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Rijal A, Adhikari TB, Dhakal S, Maagaard M, Piri R, Nielsen EE, Neupane D, Jakobsen JC, Olsen MH. Effect of exercise on functional capacity and body weight for people with hypertension, type 2 diabetes, or cardiovascular disease: a systematic review with meta-analysis and trial sequential analysis. BMC Sports Sci Med Rehabil 2024; 16:38. [PMID: 38321506 PMCID: PMC10848448 DOI: 10.1186/s13102-024-00829-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/28/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Hypertension, type 2 diabetes, and cardiovascular disease affect the activities of daily living at varying degree. While the effects of aerobic exercise on functional capacity are well-documented, the extent of change for different types of exercise in these chronic conditions remains unexplored. Additionally, there is conflicting evidence regarding the role of exercise in reducing body weight. METHODS We conducted systematic review with meta-analysis and trial sequential analysis and searched various databases from inception to July 2020. We included randomised clinical trials adding any form of trialist defined exercise to usual care versus usual care in people with either hypertension, type 2 diabetes, and/or cardiovascular disease irrespective of setting, publication status, year, and language. The outcomes assessed were i) functional capacity assessed through different scales separately i.e., Maximal Oxygen Uptake (VO2max), 6-min walk test (6MWT), 10-m walk test (10MWT), and ii) body weight. RESULTS We included 950 studies out of which 444 trials randomising 20,098 participants reported on various functional outcomes (355 trials) and body weight (169 trials). The median follow-up was 3 months (Interquartile ranges (IQR): 2.25 to 6). Exercise added to the usual care, improved VO2max (Mean Difference (MD):2.72 ml/kg/min; 95% Confidence Interval (CI) 2.38 to 3.06; p < 0.01; I2 = 96%), 6MWT (MD: 42.5 m; 95%CI 34.95 to 50.06; p < 0.01; I2 = 96%), and 10MWT (MD: 0.06 m/s; 95%CI 0.03 to 0.10; p < 0.01; I2 = 93%). Dynamic aerobic and resistance exercise showed a consistent improvement across various functional outcomes, whereas body-mind therapies (MD: 3.23 ml/kg/min; 95%CI 1.97 to 4.49, p < 0.01) seemed especially beneficial for VO2max and inspiratory muscle training (MD: 59.32 m; 95%CI 33.84 to 84.80; p < 0.01) for 6MWT. Exercise yielded significant reduction in body weight for people with hypertension (MD: -1.45 kg; 95%CI -2.47 to -0.43; p < 0.01), and type 2 diabetes (MD: -1.53 kg; 95%CI -2.19 to -0.87; p < 0.01) but not for cardiovascular disease with most pronounced for combined exercise (MD: -1.73 kg; 95%CI -3.08 to -0.39; p < 0.05). The very low certainty of evidence warrants cautious interpretations of the results. CONCLUSION Exercise seemed to improve functional capacity for people with hypertension, type 2 diabetes, and/or cardiovascular disease but the effectiveness seems to vary with different forms of exercise. The potentially superior improvement in VO2max and 6MWT by body-mind therapies and inspiratory muscle training calls for further exploration. Additionally, prescribing exercise for the sole purpose of losing weight may be a potential strategy for people with hypertension and type 2 diabetes. The extent of improvement in functional capacity and body weight reduction differed with different exercise regimens hence personalised exercise prescriptions tailored to individual needs may be of importance. PROSPERO REGISTRATION: PROSPERO registration number: CRD42019142313.
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Affiliation(s)
- Anupa Rijal
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark.
| | - Tara Ballav Adhikari
- Department of Public Health, Research Unit for Environment, Occupation & Health, Aarhus University, Aarhus, Denmark
| | - Sarmila Dhakal
- Center for Research on Environment, Health and Population Activities (CREPHA), Kusunti, Lalitpur, Nepal
| | - Mathias Maagaard
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Koge, Denmark
| | - Reza Piri
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Emil Eik Nielsen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University Baltimore, Maryland, USA
| | - Janus Christian Jakobsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Michael Hecht Olsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
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Nevelikova M, Dosbaba F, Pepera G, Felsoci M, Batalikova K, Su JJ, Batalik L. Validity and reliability of automated treadmill six-minute walk test in patients entering exercise-based cardiac rehabilitation. Ann Med 2024; 55:2304664. [PMID: 38233732 PMCID: PMC10798278 DOI: 10.1080/07853890.2024.2304664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction: The six-minute walk test (6MWT) is a well-established tool for assessing submaximal functional capacity for cardiac patients, but space limitations challenge its implementation. Treadmill-based (TR) 6MWT is a promising alternative, but it requires patients to complete a familiarization test to adapt treadmill speed regulation. With the advancement of sensors, it is possible to automatically control speed for individual patients and thus overcome the space limitation or the speed control difficulty on the treadmill for each patient.Methods: This study investigated the validity and interchangeability of automated speed TR6MWT and standard hallway (HL) 6MWT. Eighteen patients were assessed at baseline of the 12-week cardiac rehabilitation program. Fourteen of them were assessed after rehabilitation. All patients performed three TR6MWTs and three HL6MWTs at baseline and one of each test after the program.Results: Patients well tolerated the TR6MWT. There was a strong correlation between both test methods (r = 0.79). However, patients performed significantly better in HL6MWT (514.8m ± 59.7m) than in TR6MWT (447.2 ± 79.1m) with 95% CI, 40.4-94.6m, p < 0.05. Both tests showed high test-retest reliability (intraclass correlation coefficient of 0.86). The TR6MWT showed a valuable comparison of the effect of the cardiac rehabilitation program (20% increase, effect size 1.1) even though it is not interchangeable with the HL6MWT.Conclusion: The automated speed TR6MWT appears to be an acceptable tool with adequate validity, reliability, and responsiveness for assessing functional capacity in patients utilizing cardiac rehabilitation programs.
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Affiliation(s)
- Marketa Nevelikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Marian Felsoci
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
| | - Katerina Batalikova
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Althoff A, Vieira AM, da Silveira LS, Benetti M, Karsten M. Aerobic Exercise Prescription in Cardiac Rehabilitation Based on Heart Rate from Talk Test Stages and 6-Minute Walk Test. Arq Bras Cardiol 2023; 120:e20230086. [PMID: 37820173 PMCID: PMC10519355 DOI: 10.36660/abc.20230086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited. OBJECTIVE To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET). METHODS Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman's test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT-), and at the peak of the 6MWT. Pearson's or Spearman's test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%. RESULTS The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT- (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT- (p = 0.68). CONCLUSIONS HR at TT+ and TT- reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.
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Affiliation(s)
- Amanda Althoff
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Ariany Marques Vieira
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- Montreal Behavioral Medicine CentreCIUSSS du Nord-de-l’Île-de-MontréalMontrealCanadáMontreal Behavioral Medicine Centre, CIUSSS du Nord-de-l’Île-de-Montréal, Montreal – Canadá
| | - Lucas Santos da Silveira
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Magnus Benetti
- PPGCMHUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Ciências do Movimento Humano (PPGCMH) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
| | - Marlus Karsten
- PPGFTUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilPrograma de Pós-Graduação em Fisioterapia (PPGFT) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
- GEPCardioUniversidade do Estado de Santa CatarinaFlorianópolisSCBrasilGrupo de Pesquisa em Saúde Cardiovascular e Exercício (GEPCardio) – Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC – Brasil
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Lower-limb Nonparametric Functional Muscle Network: Test-retest Reliability Analysis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.08.527765. [PMID: 36798422 PMCID: PMC9934625 DOI: 10.1101/2023.02.08.527765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Objective Functional muscle network analysis has attracted a great deal of interest in recent years, promising high sensitivity to changes of intermuscular synchronicity, studied mostly for healthy subjects and recently for patients living with neurological conditions (e.g., those caused by stroke). Despite the promising results, the between- and within-session reliability of the functional muscle network measures are yet to be established. Here, for the first time, we question and evaluate the test-retest reliability of non-parametric lower-limb functional muscle networks for controlled and lightly-controlled tasks, i.e., sit-to-stand, and over-the-ground walking, respectively, in healthy subjects. Method Fifteen subjects (eight females) were included over two sessions on two different days. The muscle activity was recorded using 14 surface electromyography (sEMG) sensors. The intraclass correlation coefficient (ICC) of the within-session and between-session trials was quantified for the various network metrics, including degree and weighted clustering coefficient. In order to compare with common classical sEMG measures, the reliabilities of the root mean square (RMS) of sEMG and the median frequency (MDF) of sEMG were also calculated. Results The ICC analysis revealed superior between-session reliability for muscle networks, with statistically significant differences when compared to classic measures. Conclusion and Significance This paper proposed that the topographical metrics generated from functional muscle network can be reliably used for multi-session observations securing high reliability for quantifying the distribution of synergistic intermuscular synchronicities of both controlled and lightly controlled lower limb tasks. In addition, the low number of sessions required by the topographical network metrics to reach reliable measurements indicates the potential as biomarkers during rehabilitation.
