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Pua YH, Tay L, Clark RA, Woon EL, Thumboo J, Tay EL, Mah SM, Wang MX, Lim JJ, Ng YS. Associations of 2 Established Methods of Measuring Gait Speed and Sit-To-Stand Performance with Frailty and Life-Space Mobility in Community-Dwelling Older Adults. J Am Med Dir Assoc 2024; 25:105292. [PMID: 39368802 DOI: 10.1016/j.jamda.2024.105292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 10/07/2024]
Abstract
OBJECTIVES The 4-m gait speed (4mGS) and 10-m gait speed (10mGS) tests and the 30-second sit-to-stand (30sSTS) and 5-times sit-to-stand (5xSTS) tests are commonly used and advocated in consensus recommendations. We compared these tests on their predictive and clinical value concerning the risk of prefrailty/frailty and restricted life-space mobility (RLSM). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A sample of 1235 community-dwelling adults (mean ± SD, 68 ± 7 years) participated in this prospective cohort study. METHODS At baseline assessment, participants completed a survey and functional assessment, from which gait speed, sit-to-stand performance, self-reported mobility limitation, 40-item Frailty Index, and Life Space Assessment were measured. Participants with a 40-item Frailty Index >0.15 and a Life Space Assessment <60 points were classified as having prefrailty/frailty and RLSM, respectively. At 1-year follow-up assessment, prefrailty/frailty and RLSM were evaluated. RESULTS Correlations between gait speed and sit-to-stand measures were high (ρ values >0.80). In multivariable ordinal models, these measures added incremental prognostic value beyond a base model comprising demographics and self-reported mobility limitation variables in predicting baseline and 1-year outcomes. Between 10mGS and 4mGS, models with 10mGS had higher concordance indices (differences, 0.005-0.009), and these differences translated to generally greater net benefit in decision curve analyses. Between 30sSTS and 5xSTS measures, no one measure consistently outperformed the other, with small net benefit differences between measures (<0.2%). CONCLUSIONS AND IMPLICATIONS In community-dwelling older adults, gait speed and sit-to-stand measures meaningfully predicted prefrailty/frailty and RLSM. 10mGS provided more robust prognostic information than the 4mGS, whereas 5xSTS and 30sSTS measures showed near equivalence of performance. These findings could guide the choice of functional measures in clinical and research settings.
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Affiliation(s)
- Yong-Hao Pua
- Department of Physiotherapy, Singapore General Hospital, Singapore; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore.
| | - Laura Tay
- Department of General Medicine (Geriatric Medicine), Sengkang General Hospital, Singapore
| | - Ross Allan Clark
- School of Health and Behavioural Science, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Ee-Lin Woon
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - Julian Thumboo
- Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Health Services Research & Evaluation, SingHealth Office of Regional Health, Singapore
| | - Ee-Ling Tay
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Shi-Min Mah
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Min Xian Wang
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore
| | - Jin Jin Lim
- Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore
| | - Yee-Sien Ng
- Geriatric Education and Research Institute, Singapore; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore; Department of Rehabilitation Medicine, Singapore General Hospital and Sengkang General Hospital, Singapore
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Cruz-Montecinos C, Torres-Castro R, Otto-Yáñez M, Barros-Poblete M, Valencia C, Campos A, Jadue L, Barros M, Solis-Navarro L, Resqueti V. Which Sit-to-Stand Test Best Differentiates Functional Capacity in Older People? Am J Phys Med Rehabil 2024; 103:925-928. [PMID: 38630944 DOI: 10.1097/phm.0000000000002504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
ABSTRACT The sit-to-stand test provides insight into age-related functional capacity; however, there are various variants of sit-to-stand, and we do not know which of these better discriminates against age-related functional capacity. Our study aimed to compare the age-related functional capacity in older people by evaluating sit-to-stand power variants, using young individuals as a reference. A cross-sectional study was conducted in 102 adults (57 women) aged 60-80 and 105 adults (54 women) aged 20-30. Participants performed five times sit-to-stand (5 sit-to-stand), 30-second sit-to-stand, and 1-min sit-to-stand. Z scores were obtained for each sit-to-stand variant using power (W), relative (W/kg), and allometric (W/m 2 ) normalization methods. A mixed repeated-measures analysis of variance assessed the interactions among the sit-to-stand variants, normalization methods, sex, physical activity, and tobacco history. A significant interaction between sit-to-stand variants, normalization methods, and sex ( P = 0.002) was found. The mean effect of sit-to-stand variants revealed that the 1-min sit-to-stand had the lowest Z score ( P < 0.05). Significant variations were observed between sit-to-stand variants in all normalization methods for women ( P < 0.001). However, in men, only the difference between 5 sit-to-stand and 1-min sit-to-stand remained consistent across normalization methods ( P < 0.05). Our findings highlight the efficacy of 1-min sit-to-stand in distinguishing age-related functional capacity over the other sit-to-stand tests, especially in women.
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Affiliation(s)
- Carlos Cruz-Montecinos
- From the Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile (CC-M, RT-C, LS-N); Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile (CC-M); Kinesiología, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile (MO-Y); Programa Doctorado en Ciencias Médicas, Universidad Austral de Chile, Valdivia, Chile (MB-P); Centro de salud Dr Miguel Concha, Quillota, Chile (CV); CESFAM Alberto Allende Jones, Talagante, Chile (AC); Escuela de Kinesiología, Universidad de Santiago, Santiago, Chile (LJ); CESFAM Eduardo Frei, Villa Alemana, Chile (MB); Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil (VR)
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Delorme M, Bonnevie T. [Get up, stand up! What sit-to-stand tests tell us about respiratory failure]. Rev Mal Respir 2024; 41:583-592. [PMID: 39209564 DOI: 10.1016/j.rmr.2024.06.003] [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: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 09/04/2024]
Abstract
Diseases associated with chronic respiratory failure have a negative impact on quality of life and life expectancy, notably through a reduction in patients' functional capacity. Assessing balance, coordination, muscular strength and endurance, as well as exercise tolerance, is therefore an important component of the evaluation of individuals with chronic respiratory failure. This evaluation can be made easier by using simple tools such as sit-to-stand tests. This review presents the main sit-to-stand tests that have been described and that can be used in everyday practice. The aim is to provide information to the clinician on the contribution of each test, and to identify the extent to which and the purpose for which these tests can be incorporated into a routine pulmonology and/or respiratory rehabilitation evaluation. Because of their inherently functional nature, these tests could help to identify the indications and/or the effects of respiratory rehabilitation.
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Affiliation(s)
- M Delorme
- Centre de recherche cardio-thoracique de Bordeaux, université de Bordeaux, Bordeaux, France; Inserm, U1045, Pessac, France.
| | - T Bonnevie
- Association ADIR (Aide à domicile des patients insuffisants respiratoires), 18, rue Marie-Curie, 76000 Rouen, France; GRHVN UR 3830, université de Rouen Normandie, Normandie université, 76000 Rouen, France
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Siao SF, Wang TG, Ku SC, Wei YC, Chen CCH. Inability to Sit-to-Stand in Medical ICUs Survivors: When and Why We Should Care. Crit Care Med 2024:00003246-990000000-00370. [PMID: 39258981 DOI: 10.1097/ccm.0000000000006404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
OBJECTIVES To investigate the prevalence and association with mortality of inability to perform sit-to-stand independently in critically ill survivors 3 months following medical ICU (MICU) discharge. DESIGN Prospective cohort study. SETTING Six MICUs at a tertiary care hospital. PATIENTS MICU survivors who could sit-to-stand independently before the index hospitalization. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Inability to sit-to-stand (yes/no) was measured at four points following MICU discharge: upon ICU discharge, 1, 2, and 3 months afterward. Mortality was evaluated at 6- and 12-month post-MICU discharge. Among 194 participants, 128 (66%) had inability to sit-to-stand upon MICU discharge. Recovery occurred, with rates decreasing to 50% at 1 month, 38% at 2 months, and 36% at 3 months post-MICU discharge, plateauing at 2 months. Inability to sit-to-stand at 3 months was significantly associated with 21% mortality at 12 months and a 4.2-fold increased risk of mortality (adjusted hazard ratio, 4.2; 95% CI, 1.61-10.99), independent of age, Sequential Organ Failure Assessment score, and ICU-acquired weakness. Notably, improvement in sit-to-stand ability, even from "totally unable" to "able with assistance," correlates with reduced mortality risk. CONCLUSIONS Inability to sit-to-stand affects about 36% of MICU survivors even at 3 months post-ICU discharge, highlighting rehabilitation challenges. Revisiting sit-to-stand ability post-ICU discharge is warranted. Additionally, using sit-to-stand as a screening tool for interventions to improve return of its function and mortality is suggested.
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Affiliation(s)
- Shu-Fen Siao
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shih-Chi Ku
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Chung Wei
- Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan
| | - Cheryl Chia-Hui Chen
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Thu HNT, Khac BL, Poncin W. Reliability of the 1-minute sit-to-stand test in chronic obstructive pulmonary disease. Ann Phys Rehabil Med 2024; 67:101866. [PMID: 39173551 DOI: 10.1016/j.rehab.2024.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/13/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Hang Nguyen Thi Thu
- Department of Rehabilitation, Hai Duong Medical Technical University, 1 Vu Huu, Thanh Binh Ward, Hai Duong City, Hai Duong Province, Vietnam
| | - Bao Le Khac
- Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam; Respiratory Medicine Department, Gia Dinh People's Hospital, 1 No Trang Long, Ward 7, Binh Thanh District, Ho Chi Minh City, Vietnam
| | - William Poncin
- Institut de Recherche Expérimentale et Clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Avenue Hippocrate 55, 1200 Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
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Holst M, Geisler L, Mikkelsen S, Rasmussen HH, Jørgensen BG, Beck AM. Pulmonary rehabilitation: A cohort study assessing the effectiveness of a multi-professional nutrition intervention. Clin Nutr ESPEN 2024; 62:33-42. [PMID: 38901947 DOI: 10.1016/j.clnesp.2024.04.020] [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: 12/04/2023] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Limited benefit of pulmonary exercise rehabilitation has been associated with fulfilment of energy and protein requirements. OBJECTIVES The aim was to enhance dietary intake towards requirements and to maintain changes after a pulmonary rehabilitation program. METHODS This single arm intervention study included multidisciplinary focus on nutrition and three sessions of individual dietary counselling during a 10-week pulmonary exercise rehabilitation in five municipalities centers. Data were collected at baseline (P0), at the end of intervention (P1) and for two municipalities at three months post intervention (P2). RESULTS Of the 111 included participants, (mean age 70.8 (±9)) 99 (89%) completed the rehabilitation including the three individual dietary counselling's. A very large variation in body composition including body mass index and exercise abilities was found. Protein intake improved from 64 (±22 g) (P0) to 88 (±25 g) (P1) (p < 0.001) and energy intake from 1676 (±505 kcal) (P0) to 1941 (±553 kcal) (p < 0.001) (P1) and Muscle Mass Index increased from 10.6 (±3.2) (P0) to 10.9 (±3.2) (P1) (p = 0.007); number of 30 s chair stand test improved from 10.9 (±2.8) repetitions (P0) to 14.1 (±4.3) repetitions (P1) (p < 0.001), distance in six-minut walking test improved from 377.2 (±131.2 m) (P0) to 404.1 (±128.6 m) (P1) (p < 0.001). Two municipalities completed the three months follow-up. For those, dietary improvements remained stable, including protein intake. CONCLUSION Including three sessions of dietary counselling in a multi-professional effort was associated with improved individualized dietary intake, as well as physical function. Benefits remained almost unchanged after three months. Improvements in function could not be fully explained by improved intakes.
