Andi Alfian Zainuddin
Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

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Comparative effects of exergame intervention on cardiorespiratory function in obese and normal-weight adults Andi Miftah Khaerati Darmawan; Husnul Mubarak; Sylvia Evelyn Aritonang; Nuralam Sam; Melda Warliani; Andi Alfian Zainuddin
Physical Therapy Journal of Indonesia Vol. 6 No. 2 (2025): July-December 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i2.323

Abstract

Background: Obesity is a major risk factor for cardiovascular disease and metabolic disorders. Exergaming offers an accessible, interactive alternative to promote physical activity. This study aimed to assess the changes in the 6-minute walk test (6MWT), heart rate recovery (HRR), and maximal oxygen uptake (VO2max) in adults with obesity and normal weight after a six-week exergame intervention. Methods: A quasi-experimental pre-post study involved 29 adults (15 obese, 14 normal BMI) who participated in exergame sessions three times of 40 minutes weekly for six weeks. Inclusion criteria included adults aged 18–45 years with a BMI of 18.5–24.9 kg/m² (normal) or ≥25 kg/m² (obese), normal or corrected vision, and willingness to complete the intervention. Exclusion criteria included individuals with cardiovascular, neurological, or uncontrolled medical conditions, recent surgery or hospitalization, pregnancy, participation in other exercise programs within the previous four weeks, cognitive or sensory impairments, withdrawal from the study, repeated absences, or adverse events such as cybersickness. Outcomes included 6MWT distance, HRR, and VO2max. The paired T-test or Wilcoxon test was used for within-group comparisons, and the independent T-test or Mann-Whitney test for between-group analysis. Results: Significant within-group improvements were observed after the intervention. The 6MWT distance increased by 26.21 m, from 364.48 ± 46.92 m to 390.69 ± 43.17 m (p < 0.001). HRR improved by 11.14 bpm, from 24.41 ± 8.35 bpm to 35.55 ± 8.92 bpm (p = 0.003). VO2max increased by 0.79 mL/kg/min, from 14.91 ± 1.85 to 15.70 ± 1.84 mL/kg/min (p < 0.001). However, between-group differences were not statistically significant for 6MWT (p = 0.397), peak heart rate (p = 0.739), HRR (p = 0.220), and VO2max (p = 0.397), indicating similar improvements in both groups. Conclusion: Six weeks of exergaming significantly improved functional capacity and cardiorespiratory fitness comparably in both obese and normal-weight adults, suggesting it was an inclusive and practical option for community-based physical activity programs.
Predischarge Lung Ultrasound B-Lines as a Robust Predictor of 90-Day Rehospitalization in Heart Failure with Reduced Ejection Fraction (HFrEF): Evidence from Clinical and Classification and Regression Tree (CART)-Based Risk Stratification Akhtar Fajar Muzakkir; Yogi Andrew Taruk Padang; Peter Kabo; Ali Aspar Mappahya; Andi Alfian Zainuddin
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2051

Abstract

Background: Heart failure is a major global health burden, with high morbidity, mortality, and substantial rehospitalization rates. Residual pulmonary congestion at discharge is a key determinant of early readmission but is often underestimated using clinical assessment alone. Lung Ultrasound (LUS) offers an objective, bedside tool for detecting pulmonary congestion through B-line quantification. This study aimed to evaluate whether predischarge B-line measurements predict 90-day rehospitalization due to all cardiovascular causes in patients with Heart Failure with reduced Ejection Fraction (HFrEF). Methods: This retrospective cohort study included 107 adults hospitalized with HFrEF at Wahidin Sudirohusodo Hospital from March to July 2023. LUS was performed prior to discharge using an eight-zone protocol, and total B-line counts were recorded. Clinical, laboratory, and echocardiographic variables were obtained from the Heart Failure Registry and electronic medical records. Patients were followed for 90 days to identify heart failure–related rehospitalization. Statistical analyses included independent t-test, Mann–Whitney U tests, chi-square test, ROC curves, multivariate logistic regression, and a Classification and Regression Tree (CART) model to identify the strongest predictors of rehospitalization. Results: Among 107 patients (mean age 58.52 ± 12.16 years; 74.77% male), 48 (44.86%) experienced 90-day rehospitalization due to all cardiovascular causes. Rehospitalized patients had significantly higher predischarge B-line counts (25.98 ± 8.23 vs. 17.63 ± 8.03, p <0.0001). A B-line cutoff of ≥20 predicted rehospitalization with 75.7% accuracy, 77.08% sensitivity, 74.58% specificity, and an AUC of 0.754. Renal dysfunction (eGFR 58.72 ± 29.32 vs. 75.43 ± 27.49 mL/min/1.73 m², p = 0.003; creatinine 1.86 ± 2.01 vs. 1.21 ± 0.76 mg/dL, p = 0.021), lower EF (31.6 ± 8.15% vs. 36.64 ± 9.05%, p = 0.004), and higher filling pressures (PCWP, E/e′) were also significantly associated with rehospitalization. The CART model identified B-line ≥20 as the strongest primary classifier, with additional risk contributed by renal impairment and reduced EF, yielding an accuracy of 90.65% and an AUC of 0.966. Conclusion: Predischarge B-line quantification is a strong predictor of 90-day rehospitalization in HFrEF. Integration of B-line assessment with renal function and cardiac parameters substantially improves risk stratification. LUS provides a practical, noninvasive tool for optimizing predischarge evaluation and may guide interventions to reduce early rehospitalization.