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Loureiro M, Parola V, Duarte J, Oliveira I, Antunes M, Coutinho G, Martins MM, Novo A. Cardiac Rehabilitation to Inpatient Heart Transplant-HRN4HTx Intervention Protocol. NURSING REPORTS 2024; 14:2084-2094. [PMID: 39311164 PMCID: PMC11417762 DOI: 10.3390/nursrep14030155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 09/26/2024] Open
Abstract
Heart transplantation is the gold-standard treatment for terminal heart failure. Despite being successful, pre- and post-transplant limitations interfere with patients' functional capacity, self-care, and quality of life post-surgery. Rehabilitation is necessary to address these limitations, prevent complications, and promote a safe return home. This study analyzes the safety of a phase 1 cardiac rehabilitation protocol (RN4HTx) in heart transplant patients and its effects on self-care capacity. A quantitative, descriptive study was conducted with 19 heart transplant recipients. The protocol was implemented in collaboration with a rehabilitation professional, who monitored adverse events, hemodynamic variables, self-care capacity (Barthel) pre- and post-transplant, and functional capacity at discharge (6 min walk test). The results showed that 68.42% of recipients were men, with an average age of 50.21 years and 15 days of hospitalization post-transplant. Approximately 73.68% of recipients were transferred from other wards with changes in functional capacity. All patients progressed to the final stage of the program without adverse events. There was a notable improvement in self-care capacity before and after transplantation, with a measure of functional status of 310.035 m (6MWT). The study found that RN4HTx is a feasible cardiac rehabilitation program without adverse events in the immediate postoperative period following heart transplantation, positively impacting functional recovery and therapeutic self-care capacity, thus increasing the safety of returning home. This study was retrospectively registered on Clinical Trials-NCT06552390.
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Affiliation(s)
- Maria Loureiro
- Instituto Ciências Biomédicas Abel Salazar, Cintesis-NursID, Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal
| | - Vítor Parola
- Nursing School of Coimbra (ESEnfC), The Health Sciences Research Unit-Nursing (UICISA:E), Centre for Evidence-Based Practice—A Joanna Briggs Institute Centre of Excellence, 3004-011 Coimbra, Portugal;
| | - João Duarte
- Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal;
| | - Isabel Oliveira
- Nursing School of Coimbra (ESEnfC), The Health Sciences Research Unit-Nursing (UICISA:E), 3004-011 Coimbra, Portugal;
| | - Margarida Antunes
- Unidade Local de Saúde de Coimbra, Núcleo de Investigação em Enfermagem do CHUC, 3000-602 Coimbra, Portugal;
| | - Gonçalo Coutinho
- Faculdade de Medicina de Coimbra, Unidade Local de Saúde de Coimbra, 3000-602 Coimbra, Portugal;
| | | | - André Novo
- Instituto Politécnico de Bragança-Escola Superior de Saúde, LiveWell—Research Center for Active Living and Wellbeing, 5300-121 Bragança, Portugal;
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Appenzeller P, Gautschi F, Müller J, Lichtblau M, Saxer S, Schneider SR, Schwarz EI, Ulrich S. Prediction of peak oxygen uptake from 6-minute walk test in pulmonary hypertension. ERJ Open Res 2022; 8:00664-2021. [PMID: 35747228 PMCID: PMC9209853 DOI: 10.1183/23120541.00664-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/16/2022] [Indexed: 11/06/2022] Open
Abstract
Maximal oxygen uptake (V′O2max), assessed by cardiopulmonary exercise testing (CPET), is an important parameter for risk assessment in patients with pulmonary hypertension (PH). However, CPET may not be available for all PH patients. Thus, we aimed to test previously published predictive models of V′O2max from the 6-min walk distance (6MWD) for their accuracy and to create a new model. We tested four models (two by Ross et al. (2010), one by Miyamoto et al. (2000) and one by Zapico et al. (2019)). To derive a new model, data were split into a training and testing dataset (70:30) and step-wise linear regression was performed. To compare the different