Abraham Samuel Babu

Manipal Academy of Higher Education | MAHE · Department of Physiotherapy

Cardiac rehabilitation (CR) programs are recommended standard-of-care by all major cardiovascular medicine professional organizations. Exercise training is the cornerstone for CR, with aerobic training being the primary form of training. The benefits of exercise training are multiple; however, improved cardiorespiratory fitness is of utmost importa...

Background Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) is an evidence-based intervention recommended for patients with CVD, to prevent recurrent events and to improve quality of life. However, despite the proven benefits, only a small percentage of those would benefit from CR actually receive i...

Objectives: To assess the effects of home-based exercise training (HBET) on function and quality of life (QoL) in PH. Methods: A prospective, non-blinded, randomized clinical trial was carried out on 84, medically stable patients with PH belonging to any functional class or etiology and of either sex. Patients were randomized to either standard ca...

Purpose: The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) developed an online Cardiovascular Rehabilitation Foundations Certification (CRFC; https://globalcardiacrehab.com/Certification) in October 2017, to build cardiac rehabilitation (CR) delivery capacity in low-resource settings based on their guidelines. Herein...

Cardiovascular disease prevention in clinical practice: implementation report A recent EAPC report has been published on the implementation of ESC Guidelines on cardiovascular disease prevention in clinical practice across 13 European countries, highlighting changes between 2011 and 2021. The report discusses remaining and newly perceived issues...

Background: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient. However, this had not been quantified before the International Council of Cardiovascular Prevention and Rehabilitation’s (ICCPR) Global Audit. This presentation will summarize the results of the Globa...

Background: Cardiovascular rehabilitation (CVR) is a Level 1, Class A standard for comprehensive secondary prevention of cardiovascular disease. Despite well-established benefits, CVR delivery is lacking across the world. Reasons for this dearth have been studied globally, with one of the main issues being lack of programs in low-resource settings...

Summary Background Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burd...

Women are underrepresented in cardiac rehabilitation (CR) despite the benefits, and this is exacerbated in lower‐resource settings where CR is insufficiently available. In this randomized controlled trial, the effectiveness of the Technology‐based Comprehensive Cardiac Rehabilitation Therapy (TaCT) electronic cardiac rehabilitation (eCR) interventi...

Purpose: Given that previous reviews on exercise training in pulmonary hypertension (PH) were largely based on a small number of randomized controlled trials (RCT), their conclusions are subject to bias. This review sought to identify the impact of exercise training on functional capacity and health-related quality of life (HRQoL) in PH using adva...

Objective: Heart Failure (HF) is emerging as a crucial factor promoting muscle wasting and dysfunction contributing to sarcopenia. This modulates disease severity and reduces exercise capacity and leading to poorer outcomes. Therefore, we aimed to systematically investigate the overall prevalence of sarcopenia in HF. Methods: An electronic search w...

Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity. Exercise-based cardiac rehabilitation (EBCR) has been shown to improve clinical outcomes in these patients, and yet clinicians are often challenged to prescribe the most effective type of exercise training. Therefore, this systematic review and network meta-analy...

With the acute burden of novel coronavirus 2019 (COVID-19) winding down in many parts of the world, there is an increased appreciation for those living with COVID-19 sequelae. Clavario and colleagues 1 found almost a third of COVID-19 survivors with functional limitations identified from cardiopulmonary exercise testing (CPX). This illustrates the...

Background: Heart failure (HF) is a multi-morbid chronic condition, which adversely affects the quality of life of the affected individual. Engaging the patient and their caregivers in self-care is known to reduce mortality, rehospitalisation and improve quality of life among HF patients. The PACT-HF trial will answer whether clinical benefits in t...

We have been amid unhealthy living and related chronic disease pandemics for several decades. These longstanding crises have troublingly synergized with the coronavirus disease 2019 (COVID-19) pandemic. The need to establish research priorities in response to COVID-19 can be used to address broad health and wellbeing, social and economic impacts fo...

Traditional risk factors for cardiovascular disease (CVD) have long been the focus of preventive strategies. The impact of family stress, depression, anxiety, hostility, pessimism, job strain, social isolation, lack of purpose in life and social support, are well recognized risks for CVD development, however they are under-appreciated in clinical p...

Introduction: The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) is developing a registry (ICRR) specifically for low-resource settings, where the burden of cardiovascular diseases is greatest and the need for program development highest. Herein we describe the development process, including the variable selection pro...

Physical activity behaviour is complex, particularly in low-resource settings, while existing behavioural models of physical activity behaviour are often linear and deterministic. The objective of this review was to (i) synthesise the wide scope of factors that affect physical activity and thereby (ii) underpin the complexity of physical activity i...