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Pepera G, Sandercock GRH. Incremental shuttle walking test to assess functional capacity in cardiac rehabilitation: a narrative review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Low functional capacity has been recognised to be the most important predictor of overall mortality compared to all other cardiovascular risk factors in patients with cardiovascular disease. Walk tests, such as the incremental shuttle walking test and the 6-Minute Walk Test, are used to assess functional capacity in patients, the effectiveness of a cardiac rehabilitation programme and the prognosis of cardiovascular diseases. The aim of this review was to provide a narrative review of the literature and identify the key features of the incremental shuttle walking test as a measure of functional capacity testing in cardiac rehabilitation patients. Methods The PubMed, MEDLINE, Elsevier and Google Scholar databases were searched for relevant scientific articles published up to March 2021 with no restriction on start day. The key words defined by researchers were ‘incremental shuttle walking test’, ‘exercise test’, ‘functional capacity’, ‘cardiovascular disease’, ‘cardiac rehabilitation’, ‘reliability’ ‘prediction; ‘walk tests’. A final set of 31 articles was included in this narrative review. Results Evidence-based findings suggest that the incremental shuttle walking test is a valid, reliable, sensitive, useful tool for detecting and predict cardiorespiratory capacity. Conclusions Clinicians can be confident that they can use the incremental shuttle walking test to monitor changes in functional capacity in patients with cardiovascular disease.
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Affiliation(s)
- Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Gavin RH Sandercock
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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Calegari L, Moreira I, Falkowski A, Reolão JBC, Karsten M, Deresz LF. Agreement between heart rate at first ventilatory threshold on treadmill and at 6-min walk test in coronary artery disease patients on β-blockers treatment. J Exerc Rehabil 2021; 17:362-368. [PMID: 34805026 PMCID: PMC8566104 DOI: 10.12965/jer.2142488.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to verify the accuracy of the agreement between heart rate at the first ventilatory threshold (HRVT1) and heart rate at the end of the 6-min walk test (HR6MWT) in coronary artery disease (CAD) patients on β-blockers treatment. This was a cross-sectional study with stable CAD patients, which performed a cardiopulmonary exercise test (CPET) on a treadmill and a 6-min walk test (6MWT) on nonconsecutive days. The accuracy of agreement between HRVT1 and HR6MWT was evaluated by Bland–Altman analysis and Lin’s concordance correlation coefficient (rc), mean absolute percentage error (MAPE), and standard error of estimate (SEE). Seventeen stable CAD patients on β-blockers treatment (male, 64.7%; age, 61±10 years) were included in data analysis. The Bland–Altman analysis revealed a negative bias of −0.41±6.4 bpm (95% limits of agreements, −13 to 12.2 bpm) between HRVT1 and HR6MWT. There was acceptable agreement between HRVT1 and HR6MWT (rc=0.84; 95% confidence interval, 0.63 to 0.93; study power analysis=0.79). The MAPE of the HR6MWT was 5.1% and SEE was 6.6 bpm. The ratio HRVT1/HRpeak and HR6MWT/HRpeak from CPET were not significantly different (81%±5% vs. 81%±6%, P=0.85); respectively. There was a high correlation between HRVT1 and HR6MWT (r=0.85, P<0.0001). Finally, the results of the present study demonstrate that there was an acceptable agreement between HRVT1 and HR6MWT in CAD patients on β-blockers treatment and suggest that HR6MWT may be useful to prescribe and control aerobic exercise intensity in cardiac rehabilitation programs.
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Affiliation(s)
- Leonardo Calegari
- Physical Therapy Department, Faculdade Especializada da Área da Saúde do Rio Grande do Sul (FASURGS), Passo Fundo, RS, Brazil
| | - Igor Moreira
- Physical Therapy Department, Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Andrei Falkowski
- Physical Therapy Department, Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | | | - Marlus Karsten
- Departamento de Fisioterapia, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil.,Graduate Program in Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Brazil.,Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Luís Fernando Deresz
- Physical Education Department, Health Sciences Institute, Universidade Federal de Juiz de Fora, Governador Valadares, Brazil.,Post Graduation Program in Health Applied Sciences, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil.,Research Group Ciência, Saúde e Desempenho Físico, Universidade Federal de Juiz de Fora, Campus Governador Valadares, MG, Brazil
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Smith-Turchyn J, Adams SC, Sabiston CM. Testing of a Self-administered 6-Minute Walk Test Using Technology: Usability, Reliability and Validity Study. JMIR Rehabil Assist Technol 2021; 8:e22818. [PMID: 34554105 PMCID: PMC8498894 DOI: 10.2196/22818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/10/2020] [Accepted: 08/09/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The need to attend a medically supervised hospital- or clinic-based appointment is a well-recognized barrier to exercise participation. The development of reliable and accurate home-based functional tests has the potential to decrease the burden on the health care system while enabling support, information, and assessment. OBJECTIVE This study aims to explore the usability (ie, acceptability, satisfaction, accuracy, and practicality) of the EasyMeasure app to self-administer the 6-minute walk test (6MWT) in young, healthy adults and determine parallel form reliability and construct validity of conducting a self-administered 6MWT using technology. METHODS We used a usability study design. English-speaking, undergraduate university students who had access to an iPhone or iPad device running iOS 10 or later and self-reported ability to walk for 6 minutes were recruited for this study. Consenting participants were randomized to either a standard 6MWT group (ie, supervised without the use of the app) or a technology 6MWT group (ie, unsupervised with the app to mimic independent implementation of the test). All participants performed a maximal treadmill test. Participants in the 6MWT group completed the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire and a satisfaction questionnaire after completing the assessment. Parallel form reliability of the 6MWT using technology was analyzed by comparing participant self-administered scores and assessor scores using Pearson correlation coefficients across and between trials. Construct validity was assessed by comparing participant 6MWT scores (both standard and using technology) with maximum treadmill test variables (peak oxygen uptake and ventilatory threshold [VT]). RESULTS In total, 20 university students consented to participate in the study. All but 2 participants (8/10, 80%) in the technology 6MWT group had deviations that prevented them from accurately conducting the 6MWT using the app, and none of the participants were able to successfully score the 6MWT. However, a significantly strong correlation was found (r=.834; P=.003) when comparing participants' scores for the 6MWT using technology with the assessors' scores. No significant correlations were found between maximal treadmill test peak oxygen uptake scores and 6MWT prediction equations using standard 6MWT scores (equation 1: r=0.119; P=.78; equation 2: r=0.095; P=.82; equation 3: r=0.119; P=.78); however, standard 6MWT scores were significantly correlated with VT values (r=0.810; P=.02). The calculated submaximal treadmill scores and assessor 6MWT scores using technology also demonstrated a significant correlation (r=0.661; P=.04). CONCLUSIONS This study demonstrated significant usability concerns regarding the accuracy of a self-administered 6MWT using the EasyMeasure app. However, the strong and significant correlation between the 6MWT and VT values demonstrates the potential of the 6MWT to measure functional capacity for community-based exercise screening and patient monitoring.
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Affiliation(s)
| | - Scott C Adams
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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Passantino A, Dalla Vecchia LA, Corrà U, Scalvini S, Pistono M, Bussotti M, Gambarin FI, Scrutinio D, La Rovere MT. The Future of Exercise-Based Cardiac Rehabilitation for Patients With Heart Failure. Front Cardiovasc Med 2021; 8:709898. [PMID: 34422933 PMCID: PMC8371325 DOI: 10.3389/fcvm.2021.709898] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/29/2021] [Indexed: 01/14/2023] Open
Abstract
Cardiac rehabilitation (CR) is a comprehensive program that includes exercise training, titration of medical therapy, lifestyle modification, educational support, and psychosocial assessment. All these components are safe and beneficial resulting in significant improvements in quality of life, functional capacity, mortality, and hospital readmission. Current guidelines support its use in a broad spectrum of cardiac disease. This review focuses on exercise-based CR for heart failure (HF) patients in whom CR is a recommended treatment. Exercise should be prescribed according to a personalized approach, optimizing, and tailoring the rehabilitative program to the patient's characteristics. Specific CR programs are dedicated to older patients, those with HF and preserved ejection fraction, and recipients of cardiac implantable electronic devices or left ventricular assistance device. Telemedicine may increase CR participation and overcome some of the barriers that limit its utilization.