models, the standard error of the estimate (SEE) was calculated and the models graphically compared by Bland–Altman plots. Sensitivity and specificity for correct prediction into low-risk classification (V′O2max >15 mL/min/kg) was calculated for all models. A total of 276 observations were included in the analysis (194/82 training/testing dataset); 6MWD and V′O2max were significantly correlated (r=0.65, p<0.001). Linear regression showed significant correlation of 6MWD, weight and heart rate response (HRR) with V′O2max and the best fitting prediction equation was: V′O2max = 1.83 + 0.031 × 6MWD (m) – 0.023 × weight (kg) – 0.015 × HRR (bpm). SEEs for the different models were 3.03, 3.22, 4.36 and 3.08 mL/min/kg for the Ross et al., Miyamoto et al., Zapico et al. models and the new model, respectively. Predicted mean V′O2max was 16.5 mL/min/kg (versus observed 16.1 mL/min/kg). 6MWD and V′O2max reveal good correlation in all models. However, the accuracy of all models is inadequate for clinical use. Thus, CPET and 6MWD both remain valuable risk assessment tools in the management of PH. Although maximal oxygen uptake and the 6-min walk distance show good correlation in pulmonary hypertension, all predictive models are of inadequate accuracy for clinical use and cardiopulmonary exercise testing remains an irreplaceable toolhttps://bit.ly/33HBQFk
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Melliti W, Kammoun R, Masmoudi D, Ahmaidi S, Masmoudi K, Alassery F, Hamam H, Chlif M. Effect of Six-Minute Walk Test and Incremental Exercise on Inspiratory Capacity, Ventilatory Constraints, Breathlessness and Exercise Performance in Sedentary Male Smokers without Airway Obstruction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12665. [PMID: 34886390 PMCID: PMC8657380 DOI: 10.3390/ijerph182312665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/12/2021] [Accepted: 11/21/2021] [Indexed: 11/29/2022]
Abstract
We investigated physiological responses and exercise capacity in sedentary young smokers during sub-maximal and maximal test and its impact on dyspnea and exercise intolerance. Fifty sedentary male smokers and non-smokers (age: 24 ± 1 years., weight: 71 ± 9 kg, height: 177.3 ± 4.8 cm, body mass index: 22.6 ± 2.5 kg/m2) underwent two visits with pulmonary function tests, breathing pattern, and inspiratory capacity measurement at rest and during sub-maximal and maximal exercise. Smokers show reduced exercise capacity during six minutes walk test (6-MWT) with decreased walked distance (p < 0.001) and inspiratory capacity (p < 0.05). During cardiopulmonary exercise test (CPET), smokers had higher minute ventilation VE for a given submaximal intensity (p < 0.05) and lower minute ventilation at maximal exercise (p < 0.001). End expiratory lung volume was significantly lower in sedentary smokers at rest (p < 0.05), at ventilatory threshold during exercise (p < 0.05), but not during peak exercise. End inspiratory lung volume was significantly lower in smokers at rest (p < 0.05) and ventilatory threshold (p < 0.05). Cigarette smoking alters lung function during submaximal and maximal exercise. This alteration is manifested by the development of dynamic hyperinflation contributing to exercise capacity limitation.
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Affiliation(s)
- Wassim Melliti
- Research Unit: Education, Motor Skills, Sport and Health (EM2S), UR15JS01, High Institute of Sport and Physical Education, University of Sfax, Sfax BP 3000, Tunisia;
- Research Unit Respiratory Pathology in Southern Tunisia, Pulmonology Department CHU Hedi Chaker, Sfax 3000, Tunisia
| | - Rim Kammoun
- Physiology and Functional Exploration Service, University Hospital Habib Bourguiba, Sfax 3000, Tunisia; (R.K.); (D.M.); (K.M.)
| | - Donies Masmoudi
- Physiology and Functional Exploration Service, University Hospital Habib Bourguiba, Sfax 3000, Tunisia; (R.K.); (D.M.); (K.M.)
| | - Said Ahmaidi
- EA 3300 “APS and Motor Patterns: Adaptations-Rehabilitation”, Picardie Jules Verne University, 80025 Amiens, France;
| | - Kaouthar Masmoudi
- Physiology and Functional Exploration Service, University Hospital Habib Bourguiba, Sfax 3000, Tunisia; (R.K.); (D.M.); (K.M.)