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Affiliation(s)
- Mette Holst
- Center of Nutrition and Intestinal Failure, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Lea Geisler
- Center of Nutrition and Intestinal Failure, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Sabina Mikkelsen
- Center of Nutrition and Intestinal Failure, Department of Gastroenterology, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Henrik H Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Center of Nutrition and Intestinal Failure, Department of Gastroenterology, Aalborg University Hospital, Søndre Skovvej 5, DK-9000 Aalborg, Denmark.
| | - Birte G Jørgensen
- Department of Health Promotion, Frederikshavn Municipality, Nytorv 1, DK-9900 Frederikshavn, Denmark.
| | - Anne Marie Beck
- "EATEN" Research Unit for Dieticians and Nutrition Research, "Herlev Hospital, Borgmester Ib Juuls Vej 1, 20th Floor, DK-2730 Herlev, Denmark.
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Machado A, Dias C, Rebelo P, Souto-Miranda S, Mendes MA, Ferreira D, Martins V, Simão P, Burtin C, Marques A. Functional capacity using sit-to-stand tests in people with chronic obstructive pulmonary disease and its relationship with disease severity-a cross-sectional study with matched controls. Braz J Phys Ther 2024; 28:101090. [PMID: 38943740 PMCID: PMC11260574 DOI: 10.1016/j.bjpt.2024.101090] [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: 05/24/2023] [Revised: 04/02/2024] [Accepted: 06/05/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Functional capacity impairment is a crucial consequence of chronic obstructive pulmonary disease (COPD). Although it can be identified with simple tests, such as the sit-to-stand tests, its prevalence, relation with disease severity, and the characteristics of people presenting this impairment remain unknown. OBJECTIVE To explore the functional capacity of people with COPD. METHODS A cross-sectional study with people with COPD and age-/sex-matched healthy controls was conducted. Functional capacity was assessed with the 5-repetitions (5-STS) and the 1-minute (1-minSTS) sit-to-stand tests. People with COPD were grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifications. Comparisons between people with COPD and healthy controls, and among GOLD groups were established. Associations between symptoms, muscle strength, quality of life, and measures of functional capacity were explored. RESULTS 302 people with COPD [79% male; mean (SD) 68 (10) years old] and 304 healthy controls [75% male; 66 (9) years old] were included. 23% of people with COPD presented impairment in the 5-STS and 33% in the 1-minSTS. People with COPD from all GOLD classifications presented significantly lower functional capacity than healthy controls (5-STS: COPD median [1st quartile; 3rd quartile] 8.4 [6.7; 10.6] versus healthy 7.4 [6.2; 9.3] s; 1-minSTS: COPD 27 [21; 35] vs healthy 35 [29; 43] reps). Correlations with symptoms, muscle strength, and quality of life were mostly weak (5-STS: rs [-0.34; 0.33]; 1-minSTS: rs [-0.47; 0.40]). CONCLUSION People with COPD have decreased functional capacity independently of their GOLD classifications. The prevalence of functional impairment is 23-33%. Because impaired functional capacity is a treatable trait not accurately reflected by other outcomes, comprehensive assessment and management is needed.
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Affiliation(s)
- Ana Machado
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal; Department of Medical Sciences, University of Aveiro, Aveiro, Portugal; Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; Biomedical Research Institute (BIOMED), Hasselt University, Diepenbeek, Belgium
| | - Cíntia Dias
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Patrícia Rebelo
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal; Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Sara Souto-Miranda
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Unidade de Investigação e Desenvolvimento (UID), Northern Health School of The Portuguese Red Cross, Oliveira de Azeméis, Portugal; Insight, Jean Piaget School of Health, Piaget Institute, Vila Nova de Gaia, Portugal; Physiotherapy Department, Setúbal Polytechnic Institute, Setúbal, Portugal
| | - Maria Aurora Mendes
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal; Department of Medical Sciences, University of Aveiro, Aveiro, Portugal; Pulmonology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Diva Ferreira
- Pulmonology Department, Centro Hospitalar do Médio Ave, Famalicão, Portugal
| | - Vitória Martins
- Pulmonology Department, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Paula Simão
- Pulmonology Department, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Chris Burtin
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; Biomedical Research Institute (BIOMED), Hasselt University, Diepenbeek, Belgium
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
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Radtke T, Künzi L, Kopp J, Rasi M, Braun J, Zens KD, Winter B, Anagnostopoulos A, Puhan MA, Fehr JS. Effects of Pycnogenol® in people with post-COVID-19 condition (PYCNOVID): study protocol for a single-center, placebo controlled, quadruple-blind, randomized trial. Trials 2024; 25:385. [PMID: 38879571 PMCID: PMC11179231 DOI: 10.1186/s13063-024-08187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/17/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND A significant proportion of the global population has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at some point since the onset of the pandemic. Although most individuals who develop coronavirus disease 2019 (COVID-19) recover without complications, about 6% have persistent symptoms, referred to as post-COVID-19 condition (PCC). Intervention studies investigating treatments that potentially alleviate PCC-related symptoms and thus aim to mitigate the global public health burden and healthcare costs linked to PCC are desperately needed. The PYCNOVID trial investigates the effects of Pycnogenol®, a French maritime pine bark extract with anti-inflammatory and antioxidative properties, versus placebo on patient-reported health status in people with PCC. METHODS This is a single-center, placebo-controlled, quadruple blind, randomized trial. We aim to randomly assign 150 individuals with PCC (1:1 ratio) to receive either 200 mg Pycnogenol® or placebo daily for 12 weeks. Randomization is stratified for duration of PCC symptoms (≤ 6 months versus > 6 months) and presence of symptomatic chronic disease(s). The primary endpoint is perceived health status at 12 weeks (EuroQol-Visual Analogue Scale) adjusted for baseline values and stratification factors. Secondary endpoints include change in self-reported PCC symptoms, health-related quality of life, symptoms of depression and anxiety, cognitive function, functional exercise capacity, physical activity measured with accelerometry, and blood biomarkers for endothelial health, inflammation, coagulation, platelet function, and oxidative stress. Investigators, study participants, outcome assessors, and data analysts are blinded regarding the intervention assignment. Individuals with PCC were involved in the design of this study. DISCUSSION This is the first trial to investigate the effects of Pycnogenol® versus placebo on patient-reported health status in people with PCC. Should the trial proof clinical effectiveness, Pycnogenol® may serve as a therapeutic approach to mitigate symptoms associated with PCC. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov. :NCT05890534, June 6, 2023.
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Affiliation(s)
- Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
| | - Lisa Künzi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Kopp
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Manuela Rasi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Braun
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Kyra D Zens
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Babette Winter
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
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Bonikowske AR, Taylor JL, Larson KF, Hardwick J, Ozemek C, Harber MP, Kaminsky LA, Arena R, Lavie CJ. Evaluating current assessment techniques of cardiorespiratory fitness. Expert Rev Cardiovasc Ther 2024; 22:231-241. [PMID: 38855917 DOI: 10.1080/14779072.2024.2363393] [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: 01/26/2024] [Accepted: 05/30/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Considerable and convincing global data from cohorts across the health spectrum (i.e. apparently healthy to known disease) indicate that cardiorespiratory fitness (CRF) is a major predictor of overall and cardiovascular disease (CVD)-survival, seemingly with greater prognostic resolution compared to other traditional CVD risk factors. Therefore, the assessment of CRF in research and clinical settings is of major importance. AREAS COVERED In this manuscript, we review the technology of measuring CRF assessed by the 'gold standard,' cardiopulmonary exercise testing (CPET), as well as with various other methods (e.g. estimated metabolic equivalents, 6-minute walk tests, shuttle tests, and non-exercise equations that estimate CRF), all of which provide significant prognostic information for CVD- and all-cause survival. The literature through May 2024 has been cited. EXPERT OPINION The promotion of physical activity in efforts to improve levels of CRF is needed throughout the world to improve lifespan and, more importantly, healthspan. The routine assessment of CRF should be considered a vital sign that is routinely assessed in clinical practice.
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Affiliation(s)
| | - Jenna L Taylor
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn F Larson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joel Hardwick
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA
| | - Matthew P Harber
- Clinical Exercise Physiology, Ball State University, Muncie, IN, USA
| | - Lenny A Kaminsky
- Clinical Exercise Physiology, Ball State University, Muncie, IN, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, LA, USA
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Radtke T, von Wyl V, Haile SR, Rohrmann S, Frei A, Puhan MA. Evidence-based coaching of core competencies in epidemiology, using the framework of randomized controlled trials: the Zurich approach. Int J Epidemiol 2024; 53:dyae075. [PMID: 38847781 PMCID: PMC11157962 DOI: 10.1093/ije/dyae075] [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: 10/26/2023] [Accepted: 05/22/2024] [Indexed: 06/09/2024] Open
Abstract
Teaching epidemiological concepts in academic settings poses a challenge due to the intricate nature of the discipline as both a science and a practice. Whereas traditional classroom-based teaching methods are commonly employed, evidence suggests they may not be the most effective approach for fostering core competencies and skills required in real-life scientific work. In this article, we describe our process of transitioning from traditional classroom teaching of epidemiology towards practice-based coaching to convey epidemiological concepts to bachelor's and master's students in Biomedicine. We chose the framework of randomized controlled trials (RCT) since they offer a great opportunity to teach epidemiological concepts in a hands-on course. This practice-based course encompasses the entire life cycle of a study, allowing students to design and conduct a short-term experiment, analyse its data and prepare a scientific paper. We provide a comprehensive overview of the course structure, content, learning objectives and course evaluation, while also discussing the advantages and disadvantages of this innovative format. Our approach offers a promising alternative to classroom teaching by incorporating practical, hands-on experiences offering students a high level of independence and self-determination, as well as facilitation and coaching by faculty. It has the potential to be applied across diverse academic settings, providing students with valuable skills and competencies in epidemiology.
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Affiliation(s)
- Thomas Radtke
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sarah R Haile
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Division of Chronic Disease Epidemiology, Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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11
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Castellote JM, Kofler M, Mayr A. The benefit of knowledge: postural response modulation by foreknowledge of equilibrium perturbation in an upper limb task. Eur J Appl Physiol 2024; 124:975-991. [PMID: 37755580 PMCID: PMC10879248 DOI: 10.1007/s00421-023-05323-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
For whole-body sway patterns, a compound motor response following an external stimulus may comprise reflexes, postural adjustments (anticipatory or compensatory), and voluntary muscular activity. Responses to equilibrium destabilization may depend on both motor set and a subject`s expectation of the disturbing stimulus. To disentangle these influences on lower limb responses, we studied a model in which subjects (n = 14) were suspended in the air, without foot support, and performed a fast unilateral wrist extension (WE) in response to a passive knee flexion (KF) delivered by a robot. To characterize the responses, electromyographic activity of rectus femoris and reactive leg torque was obtained bilaterally in a series of trials, with or without the requirement of WE (motor set), and/or beforehand information about the upcoming velocity of KF (subject`s expectation). Some fast-velocity trials resulted in StartReact responses, which were used to subclassify leg responses. When subjects were uninformed about the upcoming KF, large rectus femoris responses concurred with a postural reaction in conditions without motor task, and with both postural reaction and postural adjustment when WE was required. WE in response to a low-volume acoustic signal elicited no postural adjustments. When subjects were informed about KF velocity and had to perform WE, large rectus femoris responses corresponded to anticipatory postural adjustment rather than postural reaction. In conclusion, when subjects are suspended in the air and have to respond with WE, the prepared motor set includes anticipatory postural adjustments if KF velocity is known, and additional postural reactions if KF velocity is unknown.