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Affiliation(s)
- Andrea Passantino
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Bari, Italy
| | | | - Ugo Corrà
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Simonetta Scalvini
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Cardiac Rehabilitation, Lumezzane, Italy
| | - Massimo Pistono
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Maurizio Bussotti
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Milan, Italy
| | - Fabiana Isabella Gambarin
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Veruno, Italy
| | - Domenico Scrutinio
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Division of Cardiac Rehabilitation, Bari, Italy
| | - Maria Teresa La Rovere
- Istituti Clinici Scientifici Maugeri Spa SB, Division of Cardiac Rehabilitation, Montescano, Italy
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Tomkinson GR, Kidokoro T, Dufner TJ, Noi S, Fitzgerald JS, Brown-Borg HM. Temporal trends in 6-minute walking distance for older Japanese adults between 1998 and 2017. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:462-469. [PMID: 32553730 PMCID: PMC8343061 DOI: 10.1016/j.jshs.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/18/2020] [Accepted: 05/12/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND The 6-minute walking distance (6MWD) is an excellent measure of both functional endurance and health. The primary aim of this study was to estimate temporal trends in 6MWD for older Japanese adults between 1998 and 2017; the secondary aim was to estimate concurrent trends in body size (i.e., height and mass) and self-reported participation in exercise/sport. METHODS Adults aged 65-79 years were included. Annual nationally representative 6MWD data (n = 103,505) for the entire period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in means (and relative frequencies) were estimated at the gender-age level by best-fitting sample-weighted linear/polynomial regression models, with national trends estimated by a post-stratified population-weighting procedure. Temporal trends in distributional variability were estimated as the ratio of coefficients of variation. RESULTS Between 1998 and 2017 there was a steady, moderate improvement in mean 6MWD (absolute = 45 m (95% confidence interval (95%CI): 43-47); percent = 8.0% (95%CI: 7.6%-8.4%); effect size = 0.51 (95%CI: 0.48-0.54)). Gender- and age-related temporal differences in means were negligible. Variability in 6MWD declined substantially (ratio of coefficients of variation = 0.89, 95%CI: 0.87-0.92), with declines larger for women compared to men, and for 75-79-year-olds compared to 65-74-year-olds. Correspondingly, there were moderate and negligible increases in mean height and mass, respectively, and negligible increases in the percentage who participated in exercise/sport at least 3 days per week and at least 30 min per session. CONCLUSION There has been a steady, moderate improvement in mean 6MWD for older Japanese adults since 1998, which is suggestive of corresponding improvements in both functional endurance and health. The substantial decline in variability indicates that the temporal improvement in mean 6MWD was not uniform across the distribution. Trends in 6MWD are probably influenced by corresponding trends in body size and/or participation in exercise/sport.
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Affiliation(s)
- Grant R Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND 58202, USA; Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.
| | - Tetsuhiro Kidokoro
- Department of Health & Physical Education, International Christian University, Tokyo 181-8585, Japan
| | - Trevor J Dufner
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND 58202, USA
| | - Shingo Noi
- Nippon Sport Science University, Tokyo 158-8508, Japan
| | - John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND 58202, USA
| | - Holly M Brown-Borg
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202, USA
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Fell BL, Hanekom S, Heine M. Six-minute walk test protocol variations in low-resource settings - A scoping review. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1549. [PMID: 34230901 PMCID: PMC8252166 DOI: 10.4102/sajp.v77i1.1549] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/21/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The 6-min walk test (6MWT) is a validated tool, of submaximal intensity, used to objectively measure functional exercise capacity. In 2002, the American Thoracic Society (ATS) developed guidelines on standardising the implementation of the 6MWT. Despite the relative ease of conducting the 6MWT as per these guidelines, adaptations are implemented. OBJECTIVES Identify (1) what 6MWT adaptations to the ATS guidelines have been described in low-resource settings (LRS), (2) the purpose of the adapted 6MWT and (3) the reported argumentation for making these adaptations in relation to the specific context. METHODS Five databases were searched from inception until February 2021. Studies that adapted and conducted the 6MWT in LRS were included. Data concerning the study source, participants, 6MWT: purpose, variations, outcome and rationale were extracted. RESULTS A total of 24 studies were included. The majority of studies (n = 18; 75%) were conducted in lower-middle income countries. The most common adaptation implemented was variation to course length. Eight studies provided a rationale for adapting the 6MWT. Space constraint was the most common reason for adaptation. CONCLUSION The most common reason (space constraints) for adapting the 6MWT in LRS was addressed through adaptations in course length and/or configuration. The results of this review suggest that the value of the ATS-guided 6MWT in LRS may need to be re-evaluated. CLINICAL IMPLICATIONS Using adapted forms of the 6MWT may lead to an underestimation of a patient's abilities, misinformed discharge and developing inappropriate exercise programmes. Additionally, diverting from ATS guidelines may affect the continuity of care.
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Affiliation(s)
- Brittany L. Fell
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Martin Heine
- Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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11
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Tashima Y, Toyoshima Y, Chiba K, Nakamura N, Adachi K, Inoue Y, Yamaguchi A. Physical activities and surgical outcomes in elderly patients with acute type A aortic dissection. J Card Surg 2021; 36:2754-2764. [PMID: 33974291 DOI: 10.1111/jocs.15617] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/12/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Although elderly patients undergoing surgery for acute type A aortic dissection (ATAAD) is increasing, their physical activities are not fully understood. We report the physical activities and surgical outcomes in elderly patients who underwent ATAAD. METHODS From 2009 to 2019, 103 consecutive patients underwent surgery for ATAAD at our institution. Surgical outcomes along with pre- and postoperative physical activities in 52 elderly patients (≥70 years old) were compared with those in 51 younger patients (<70 years old). Postoperative walking difficulty was defined as taking ≥30 days to regain the ability to walk 200 m postoperatively or as the inability to walk at discharge. RESULTS It took longer for elderly patients to regain the ability to walk 100 or 200 m postoperatively. ROC analysis revealed the AUC of the duration for walking 200 m postoperatively as a prognostic indicator for late deaths was 0.878, with the highest accuracy at 30 days (sensitivity = 83.3%, specificity = 91.8%). Hospital mortality within 30 days was 3.8%, and 1-, 3-, and 5-years survival rates were 92%, 84.7%, 84.7%, respectively, for elderly patients, with no significant differences between groups. Cox proportional hazard analysis showed postoperative walking difficulty was an independent risk factor for late mortality in all cohorts (p = .017). CONCLUSIONS Elderly patients undergoing surgical ATAAD repair showed acceptable surgical outcomes. However, they were more likely to decrease their physical activities postoperatively. Postoperative difficulty in walking was an independent risk factor for the late mortality in patients with ATAAD.
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Affiliation(s)
- Yasushi Tashima
- Department of Cardiovascular Surgery, Yokosuka General Hospital, Uwamachi, Japan.,Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Yurie Toyoshima
- Department of Rehabilitation, Yokosuka General Hospital Uwamachi, Yokosuka, Japan
| | - Kota Chiba
- Department of Rehabilitation, Yokosuka General Hospital Uwamachi, Yokosuka, Japan
| | - Noriyuki Nakamura
- Department of Cardiovascular Surgery, Yokosuka General Hospital, Uwamachi, Japan.,Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Koichi Adachi
- Department of Cardiovascular Surgery, Yokosuka General Hospital, Uwamachi, Japan.,Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
| | - Yoshimitsu Inoue
- Department of Rehabilitation, Yokosuka General Hospital Uwamachi, Yokosuka, Japan
| | - Atsushi Yamaguchi
- Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan
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12
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Amin R, Alaparthi GK, Samuel SR, Bairapareddy KC, Raghavan H, Vaishali K. Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Sci Rep 2021; 11:6730. [PMID: 33762655 PMCID: PMC7990944 DOI: 10.1038/s41598-021-86281-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/25/2021] [Indexed: 11/21/2022] Open
Abstract
The aim was to compare the effect of diaphragmatic breathing exercise (DBE), flow- (FIS) and volume-oriented incentive spirometry (VIS) on pulmonary function- (PFT), functional capacity-6-Minute Walk Test (6 MWT) and Functional Difficulties Questionnaire (FDQ) in subjects undergoing Coronary Artery Bypass Graft surgery (CABG). The purpose of incorporating pulmonary ventilator regimes is to improve ventilation and avoid post-operative pulmonary complications. CABG patients (n = 72) were allocated to FIS, VIS and DBE groups (n = 24 each) by block randomization. Preoperative and postoperative values for PFT were taken until day 7 for all three groups. On 7th postoperative day, 6 MWT and FDQ was analyzed using ANOVA and post-hoc analysis. PFT values were found to be decreased on postoperative day 1(Forced Vital Capacity (FVC) = FIS group-65%, VIS group-47%, DBE group-68%) compared to preoperative day (p < 0.001). PFT values for all 3 groups recovered until postoperative day 7 (FVC = FIS group-67%, VIS group-95%, DBE group-59%) but was found to reach the baseline in VIS group (p < 0.001). When compared between 3 groups, statistically significant improvement was observed in VIS group (p < 0.001) in 6 MWT and FDQ assessment. In conclusion, VIS was proven to be more beneficial in improving the pulmonary function (FVC), functional capacity and FDQ when compared to FIS and DBE.