| | - Fawaz Alassery
- Department of Computer Engineering, College of Computers and Information Technology, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Habib Hamam
- Department of Electrical Engineering, Faculty of Engineering, Moncton University, Moncton, NB E1A 3E9, Canada;
| | - Mehdi Chlif
- EA 3300 “APS and Motor Patterns: Adaptations-Rehabilitation”, Picardie Jules Verne University, 80025 Amiens, France;
- National Center of Medicine and Science in Sports (NCMSS), Tunisian Research Laboratory Sports Performance Optimization, Ave Med Ali Akid, El Menzah, Tunis 263, Tunisia
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Schmidt T, Bjarnason-Wehrens B, Predel HG, Reiss N. Exercise after Heart Transplantation: Typical Alterations,
Diagnostics and Interventions. Int J Sports Med 2020; 42:103-111. [DOI: 10.1055/a-1194-4995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractFor the treatment of terminal heart failure, heart transplantation is considered
to be the gold standard, leading to significantly improved quality of life and
long-time survival. For heart transplant recipients, the development and
maintenance of good functional performance and adequate exercise capacity is
crucial for renewed participation and integration in self-determined live. In
this respect, typical transplant-related alterations must be noted that play a
significant role, leading to restrictions both centrally and peripherally.
Before patients begin intensive and structured exercise training, a
comprehensive diagnosis of their exercise capacity should take place in order to
stratify the risks involved and to plan the training units accordingly.
Particularly endurance sports and resistance exercises are recommended to
counter the effects of the underlying disease and the immunosuppressive
medication. The performance level achieved can vary considerably depending on
their individual condition, from gentle activity through a non-competitive-level
to intensive competitive sports. This paper includes an overview of the current
literature on heart transplant recipients, their specific characteristics, as
well as typical cardiovascular and musculoskeletal alterations. It also
discusses suitable tools for measuring exercise capacity, recommendations for
exercise training, required precautions and the performance level usually
achieved.
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Affiliation(s)
- Thomas Schmidt
- Institute for Cardiovascular Research, Schüchtermann-Klinik Bad
Rothenfelde, Bad Rothenfelde, Germany
- Department of Preventive and Rehabilitative Sport and Exercise
Medicine, Institute for Cardiology and Sports Medicine, Cologne, German Sport
University Cologne, Germany
| | - Birna Bjarnason-Wehrens
- Department of Preventive and Rehabilitative Sport and Exercise
Medicine, Institute for Cardiology and Sports Medicine, Cologne, German Sport
University Cologne, Germany
| | - Hans-Georg Predel
- Department of Preventive and Rehabilitative Sport and Exercise
Medicine, Institute for Cardiology and Sports Medicine, Cologne, German Sport
University Cologne, Germany
| | - Nils Reiss
- Institute for Cardiovascular Research, Schüchtermann-Klinik Bad
Rothenfelde, Bad Rothenfelde, Germany
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Exercise for Solid Organ Transplant Candidates and Recipients: A Joint Position Statement of the Canadian Society of Transplantation and CAN-RESTORE. Transplantation 2019; 103:e220-e238. [DOI: 10.1097/tp.0000000000002806] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Tsai W, Tsai H, Kuo L, Lin Y, Chen B, Lin W, Shen S, Huang H. VE/VCO2 Slope and Functional Capacity in Patients Post-Heart Transplantation. Transplant Proc 2018; 50:2733-2737. [DOI: 10.1016/j.transproceed.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 11/27/2022]
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Rocco IS, Viceconte M, Pauletti HO, Matos-Garcia BC, Marcondi NO, Bublitz C, Bolzan DW, Moreira RSL, Reis MS, Hossne NA, Gomes WJ, Arena R, Guizilini S. Oxygen uptake on-kinetics during six-minute walk test predicts short-term outcomes after off-pump coronary artery bypass surgery. Disabil Rehabil 2017; 41:534-540. [PMID: 29279000 DOI: 10.1080/09638288.2017.1401673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We aimed to investigate the ability of oxygen uptake kinetics to predict short-term outcomes after off-pump coronary artery bypass grafting. METHODS Fifty-two patients aged 60.9 ± 7.8 years waiting for off-pump coronary artery bypass surgery were evaluated. The 6-min walk test distance was performed pre-operatively, while simultaneously using a portable cardiopulmonary testing device. The transition of oxygen uptake kinetics from rest to exercise was recorded to calculate oxygen uptake kinetics fitting