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Affiliation(s)
- Juan M Castellote
- Radiology, Rehabilitation and Physiotherapy Department, Faculty of Medicine, Universidad Complutense, Madrid, Spain.
| | - Markus Kofler
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Andreas Mayr
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
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12
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Pancera S, Lopomo NF, Porta R, Sanniti A, Buraschi R, Bianchi LNC. Effects of Combined Endurance and Resistance Eccentric Training on Muscle Function and Functional Performance in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. Arch Phys Med Rehabil 2024; 105:470-479. [PMID: 37716519 DOI: 10.1016/j.apmr.2023.09.004] [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: 04/06/2023] [Revised: 08/03/2023] [Accepted: 09/01/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To evaluate the adherence to treatment and efficacy of an eccentric-based training (ECC) program on peripheral muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). DESIGN Prospective, assessor-blinded, randomized controlled trial. SETTING The cardiopulmonary rehabilitation unit of a tertiary subacute referral center. PARTICIPANTS Thirty (N=30) stable inpatients (mean age 68±8 years; FEV1 44±18% of predicted) with COPD were included in the study. INTERVENTIONS Inpatients were randomly assigned to 4 weeks of a combined endurance and resistance ECC (n=15) or conventional training (CON; n=15). MAIN OUTCOME MEASURES Quadriceps peak torque (PT) was the primary outcome measure for muscle function. Rate of force development (RFD), muscle activation and quality (quadriceps PT/leg lean mass), 6-min walk distance (6MWD), 4-meter gait speed (4mGS), 10-meter gait speed, 5-repetition sit-to-stand (5STS), dyspnea rate, and mortality risk were the secondary outcomes. Evaluations were performed at baseline and repeated after 4 weeks and 3 months of follow-up. RESULTS Quadriceps PT, RFD, and muscle quality improved by 17±23% (P<.001), 19±24%, and 16±20% (both P<.05) within the ECC group. Besides, a significant between-group difference for RFD (56±94 Nm/s, P=.038) was found after training. Both groups showed clinically relevant improvements in 6MWD, 4mGS, dyspnea rate, and mortality risk, with no significant differences between groups. CONCLUSION Combined endurance and resistance ECC improved lower limbs muscle function compared with CON in inpatients with COPD. In contrast, ECC did not further improve functional performance, dyspnea, and mortality risk. ECC may be of particular benefit to effect on skeletal muscle function in patients with COPD.
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Affiliation(s)
| | - Nicola F Lopomo
- Department of Information Engineering, University of Brescia, Brescia, Italy
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13
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Bourgeois N, Lands LC, Prévost K, Poirier C, Janaudis-Ferreira T. Virtual Physical Prehabilitation in Lung Transplant Candidates: A Proof-of-Concept Study. Transpl Int 2024; 37:12355. [PMID: 38433973 PMCID: PMC10904465 DOI: 10.3389/ti.2024.12355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Abstract
This study aimed to preliminary test the effectiveness of 12-week virtual physical prehabilitation program followed by a maintenance phase. The main objective was to estimate the extent to which it affects exercise capacity, frailty, lower limb strength and health-related quality of life (HRQOL) in lung transplant candidates. The program offered supervised strengthening exercises, independent aerobic exercises and weekly phone calls (maintenance phase). Primary outcome was the six-minute walk distance (6MWD). Secondary outcomes: the Short Physical Performance Battery (SPPB), five-times sit-to-stand test (5STS), the St George's Respiratory Questionnaire (SGRQ) for HRQOL. Twenty patients were included (mean age 57.9; 6 women/14 men); fourteen completed the prehabilitation program and 5 completed the maintenance phase. There was no statistically significant improvement in 6MWD, SPPB or SGRQ after the 12-week program. Most patients either maintained or improved the 6MWT and SPPB scores. There was a significant improvement in the 5STS. After the maintenance phase, most patients either improved or maintained their scores in all outcomes except for the sub-score of symptoms in the SGRQ. A 12-week virtual physical prehabilitation program with a 12-week maintenance phase can help lung transplant candidates improve or maintain their physical function while waiting for transplantation.
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Affiliation(s)
- Nicholas Bourgeois
- Lung Transplant Program, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| | - Larry C. Lands
- Lung Transplant Program, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Department of Pediatrics, Montreal Children’s Hospital-McGill University Health Centre, Montreal, QC, Canada
| | - Karina Prévost
- Lung Transplant Program, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Charles Poirier
- Lung Transplant Program, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Tania Janaudis-Ferreira
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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14
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Mellaerts P, Demeyer H, Blondeel A, Vanhoutte T, Breuls S, Wuyts M, Coosemans I, Claes L, Vandenbergh N, Beckers K, Bossche LV, Stylemans D, Janssens W, Everaerts S, Troosters T. The one-minute sit-to-stand test: A practical tool for assessing functional exercise capacity in patients with COPD in routine clinical practice. Chron Respir Dis 2024; 21:14799731241291530. [PMID: 39400070 PMCID: PMC11483694 DOI: 10.1177/14799731241291530] [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: 05/30/2024] [Revised: 09/12/2024] [Accepted: 09/24/2024] [Indexed: 10/15/2024] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with a reduced exercise capacity. Although several field tests for exercise capacity have been modified for non-standard settings, i.e. outside the hospital clinic or pulmonary rehabilitation center, their uptake remains limited. Objectives: To assess the test-retest reliability, constuct validity and responsiveness of the one-minute sit-to-stand test (1'STST) adopted in clinical practice among patients with COPD and to confirm the earlier established minimal important difference (MID) of three repetitions. Methods: Patients with COPD performed two 1'STSTs, two 6-minute walk tests (6MWT), an isometric quadriceps force (QF) measurement, a cardiopulmonary exercise test (CPET), and a seven-day physical activity (PA) measurement before and after three months of pulmonary rehabilitation (PR). An Intraclass Correlation Coefficient (ICC) evaluated the agreement between two 1'STSTs. Pearson Correlation examined the association between the 1'STST and other physical measurements, and their changes following PR. A receiver operating characteristic (ROC) curve was constructed using a 30-meter increment in the 6MWT as cut-off to identify responders. Results: The 1'STST demonstrated good reliability (Δ0.9 ± 4.0 repetitions, p = .13; ICC = 0.79). The 1'STST was moderately correlated with the 6MWT (r = 0.57, p < .0001), VO2max (r = 0.50, p = .0006) and maximal work rate (r = 0.52, p = .0003). Weak correlations were observed with QF (r = 0.33, p = .03) and step count (r = 0.38, p = .013). The 1'STST improved after PR (∆ = 3.6 ± 6.4 repetitions, p = .0013) and changes correlated moderately with changes in the 6MWT (r = 0.57, p = .002), QF (r = 0.48, p = .003) and VO2max (r = 0.41, p = .014). A cut-off of three repetitions demonstrated a 71% accuracy in identifying responders to a rehabilitation program. Conclusion: The 1'STST is a valuable alternative to evaluate exercise capacity in patients with COPD when more expensive and time-consuming tests are unavailable.
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Affiliation(s)
| | - Heleen Demeyer
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Astrid Blondeel
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- IS Global, Barcelona, Spain
| | - Tim Vanhoutte
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Sofie Breuls
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Marieke Wuyts
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Iris Coosemans
- Respiratory division, University Hospitals Leuven, Leuven, Belgium
| | - Lode Claes
- Respiratory division, University Hospitals Leuven, Leuven, Belgium
| | - Nele Vandenbergh
- Respiratory division, University Hospitals Leuven, Leuven, Belgium
| | - Kaat Beckers
- Respiratory division, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Wim Janssens
- Clinical department of Respiratory diseases, UZ Leuven- BREATHE, department CHROMETA, KU Leuven, Leuven, Belgium
| | - Stephanie Everaerts
- Clinical department of Respiratory diseases, UZ Leuven- BREATHE, department CHROMETA, KU Leuven, Leuven, Belgium
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15
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Faitatzidou D, Dipla K, Theodorakopoulou MP, Koutlas A, Tsitouridis A, Dimitriadis C, Pateinakis P, Zafeiridis A, Papagianni A, Jadoul M, Sarafidis P. Heart rate variability at rest and in response to stress: Comparative study between hemodialysis and peritoneal dialysis patients. Exp Biol Med (Maywood) 2023; 248:1745-1753. [PMID: 37916412 PMCID: PMC10792413 DOI: 10.1177/15353702231198081] [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: 04/02/2023] [Accepted: 07/10/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiac arrhythmias and sudden death are the leading causes of mortality in end-stage kidney disease (ESKD). Autonomic nervous system (ANS) dysfunction contributes to this arrhythmogenic background. This study compared heart rate variability (HRV) indices between hemodialysis (HD) and peritoneal dialysis (PD) patients, both at rest and in response to mental and physical stimulation maneuvers. Thirty-four HD and 34 PD patients matched for age, sex, and dialysis vintage, and 17 age- and sex-matched controls were studied. ANS function was examined by linear and non-linear HRV indices. Heart rate was recorded continuously (Finometer-PRO) at rest and during ANS maneuvers (orthostatic, mental-arithmetic, sit-to-stand, handgrip exercise tests). At rest, no significant differences between HD and PD were observed in HRV (root mean square of successive differences [RMSSD]: HD = 57.1 ± 81.1 vs PD = 69.6 ± 113.4 ms; P = 0.792), except for detrended fluctuation analysis (DFA-α1) (HD = 0.87 ± 0.40 vs PD = 0.70 ± 0.20; P = 0.047). DFA-α1 was significantly lower in PD than controls (1.00 ± 0.33; P < 0.05). All HRV indices during the mental-arithmetic test (RMSSD: HD = 128.2 ± 346.0 vs PD = 87.5 ± 150.0 ms; P = 0.893) and the physical stress tests were similar between HD and PD. The standard deviation along the line-of-identity (SD2)/the standard deviation perpendicular to the line-of-identity (SD1) ratio during mental-arithmetic was marginally lower in HD and significantly lower in PD than controls (PD = 1.31 ± 0.47 vs controls = 1.79 ± 0.64; P < 0.05). Both dialysis groups presented similar patterns in HRV responses during orthostatic and handgrip exercise tests. After the sit-to-stand, RMSSD, SD1, SD2, and DFA-α2 were higher compared to rest only in HD (RMSSD = 57.1 ± 81.1 vs 126.7 ± 185.7 ms; P = 0.028), suggesting a greater difficulty of HD patients in recovering normal ANS function in response to physical stress. In conclusion, HRV indices at rest and after mental and physical stimulation did not differ between HD and PD; however, the ANS responses following the sit-to-stand test were more impaired in HD. These findings suggest that ANS dysfunction is not largely affected by dialysis modality, but small differences in normal ANS recovery may exist.