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Affiliation(s)
- Revati Amin
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Bejai, Mangalore, 575004, India
| | - Gopala Krishna Alaparthi
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Stephen R Samuel
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Bejai, Mangalore, 575004, India
| | | | - Harish Raghavan
- Department of Cardiothoracic Surgery, Kasturba Medical Hospital, Mangalore, 575004, India
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, India
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13
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Besson D, Gouteron A, Hannequin A, Casillas JM, Rigaud L, Ornetti P, Fournel I, Ksiazek E, Laroche D, Gueugnon M. Is the Short and Fast Step Test a safe and feasible tool for exploring anaerobic capacities of individuals with coronary heart disease in clinical practice? Eur J Phys Rehabil Med 2021; 57:977-984. [PMID: 33619946 DOI: 10.23736/s1973-9087.21.06713-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND While its importance in daily living, the anaerobic metabolism is not taken into account in clinical practice. The lack of validated functional performance tests for patients with chronic disabilities may explain this defect. In this context, the Short and Fast Step Test (SFST) was recently developed and validated in healthy volunteers. AIM The purpose of this study was to investigate the safety, feasibility and reliability of the SFST, a functional test exploring anaerobic metabolism in coronary patients during cardiac rehabilitation. DESIGN This study was a monocentric prospective study. SETTINGS This study took place in the rehabilitation center of the University Hospital Center of Dijon, France. POPULATION 44 coronary patients, addressed for a first cardiac rehabilitation, were included in this protocol. METHODS All participants performed three SFST: T1 and T2 (including respiratory gas exchange) the first day of the program and T3 after 3 to 7 days. SFST consists of walking up and down a 17.5cm-high step as many times as possible in 1 minute. Safety was assessed by the percentage of patients who performed the SFST without reporting a fall, or muscular or cardiovascular events. Feasibility was evaluated by the percentage of patients who succeeded in doing the SFST. Reliability was assessed with the number of raised steps in same condition (T1-T3) and different conditions (T1-T2) using a 2-way intraclass correlation coefficient (ICC). Values were given with their 90% confidence interval [90%CI]. RESULTS The safety was 95.2% [85.8;99.2] for T1, 88.1% [76.6;95.2] for T2 and 90.4% [79.5;96.7] for T3. 100% [93,1;100] of participants completed T1 and T2, 92.9% [82.6;98] T3. An ICC of 0.74 [0.60;0.84] was observed between T1 and T3 and of 0.87 [0.79;0.92] between T1 and T2. CONCLUSIONS This study demonstrates the good safety, feasibility and reliability of the SFST to assess anaerobic metabolism in coronary patients in a rehabilitation program. CLINICAL REHABILITATION IMPACT These results show that the SFST seems suitable for the evaluation of brief submaximal functional capacity in daily activities. It offers a real possibility to assess such capacity during the cardiac rehabilitation routine.
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Affiliation(s)
- Delphine Besson
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Anais Gouteron
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Armelle Hannequin
- Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Jean-Marie Casillas
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Lucie Rigaud
- Department of Physical Medicine and Rehabilitation, CHU Dijon-Bourgogne, Dijon, France
| | - Paul Ornetti
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France.,Department of Rheumatology, CHU Dijon-Bourgogne, Dijon, France
| | - Isabelle Fournel
- INSERM, CIC1432, Clinical Epidemiology Unit, Dijon, France Dijon-Bourgogne University Hospital, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - Elea Ksiazek
- INSERM, CIC1432, Clinical Epidemiology Unit, Dijon, France Dijon-Bourgogne University Hospital, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - Davy Laroche
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France.,INSERM, UMR1093-CAPS, Université de Bourgogne Franche Comté, UFR des Sciences du Sport, Dijon, France
| | - Mathieu Gueugnon
- INSERM, CIC 1432, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, CHU Dijon-Bourgogne, Dijon, France -
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14
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Bubnova MG, Persiyanova-Dubrova AL. Six-minute walk test in cardiac rehabilitation. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Six-minute walk test (6MWT) is a simple and safe tool for assessing exercise tolerance in various categories of patients. Currently, 6MWT is used to assess the functional status of a patient and determine the strategy of increasing physical activity, primarily in patients with reduced exercise tolerance and contraindications for cardiopulmonary exercise test. The basic requirements for the 6MWT are presented, taking into account the factors affecting its informativeness and accuracy, as well as the interpretation of results. The diagnostic and prognostic value of 6MWT in different categories of patients are discussed. The prospects for 6MWT use in cardiac rehabilitation for planning rehabilitation program, prescribing exercises, determining the risk of complications, and evaluating the effectiveness are considered. The limitations of 6MWT and ways to overcome it, as well as directions for further research are presented.
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Affiliation(s)
- M. G. Bubnova
- National Medical Research Center for Therapy and Preventive Medicine
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15
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Validity of the Incremental Shuttle Walk Test to Assess Exercise Safety When Initiating Cardiac Rehabilitation in Low-Resource Settings. J Cardiopulm Rehabil Prev 2020; 39:E1-E7. [PMID: 31022005 DOI: 10.1097/hcr.0000000000000412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the validity of the Incremental Shuttle Walk Test (ISWT) for determining risk stratification in cardiac rehabilitation (CR). METHODS This is a cross-sectional study at a major CR center in a middle-income country. Clinically stable adult cardiac patients underwent an ISWT and an exercise test (ET), wore a pedometer for 7 d, and completed the Godin-Shepherd Leisure-Time Physical Activity Questionnaire. Metabolic equivalents of task (METs) achieved on the ISWT were calculated. RESULTS One hundred fifteen patients were evaluated. The mean ± standard deviation distance on the ISWT was 372.70 ± 128.52 m and METs were 5.03 ± 0.62. The correlation of ISWT distance with ET METs (7.57 ± 2.57), steps/d (4556.71 ± 3280.88), and self-reported exercise (13.08 ± 15.19) was rs = 0.61 (P < .001), rs = 0.37 (P < .001), and rs = 0.20 (P = .031), respectively. Distance on the ISWT accurately predicted METs from the ET (area under the receiver operating characteristic curve = 0.774). The ability to walk ≥410 m on the ISWT predicted, with a specificity of 81.5% and a sensitivity of 65.6%, a functional capacity of ≥7 METs on ET. CONCLUSION The ISWT is an alternative way to evaluate functional capacity in CR and can contribute to the process of identifying patients at low risk for a cardiac event during exercise at moderate intensity.
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16
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Increased Heart Rate during Walk Test Predicts Chronic-Phase Worsening of Renal Function in Patients with Acute Myocardial Infarction and Normal Kidney Function. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234785. [PMID: 31795311 PMCID: PMC6926904 DOI: 10.3390/ijerph16234785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 11/17/2022]
Abstract
Chronic-phase worsening renal function (WRF) in patients with acute myocardial infarction (AMI) has been associated with poor prognosis. However, there is no consensus on either the method of prevention or the cause. The aim of this study was to determine factors predictive of chronic-phase WRF from the viewpoint of circulatory dynamics response to exercise during hospitalization of AMI patients without renal dysfunction on admission. We studied 186 consecutively AMI patients who underwent the 200-m walk test. Chronic-phase WRF was defined as a 20% decrease in estimated glomerular filtration rate (eGFR) from baseline to 8–10 months after AMI onset. Heart rate (HR) and systolic blood pressure recorded during the 200-m walk test were evaluated as circulatory dynamics responses. In total, 94 patients were enrolled. Multiple linear regression analysis showed that ΔHR (peak-rest) associated significantly with ΔeGFR (β = 0.427, p = 0.018). The receiver operating characteristic curve of ΔHR to predict chronic-phase WRF showed an area under the curve of 0.77, with a cut-off value of 22.0 bpm having a 95% sensitivity and 55% specificity. Among circulatory dynamics responses during exercise in the acute phase after AMI, ΔHR was an independent predictor of chronic-phase WRF.
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17
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Eriksson F, Trölle U, Becovic S, Hermansson M, Olsén MF. The relationship between measures of physical performance in preoperative oesophageal cancer patients. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1657944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Frances Eriksson
- Department of Physical Therapy, Karolinska Hospital Stockholm, Stockholm, Sweden
| | - Ulrika Trölle
- Department of Surgery, Skånes University Hospital, Lund, Sweden
| | - Suada Becovic
- Department of Physical Therapy, Sahlgrenska University Hospital and Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
| | | | - Monika Fagevik Olsén
- Department of Physical Therapy, Sahlgrenska University Hospital and Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
- Department of Surgery/Gastrosurgical Research and Education Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden
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18
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Kunimoto M, Shimada K, Yokoyama M, Matsubara T, Aikawa T, Ouchi S, Shimizu M, Fukao K, Miyazaki T, Kadoguchi T, Fujiwara K, Honzawa A, Yamada M, Shimada A, Yamamoto T, Amano A, Daida H. Relationship between the Kihon Checklist and the clinical parameters in patients who participated in cardiac rehabilitation. Geriatr Gerontol Int 2019; 19:287-292. [PMID: 30793829 DOI: 10.1111/ggi.13617] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/10/2018] [Accepted: 12/25/2018] [Indexed: 11/28/2022]
Abstract
AIM The Kihon Checklist is a useful screening tool for assessing frailty in older individuals. However, the clinical significance of the Kihon Checklist in cardiac rehabilitation patients remains unclear. The present study aimed to evaluate the relationship between the Kihon Checklist and the clinical parameters in patients who participated in cardiac rehabilitation. METHODS We enrolled 845 consecutive patients (584 men, mean age 71 years) who participated in cardiac rehabilitation at Juntendo University Hospital, Tokyo, Japan, between November 2015 and October 2017. The patients were divided into non-frailty (n = 287), pre-frailty (n = 270) and frailty (n = 288) groups according to their Kihon Checklist scores. Cardiopulmonary exercise testing was carried out in 302 patients. RESULTS The frailty group was older and had a higher prevalence of history of heart failure than the non-frailty group, although left ventricular ejection fraction did not differ significantly between groups. Nutritional index, trunk and limb muscle mass, lean body weight, and grip strength were significantly lower in the frailty and pre-frailty groups than those in the non-frailty group. In the cardiopulmonary exercise test, a stepwise significant decrease in peak oxygen uptake was observed across the three groups (non-frailty 17.2 ± 3.6, pre-frailty 16.0 ± 3.4, frailty 14.4 ± 3.5 mL/kg/min, P < 0.01). Multivariate regression analyses showed that the Kihon Checklist score was significantly and independently associated with peak oxygen uptake (r = -0.34, P < 0.0001). CONCLUSIONS The Kihon Checklist, which was associated with frailty and exercise tolerance, could be used as a clinical assessment method for patients who participated in cardiac rehabilitation. Geriatr Gerontol Int 2019; 19: 287-292.