Background: The aims of this study were to establish cardiac rehabilitation (CR) availability and density, as well as the nature of programs in South-East Asian Region (SEAR) countries, and to compare this with other regions globally. Methods: In 2016/2017, the International Council of Cardiovascular Prevention and Rehabilitation engaged cardiac...

Background: We investigated impacts of COVID-19 on cardiac rehabilitation (CR) delivery around the globe, including virtual delivery, as well as effects on providers and patients. Methods: In this cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April to June 2020. The 50 members of the Internation...

Purpose: To estimate the levels of physical activity (PA) in community-dwelling adults with stroke and to correlate it with the quality of life (QoL). Methods: In a cross-sectional study, adults with chronic stroke were assessed for PA using Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and an accelerometer (Actigraph...

Purpose: Cardiac rehabilitation is an important intervention for patients with heart failure. However, its clinical application in acute decompensated heart failure (ADHF) remains underutilized with limited research available. An assessment of current research in this area will help guide future investigations. The aim of this review is to summari...

COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will...

We continue to increase our cognizance and recognition of the importance of healthy living (HL) behaviors and HL medicine (HLM) to prevent and treat chronic disease. The continually unfolding events precipitated by the coronavirus disease 2019 (COVID-19) pandemic have further highlighted the importance of HL behaviors, as indicated by the character...

Background Post-operative pulmonary complications are common after exploratory laparotomy. Good abdominal muscle functioning is essential for forced exhalation and effective coughing. However, the impact of a laparotomy on abdominal muscle activity remains uncertain. The study aimed to assess abdominal muscle activity during forced exhalation follo...

Objective: Epicardial adipose tissue (EAT) represents a proportion of visceral fat distributed around the heart. Measurement of EAT thickness is important for the diagnosis of visceral obesity. Skinfold thickness has been used in both clinical and research settings for visceral obesity diagnosis. The aim of this study is to evaluate the correlation...

Background To investigate impacts of COVID-19 on CR delivery around the globe, including effects on providers and patients. Methods In this cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April-June/2020. The 50 members of the ICCPR and personal contacts facilitated program identification. Results...

Background: Cardiopulmonary resuscitation (CPR) is a lifesaving skill performed during the cardiac arrest. Various factors of rescuer affect CPR quality, and rescuers physical fitness is one among the important factors needs to be explored for improved CPR quality. This study aimed to assess the physical activity (PA) levels of the health care prov...

Cardiac rehabilitation (CR) is underutilised across the world and India. The use of simple algorithms is one way to facilitate CR, however, these algorithms need to be feasible to use across low resource settings. The objectives were to assess the feasibility of a CR algorithm following percutaneous coronary intervention (PCI) for acute coronary sy...

Purpose: Cardiac rehabilitation (CR) is a recommendation in international clinical practice guidelines given its benefits; however, use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrollment and adherence into implementable recommendations. Methods: The writing panel was const...

Background: Cardiac rehabilitation (CR) is recommended in clinical practice guidelines for comprehensive secondary prevention. While India has a high burden of cardiovascular diseases (CVD), availability and nature of services delivered there is unknown. In this study, we undertook secondary analysis of the Indian data from the global CR audit and...

Background: Cardiac Rehabilitation (CR) is a recommendation in international clinical practice guidelines given its' benefits, however use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrolment and adherence into implementable recommendations. Methods: The writing panel was con...

highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions— medications, su...

Background Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods A survey was administered to CR programs globally. Cardiac associations and local...

Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was a...

Objective Cardiac rehabilitation (CR) availability, programme characteristics and barriers are not well-known in low/middle-income countries (LMICs). In this study, they were compared with high-income countries (HICs) and by CR funding source. Methods A cross-sectional online survey was administered to CR programmes globally. Need for CR was compu...

Unplanned hospital readmissions are the most important, preventable cost in heart failure (HF) health economics. Current professional guidelines recommend that patient self-care is an important means by which to reduce this burden. Patients with HF should be engaged in their care such as by detecting, monitoring, and managing their symptoms. A vari...

Introduction: Exercise intolerance is a common and often significant limitation in pulmonary arterial hypertension (PAH). This intolerance greatly affects the quality of life and function of the individual with PAH, irrespective of its etiology. In PAH associated with connective tissue disorders (PAH-CTD), exercise intolerance is further amplified...

A patient’s physical activity (PA) level is quite clinically significant in identifying sedentary behavior and associated cardiovascular risk. Although PA level may be related to many disorders, chronic metabolic disease such as type 2 diabetes mellitus (T2DM) is more significant than others when measuring for cardiovascular risk in the Indian popu...