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Affiliation(s)
- Danai Faitatzidou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Marieta P Theodorakopoulou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Aggelos Koutlas
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Alexandros Tsitouridis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Chrysostomos Dimitriadis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Panagiotis Pateinakis
- Department of Nephrology, Papageorgiou General Hospital, Thessaloniki GR56429, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Aikaterini Papagianni
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Michel Jadoul
- Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels B-1200, Belgium
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
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16
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Leonardi NT, Kawakami DMO, Hurst JR, Cruz J, Mendes RG. Performance-based outcome measures to assess functionality in hospitalised patients with COPD exacerbations: a systematic review of the measurement properties. Eur Respir Rev 2023; 32:230013. [PMID: 37437913 DOI: 10.1183/16000617.0013-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Hospitalised patients with exacerbations of COPD (ECOPD) may have physical and functional impairments that impact morbidity and readmission. Therefore, it is crucial to properly identify reduced functionality in these patients to support a personalised rehabilitation. The objective of this study is to summarise and compare the measurement properties of functionality performance-based outcome measures for hospitalised patients with ECOPD. METHODS A systematic review based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) was performed. The PubMed, Embase, PEDro and Cochrane databases were searched using terms related to functionality, hospitalised patients with ECOPD and measurement properties. Studies were selected and extracted by two researchers. The COSMIN Risk of Bias checklist was applied to assess the methodological quality of the studies and measurement property results were compared with the criteria for good measurement properties. Quality of evidence was graded using a modified Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS 13 studies were included with nine outcome measures, namely the 6-min pegboard ring test, the de Morton mobility index, the incremental shuttle walk test (ISWT), the 6-min walk test (6MWT), maximum inspiratory pressure (MIP), the Berg balance scale, 4-m gait speed, handgrip strength and the 6-min stepper test. Construct validity was rated as sufficient, except for the ISWT. Responsiveness, assessed only for MIP, was considered insufficient and measurement errors for the ISWT and 6MWT were insufficient, with a very low quality of evidence for all measurement properties. CONCLUSION Measurement properties of performance-based outcome measures to assess functionality in patients hospitalised with ECOPD are still scarce, with very low evidence supporting validity and a lack of evidence of responsiveness and reliability. Further studies are needed to address this topic and guide assertive and personalised management.
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Affiliation(s)
- Naiara Tais Leonardi
- Department of Physical Therapy, Federal University of Sao Carlos, São Paulo, Brazil
| | | | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Joana Cruz
- School of Health Sciences of the Polytechnic of Leiria, Leiria, Portugal
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17
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Saynor ZL, Gruet M, McNarry MA, Button B, Morrison L, Wagner M, Sawyer A, Hebestreit H, Radtke T, Urquhart DS. Guidance and standard operating procedures for functional exercise testing in cystic fibrosis. Eur Respir Rev 2023; 32:230029. [PMID: 37558263 PMCID: PMC10410399 DOI: 10.1183/16000617.0029-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/31/2023] [Indexed: 08/11/2023] Open
Abstract
Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated.
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Affiliation(s)
- Zoe L Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
- Wessex Cystic Fibrosis Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Mathieu Gruet
- Laboratory of the Impact of Physical Activity on Health (IAPS), University of Toulon, Toulon, France
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Brenda Button
- Department of Physiotherapy, Melbourne School of Health Science, University of Melbourne, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia
| | - Lisa Morrison
- West of Scotland Adult CF Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Marlies Wagner
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Abbey Sawyer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helge Hebestreit
- Paediatric Department, University Hospitals Würzburg, Würzburg, Germany
| | - Thomas Radtke
- Division of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Don S Urquhart
- Royal Hospital for Children and Young People, Edinburgh, UK
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
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18
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Schlöglhofer T, Gross C, Moscato F, Neumayer A, Kandioler E, Leithner D, Skoumal M, Laufer G, Wiedemann D, Schima H, Zimpfer D, Marko C. Exercise Performance and Quality of Life of Left Ventricular Assist Device Patients After Long-Term Outpatient Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2023; 43:346-353. [PMID: 37014949 DOI: 10.1097/hcr.0000000000000789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
PURPOSE Exercise performance and quality of life (QoL) of left ventricular assist device (LVAD) patients improve after early cardiac rehabilitation (CR). The purpose of this study was to examine the efficacy of multiprofessional long term phase 3 outpatient CR, and whether cardiopulmonary exercise testing (CPX) and 6-min walk testing (6MWT) post-LVAD implantation predict hospital readmission. METHODS This retrospective observational cohort study included 29 LVAD patients (58.6 ± 7.7 yr, female: 13.8%, body mass index: 29.4 ± 3.3 kg/m 2 ). Functional performance tests (CPX, 6MWT, sit-to-stand test), QoL, and psychological surveys (Kansas City Cardiomyopathy Questionnaire, hospital anxiety and depression scale, and Control Convictions about Disease and Health [KKG]) were performed at baseline and at the end of CR. RESULTS The CR was initiated at a median (IQR) of 159 (130-260) d after LVAD implantation for a duration of 340 (180-363) d with 46.8 ± 23.2 trainings. The 6MWT (408.4 ± 113.3 vs 455.4 ± 115.5 m, P = .003) and sit-to-stand test (16.7 ± 6.9 vs 19.0 ± 5.3 repetitions, P = .033) improved, but relative peak oxygen uptake (V˙ o2peak : 9.4 [8.2-14.4] vs 9.3 [7.8-13.4] mL/min/kg, P = .57) did not change. Using receiver operating characteristic curve analysis, baseline V˙ o2peak values were associated with readmission 1-yr after CR onset (C-statistic = 0.88) with a cutoff value of V˙ o2peak < 9.15 mL/min/kg (100% sensitivity, 78% specificity, P < .001). The Kansas City Cardiomyopathy Questionnaire self-efficacy and knowledge (+6.3 points), QoL (+5.0 points), and social limitation (+7.1 points) demonstrated clinically important changes. In addition, the hospital anxiety and depression scale showed a significant reduction in anxiety (4.6 ± 3.2 vs 2.6 ± 2.4, P = .03). CONCLUSIONS Long-term CR is safe and LVAD outpatients showed improvement of QoL, anxiety, and submaximal exercise performance. In addition, V˙ o2peak and 6MWT have prognostic value for readmission.
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Affiliation(s)
- Thomas Schlöglhofer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (Messrs Schlöglhofer and Neumayer and Drs Gross, Laufer, Wiedemann, Schima, Zimpfer, and Marko); Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria (Messrs Schlöglhofer and Neumayer and Drs Moscato, Schima, and Zimpfer); Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria (Mr Schlöglhofer and Drs Moscato and Schima); Austrian Cluster for Tissue Regeneration, Vienna, Austria (Dr Moscato); and Center for Outpatient Rehabilitation Vienna, Vienna, Austria (Drs Kandioler and Skoumal and Ms Leithner)
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19
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Ernst R, Bouteleux B, Malhouitre M, Grassion L, Zysman M, Henrot P, Delorme M. The Non-Paced 3-Minute Sit-to-Stand Test: Feasibility and Clinical Relevance for Pulmonary Rehabilitation Assessment. Healthcare (Basel) 2023; 11:2312. [PMID: 37628511 PMCID: PMC10454867 DOI: 10.3390/healthcare11162312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Pulmonary rehabilitation (PR) improves health-related quality-of-life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD), notably by increasing exercise tolerance. Easy-to-implement sit-to-stand tests can facilitate the assessment of exercise tolerance in routine practice. This retrospective study conducted in a real-life setting was designed to describe the non-paced 3-min sit-to-stand test (3-STST) and to evaluate its relationship with HRQoL (VQ11 questionnaire) to identify the determinants of 3-STST performance and to analyze the evolution of 3-STST performance and HRQoL over the course of a community-based PR program. Seventy-one COPD patients (age 69 ± 10 years old; 51% with GOLD spirometric stages III-IV) were included. Mean ± SD 3-STST performance at the initial PR assessment was 43 ± 15 repetitions. This performance was significantly associated with HRQoL and other indicators of clinical severity (lung function, dyspnea, and functional capacities). During the multivariate analysis, younger age, exertional dyspnea with mMRC ≤ 1, and better HRQoL were significantly associated with better 3-STST performance. From the initial to second PR assessment, changes in 3-STST performance were significantly associated with changes in HRQoL. This study provides evidence that the non-paced 3-STST is feasible and might be clinically relevant in the assessment of patients with COPD referred for community-based PR. This test deserves to be prospectively validated.
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Affiliation(s)
| | | | | | - Léo Grassion
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
| | - Maéva Zysman
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
| | - Pauline Henrot
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
- Service des Explorations Fonctionnelles Respiratoires, Département de Physiologie, CHU de Bordeaux, 33604 Pessac, France
| | - Mathieu Delorme
- Resp’Air, 33400 Talence, France
- Direction des Actions Médicales, AFM-Téléthon, 91000 Evry, France
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20
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Zhang P, Liu S, Zhu X, Liu H, Zeng L, Yan J, Liu J. The effects of a physical exercise program in Chinese kidney transplant recipients: a prospective randomised controlled trial. Clin Kidney J 2023; 16:1316-1329. [PMID: 37529646 PMCID: PMC10387397 DOI: 10.1093/ckj/sfad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Indexed: 08/03/2023] Open
Abstract
Background Kidney transplant has become the preferred therapy for end-stage renal disease. However, kidney transplant recipients (KTRs) still face several challenges, such as physical inactivity. The purpose of this study was to explore the effects of a nurse-led physical exercise program in Chinese KTRs. Methods A total of 106 participants were enrolled from the Third Xiangya Hospital of Central South University between July 2021 and June 2022 and randomly assigned to the control or intervention groups. Participants in the control group were provided with routine nursing care and participants in the intervention group received a nurse-led rigorous physical exercise program that was divided into two stages: the pre-discharge stage and the post-discharge stage. The pre-discharge stage included the non-ambulatory and ambulatory stages. The Chinese traditional exercise Baduanjin was incorporated into the physical exercise during the ambulatory stage. The post-discharge stage continued the same exercise as the ambulatory stage at home. After 3 months of intervention, both groups received the same follow-up for 3 months. The primary and secondary outcomes of all participants were collected. The data were analysed with repeated measures analysis of variance to examine the effectiveness of the intervention. Results Compared with the control group, the intervention group had less fatigue and more motivation to be active in primary outcomes. Moreover, patients in the intervention group had a higher phase angle, a longer 6-minute walk distance, more 30-second chair stand times and decreased anxiety and depression levels in secondary outcomes. No adverse events were observed during the intervention. There were no significant differences in all dimensions of the quality-of-life questionnaire between the intervention and the control group. Conclusion Chinese KTRs could benefit from the nurse-led physical exercise program post-operatively. Trial registration ChiCTR2100048755.
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Affiliation(s)
- Pengpeng Zhang
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shan Liu
- Adelphi University College of Nursing and Public Health, Garden City, NY, USA
| | - Xiao Zhu
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Huan Liu
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Le Zeng
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jin Yan
- Nursing Department, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jia Liu
- Correspondence to: Jia Liu; E-mail:
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21
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Ng DP, Thiviyan P, Shrida S, Ng LWC. Feasibility of Conducting Sit-to-Stand Tests Using Video Consultation. Int J Telemed Appl 2023; 2023:8551680. [PMID: 39280702 PMCID: PMC11401680 DOI: 10.1155/2023/8551680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 09/18/2024] Open
Abstract
Objective This study is aimed at ascertaining the feasibility of conducting the 1-minute sit-to-stand (1MSTS) and 30-second sit-to-stand (30SSTS) tests for healthy participants via video consultation. A secondary aim was to compare the relationship between the 1MSTS and 30SSTS. Methods A total of 63 participants were recruited via the Singapore Institute of Technology emails and social media in 2020 during the peak of COVID-19. Prior to the sit-to-stand testing, all participants completed the consent form and physical activity questionnaires. Anthropometric data such as height and weight were also collected prior to testing. An instructional video detailing the sit-to-stand (STS) movement and the requirements for the environment set-up were sent to the participants via email. All STS tests were conducted virtually via the Zoom application. Healthy participants aged 21 to 55 years old performed a 1MSTS and 30SSTS each in random order. Results All recruited participants completed the STS tests with no reported adverse events. Majority of participants were from the 21- to 25-year-old age groups, and the average number of repetitions performed by this group was 21.9 ± 5.6 for the 30SSTS and 44.7 ± 12.6 for the 1MSTS. Conclusion Conducting the STS tests via video consultation was demonstrated to be safe and feasible. The number of repetitions performed in the 1MSTS is correlated to that of the 30SSTS, but 1MSTS has the ability to elicit a greater HR response among younger adults.