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Affiliation(s)
- Mitsuhiro Kunimoto
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Miho Yokoyama
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Tomomi Matsubara
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tatsuro Aikawa
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shohei Ouchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Megumi Shimizu
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kosuke Fukao
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuro Miyazaki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoyasu Kadoguchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kei Fujiwara
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akio Honzawa
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Miki Yamada
- Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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19
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Grelat M, Gouteron A, Casillas JM, Orliac B, Beaurain J, Fournel I, Laroche D. Walking Speed as an Alternative Measure of Functional Status in Patients with Lumbar Spinal Stenosis. World Neurosurg 2019; 122:e591-e597. [DOI: 10.1016/j.wneu.2018.10.109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 11/28/2022]
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20
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Costa HS, Lima MMO, Lage SM, da Costa FSM, Figueiredo PHS, da Costa Rocha MO. Six-minute walk test and incremental shuttle walk test in the evaluation of functional capacity in Chagas heart disease. J Exerc Rehabil 2018; 14:844-850. [PMID: 30443532 PMCID: PMC6222153 DOI: 10.12965/jer.1836326.163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 08/21/2018] [Indexed: 01/04/2023] Open
Abstract
Chagas heart disease (CHD) leads to a progressive functional impairment. Field tests, as the 6-min walk test (6MWT) and the incremental shuttle walk test (ISWT), may be inexpensive approaches in the evaluation of functional capacity of these patients. The present study was addressed to compare the 6MWT and the ISWT measures, and to determine the accuracy of these tests in the identification of functional impairment in patients with CHD. Thirty-five patients with CHD (47.1±8.2 years, NYHA I–III) were evaluated by echocardiography, cardiopulmonary exercise test (CPET), 6MWT, and ISWT. Correlations between the CPET (peak oxygen uptake [peak VO2] and the ratio between ventilation and the carbon dioxide production [VE/VCO2 slope]) and the field tests (walking distances) were also performed. The receiver operating characteristic (ROC) curve was selected to identify the best distances related to identify those patients with functional impairment. There was no difference between distances walked during the 6MWT and ISWT (P=0.694). The Bland-Altman analysis showed good agreement between the field tests. Both 6MWT and ISWT correlated with peak VO2 (r=0.577, P<0.001 and r=0.587, P<0.001, respectively) and ISWT correlated with VE/VCO2 slope (r=−0.339, P=0.003). The cutoff distances of 6MWT and ISWT to identify patients with peak VO2 less than 20 mL/kg/min were 520 m and 400 m, respectively, with no difference between the areas under ROC curves (P=0.276). Both the 6MWT and the ISWT demonstrated accuracy in identify functional impairment in patients with CHD, being useful tools for the risk stratification of these patients.
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Affiliation(s)
- Henrique Silveira Costa
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clínicas of the Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Márcia Maria Oliveira Lima
- School of Biological and Health Sciences, School of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Susan Martins Lage
- Rehabilitation Sciences Program, Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fábio Silva Martins da Costa
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clínicas of the Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- School of Biological and Health Sciences, School of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Manoel Otávio da Costa Rocha
- Postgraduate Course of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical School and Hospital das Clínicas of the Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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21
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Hadouiri N, Feuvrier D, Pauchot J, Decavel P, Sagawa Y. Donor site morbidity after vascularized fibula free flap: gait analysis during prolonged walk conditions. Int J Oral Maxillofac Surg 2018; 47:309-315. [PMID: 29100670 DOI: 10.1016/j.ijom.2017.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/31/2017] [Accepted: 10/12/2017] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the effect of vascularized fibula free flap (VFFF) harvest on gait variables during the six-minute walk test (6MWT). Eleven patients who had undergone VFFF harvest and 11 healthy peers participated in this case-control study. The main evaluation consisted of the collection of gait variables using the GAITRite system during three periods of the 6MWT: beginning (0-1min), middle (2:30-3:30min), and end (5-6min). The 6MWT was significantly shorter in the VFFF group than in the reference group (-31%, P<0.001). Most gait variables differed significantly between the groups for each period (P-value range 0.04-0.0004), including toe in/out on the operated side (P-value range 0.005-0.01). The increase in toe in/out on the operated side suggests a functional modification caused by an imbalance of the agonist-antagonist muscles. On comparison of the different periods, gait velocity decreased between the beginning and middle periods and increased between the middle and end periods in both groups. However, a significantly lower velocity between the beginning and end periods was found only for the VFFF group (P=0.026), suggesting an alteration in physical management. In conclusion, these results suggest that VFFF harvesting could alter gait and joint integrity.
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Affiliation(s)
- N Hadouiri
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France
| | - D Feuvrier
- Orthopaedic, Traumatology, Plastic, Reconstructive and Hand Surgery Unit, University Hospital of Besançon, Besançon, France; Anatomy Laboratory, UFR SMP, University of Franche-Comte, Besançon, France
| | - J Pauchot
- Orthopaedic, Traumatology, Plastic, Reconstructive and Hand Surgery Unit, University Hospital of Besançon, Besançon, France
| | - P Decavel
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France; Integrative and Clinical Neurosciences EA481, Bourgogne Franche-Comte University, Besançon, France
| | - Y Sagawa
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France; Integrative and Clinical Neurosciences EA481, Bourgogne Franche-Comte University, Besançon, France.
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Stam M, Wadman RI, Wijngaarde CA, Bartels B, Asselman FL, Otto LAM, Goedee HS, Habets LE, de Groot JF, Schoenmakers MAGC, Cuppen I, van den Berg LH, van der Pol WL. Protocol for a phase II, monocentre, double-blind, placebo-controlled, cross-over trial to assess efficacy of pyridostigmine in patients with spinal muscular atrophy types 2-4 (SPACE trial). BMJ Open 2018; 8:e019932. [PMID: 30061431 PMCID: PMC6067401 DOI: 10.1136/bmjopen-2017-019932] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Hereditary proximal spinal muscular atrophy (SMA) is caused by homozygous loss of function of the survival motor neuron 1 gene. The main characteristic of SMA is degeneration of alpha motor neurons in the anterior horn of the spinal cord, but recent studies in animal models and patients have shown additional anatomical abnormalities and dysfunction of the neuromuscular junction (NMJ). NMJ dysfunction could contribute to symptoms of weakness and fatigability in patients with SMA. We hypothesise that pyridostigmine, an acetylcholinesterase inhibitor that improves neuromuscular transmission, could improve NMJ function and thereby muscle strength and fatigability in patients with SMA. METHODS AND ANALYSIS We designed a monocentre, placebo-controlled, double-blind cross-over trial with pyridostigmine and placebo to investigate the effect and efficacy of pyridostigmine on muscle strength and fatigability in patients with genetically confirmed SMA. We aim to include 45 patients with SMA types 2-4, aged 12 years and older in the Netherlands. Participants receive 8 weeks of treatment with pyridostigmine and 8 weeks of treatment with placebo in a random order separated by a washout period of 1 week. Treatment allocation is double blinded. Treatment dose will gradually be increased from 2 mg/kg/day to the maximum dose of 6 mg/kg/day in four daily doses, in the first week of each treatment period. The primary outcome measures are a change in the Motor Function Measure and repeated nine-hole peg test before and after treatment. Secondary outcome measures are changes in recently developed endurance tests, that is, the endurance shuttle nine-hole peg test, the endurance shuttle box and block test and the endurance shuttle walk test, muscle strength, level of daily functioning, quality of and activity in life, perceived fatigue and fatigability, presence of decrement on repetitive nerve stimulation and adverse events. ETHICS AND DISSEMINATION The protocol is approved by the local medical ethical review committee at the University Medical Center Utrecht and by the national Central Committee on Research Involving Human Subjects. Findings will be shared with the academic and medical community, funding and patient organisations in order to contribute to optimisation of medical care and quality of life for patients with SMA. TRIAL REGISTRATION NUMBER NCT02941328.
