for all subjects. Mean attendance of the TCC group was 3.8+/-1.5 times weekly in contrast to 1.7+/-1.1 times for the control group. During the follow-up examination, the TCC group increased 10.3% in VO2peak (from 26.2+/-4.4 to 28.9+/-5.0 mL x kg(-1) min(-1), P<0.01) and increased 11.9% in peak work rate (from 135+/-26 W to 151+/-28 W, P<0.01). However, the control group showed slight decrease in VO2peak from 26.0+/-3.9 to 25.6+/-4.6 mL x kg(-1) x min(-1) and in peak work rate from 131+/-23 W to 128+/-32 W. At the ventilatory threshold, the TCC group also showed significant increase in VO2 and work rate (P<0.05). The control group did not significantly change in these variables. The study demonstrated that a 1-yr TCC program for low-risk patients with CABS could favorably enhance cardiorespiratory function.
  Medicine &amp Science in Sports &amp Exercise 05/1999; 31(5):634-8. · 4.43 Impact Factor
• Article: Cardiorespiratory response of heart transplantation recipients to exercise in the early postoperative period.

  S Y Chen, C Lan, W J Ko, N K Chou, R B Hsu, Y S Chen, S H Chu, J S Lai
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  ABSTRACT: In this study, we evaluated the cardiorespiratory function of orthotopic heart transplantation (OHT) recipients during exercise. Seventeen male OHT recipients, ranging in age from 22 to 60 years, participated in this study 47 +/- 21 days after surgery. The control group consisted of 17 sedentary healthy men. Breath-by-breath measurement of cardiorespiratory function was obtained during the incremental exercise of leg cycling. At peak exercise, the oxygen (O2) uptake (16.5 +/- 3.3 vs 33.9 +/- 8.2 mL.kg-1.min-1), work rate (82 +/- 19 vs 169 +/- 42 watts), heart rate (HR), O2 pulse, and blood lactate level of the OHT recipients were significantly lower than the respective values of the control group. At the ventilatory threshold, the OHT group also showed a significantly lower O2 uptake (10.7 +/- 1.6 vs 18.3 +/- 5.1 mL.kg-1.min-1), work rate (39 +/- 12 vs 89 +/- 33 watts), HR, O2 pulse, ventilatory equivalent for O2, and ventilatory equivalent for carbon dioxide. The OHT recipients showed a high resting HR (97 +/- 7 beats/min) and a low peak HR (123 +/- 14 beats/min) during exercise, and their HR continued to increase for 1 to 3 minutes after cessation of exercise. Our data revealed a low level of cardiorespiratory endurance in OHT recipients during the early postoperative stage. A multidisciplinary cardiac rehabilitation program should be considered to enhance physical functional capacity and quality of life, and promote return to work.
  Journal of the Formosan Medical Association 04/1999; 98(3):165-70. · 1.13 Impact Factor
• Article: 12-month Tai Chi training in the elderly: its effect on health fitness.

  C Lan, J S Lai, S Y Chen, M K Wong
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  ABSTRACT: The objective of this study was to evaluate the effect of Tai Chi Chuan (TCC) on health fitness in older individuals. Methods: Thirty-eight community-dwelling persons aged 58 to 70 yr completed this study. The TCC group included 9 men and 11 women; the control group included 9 men and 9 women. The TCC group practiced TCC for 11.2+/-1.4 months, with the attendance of 4.6+/-1.3 times x wk(-1). Each session included 20 min of warm-up, 24 min of TCC practice, and 10 min of cooldown. The exercise intensity was 52-63% of the heart rate range. Cardiorespiratory function, strength, flexibility, and percent of body fat were evaluated before and at the end of this study. The male TCC group showed 16.1% increase in VO2max (P < 0.01), 11 degrees increase in thoracic/lumbar flexibility (P < 0.05), 18.1% increase in muscle strength of knee extensor (P < 0.01), and 15.4% increase of knee flexor (P < 0.05). The female TCC group showed 21.3% increase in VO2max (P < 0.01), 8.8 degrees increase in flexibility (P < 0.05), 20.3% increase in muscle strength of knee extensor (P < 0.05), and 15.9% increase of knee flexor (P < 0.05). The control group showed no significant change in these variables. The results indicate that a 12-month Tai Chi Chuan program is effective for improving health fitness of the elderly.
  Medicine &amp Science in Sports &amp Exercise 03/1998; 30(3):345-51. · 4.43 Impact Factor
• Article: Pulmonary embolism presenting as syncope in paraplegia: a case report.

  S Y Chen, Y H Wang, J J Hwang, T S Huang, J S Lai, I N Lien
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  ABSTRACT: Syncope as an initial presentation of pulmonary embolism is unusual. A 16-year-old girl, with T7 paraplegia after a traumatic spinal cord injury, developed syncope on the 33rd hospital day. The episode occurred approximately 3 hours after her first tilting table training and just after her attendant had assisted passive range-of-motion exercise. Subsequent studies showed pulmonary embolism at the left lower branch of the left pulmonary artery, and the branch to lower segment of the lingual lobe. Doctors should be alert to possible diagnosis of pulmonary embolism in such high-risk patients, especially when new onset symptoms or signs appear.
  Archives of Physical Medicine and Rehabilitation 05/1995; 76(4):387-90. · 2.28 Impact Factor