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Affiliation(s)
- Deng Peng Ng
- Physiotherapy Department, Singapore General Hospital, Singapore
| | - P Thiviyan
- Faculty of Health & Social Sciences, School of Physiotherapy, Singapore Institute of Technology, Singapore
| | - Sailli Shrida
- Faculty of Health & Social Sciences, School of Physiotherapy, Singapore Institute of Technology, Singapore
| | - Li Whye Cindy Ng
- Physiotherapy Department, Singapore General Hospital, Singapore
- Faculty of Health & Social Sciences, School of Physiotherapy, Singapore Institute of Technology, Singapore
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22
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Albalwi AA, Alharbi AA. Optimal procedure and characteristics in using five times sit to stand test among older adults: A systematic review. Medicine (Baltimore) 2023; 102:e34160. [PMID: 37390277 PMCID: PMC10313281 DOI: 10.1097/md.0000000000034160] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Falls are a major concern for people of all ages, especially older adults with declining physical functions and deteriorating muscle strength. The Five Times Sit to Stand Test is used for the assessment of lower limb strength along with balance and postural control. Therefore, the systematic review at hand aimed to determine the optimal procedure and characteristics among older adults. METHODS The following databases served as the primary sources through which the target studies were searched for and obtained for review. They included Google Scholar, Pedro, BIOMED Central, Cochrane Library, MEDLINE, PUBMED and Science DIRECT. With the aim of fulfilling the eligibility criteria, 16 full-text studies were included and the quality assessment was performed. using the Thomas Tool. RESULTS The total number of the subjects who participated in the included studies was 15,130 and the ages of the aforementioned participants ranged from 60 to 80 years. In 15 of the studies, a stopwatch was used as the scoring method where the mean chair height of 42 cm was reported. Two studies reported that no significant influence of the arm position (P = .096) on the time allocated for test completion was identified. However, posterior foot placement (P < .001) led to shorter times of completion. Individuals who are unable to complete the test are more susceptible to activities of daily living related disabilities (P < .01) when compared to fall risk (P = .09). CONCLUSION The Five Times Sit-to-Stand Test is a safe test, providing added value to apply risk for falls in people at moderate risk and in healthy populations using standardized chair heights and stopwatches.
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Affiliation(s)
- Abdulaziz Aoudh Albalwi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Ahmad Abdullah Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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23
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Björklund F, Palm A, Gorani JA, Ahmadi Z, Sundh J, Theorell-Haglöw J, Ljunggren M, Grote L, Wadell K, Ekström M. Breathlessness and exercise performance to predict mortality in long-term oxygen therapy - The population-based DISCOVERY study. Respir Med 2023:107306. [PMID: 37286141 DOI: 10.1016/j.rmed.2023.107306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Patients with chronic respiratory failure treated with long-term oxygen therapy (LTOT) often have severe breathlessness, impaired exercise performance, and high but variable mortality that is difficult to predict. We aimed to evaluate breathlessness and exercise performance upon starting LTOT as predictors of overall and short-term mortality. METHODS This was a longitudinal, population-based study of patients who initiated LTOT between 2015-2018 in Sweden. Breathlessness was measured using the Dyspnea Exertion Scale, and exercise performance using the 30s-Sit-To-Stand test. Associations with overall and three-month mortality were analyzed using Cox-regression. Subgroup analyses were performed for patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) respectively. The predictive capacity of models was assessed using a C-statistic. RESULTS A total of 441 patients (57.6% female, aged 75.4 ± 8.3 years) were analyzed, of whom 141 (32%) died during a median follow-up of 260 (IQR 75-460) days. Both breathlessness and exercise performance were independently associated with overall mortality in the crude models, but only exercise performance remained independently associated with overall mortality when models were adjusted for other predictors, when short-term mortality was analyzed, or when breathlessness and exercise capacity were analyzed concurrently. The multivariable model including exercise performance but not breathlessness provided a relatively high predictive capacity for overall mortality, C-statistic 0.756 (95% CI 0.702-0.810). Similar results were seen in the COPD and ILD subgroups. CONCLUSION Exercise performance as measured by the 30s-STS may be useful to identify patients with higher mortality on LTOT for optimized management and follow-up.
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Affiliation(s)
- Filip Björklund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
| | - Andreas Palm
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden; Region of Gävleborg, Gävle Hospital, Centre for Research and Development, Gävle, Sweden.
| | | | - Zainab Ahmadi
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
| | - Josefin Sundh
- Örebro University, Faculty of Medicine and Health, Department of Respiratory Medicine, Örebro, Sweden.
| | - Jenny Theorell-Haglöw
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden.
| | - Mirjam Ljunggren
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden.
| | - Ludger Grote
- Sahlgrenska University Hospital, Department of Pulmonary Medicine, Gothenburg, Sweden; Sahlgrenska Academy, Center for Sleep and Wake Disorders, Gothenburg, Sweden.
| | - Karin Wadell
- Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå, Sweden.
| | - Magnus Ekström
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
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McDonald O, Perraton L, Osadnik C. Validity and clinical applicability of the 60-secondecond sit-to-stand test in people with acute exacerbations of COPD. Respir Med 2023:107264. [PMID: 37217083 DOI: 10.1016/j.rmed.2023.107264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/19/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND The 60-second sit-to-stand test (60STS) is a simple and increasingly popular test of physical function, however evidence to support its appropriateness for assessing people with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is lacking. AIMS To evaluate the concurrent, convergent, predictive and discriminant validity, and responsiveness of the 60STS against the six-minute walk test (6MWT) in people hospitalised due to AECOPD. METHODS Prospective cohort study involving 54 inpatients with AECOPD (53% males, mean age 69.0 years, FEV1 46.5% predicted). 60STS was performed 30 min after a six-minute walk test (6MWT) upon discharge, with follow-up testing repeated one-month later (n = 39). Outcome measures included 60STS repetitions (60STSr), six-minute walk distance (6MWD), heart rate, oxyhaemoglobin saturation (SpO2), perceived dyspnoea (Borg scale), and rate of perceived exertion (RPE). Concurrent validity was assessed via correlation, convergent validity via Bland-Altman plots, predictive validity via multivariate linear regression (adjusted for confounders), discriminant validity via unpaired t tests and responsiveness via Chi (Jenkins, 2007) [2] tests. RESULTS Discharge 60STSr and 6MWD were strongly correlated (r = 0.61). Bland-Altman plots for nadir SpO2, peak HR, Borg and RPE scores showed acceptable agreement in terms of mean differences, but wide limits of agreement. Poor 60STSr performers were older, had weaker quadriceps, and had lower 6MWD than high performers (p < 0.05 for all). 60STSr was not retained as a significant predictor of 6MWD in multivariate regression analyses. 80% of 60STSr improvers also improved >30m on 6MWT at follow-up. CONCLUSION The 60STS demonstrates satisfactory validity and responsiveness as a measure of exercise performance in people with AECOPD.
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Affiliation(s)
- Olivia McDonald
- Department of Physiotherapy, Monash University, Melbourne, Australia.
| | - Luke Perraton
- Department of Physiotherapy, Monash University, Melbourne, Australia.
| | - Christian Osadnik
- Department of Physiotherapy, Monash University, Melbourne, Australia.
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Adsett JA, Bowe R, Kelly R, Louis M, Morris N, Hwang R. A Study of the Reliability, Validity, and Physiological Changes of Sit-to-Stand Tests in People With Heart Failure. J Cardiopulm Rehabil Prev 2023; 43:214-219. [PMID: 36729608 DOI: 10.1097/hcr.0000000000000739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The objective of this study was to describe the psychometric properties and physiological response of the five times sit-to-stand (STST-5) and 60-sec sit-to-stand test (STST-60) in adults with heart failure (HF). METHODS People with HF enrolled in a 12-wk exercise rehabilitation program completed two STST-5 and two STST-60 as part of their usual baseline and follow-up assessments. Test-retest reliability, validity, and responsiveness of the two STSTs were described. Results were correlated with the 6-min walk test (6MWT) and timed up and go test (TUGT), and rating of perceived exertion and physiological responses were compared between all tests. Feasibility was also reported according to the presence of adverse events and adherence to the protocol. RESULTS Forty-nine adults with HF participated in this study. Intraclass correlation coefficients of the STST-5 and STST-60 were 0.91 (95% CI, 0.78-0.96) and 0.96 (95% CI, 0.93-0.98), respectively. The STST-60 was strongly associated with both the 6MWT ( r = 0.76) and the TUGT ( rs =-0.77). The STST-5 was strongly associated with the TUGT ( rs = 0.79) and moderately associated with the 6MWT ( rs =-0.70). Rating of perceived exertion and lower limb fatigue were greater in the STST-60 than in the 6MWT ( P < .001) or STST-5 ( P < .001). Adverse events occurred in five participants undertaking the STST-60 and one participant undertaking the STST-5. CONCLUSIONS The STST-5 and STST-60 are reliable and valid measures of functional exercise capacity in people with HF.
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Affiliation(s)
- Julie A Adsett
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia (Dr Adsett); Physiotherapy Department, Cairns Base Hospital, Cairns, Queensland Australia (Ms Bowe); Physiotherapy Department, The Prince Charles Hospital, Brisbane, Queensland, Australia (Ms Kelly and Dr Morris); Chronic Disease and Post-acute Programmes, Robina Health Precinct, Gold Coast, Queensland, Australia (Ms Louis); School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia (Ms Louis and Dr Morris); Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia (Dr Morris); and Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia (Dr Hwang)
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26
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Pichon R, Ménard M, Haering D, Crétual A, Beaumont M. Characteristics and Predictors of Postural Control Impairment in Patients With COPD Participating in a Pulmonary Rehabilitation Program. J Cardiopulm Rehabil Prev 2023; 43:198-204. [PMID: 36728886 DOI: 10.1097/hcr.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Postural control impairment has been identified as a potential extrarespiratory manifestation in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to identify clinical factors that characterize patients with reduced postural control, to examine the correlation between clinical factors and postural control and to determine predictors of an impaired postural control among COPD participants enrolled in a pulmonary rehabilitation (PR) program. METHODS This study is a secondary analysis of an observational study (PARACHUTE). The baseline assessment of the PR program was used for the analysis. Postural control impairment was defined using the Brief BESTest score (BBT). RESULTS Participants (n = 73) were included in the analysis, 43 of them were classified in the reduced postural control group. The between-group comparison (non-reduced vs reduced postural control) identified differences for partial pressure in oxygen (Pa O2 ), Saint George Respiratory Questionnaire (SGRQ) total score and subscores (SGRQ-Symptoms, SGRQ-Activities, and SGRQ-Impact), COPD assessment test (CAT), and anxiety score of the Hospital Anxiety and Depression Scale. The BBT score was significantly correlated with maximal inspiratory pressure (MIP), SGRQ, SGRQ-Symptoms, SGRQ-Impact, Falls Efficacy Scale, modified Medical Research Council Scale, 6-min walk test, and Pa O2 . Logistic regression identified SGRQ-Symptoms, Pa O2 , MIP, and body mass index (BMI) as predictors of the presence of reduced postural control. CONCLUSION Low quality of life (QoL) and Pa O2 and high anxiety seem to be discriminative characteristics of patients with COPD with reduced postural control. Furthermore, QoL, Pa O2 , inspiratory muscle strength, and BMI seem to be acceptable predictors of the presence of postural control impairment.