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Affiliation(s)
- Marloes Stam
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Renske I Wadman
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Camiel A Wijngaarde
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bart Bartels
- Child Development and Exercise Center, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fay-Lynn Asselman
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Louise A M Otto
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - H Stephan Goedee
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Laura E Habets
- Child Development and Exercise Center, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Janke F de Groot
- Child Development and Exercise Center, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Marja A G C Schoenmakers
- Child Development and Exercise Center, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Inge Cuppen
- Department of Neurology and Child Neurology, Brain Center Rudolf Magnus, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leonard H van den Berg
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - W Ludo van der Pol
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Dorje T, Zhao G, Scheer A, Tsokey L, Wang J, Chen Y, Tso K, Tan BK, Ge J, Maiorana A. SMARTphone and social media-based Cardiac Rehabilitation and Secondary Prevention (SMART-CR/SP) for patients with coronary heart disease in China: a randomised controlled trial protocol. BMJ Open 2018; 8:e021908. [PMID: 29961032 PMCID: PMC6042601 DOI: 10.1136/bmjopen-2018-021908] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/05/2018] [Accepted: 05/15/2018] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The burden of cardiovascular disease (CVD) is rapidly increasing in developing countries, however access to cardiac rehabilitation and secondary prevention (CR/SP) in these countries is limited. Alternative delivery models that are low-cost and easy to access are urgently needed to address this service gap. The objective of this study is to investigate whether a smartphone and social media-based (WeChat) home CR/SP programme can facilitate risk factor monitoring and modification to improve disease self-management and health outcomes in patients with coronary heart disease (CHD), after percutaneous coronary intervention (PCI) therapy. METHODS AND ANALYSIS We propose a single-blind, randomised controlled trial of 300 patients post-PCI with follow-up over 12 months. The intervention group will receive a smartphone-based and WeChat-based CR/SP programme providing education and support for risk factor monitoring and modification. SMART-CR/SP incorporates core components of modern CR/SP: physical activity tracking with interactive feedback and goal setting; education modules addressing CHD understanding and self-management; remote blood pressure monitoring and strategies to improve medication adherence. Furthermore, a dedicated data portal and a CR/SP coach will facilitate individualised supervision and counselling. The control group will receive usual care but no formal CR/SP programme. The primary outcome is change in exercise capacity measured by 6 minute walk test distance. Secondary outcomes include knowledge and awareness of CHD, risk factor status, medication adherence, psychological well-being and quality of life, major cardiovascular events, re-hospitalisations and all-cause mortality. To assess the feasibility and patients' acceptance of the intervention, a process evaluation will be performed at the conclusion of the study. ETHICS AND DISSEMINATION Ethics approval was granted by both the Human Research Ethics Committee of Fudan University Zhongshan Hospital (HREC B2016-058) and Curtin University Human Research Ethics Office (HRE2016-0120). Results will be disseminated via peer-reviewed publications and presentations at conferences. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR-INR-16009598; Pre-results.
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Affiliation(s)
- Tashi Dorje
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Gang Zhao
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China
| | - Anna Scheer
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Lhamo Tsokey
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China
| | - Jing Wang
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China
| | - Yaolin Chen
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China
| | - Khandro Tso
- Internal Medicine Department, Qilian County Hospital, Qinghai, China
| | - B-K Tan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Allied Health Department, Armadale Health Service, Perth, Western Australia, Australia
| | - Junbo Ge
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Allied Health Department, Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Western Australia, Australia
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Travensolo C, Goessler K, Poton R, Pinto RR, Polito MD. Measurement of physical performance by field tests in programs of cardiac rehabilitation: A systematic review and meta-analysis. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.repce.2017.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Medida do desempenho físico por testes de campo em programas de reabilitação cardiovascular: revisão sistemática e meta‐análise. Rev Port Cardiol 2018; 37:525-537. [DOI: 10.1016/j.repc.2017.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/29/2017] [Accepted: 07/24/2017] [Indexed: 11/24/2022] Open
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Utility of Walk Tests in Evaluating Functional Status Among Participants in an Outpatient Cardiac Rehabilitation Program. J Cardiopulm Rehabil Prev 2018; 37:329-333. [PMID: 28306686 DOI: 10.1097/hcr.0000000000000242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Although walk tests are frequently used in cardiac rehabilitation (CR), no prior study has evaluated the capacity of these measures to predict peak oxygen uptake during exercise testing ((Equation is included in full-text article.)O2peak). This study evaluated the interrelationship of objective measures of exercise performance (walk and exercise testing) among patients entering CR as well as a novel measure of functional status assessment for use in CR. METHODS Forty-nine patients (33 males) referred to an outpatient CR program were evaluated with objective measures of ambulatory functional status (peak oxygen uptake [(Equation is included in full-text article.)O2peak], 6-minute walk test [6MWT], and 60-ft walk test [60ftWT]). RESULTS All measures of functional status were moderately to highly intercorrelated (r values from 0.50 to 0.88; P values < .05). The relationship among measures differed by sex, but not by age or diagnosis. Among men, results were generally consistent with the full sample. Among women, the magnitude of correlations was generally lower and there was no relationship between (Equation is included in full-text article.)O2peak and other measures. CONCLUSIONS Measures of functional status, including (Equation is included in full-text article.)O2peak, 6MWT, and 60ftWT, were highly correlated among CR patients, suggesting the plausibility of using them interchangeably to fit the needs of the patient and testing environment. Among women, walk tests may not be appropriate substitutes for (Equation is included in full-text article.)O2peak. Because of the brevity of the 60ftWT, it may be particularly useful for measuring functional status in patients with greater symptoms and those with comorbidities limiting walking.
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Laroche D, Mangin M, Besson D, Naaim A, Gouteron A, Casillas JM. Number of raised steps: A tool to assess brief and intense effort involving anaerobic metabolism. Ann Phys Rehabil Med 2018; 61:156-163. [PMID: 29471056 DOI: 10.1016/j.rehab.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/02/2017] [Accepted: 12/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the initial anaerobic component of exercise adaptation is unavoidable, no specific functional test is available for use in routine non-sporting practice to evaluate it. OBJECTIVE To assess the bioenergetic and biomechanical properties of the Short and Fast Step Test (SFST), which consists of walking up and down a step as many times as possible in 1minute and to analyse its ability to explore the initial anaerobic component of effort in comparison to a reference self-paced step test. METHODS Overall, 31 healthy subjects (19 women; mean [SD] age, 32.4 [10.2] years) completed a test-retest of a self-paced step test and the SFST, with pre- and post-test measurement of blood lactate concentration and continuous recording of VO2 and modelling of excess post-exercise oxygen consumption (EPOC), near-infrared spectroscopy (NIRS) of the quadriceps and mechanical power (estimated by the number of steps climbed and 3-D motion analysis). RESULTS Both step tests were well tolerated. The reliability of the bioenergetics parameters, number of raised steps, mechanical power and NIRS tissue saturation index was good. Indirect mechanical power (estimated from number of steps) was correlated with direct power (computed from the centre of mass). Lactate accumulation was significantly increased during exercise with only the SFST (mean [SD] increase, 3.86 [3.26]mmolL-1 from resting values, P<0.05). EPOC was higher with the SFST than the self-paced step test (P<0.05). Only the SFST showed significant correlations between number of steps climbed and EPOC (r=0.84; P<0.001) and decreased tissue saturation index (NIRS) and EPOC area (r=-0.39; P<0.05). CONCLUSIONS SFST is feasible, well tolerated, reliable and responsive to explore a brief exercise involving anaerobic metabolism at submaximal intensity. The number of steps taken in 1minute seems a suitable parameter for practical application.
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Affiliation(s)
- Davy Laroche
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, 21000 Dijon, France
| | - Morgane Mangin
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Delphine Besson
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Alexandre Naaim
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Anaïs Gouteron
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Jean-Marie Casillas
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, 21000 Dijon, France.
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Heart rate recovery of individuals undergoing cardiac rehabilitation after acute coronary syndrome. Ann Phys Rehabil Med 2017; 61:65-71. [PMID: 29223653 DOI: 10.1016/j.rehab.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND An efficient cardiac rehabilitation programme (CRP) can improve the functional ability of patients after acute coronary syndrome (ACS). OBJECTIVE To examine the effect of a CRP on parasympathetic reactivation and heart rate recovery (HRR) measured after a 6-min walk test (6MWT), and correlation with 6MWT distance and well-being after ACS. METHODS Eleven normoweight patients after ACS (BMI<25kg/m2; 10 males; mean [SD] age 61 [9] years) underwent an 8-week CRP. Before (pre-) and at weeks 4 (W4) and 8 (W8) during the CRP, they performed a 6MWT on a treadmill, followed by 10-min of seated passive recovery, with HRR and HR variability (HRV) recordings. HRR was measured at 1, 3, 5 and 10min after the 6MWT (HRR1, HRR3, HRR5, HRR10), then modelized by a mono-exponential function. Time-domain (square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals [RMSSD]) and frequency-domain (with high- and low-frequency band powers) were used to analyse HRV. Participants completed a mental and physical well-being questionnaire at pre- and W8. Exhaustion after tests was assessed by the Borg scale. Pearson correlation was used to assess correlations. RESULTS HRR3, HRR5 and HRR10 increased by 37%, 36% and 28%, respectively, between pre- and W8 (P<0.05), and were positively correlated with change in 6MWT distance (r=0.58, 0.66 and 0.76; P<0.05). Percentage change in HRR3 was positively correlated with change in well-being (r=0.70; P=0.01). Parasympathic reactivation (RMSSD) was improved only during the first 30sec of recovery (P=0.04). CONCLUSION Among patients undergoing a CRP after ACS, increased HRR after a 6MWT, especially at 3min, was positively correlated with 6MWT distance and improved well-being. HRR raw data seem more sensitive than post-exercise HRV analysis for monitoring functional and autonomic improvement after ACS.
