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Biomedical subjects

H J Bethell

Publications and source records attributed to H J Bethell.

At least 19 recordsLinked to original sources
PubMed1996

Going home.

Explore the source record for details and available documents.

Aftercare↗
PubMed1992

Exercise in post infarct rehabilitation.

In 1957, Hellerstein and Ford defined rehabilitation as 'the process by which a patient is returned realistically to his greatest physical, mental, social, vocational and economic usefulness and, if employable, is provided an opportunity for gainful employment in a competitive industrial world'. They stressed the importance of starting the rehabilitation process 'at the moment the patient is first stricken with his disease', of mobilising the patient as soon as is practical and of paying close attention to the emotional as well as physical consequences of the attack. They believed that 80% of the aftercare of cardiac patients could be managed by the 'private physician' and only a minority required the attention of a specialist team. The time scale used in 1957 (three to four weeks in hospital) was rather different to the one we use today, but otherwise most of what he suggested then has scarcely been improved upon since. In 1968 Hellerstein went on to describe the physical training programme he had devised to improve the fitness of 'habitually lazy, hypokinetic, sloppy, endomesomorphic over-weight males' who were the usual victims of myocardial infarction. He wished to 'add life to years and perhaps add years to life'. The conclusions from his original study were that 'an active intervention programme of conditioning including exercise, weight reduction, diet therapy, and cessation of smoking is feasible, reasonably acceptable and appears to be of benefit in the treatment of coronary heart disease'.

Exercise Therapy↗
PubMed1990

A controlled trial of community based coronary rehabilitation.

Two hundred patients who had suffered an acute myocardial infarction 4-6 weeks before entered a randomised controlled trial of exercise treatment at a community sports centre supervised by a general practitioner. Eighty one per cent of the treatment group continued to exercise until they returned to work and 73% completed three months' exercise. There were no serious complications of the exercise course. The prevalence of angina pectoris fell by 10% in the treatment group but rose by 60% in the control group. The perceived energy level rose by significantly more in the treatment group than in the controls. The rise in predicted maximum oxygen uptake was significantly greater in the treatment group than in the control group as was the reduction in the double product (a reflection of myocardial workload) at peak exercise. Coronary rehabilitation in the community can be both safe and effective.

Adult↗
PubMed1983

Coronary rehabilitation in the community.

Over a five-year period, 162 patients with coronary disease joined a physical rehabilitation course at a community sports centre gymnasium under the supervision of a general practitioner. One hundred and forty-seven patients had suffered a recent or old myocardial infarction and 15 suffered from angina pectoris. One hundred and thirty-eight patients (85 per cent) completed a three-month course of exercises, 16 (10 per cent) defaulted and eight (5 per cent) were withdrawn. One patient died at home during the three-month course. There were no changes in weight, blood pressure or blood fat measurements during the course but predicted maximum oxygen uptake increased by 26.9 per cent and the double product after effort (which is proportional to myocardial oxygen uptake) decreased by 13.6 per cent.We believe that the rehabilitation of patients in community sports centres is safe and effective and should be more widely practised.

Adult↗
PubMed1976

British pilot study of exercise therapy. II. Patients with cardiovascular disease.

Two groups of middle-aged men, one with and one without overt cardiovascular disease, were studied while they were taking part in a specially designed course of exercise therapy in a gymnasium. The "patients" group had at least two months pre-treatment to allow physical recovery and mental re-education before their initial very small test dose of exercise. Using short periods of progressive, mainly weight-loaded, isotonic exercises carefully regulated by control of pulse rate and avoidance of symptoms of over-exertion, both groups showed large increases in effort capacity and reductions in resting pulse rate, blood pressure and plasma lipid levels within two months. The safety of this particular form of exercise was shown in this high-risk population by the low drop-out rate and the absence of cardiovascular accidents in the gymnasium over a ten year period. It is suggested that, given suitable training of the staff and using the safeguards described, the presence of doctors and a cardiac resuscitation team is unnecessary in a gymnasium specializing in cardiac rehabilitation. This makes it possible for rehabilitation and physiotherapy departments throughout the country to carry out this effective and positive form of exercise therapy.

Adult↗