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Affiliation(s)
- Romain Pichon
- Institut de Formation en Pédicurie-Podologie, Ergothérapie et Kinésithérapie (IFPEK), Rennes, France (Mr Pichon); M2S Laboratory, University Rennes 2, Rennes, France (Mr Pichon and Drs Ménard, Haering, and Crétual); Institut d'Ostéopathie de Rennes-Bretagne (IO-RB), Bruz, France (Dr Ménard); and Pulmonary Rehabilitation Unit, Morlaix, France, and Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France (Dr Beaumont)
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27
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Kuhn M, Vollenweider S, Clarenbach CF, Kohlbrenner D. The effects of standardised versus individualised seat height on 1-minute sit-to-stand test performance in healthy individuals: a randomised crossover trial. Eur J Appl Physiol 2023:10.1007/s00421-023-05174-8. [PMID: 36932213 DOI: 10.1007/s00421-023-05174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/04/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE We aimed to (i) investigate differences in 1-minute sit-to-stand test (1MSTST) performance (i.e., the number of repetitions) between a standardised modality (i.e., starting from a conventional chair with 46 cm seat height) and an individualised modality (i.e., starting with a knee joint flexion angle of 90°), and to (ii) quantify the influence of tibia and femur length on 1MSTST performance. METHODS Healthy participants were recruited for this randomised crossover study, performing each 1MSTST modality twice in a randomised order. The primary outcome was the number of repetitions in the 1MSTST. Secondary endpoints were the acute responses in peripheral oxygen saturation, heart rate, and leg fatigue and dyspnoea. Additionally, we investigated correlations of performance with knee extensor strength in both modalities. RESULTS Thirty participants were recruited and completed the study. They achieved significantly less repetitions in the standardised 1MSTST compared to the individualised 1MSTST (B = - 12.1, 95% confidence interval [95% CI] = - 14.8/- 9.4, p < 0.001). We found a significant effect of femur length on 1MSTST performance (B = - 1.6, 95% CI = - 2.6/- 0.7, p = 0.01), tibia length showed significant interaction with the 1MSTST modality (B = 1.2, 95% CI = 0.2/2.2, p = 0.03). CONCLUSION An individualisation of the 1MSTST starting position to 90° knee flexion angle leads to more repetitions compared to the traditional starting position. The higher repetition count is explained by controlling for differences in tibia length. We recommend individualisation of the 1MSTST, enabling more valid comparisons across populations and study samples. TRIAL REGISTRATION NUMBER http://www. CLINICALTRIALS gov , NCT04772417. TRIAL REGISTRATION DATE February 26, 2021.
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Affiliation(s)
- Manuel Kuhn
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | | | | | - Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
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One-minute sit-to-stand test as a quick functional test for people with COPD in general practice. NPJ Prim Care Respir Med 2023; 33:11. [PMID: 36922535 PMCID: PMC10015133 DOI: 10.1038/s41533-023-00335-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023] Open
Abstract
Assessing changes in functional exercise capacity is highly relevant in the treatment of people with Chronic Obstructive Pulmonary Disease (COPD), as lung function is often static. In Denmark, most people with COPD are followed in general practice where traditional functional tests, like six-minute walk test, require too much time and space. Therefore, there is an urgent need for a quick functional exercise capacity test that can be performed in a limited setting, such as general practice. This study aimed to identify a quick test to measure functional exercise capacity in people with COPD and identify which factors could affect the implementation of such a test in general practice. A mixed method feasibility study composed of a literature review and qualitative interviews was used. Quick functional tests for people with COPD were identified and evaluated through the COSMIN methodology. For the interviews, 64 general practices were included, and 50 staff members and 14 general practitioners (GPs) participated in the interviews. Responses were categorized and thematically analyzed. The 1 min sit-to-stand-test (1 M STST) was found suitable for a general practice setting. The COSMIN methodology rated it "sufficient" in reliability (ICC 0.90-0.99), measurement error (MID 2.5-3), construct validity and responsiveness (AUC 0.72), and found a moderate to strong correlation in criterion validity (r = 0.4-0.75). Several GPs wished for a quick functional test and emphasized evidence, information, and limitations as essential when deciding on implementation. Other factors identified included time, other tests, and economy. 1 M STST is a valid test to assess functional exercise capacity in people with COPD. The test is quick and can easily be performed in a standard consultation, and several GPs wished for such a test.
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Evaluation of an In-Home Virtual Pulmonary Rehabilitation Program for Respiratory Patients Delivered in Response to the COVID Pandemic. Chest 2023; 163:529-532. [PMID: 36368614 PMCID: PMC9767815 DOI: 10.1016/j.chest.2022.10.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
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30
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Zeren M, Demir R, Yildiz E, Yigit Z, Atmaca SN, Atahan E. Six-minute stepper test for evaluating functional exercise capacity in patients with sarcoidosis. Heart Lung 2023; 58:152-157. [PMID: 36516608 DOI: 10.1016/j.hrtlng.2022.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Researchers and clinicians may benefit from alternative tests that do not require large physical spaces or corridors for simply evaluating functional exercise capacity in the clinical practice. OBJECTIVE Aim of this study was to investigate whether six-minute stepper test (6MST) is a valid tool for measuring functional exercise capacity in patients with sarcoidosis. METHODS Thirty-six patients with sarcoidosis and 18 healthy controls were evaluated with 6MST and six-minute walk test (6MWT). Patients performed 6MST twice. Cardiovascular and symptom responses to tests including heart rate, blood pressure, SpO2, levels of dyspnea and fatigue were recorded. RESULTS Receiver operating characteristic (ROC) curve analysis revealed an area under the ROC curve of 0.74 for 6MST in identifying the patients and controls, indicating acceptable discriminative ability. Patients performed significantly worse in 6MST compared to controls (277±54 vs 349±87 steps; p<0.001). 6MST was able to explain 66% of variance in 6MWT (p<0.001), and there was a strong relationship between 6MWT and 6MST (r = 0.812). SpO2 responses to tests were similar, however, 6MST generated more severe heart rate, dyspnea and fatigue responses. Intraclass correlation coefficient calculated for initial and retest scores of 6MST was 0.990, indicating excellent test-retest reliability. However, there was a systematical improvement (∼4%) in retest 6MST scores. CONCLUSIONS 6MST is a valid and reliable alternative test for measuring functional exercise capacity in sarcoidosis. 6MST may also help better testing the upper limits of cardiac system and physical endurance as it is more physically demanding than 6MWT.
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Affiliation(s)
- Melih Zeren
- Izmir Bakircay University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Izmir, Turkey
| | - Rengin Demir
- Istanbul University-Cerrahpasa, Cardiology Institute, Department of Cardiology, Istanbul, Turkey.
| | - Esma Yildiz
- Istanbul University-Cerrahpasa, Institute of Graduate Studies, Department of Cardiology, Istanbul, Turkey
| | - Zerrin Yigit
- Istanbul University-Cerrahpasa, Cardiology Institute, Department of Cardiology, Istanbul, Turkey
| | - Sema Nur Atmaca
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Ersan Atahan
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
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Valera-Novella E, Bernabeu-Mora R, Montilla-Herrador J, Escolar-Reina P, García-Vidal JA, Medina-Mirapeix F. Development of the ESEx index: a tool for predicting risk of recurrent severe COPD exacerbations. Ther Adv Chronic Dis 2023; 14:20406223231155115. [PMID: 38405221 PMCID: PMC10893840 DOI: 10.1177/20406223231155115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/18/2023] [Indexed: 02/27/2024] Open
Abstract
Background In chronic obstructive pulmonary disease (COPD), multiple recurrent severe exacerbations that require hospitalization can occur. These events are strongly associated with death and other clinical complications. Objectives We aimed to develop a prognostic model that could identify patients with COPD that are at risk of multiple recurrent severe exacerbations within 3 years. Design Prospective cohort. Methods The derivation cohort comprised patients with stable, moderate-to-severe COPD. Multivariable logistic regression analyses were performed to develop the final model. Based on regression coefficients, a simplified index (ESEx) was established. Both, model and index, were assessed for predictive performance by measuring discrimination and calibration. Results Over 3 years, 16.4% of patients with COPD experienced at least three severe recurrent exacerbations. The prognostic model showed good discrimination of high-risk patients, based on three characteristics: the number of severe exacerbations in the previous year, performance in the five-repetition sit-to-stand test, and in the 6-minute-walk test. The ESEx index provided good level of discrimination [areas under the receiver operating characteristic curve (AUCs): 0.913]. Conclusions The ESEx index showed good internal validation for the identification of patients at risk of three recurrent severe COPD exacerbations within 3 years. These tools could be used to identify patients who require early interventions and motivate patients to improve physical performance to prevent recurrent exacerbations.
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Affiliation(s)
- Elisa Valera-Novella
- Department of Physical Therapy, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca (IMIB), Murcia, Spain
| | - Roberto Bernabeu-Mora
- Department of Pneumology, Hospital General Universitario Morales Meseguer, Adva. Marqués de los Vélez s/n, Murcia 30008, Spain
- Department of Internal Medicine, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Joaquina Montilla-Herrador
- Department of Physical Therapy, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca (IMIB), Murcia, Spain
| | - Pilar Escolar-Reina
- Department of Physical Therapy, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca (IMIB), Murcia, Spain
| | - José Antonio García-Vidal
- University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca (IMIB), Murcia, Spain
| | - Francesc Medina-Mirapeix
- Department of Physical Therapy, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca (IMIB), Murcia, Spain
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Fredwall SO, Linge J, de Vries O, Leinhard OD, Eggesbø HB, Weedon-Fekjær H, Petersson M, Widholm P, Månum G, Savarirayan R. Fat infiltration in the thigh muscles is associated with symptomatic spinal stenosis and reduced physical functioning in adults with achondroplasia. Orphanet J Rare Dis 2023; 18:35. [PMID: 36814258 PMCID: PMC9945720 DOI: 10.1186/s13023-023-02641-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 02/12/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Symptomatic spinal stenosis is a prevalent complication in adults with achondroplasia. Increased muscle fat infiltration (MFI) and reduced thigh muscle volumes have also been reported, but the pathophysiology is poorly understood. We explored whether the increased MFI and reduced thigh muscle volumes were associated with the presence of symptomatic spinal stenosis and physical functioning. METHODS MFI and thigh muscle volumes were assessed by MRI in 40 adults with achondroplasia, and compared to 80 average-statured controls, matched for BMI, gender, and age. In achondroplasia participants, the six-minute walk-test (6MWT), the 30-s sit-to-stand test (30sSTS), and a questionnaire (the IPAQ) assessed physical functioning. RESULTS Symptomatic spinal stenosis was present in 25 of the participants (the stenosis group), while 15 did not have stenosis (the non-stenosis group). In the stenosis group, 84% (21/25) had undergone at least one spinal decompression surgery. The stenosis group had significantly higher MFI than the non-stenosis group, with an age-, gender and BMI-adjusted difference in total MFI of 3.3 percentage points (pp) (95% confidence interval [CI] 0.04 to 6.3 pp; p = 0.03). Compared to matched controls, the mean age-adjusted difference was 3.3 pp (95% CI 1.7 to 4.9 pp; p < 0.01). The non-stenosis group had MFI similar to controls (age-adjusted difference - 0.9 pp, 95% CI - 3.4 to 1.8 pp; p = 0.51). MFI was strongly correlated with the 6MWT (r = - 0.81, - 0.83, and - 0.86; all p-values < 0.01), and moderately correlated with the 30sSTS (r = - 0.56, - 0.57, and - 0.59; all p-values < 0.01). There were no significant differences in muscle volumes or physical activity level between the stenosis group and the non-stenosis group. CONCLUSION Increased MFI in the thigh muscles was associated with the presence of symptomatic spinal stenosis, reduced functional walking capacity, and reduced lower limb muscle strength. The causality between spinal stenosis, accumulation of thigh MFI, and surgical outcomes need further study. We have demonstrated that MRI might serve as an objective muscle biomarker in future achondroplasia studies, in addition to functional outcome measures. The method could potentially aid in optimizing the timing of spinal decompression surgery and in planning of post-surgery rehabilitation.