a monoexponential regression model. Oxygen uptake at steady state, constant time, and mean response time corrected by work rate were analysed. Short-term clinical outcomes were evaluated during the early post-operative of off-pump coronary artery bypass surgery. RESULTS Multivariate analysis showed body mass index, surgery time, and mean response time corrected by work rate as independent predictors for short-term outcomes. The optimal mean response time corrected by work rate cut-off to estimate short-term clinical outcomes was 1.51 × 10-3 min2/ml. Patients with slower mean response time corrected by work rate demonstrated higher rates of hypertension, diabetes, EuroSCOREII, left ventricular dysfunction, and impaired 6-min walk test parameters. The per cent-predicted distance threshold of 66% in the pre-operative was associated with delayed oxygen uptake kinetics. CONCLUSIONS Pre-operative oxygen uptake kinetics during 6-min walk test predicts short-term clinical outcomes after off-pump coronary artery bypass surgery. From a clinically applicable perspective, a threshold of 66% of pre-operative predicted 6-min walk test distance indicated slower kinetics, which leads to longer intensive care unit and post-surgery hospital length of stay. Implications for rehabilitation Coronary artery bypass grafting is a treatment aimed to improve expectancy of life and prevent disability due to the disease progression; The use of pre-operative submaximal functional capacity test enabled the identification of patients with high risk of complications, where patients with delayed oxygen uptake kinetics exhibited worse short-term outcomes; Our findings suggest the importance of the rehabilitation in the pre-operative in order to "pre-habilitate" the patients to the surgical procedure; Faster oxygen uptake on-kinetics could be achieved by improving the oxidative capacity of muscles and cardiovascular conditioning through rehabilitation, adding better results following cardiac surgery.
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Affiliation(s)
- Isadora Salvador Rocco
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Marcela Viceconte
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Hayanne Osiro Pauletti
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Bruna Caroline Matos-Garcia
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Natasha Oliveira Marcondi
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Caroline Bublitz
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Douglas William Bolzan
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Rita Simone Lopes Moreira
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Michel Silva Reis
- c Department of Physical Therapy , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - Nelson Américo Hossne
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Walter José Gomes
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Ross Arena
- d Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Solange Guizilini
- a Cardiology and Cardiovascular Surgery Disciplines , Federal University of Sao Paulo , Sao Paulo , Brazil.,b Department of Human Motion Sciences, Physical Therapy School , Federal University of Sao Paulo , Sao Paulo , Brazil
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Schmidt T, Bjarnason-Wehrens B, Bartsch P, Deniz E, Schmitto J, Schulte-Eistrup S, Willemsen D, Reiss N. Exercise Capacity and Functional Performance in Heart Failure Patients Supported by a Left Ventricular Assist Device at Discharge From Inpatient Rehabilitation. Artif Organs 2017. [DOI: 10.1111/aor.12936] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Thomas Schmidt
- Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
- Department of Preventive and Rehabilitative Sport and Exercise Medicine, Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Birna Bjarnason-Wehrens
- Department of Preventive and Rehabilitative Sport and Exercise Medicine, Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Petra Bartsch
- Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
| | - Ezin Deniz
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Jan Schmitto
- Department for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | | | - Detlev Willemsen
- Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
| | - Nils Reiss
- Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany
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Six-Minute Walk Test Among Heart Transplant Recipients. Transplant Proc 2014; 46:929-33. [DOI: 10.1016/j.transproceed.2013.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/12/2013] [Accepted: 11/27/2013] [Indexed: 01/08/2023]