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Papathanasiou J, Troev T, Ferreira AS, Tsekoura D, Elkova H, Kyriopoulos E, Ilieva E. Advanced Role and Field of Competence of the Physical and Rehabilitation Medicine Specialist in Contemporary Cardiac Rehabilitation. Hellenic J Cardiol 2017; 57:16-22. [PMID: 26856196 DOI: 10.1016/s1109-9666(16)30013-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Jannis Papathanasiou
- Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, Bulgaria
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Morard MD, Besson D, Laroche D, Naaïm A, Gremeaux V, Casillas JM. Fixed-distance walk tests at comfortable and fast speed: Potential tools for the functional assessment of coronary patients? Ann Phys Rehabil Med 2016; 60:13-19. [PMID: 27915207 DOI: 10.1016/j.rehab.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVES There is ambiguity concerning the walk tests available for functional assessment of coronary patients, particularly for the walking speed. This study explores the psychometric properties of two walking tests, based on fixed-distance tests, at comfortable and fast velocity, in stabilized patients at the end of a cardiac rehabilitation program. METHODS At a three-day interval 58 coronary patients (mean age of 64.85±6.03 years, 50 men) performed three walk tests, the first two at a comfortable speed in a random order (6-minute walk test - 6MWT - and 400-metre comfortable walk test - 400mCWT) and the third at a brisk speed (200-metre fast walk test - 200mFWT). A modified Bruce treadmill test was associated at the end of the second phase. Monitored main parameters were: heart rate, walking velocity, VO2. RESULTS Tolerance to the 3 tests was satisfactory. The reliability of the main parameters was good (intraclass correlation coefficient>0.8). The VO2 concerning 6MWT and 400mCWT were not significantly different (P=0.33) and were lower to the first ventilatory threshold determined by the stress test (P<0.001): 16.2±3.0 vs. 16.5±2.6 vs. 20.7±5.1mL·min-1·kg-1 respectively. The VO2 of the 200mFWT (20.2±3.7) was not different from the first ventilatory threshold. CONCLUSIONS 400mCWT and 200mFWT are feasible, well-tolerated and reliable. They explore two levels of effort intensity (lower and not different to the first ventilatory threshold respectively). 400mCWT is a possible alternative to 6MWT. Associated with 200mFWT it should allow a better measurement of physical capacities and better customization of exercise training.
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Affiliation(s)
- Marie-Doriane Morard
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France; Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Delphine Besson
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France; Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Davy Laroche
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France
| | - Alexandre Naaïm
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France
| | - Vincent Gremeaux
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, Dijon, France; Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France
| | - Jean-Marie Casillas
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, Dijon, France; Cardiac Rehabilitation Department, University Hospital of Dijon, Dijon, France.
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The Functional Exercise Capacity Is Associated With Global Functioning in People With Bipolar Disorder. J Nerv Ment Dis 2016; 204:673-7. [PMID: 27570898 DOI: 10.1097/nmd.0000000000000580] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the current study was to determine whether the Global Assessment of Functioning (GAF) score is associated with the functional exercise capacity among in- and outpatients with bipolar disorder. Sixty-five (36♀) persons with bipolar disorder performed a 6-minute walk test (6MWT) and were assessed with the GAF, Quick Inventory of Depressive Symptomatology Self Report (QIDS), and the International Physical Activity Questionnaire (IPAQ). The mean GAF-score was 55.0 ± 15.0, whereas the mean distance achieved on the 6MWT was 615.6 ± 118.6 m. There was a positive association between the GAF score and 6MWT score (r = 0.60, p < 0.001). A backward regression analysis demonstrated that an inpatient status, illness duration (16.1 ± 10.7 years), and the QIDS score (7.7 ± 5.7) explained 72.4% of the GAF-score variance. The GAF, QIDS score, and age explained 74.1% of the 6MWT-score variance. Our results indicate that a bidirectional relationship is evident between the exercise capacity and global functioning among people with bipolar disorder.
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Gloeckl R, Teschler S, Jarosch I, Christle JW, Hitzl W, Kenn K. Comparison of two- and six-minute walk tests in detecting oxygen desaturation in patients with severe chronic obstructive pulmonary disease - A randomized crossover trial. Chron Respir Dis 2016; 13:1479972316636991. [PMID: 26961775 PMCID: PMC5720185 DOI: 10.1177/1479972316636991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The two-minute walk test (2MWT) is less well validated than the well-known six-minute walk test (6MWT) as a field walking test in patients with chronic obstructive pulmonary disease (COPD). The primary objective of this study was to compare the accuracy of the 2MWT to the 6MWT in detecting exercise-induced oxygen desaturation in patients with severe COPD. Twenty-six patients with COPD (age: 61 ± 10 years, forced expired volume in one second: 37 ± 10%) that were normoxemic at rest performed a 2MWT and a 6MWT under normal ambient conditions on two consecutive days in random order. Oxygen saturation, total walking distance, heart rate, breathing frequency, dyspnea, and leg fatigue were evaluated. Average walking distances were 150 m (95% confidence interval (95% CI): 134-165 m) and 397 m (95% CI: 347-447 m) for the 2MWT and 6MWT, respectively (r = 0.80, p < 0.0001). The difference in minimum oxygen saturation during the 2MWT (83%, 95% CI: 81-86%) and 6MWT (mean 82%, 95% CI: 80-84%) was not statistically different and the data strongly correlated between the groups (r = 0.81, p < 0.0001). Other measurements from the 6MWT, including heart rate, breathing rate, and levels of perceived exertion were also comparable in 2MWT. The 2MWT showed comparable validity in detecting exercise-induced oxygen desaturation in patients with severe COPD compared to the 6MWT.
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Affiliation(s)
- Rainer Gloeckl
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | | | - Inga Jarosch
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Jeffrey W Christle
- Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | - Wolfgang Hitzl
- Research Department, Paracelsus Medical University, Salzburg, Austria
| | - Klaus Kenn
- Department of Respiratory Medicine & Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany Pulmonary Rehabilitation, Philipps University of Marburg, Germany
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Tuzuner A, Bilgin G, Demirci S, Yuce GD, Acikgoz C, Samim EE. Improvement of Pulmonary Functions Following Septoplasty: How Are Lower Airways Affected? Clin Exp Otorhinolaryngol 2016; 9:51-5. [PMID: 26976027 PMCID: PMC4792248 DOI: 10.21053/ceo.2016.9.1.51] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/10/2015] [Accepted: 03/13/2015] [Indexed: 11/25/2022] Open
Abstract
Objectives Nasal septal deviation is a frequent cause of increased nasal airway resistance. A narrow nasal airway would result in a decreased airflow into the lungs. The aim of the present study was to evaluate the alterations of the pulmonary functions following septoplasty using spirometry and 6 minutes walking test (6mWT). And reveal the correlation of symptom score improvement with nasal obstruction symptom score (NOSE) and sino-nasal outcome test (SNOT22) questionnaires following surgery. Methods Thirty patients with obvious nasal septal deviations were enrolled in the study. All patients had a detailed otorhinolaryngologic examination, filled NOSE/SNOT22 questionnaires, performed spirometry and 6mWT preoperatively. One month after surgery, NOSE/SNOT22 questionnaires filled by subjects and spirometry with 6mWT were performed again, and the results were compared. Results The mean total walking distance was 702.3±68.2 m preoperatively, and it improved to 753.2±72.6 m postoperatively (P<0.001). Total tour count increased from 11 (range, 10.8 to 12.0) to 12 (range, 11 to 13.3), and the difference was found statistically significant (P<0.001). When the preoperative and postoperative mean 6mWT results were compared, diastolic blood pressure increased from 70 to 80 mmHg (P=0.031), heart rate increased from 83.5±13.2 to 90.1±12.5 bpm (P=0.017), dyspnea rate decreased from 1 to 0 (P=0.002), and fatigue scores reduced from 2 to 1 (P=0.003). Evaluation on spirometry findings revealed that FIF50% (maximum inspiratory flow at 50% of forced vital capacity [FVC]) scores and peak expiratory flow (PEF) values improved significantly after surgery. Septoplasty improves the nasal breathing pattern. While reducing FEF50% (maximum expiratory flow at 50% of FVC)/FIF50%, it increases PEF and FIF50% values. In addition, as shown by 6mWT, exercise capacity improves following surgery. Postoperative NOSE and SNOT22 scores reduced markedly compared to preoperative values (P<0.001). Conclusion These findings suggest that nasal septal surgery has a positive effect on pulmonary functions, and this can be an important clue for the relationship of lung disorders and nasal obstruction.