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Affiliation(s)
- Svein O. Fredwall
- grid.416731.60000 0004 0612 1014Sunnaas Rehabilitation Hospital, TRS National Resource Centre for Rare Disorders, 1450 Nesodden, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jennifer Linge
- AMRA Medical AB, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden
| | - Olga de Vries
- grid.416731.60000 0004 0612 1014Sunnaas Rehabilitation Hospital, TRS National Resource Centre for Rare Disorders, 1450 Nesodden, Norway
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Center for Medical Image Science and Visualization, University of Linköping, Linköping, Sweden
| | - Heidi Beate Eggesbø
- grid.5510.10000 0004 1936 8921Division of Radiology and Nuclear Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Harald Weedon-Fekjær
- grid.55325.340000 0004 0389 8485Oslo Centre for Biostatistics and Epidemiology, Research Support Service, Oslo University Hospital, Oslo, Norway
| | | | - Per Widholm
- AMRA Medical AB, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Center for Medical Image Science and Visualization, University of Linköping, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Grethe Månum
- grid.416731.60000 0004 0612 1014Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Ravi Savarirayan
- grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute and University of Melbourne, Parkville, Australia
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Lionardo de Paula B, Pinheiro BV, Segura-Ortí E, Barros FS, Veras PM, Ávila KS, Lucinda LMF, Cavalcanti Garcia MA, Reboredo MM. Association Between Protocols of the Sit-to-Stand Test and Lower Limb Muscle Force Output in Patients on Hemodialysis and Subjects Without Chronic Kidney Disease. J Ren Nutr 2023:S1051-2276(23)00019-5. [PMID: 36791983 DOI: 10.1053/j.jrn.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/29/2022] [Accepted: 01/29/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE To evaluate the association of three protocols of the sit-to-stand (STS) test with muscle force output of knee extension (KE) and knee flexion (KF) in patients on hemodialysis and subjects without chronic kidney disease. METHODS This cross-sectional study included a hemodialysis group [n = 60, 59.5 (16.8) years, 55% female] and a control group [n = 60, 43.0 (11.8) years, 50% female]. The assessments were performed in 2 days, and the participants were submitted to three protocols of STS test (5-repetition STS, 10-repetition STS and 30-s STS) or muscle force output of the KE and KF evaluation by handheld dynamometer based on randomization. RESULTS The hemodialysis group presented reduced muscle force output of the KE and KF, a longer time to perform the 5 STS and 10 STS tests, and a lower number of repetitions in the 30-s STS test. The three STS tests were associated with muscle force output of the KE in the hemodialysis group, in which the 10-repetition STS test showed the best association (R2 = 0.47; adjusted R2 = 0.42). However, the only association between the STS test and muscle force output of the KE in the control group was found in the 10-repetition STS test (R2 = 0.20; adjusted R2 = 0.13). CONCLUSIONS The three protocols of STS tests were associated with muscle force output of the KE in patients on hemodialysis. However, the 10-repetition STS test was the best protocol to estimate the quadriceps muscle torque in these patients.
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Affiliation(s)
- Bruno Lionardo de Paula
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil
| | - Bruno Valle Pinheiro
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil; School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Fabrício Sciammarella Barros
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil
| | - Priscila Monteiro Veras
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil
| | - Kéller Soares Ávila
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil
| | - Leda Marília Fonseca Lucinda
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil; Institute of Biological Sciences, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | | | - Maycon Moura Reboredo
- University Hospital of Federal University of Juiz de Fora - Empresa Brasileira de Serviços Hospitalares, Minas Gerais, Brazil; School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil.
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Vallier JM, Simon C, Bronstein A, Dumont M, Jobic A, Paleiron N, Mely L. Randomized controlled trial of home-based vs. hospital-based pulmonary rehabilitation in post COVID-19 patients. Eur J Phys Rehabil Med 2023; 59:103-110. [PMID: 36700245 PMCID: PMC10035444 DOI: 10.23736/s1973-9087.22.07702-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Between 30% and 60% of people who have been infected with COVID-19 still had symptoms 3 months after the start of the disease. Prescribing a pulmonary rehabilitation program in rehabilitation facilities for post COVID-19 patients could help alleviate the symptoms. However, rehabilitation facilities known to provide good quality care to COVID-19 patients and all other patients, could become saturated by the rise in cases. Home-based rehabilitation is a potential solution that could be sustainable in the long term to avoid this saturation and/or a very long waiting list for patients. AIM The aim of this study was to investigate whether home-based rehabilitation would have similar effects compared to inpatient rehabilitation on physical and respiratory variables in post COVID-19 patients. DESIGN This is a randomized controlled trial. SETTING Pulmonary rehabilitation facility. POPULATION Seventeen post COVID-19 patients were randomized into two groups: inpatient pulmonary rehabilitation (IPR) or home-based pulmonary rehabilitation (HPR). METHODS The comparison of the two rehabilitation methods relied on questionnaires, physical tests and the evaluation of several respiratory parameters. A 2-way Analysis of Variance (ANOVA) with repeated measures was performed to assess the effects of time (pre- vs. post-rehabilitation), group (IPR vs. HPR) and their interaction for all parameters. RESULTS The main result of this study is that distance covered in the 6MWT (6MWD) shows significant improvements, between pre- and postrehabilitation program in both groups (+95 m in IPR group vs.+72 m in HPR group, P<0.001) with no significant interaction between time and group (P=0.420). CONCLUSIONS These results suggest that home-based pulmonary rehabilitation would be as efficient as IPR to decrease physical sequelae in post COVID-19 patients. CLINICAL REHABILITATION IMPACT It is possible to suggest both methods (home-based rehabilitation or inpatient pulmonary rehabilitation) according to the specificities of each patient and depending on hospital saturation. The choice of one or the other method should not be made to the detriment of the patient.
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Affiliation(s)
- Jean-Marc Vallier
- Laboratoire Impact de l'Activité Physique sur la Santé IAPS, University of Toulon, Toulon, France -
| | - Charles Simon
- Service des Maladies Respiratoires, Renée Sabran Hôpital, Hospices Civils de Lyon, Giens, France
| | - Antoine Bronstein
- Service de Pneumologie, HIA Sainte-Anne, Service des Santé des Armées, Toulon, France
| | - Maxence Dumont
- Laboratoire Impact de l'Activité Physique sur la Santé IAPS, University of Toulon, Toulon, France
| | - Asmaa Jobic
- Centre Hospitalier Intercommunal of Toulon-La Seyne sur Mer (CHITS), Toulon, France
| | - Nicolas Paleiron
- Service de Pneumologie, HIA Sainte-Anne, Service des Santé des Armées, Toulon, France
| | - Laurent Mely
- Service des Maladies Respiratoires, Renée Sabran Hôpital, Hospices Civils de Lyon, Giens, France
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Núñez-Cortés R, Padilla-Acevedo P, Vergara-Peña F, Mollà-Casanova S, Espinoza-Bravo C, Torres-Castro R, Cruz-Montecinos C. Clinical assessment of balance and functional impairments in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. ERJ Open Res 2022; 8:00164-2022. [PMID: 36655220 PMCID: PMC9835973 DOI: 10.1183/23120541.00164-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/16/2022] [Indexed: 02/01/2023] Open
Abstract
The objective of this study was to compare the balance and functional capacity between stable chronic obstructive pulmonary disease (COPD) patients versus healthy controls using clinical tests. A comprehensive search of PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase and Web of Science was conducted from inception to 21 January 2022. Studies reporting the association between COPD status and balance or functional capacity using clinical tests were included. Two independent reviewers examined the titles and abstracts, extracted the data using a standardised form, and assessed the risk of bias of the included articles. A total of 27 studies with 2420 individuals with stable COPD were included. Overall, the risk of bias in the included studies was low to moderate. The meta-analysis showed a higher history of falls in individuals with COPD (odds ratio 1.59, 95% CI 1.25-2.02). Furthermore, an overall effect in favour of the healthy controls was observed in the Timed Up and Go (mean difference: 2.61 s, 95% CI 1.79-3.43), Berg Balance Scale (mean difference: -6.57 points, 95% CI -8.31 to -4.83), static balance tests (standardised mean difference: -1.36, 95% CI -2.10 to -0.62) and the 6-min walk test (mean difference: -148.21 m, 95% CI -219.37 to -77.39). In conclusion, individuals with stable COPD have worse balance and functional capacity compared to healthy controls. These results may guide clinicians to elaborate on therapeutic strategies focused on screening of balance and functional impairments. This is in addition to generating rehabilitation guidelines aimed at reducing the risk of falling in people with COPD.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile,Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, València, Spain,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain,Corresponding author: Rodrigo Núñez-Cortés ()
| | - Paloma Padilla-Acevedo
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | | | | | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile,Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, València, Spain,Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
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Whole-Body Vibration or Aerobic Exercise in Patients with Bronchiectasis? A Randomized Controlled Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121790. [PMID: 36556991 PMCID: PMC9787527 DOI: 10.3390/medicina58121790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/14/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Background and Objectives: The whole-body vibration (WBV) technique is an exercise training method. It has been reported to improve muscle strength, exercise capacity, and the quality of life. However, there is no study on the use of the WBV technique in bronchiectasis. The aim of the present study is to compare the effect of aerobic exercise with whole-body vibration on exercise capacity, respiratory function, dyspnea, and quality of life (QoL) in bronchiectasis patients. Materials and Methods: Clinically stable bronchiectasis patients aged 18−74 years participated in this study. A pulmonary function test, 6 minute walk test (6MWT), five times sit-to-stand test (FTSST), Modified Medical Research Council (mMRC) Scale, an, St. Georges Respiratory Questionnaire (SGRQ) were used in the evaluation. In total, 41 patients (WBV group: 20, aerobic group: 21) completed the study. The patients were treated for eight weeks. Results: When the two groups were compared after the treatment, there was a significant difference between the mMRC scores in favor of the WBV group (p < 0.05). When the results of the WBV group were examined before and after treatment, a significant difference was found between the 5SST and 6MWT (p < 0.05). When the aerobic group was compared before and after the treatment, it was observed that there was a significant difference in FVC, FVC%, 5SST, 6MWT, and SGRQ total score, and activity and impact scores, which are the sub-parameters (p < 0.05). Conclusions: Eight weeks of WBV exercise can lead to significant improvements in patients with bronchiectasis, exercise capacity, and dyspnea. Larger studies are needed to define the optimal intensity and duration of WBV, as well as to investigate its possible long-term effects.