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Casillas JM, Hannequin A, Besson D, Benaïm S, Krawcow C, Laurent Y, Gremeaux V. Walking tests during the exercise training: specific use for the cardiac rehabilitation. Ann Phys Rehabil Med 2013; 56:561-75. [PMID: 24126080 DOI: 10.1016/j.rehab.2013.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 09/01/2013] [Accepted: 09/05/2013] [Indexed: 12/13/2022]
Abstract
Walk tests, principally the six-minute walk test (6mWT), constitute a safe, useful submaximal tool for exercise tolerance testing in cardiac rehabilitation (CR). The 6mWT result reflects functional status, walking autonomy and efficacy of CR on walking endurance, which is more pronounced in patients with low functional capacity (heart failure - cardiac surgery). The 6mWT result is a strong predictor of mortality. However, clinically significant changes and reliability are still subject to debate - probably because of the ambiguity in terms of the target speed (either comfortable or brisk walking). Of the other time-based walk tests, the 2-minute-walk test is the only one applicable during CR, reserved for patients with severe disabilities by its psychometric properties. Fixed-distance tests (principally the 200m fast walk test) and incremental shuttle walking, tests explore higher levels of effort and may represent a safe and inexpensive alternative to laboratory-based tests during CR. These walking tests may be useful for personalizing prescription of training programs. However, the minimum clinically significant difference has not yet been determined. Lastly, walking tests appear to be potential useful tools in promoting physical activity and behavioural changes at home. Thus, validation of other walk tests with better psychometric properties will be necessary.
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Affiliation(s)
- J-M Casillas
- Pôle rééducation-réadaptation, CHU de Dijon, 23, rue Gaffarel, 21079 Dijon, France; CIC-P Inserm 803, plateforme d'investigation technologique, CHU de Dijon, 23, rue Gaffarel, 21079 Dijon, France; Inserm U1093, 21078 Dijon, France.
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Tomás MT, Santa-Clara MH, Monteiro E, Baynard T, Carnero EÁ, Bruno PM, Barroso E, Sardinha LB, Fernhall B. Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients. Clin Transplant 2011; 25:E406-14. [PMID: 21418328 DOI: 10.1111/j.1399-0012.2011.01436.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease leading to sensory and motor polyneuropathies, and functional limitations. Liver transplantation is the only treatment for FAP, requiring medication that negatively affects bone and muscle metabolism. The aim of this study was to compare body composition, levels of specific strength, level of physical disability risk, and functional capacity of transplanted FAP patients (FAPTx) with a group of healthy individuals (CON). METHODS A group of patients with 48 FAPTx (28 men, 20 women) was compared with 24 CON individuals (14 men, 10 women). Body composition was assessed by dual-energy X-ray absorptiometry, and total skeletal muscle mass (TBSMM) and skeletal muscle index (SMI) were calculated. Handgrip strength was measured for both hands as was isometric strength of quadriceps. Muscle quality (MQ) was ascertained by the ratio of strength to muscle mass. Functional capacity was assessed by the six-minute walk test. RESULTS Patients with FAPTx had significantly lower functional capacity, weight, body mass index, total fat mass, TBSMM, SMI, lean mass, muscle strength, MQ, and bone mineral density. CONCLUSION Patients with FAPTx appear to be at particularly high risk of functional disability, suggesting an important role for an early and appropriately designed rehabilitation program.
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Affiliation(s)
- Maria T Tomás
- Exercise and Health Laboratory, Faculty of Human Kinetics, Technical University of Lisbon, Portugal.
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Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood 2011; 117:2604-13. [DOI: 10.1182/blood-2010-09-306308] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a home-based setting before hospital admission, during inpatient treatment and a 6- to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P < .01-.03), physical fitness/functioning (P = .02-.03) and global distress (P = .03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care.
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Gruet M, Brisswalter J, Mely L, Vallier JM. Use of the Peak Heart Rate Reached During Six-Minute Walk Test to Predict Individualized Training Intensity in Patients With Cystic Fibrosis: Validity and Reliability. Arch Phys Med Rehabil 2010; 91:602-7. [DOI: 10.1016/j.apmr.2009.12.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 11/05/2009] [Accepted: 12/09/2009] [Indexed: 12/23/2022]
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