Lifestyle modifications including diet, exercise, and physical activity (PA) form the cornerstone of management of prediabetes. Among these interventions, PA promotion has been gaining popularity and has been used with a variety of clinical populations. However, limited literature is available on the effects of a PA promotion program on prediabetes...

Pulmonary hypertension (PH) is a chronic, debilitating condition which gravely affects exercise tolerance and quality of life. Though most therapies focus purely on medical intervention, there is a growing body of evidence to suggest the role and benefits of exercise training. This chapter discusses the various physiological basis for exercise into...

Introduction: Pulmonary hypertension (PH) is a complex disease resulting in severe limitation to exercise performance because of dyspnea and fatigue. The six-minute walk test (6MWT) is a commonly used exercise test in the evaluation of patients with PH. Despite the use of the absolute distance covered, recently there has been a focus on the derived...

Introduction: Eisenmenger’s syndrome is a major finding in low resource settings like India where valvular heart diseases are diagnosed late. Purpose: To assess the effects of a 12 week home based exercise program on function and quality of life among patients with Eisenmenger’s syndrome. Design:This is a secondary analysis from a randomized cont...

Few data are available regarding the influence of body phenotype on systemic hypertension (SH) and whether cardiorespiratory fitness (CRF) attenuates this relation. We tested the hypothesis that obesity phenotypes and CRF would predict incident hypertension, evaluating 3800 Korean men who participated in 2 health examinations between 1998 and 2009....

Clinical trials registration has been advocated for improving transparency and reducing publication bias in clinical trials. Prospective registration of clinical trial in Clinical Trial Registry India (CTRI) is a mandatory requirement in India and it is the obligation of every researcher and institution to ensure that all clinical trials in their i...

Admission to an intensive care unit (ICU) initiates an inter-professional and inter-disciplinary approach to bring the patient back to health with normal or near normal function. Physiotherapists play a vital role in restoring function to the patient. The role of physiotherapy (PT) in the ICU has moved from primarily being one of only respiratory c...

Objective: 1. Identify studies analysing complementary roles of herbal medicine and exercise intervention in CVD prevention and management, 2. Identify herbs and exercise strategies that have been reported to exhibit complementary roles in CVD prevention and management, and 3. Summarize evidence of complementary roles of herbal medicine and exerci...

Cardiovascular disease (CVD) is the leading cause of death worldwide. Herbal medicine and exercise interventions have individually been shown to be effective in the prevention and management of CVD. However, the complementary roles of herbal medicine and exercise interventions for CVD prevention and management have not been adequately reported. Thi...

OBJECTIVE: The aim of this study was to investigate the association between platelet-to-lymphocyte ratio (PLR) and atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. SUBJECTS AND METHODS: A total of 125 patients were retrospectively analyzed. AF was diagnosed using standard clinical criteria, and PLR was calculated as the r...

The effectiveness of exercise-based cardiac rehabilitation (CR) following an acute coronary syndrome (ACS) is well established. However, ACS complicated by an orthopedic limitation, poses greater challenges to early mobilization. Thus, there is a need for an alternative rehabilitation approach to improving exercise capacity and in preventing and re...

Introduction: Exercise intolerance in pulmonary hypertension (PH) is a major factor affecting activities of daily living and quality of life. Evaluation strategies (i.e., non-invasive and invasive tests) are integral to providing a comprehensive assessment of clinical and functional status. Despite a growing body of literature on the clinical cons...

The response of derived parameters from six minute walk distance (6MWD) like 6MW work (6MWW), to exercise training and its correlation with quality of life (QoL) is not known. A secondary analysis from a randomized controlled trial on 30 patients (23 males; mean age 57.7±10.4 years; mean ejection fraction 31±10%) with HF in NYHA class I-IV who comp...

Background: Pulmonary arterial hypertension (PAH) causes profound functional limitations and poor quality of life. Yet, there is only a limited literature available on the role of exercise training. This paper systematically reviews the effects of exercise training on exercise capacity in PAH. Methods: A systematic search of databases (PubMed, C...

Background Patient education is an important part of holistic care for patients with chronic diseases. With the success of the Heart Manual, it was felt there is a strong need to develop such a manual for those with pulmonary hypertension (PH) - the Pulmonary Hypertension Manual (PulHMan). This was developed through a qualitative methodology in ord...

Introduction The presence of more than one musculoskeletal disease has been found to impair quality of life (QoL). The influence of low bone mineral density (BMD) on symptoms and function in those with fibromyalgia syndrome (FMS) is unknown. Methodology A cross sectional study was carried out on 158 patients attending camps in rural South India. B...