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Affiliation(s)
- Arzu Tuzuner
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Gulden Bilgin
- Department of Pulmonology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Sule Demirci
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Gulbahar Darilmaz Yuce
- Department of Pulmonology, Ministry of Health, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Cemile Acikgoz
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ethem Erdal Samim
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
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Węgrzynowska-Teodorczyk K, Mozdzanowska D, Josiak K, Siennicka A, Nowakowska K, Banasiak W, Jankowska EA, Ponikowski P, Woźniewski M. Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure? Eur J Prev Cardiol 2016; 23:1307-13. [PMID: 26743588 DOI: 10.1177/2047487315625235] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 12/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The consequence of exercise intolerance for patients with heart failure is the difficulty climbing stairs. The two-minute step test is a test that reflects the activity of climbing stairs. DESIGN The aim of the study design is to evaluate the applicability of the two-minute step test in an assessment of exercise tolerance in patients with heart failure and the association between the six-minute walk test and the two-minute step test. METHODS Participants in this study were 168 men with systolic heart failure (New York Heart Association (NYHA) class I-IV). In the study we used the two-minute step test, the six-minute walk test, the cardiopulmonary exercise test and isometric dynamometer armchair. RESULTS Patients who performed more steps during the two-minute step test covered a longer distance during the six-minute walk test (r = 0.45). The quadriceps strength was correlated with the two-minute step test and the six-minute walk test (r = 0.61 and r = 0.48). The greater number of steps performed during the two-minute step test was associated with higher values of peak oxygen consumption (r = 0.33), ventilatory response to exercise slope (r = -0.17) and longer time of exercise during the cardiopulmonary exercise test (r = 0.34). Fatigue and leg fatigue were greater after the two-minute step test than the six-minute walk test whereas dyspnoea and blood pressure responses were similar. CONCLUSION The two-minute step test is well tolerated by patients with heart failure and may thus be considered as an alternative for the six-minute walk test.
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Affiliation(s)
- Kinga Węgrzynowska-Teodorczyk
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland
| | - Dagmara Mozdzanowska
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Krystian Josiak
- Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland Department of Heart Diseases, Wroclaw Medical University, Poland
| | - Agnieszka Siennicka
- Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland Department of Physiology, Wroclaw Medical University, Poland
| | | | - Waldemar Banasiak
- Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland
| | - Ewa A Jankowska
- Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland Department of Heart Diseases, Wroclaw Medical University, Poland
| | - Piotr Ponikowski
- Center for Heart Disease, 4th Military Academic Hospital Wroclaw, Poland Department of Heart Diseases, Wroclaw Medical University, Poland
| | - Marek Woźniewski
- Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Poland
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Di Thommazo-Luporini L, Carvalho LP, Luporini RL, Trimer R, Pantoni CBF, Martinez AF, Catai AM, Arena R, Borghi-Silva A. Are cardiovascular and metabolic responses to field walking tests interchangeable and obesity-dependent? Disabil Rehabil 2015; 38:1820-9. [PMID: 26681386 DOI: 10.3109/09638288.2015.1107645] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate if cardiovascular and metabolic responses to the six-minute walk test (6MWT) and incremental shuttle walking test (ISWT) are in agreement with cardiopulmonary exercise testing (CPX) and determine if both submaximal tests are interchangeable in obese and eutrophic individuals. METHOD Observational and cross-sectional study included 51 obese women (ObG) and 21 controls (CG) (20-45 years old). Subjects underwent clinical evaluation, CPX, the 6MWT and ISWT. We applied Bland-Altman plots to assess agreement between walking tests and CPX. Correlation analysis assessed relationships between key variables. RESULTS There was an agreement between CPX and both the 6MWT [oxygen uptake (VO2 mL kg(-1) min(-1)) = 6.9 (CI: 5.7-8.1), and heart rate (bpm) = 37.0 (CI: 33.3-40.7)] and ISWT [VO2 (mL kg(-1) min(-1)) = 6.1 (CI: 4.9-7.3), and heart rate (bpm) = 36.2 (CI: 32.1-40.3)]. We found similar cardiovascular and metabolic responses to both tests in the ObG but not in the CG. Strong correlations were demonstrated between 6MWT and ISWT variables: VO2 ( r = 0.70); dyspnoea (r = 0.80); and leg fatigue (r = 0.70). CONCLUSIONS 6MWT and ISWT may both hold interchangeable clinical value when contrasted with CPX in obese women and may be a viable alternative in the clinical setting when resources and staffing are limited. Implications for Rehabilitation Obesity is a worldwide epidemic, with high prevalence in women, and it is associated to impaired cardiorespiratory fitness and functional capacity as well as high mortality risk. Assessing oxygen uptake by means of cardiopulmonary exercise testing is the gold standard method for evaluating and stratifying cardiorespiratory fitness, however it is not ever applied due to costs and staffing. Walking field tests may be a cost-effective approach that provides valuable information regarding the functional capacity in agreement to metabolic and cardiovascular responses of cardiopulmonary exercise testing.
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Affiliation(s)
- Luciana Di Thommazo-Luporini
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | - Lívia Pinheiro Carvalho
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | | | - Renata Trimer
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | - Camila Bianca Falasco Pantoni
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | - Adalberto Felipe Martinez
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | - Aparecida Maria Catai
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
| | - Ross Arena
- c Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences , University of Illinois Chicago , Chicago , IL , USA
| | - Audrey Borghi-Silva
- a Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department , Federal University of Sao Carlos , Sao Carlos , Brazil
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Keeratichananont W, Thanadetsuntorn C, Keeratichananont S. Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications. Ther Adv Respir Dis 2015; 10:18-25. [PMID: 26546478 DOI: 10.1177/1753465815615509] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine the performance of preoperative 6-minute walk test (6MWT) for predicting postoperative pulmonary complications (PPC) in high risk patients undergoing elective surgery under general anesthesia. METHODS A prospective cohort study was conducted in patients scheduled to undergo elective thoracic or nonthoracic surgery and indicated for preoperative pulmonary evaluation in Songklanagarind Hospital, Songkhla, Thailand. Preoperative spirometry, 6MWT were done and 30-day PPC were recorded. The multiple regression analysis and receiver operating characteristic (ROC) curves were used to analyze the variables and to compare the performance of 6MWT and spirometry tests. RESULTS A total of 78 participants were recruited into the study. 6MWT was done completely in all cases without any complications. Among these tests, 14 cases (17.9%) had contraindications to spirometry and two cases were unable to achieve the criteria for acceptable efforts. PPC developed in 17 cases (21%) with a high mortality (17.7%). A multiple regression analysis showed elderly, poor general health status, smoking history, low level of the mean value of forced expiratory volume in 1 second (FEV1) % predicted (by spirometry) and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. Patients developing PPC had a significantly lower preoperative 6MWD compared with patients without PPC (256.0 ± 48.0 versus 440.0 ± 117.1 meters, p < 0.001). 6MWD of ⩽325 meters was a threshold for predicting PPC with 77% sensitivity and 100% specificity, and had a good predictive value for PPC similar to that for the FEV1 %. CONCLUSIONS Preoperative 6MWT is a very useful alternative test for predicting PPC in high risk patients scheduled to undergo surgery under GA.
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Affiliation(s)
- Warangkana Keeratichananont
- Assistant Professor, Division of Respiratory and Respiratory Critical Care Medicine, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla 90110, Thailand
| | - Chokchai Thanadetsuntorn
- Division of Respiratory and Respiratory Critical Care Medicine, Department of Medicine, Faculty of Medicine, Songklanakarind Hospital, Prince of Songkla University, Songkhla, Thailand
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Outcome Measures in Clinical Practice: Five Questions to Consider When Assessing Patient Outcome. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0098-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Casillas JM. Improving scientific production in cardiovascular rehabilitation: A reasonable challenge for the Annals? Ann Phys Rehabil Med 2015; 58:117-8. [DOI: 10.1016/j.rehab.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/17/2015] [Indexed: 11/29/2022]
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Satge J, Guiraud T, Carette P, Granger R, Labrunee M. Reliability and concurrent validity of the Acti’MET® calculator: A new tool to assess physical activity in cardiac rehabilitation. Ann Phys Rehabil Med 2015; 58:157-60. [DOI: 10.1016/j.rehab.2015.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/18/2015] [Accepted: 01/20/2015] [Indexed: 10/23/2022]
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Morard M, Bosquet L, Laroche D, Joussain C, Besson D, Deley G, Casillas J, Gremeaux V. Are first ventilatory threshold and 6-minute walk test heart rate interchangeable? A pilot study in healthy elderlies and cardiac patients. Ann Phys Rehabil Med 2015; 58:92-7. [DOI: 10.1016/j.rehab.2014.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/07/2014] [Accepted: 07/30/2014] [Indexed: 12/26/2022]
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