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The sit-to-stand test as a patient-centered functional outcome for critical care research: a pooled analysis of five international rehabilitation studies. Crit Care 2022; 26:175. [PMID: 35698237 PMCID: PMC9195216 DOI: 10.1186/s13054-022-04048-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background With ICU mortality rates decreasing, it is increasingly important to identify interventions to minimize functional impairments and improve outcomes for survivors. Simultaneously, we must identify robust patient-centered functional outcomes for our trials. Our objective was to investigate the clinimetric properties of a progression of three outcome measures, from strength to function. Methods Adults (≥ 18 years) enrolled in five international ICU rehabilitation studies. Participants required ICU admission were mechanically ventilated and previously independent. Outcomes included two components of the Physical Function in ICU Test-scored (PFIT-s): knee extensor strength and assistance required to move from sit to stand (STS); the 30-s STS (30 s STS) test was the third outcome. We analyzed survivors at ICU and hospital discharge. We report participant demographics, baseline characteristics, and outcome data using descriptive statistics. Floor effects represented ≥ 15% of participants with minimum score and ceiling effects ≥ 15% with maximum score. We calculated the overall group difference score (hospital discharge score minus ICU discharge) for participants with paired assessments. Results Of 451 participants, most were male (n = 278, 61.6%) with a median age between 60 and 66 years, a mean APACHE II score between 19 and 24, a median duration of mechanical ventilation between 4 and 8 days, ICU length of stay (LOS) between 7 and 11 days, and hospital LOS between 22 and 31 days. For knee extension, we observed a ceiling effect in 48.5% (160/330) of participants at ICU discharge and in 74.7% (115/154) at hospital discharge; the median [1st, 3rd quartile] PFIT-s difference score (n = 139) was 0 [0,1] (p < 0.05). For STS assistance, we observed a ceiling effect in 45.9% (150/327) at ICU discharge and in 77.5% (79/102) at hospital discharge; the median PFIT-s difference score (n = 87) was 1 [0, 2] (p < 0.05). For 30 s STS, we observed a floor effect in 15.0% (12/80) at ICU discharge but did not observe a floor or ceiling effect at hospital discharge. The median 30 s STS difference score (n = 54) was 3 [1, 6] (p < 0.05). Conclusion Among three progressive outcome measures evaluated in this study, the 30 s STS test appears to have the most favorable clinimetric properties to assess function at ICU and hospital discharge in moderate to severely ill participants. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04048-3.
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Cardoso NL, de Sá JF, do Nascimento LFE, Mendes LA, Bruno S, Torres-Castro R, Fregonezi GAF, Resqueti VR. Psychometric properties of the sit-to-stand test for patients with pulmonary hypertension: A systematic review protocol. PLoS One 2022; 17:e0275646. [PMID: 36197937 PMCID: PMC9534407 DOI: 10.1371/journal.pone.0275646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 09/10/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) is a complex syndrome characterized by increased pulmonary arterial pressure and classified into five groups, according to dyspnea on exertion and systemic muscle dysfunction. These symptoms can be identified using the sit-to-stand test (STS), which indirectly evaluates exercise tolerance and lower limb muscle strength. Previous studies used the STS in PH; however, psychometric properties to understand and validate this test were not described for patients with PH. OBJECTIVE To evaluate the psychometric properties (validity, reliability, and responsiveness) of different STS protocols in patients with PH. METHODS AND ANALYSES This is a systematic review protocol that will include studies using STS in patients with PH. Searches will be conducted on PubMed/MEDLINE, EMBASE, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases following PICOT mnemonic strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). Rayyan software will be used for study selection. The Risk of bias will be assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) tool, while the quality of evidence will be assessed using the modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Two researchers will independently conduct the study, and a third researcher will be consulted in case of disagreement. The psychometric properties will be evaluated according to the COSMIN. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, no. CRD42021244271). CONCLUSION This systematic review will attempt to identify and show the available evidence on STS for different groups of PH and report validity, reliability, and responsiveness of different protocols.
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Affiliation(s)
- Natália Lopes Cardoso
- Laboratory of Technological Innovation in Rehabilitation and PneumoCardioVascular Lab/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Joceline Ferezini de Sá
- Laboratory of Cardiorespiratory and Metabolic Assessment—CORE/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Larissa F. E. do Nascimento
- Laboratory of Technological Innovation in Rehabilitation and PneumoCardioVascular Lab/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Luciana A. Mendes
- Department of Biomedical Engineering, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Selma Bruno
- Laboratory of Cardiorespiratory and Metabolic Assessment—CORE/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Guilherme A. F. Fregonezi
- Laboratory of Technological Innovation in Rehabilitation and PneumoCardioVascular Lab/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Vanessa R. Resqueti
- Laboratory of Technological Innovation in Rehabilitation and PneumoCardioVascular Lab/HUOL, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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Kronberger C, Mousavi RA, Öztürk B, Dachs TM, Rettl R, Camuz-Ligios L, Litschauer B, Badr-Eslam R. Exercise capacity assessed with the one-minute sit-to-stand test (1-min STST) and echocardiographic findings in patients with heart failure with preserved ejection fraction (HFpEF). Heart Lung 2022; 55:134-139. [PMID: 35567840 DOI: 10.1016/j.hrtlng.2022.05.001] [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: 12/29/2021] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality. Precise risk stratification remains challenging. The one-minute sit-to-stand-test (1-min STST), a quick, objective test of functional capacity may be helpful for stratification of clinical profile in HFpEF patients. OBJECTIVE The aim of this initial investigation was to prospectively examine whether the 1-min STST can be used for the evaluation of exercise capacity in HFpEF patients and whether it is in line with echocardiographic as well as quality of life (QoL) findings. METHODS 39 HFpEF patients were prospectively studied. Functional performance was examined with the 1-min STST and QoL with the CAMPHOR questionnaire. Clinical parameters including echocardiographic measurements [estimated pulmonary artery systolic pressure (ePASP), tricuspid regurgitation velocity (TRV)] were obtained. Patients were divided into two groups based on their number of 1-min STST repetitions (Group I: ≤50% of predicted 1-min STST repetitions using the norm-reference values developed by Strassmann et al. for healthy people, N=24; Group II: >50% of predicted 1-min STST repetitions, N=15). RESULTS Patients in group I with limited 1-min STST performance showed worse echocardiographic parameters [higher ePASP (p=0.038), higher TRV (p=0.018) and more reduced tricuspid annular plane systolic excursion (TAPSE) (p=0.001)], worse six-minute walk test (6MWT) (p<0.001) and worse QoL (p<0.001) compared to patients in group II. CONCLUSION Our study shows potential usefulness of the 1-min STST as an evaluative tool for exercise capacity in HFpEF patients, because patients with worse 1-min STST performance have worse clinical parameters and QoL.
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Affiliation(s)
- Christina Kronberger
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Roya Anahita Mousavi
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Begüm Öztürk
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Theresa-Marie Dachs
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - René Rettl
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Luciana Camuz-Ligios
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Brigitte Litschauer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Roza Badr-Eslam
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Zumbrunnen V, Riegler TF, Haile SR, Radtke T. The impact of seat height on 1-min sit-to-stand test performance in COPD: a randomised crossover trial. ERJ Open Res 2022; 8:00033-2022. [PMID: 36171989 PMCID: PMC9511143 DOI: 10.1183/23120541.00033-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Study question Is there a difference in the number of repetitions in the 1-minute sit-to-stand (1MSTS) test using an individually adapted seat height to 90° knee flexion (1MSTSIND), compared with the commonly used standard chair seat height of 46 cm (1MSTSSTD), in people with COPD? Methods We conducted a single-centre, single-blinded, randomised crossover trial in people with COPD between August 2020 and March 2021 at a specialised rehabilitation clinic in Switzerland. After a learning 1MSTS test, all participants performed two 1MSTS tests in random order on consecutive days. Participants were blinded, as they did not receive detailed information on the testing protocols. Results 49 individuals with COPD (47% female) participated. In a regression model adjusted for sequence period and subject, 1MSTS test performance was lower on 1MSTSIND compared to 1MSTSSTD (−0.78 repetitions, 95% CI −1.47 to −0.11). In a second regression model additionally including the knee angle and an interaction term (1MSTSIND×knee angle), the interaction term was significant: 0.18 (95% CI 0.05 to 0.30). The limits of agreement were between −5.5 and 4 repetitions. Conclusion Although we observed a statistically significant difference between 1MSTSIND and 1MSTSSTD on a population level, the difference is negligible. Further studies may be needed to determine whether individual adaptation of seat height is needed for very tall or short people to ensure a valid assessment of 1MSTS test performance in COPD. Performing the 1MSTS test on an individually adjusted chair versus a standard chair results in fewer repetitions (mean difference −0.78, 95% CI −1.47 to −0.11). However, the difference in repetitions is clinically negligible.https://bit.ly/3Oc8Rvp
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Affiliation(s)
- Valerie Zumbrunnen
- Berner Reha Zentrum AG, Heiligenschwendi, Switzerland.,Department of Health Professions, Bern University of Applied Science, Bern, Switzerland
| | - Thomas F Riegler
- Berner Reha Zentrum AG, Heiligenschwendi, Switzerland.,Institute for Physiotherapy, Zurich University of Applied Science, Zurich, Switzerland
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Deng M, Bian Y, Zhang Q, Zhou X, Hou G. Growth Differentiation Factor-15 as a Biomarker for Sarcopenia in Patients With Chronic Obstructive Pulmonary Disease. Front Nutr 2022; 9:897097. [PMID: 35845807 PMCID: PMC9282868 DOI: 10.3389/fnut.2022.897097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/19/2022] [Indexed: 12/18/2022] Open
Abstract
Purpose Sarcopenia is an important factor contributing to comorbidities in patients with chronic obstructive pulmonary disease (COPD) and is an independent risk factor for increased mortality. The diagnostic process for sarcopenia requires specific equipment and specialized training and is difficult procedurally. A previous study found that GDF15 levels are associated with skeletal muscle mass and function in patients with COPD. However, whether circulating GDF15 levels can be used for the prediction of sarcopenia in patients with COPD is unknown. Methods This study included 235 patients with stable COPD who were divided into a development set (n = 117) and a validation set (n = 118), and we followed the definition of sarcopenia as defined by the guidelines from the Asian Working Group for Sarcopenia. Serum concentrations of GDF15 were measured using an enzyme-linked immunosorbent assay (ELISA), and construction of a nomogram and decision curve analysis were performed using the R package “rms.” Results In this study, serum GDF15 levels were negatively associated with skeletal muscle mass (r = –0.204, p = 0.031), handgrip strength (r = –0.274, p = 0.004), quadriceps strength (r = –0.269, p = 0.029), and the thickness (r = –0.338, p < 0.001) and area (r = –0.335, p < 0.001) of the rectus femoris muscle in patients with COPD. Furthermore, the serum levels of GDF15 in patients with sarcopenia were significantly higher than those in controls. Importantly, serum levels of GDF15 could effectively predict sarcopenia in patients with COPD based on the development set (AUC = 0.827) and validation set (AUC = 0.801). Finally, a nomogram model based on serum GDF15 levels and clinical features showed good predictive ability (AUC > 0.89) in the development and validation sets. Conclusion Serum GDF15 levels could be used to accurately and easily evaluate sarcopenia in patients with COPD.
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Affiliation(s)
- Mingming Deng
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yiding Bian
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Qin Zhang
- Department of Pulmonary and Critical Care Medicine, First Hospital of China Medical University, Shenyang, China
| | - Xiaoming Zhou
- Respiratory Department, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Gang Hou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- *Correspondence: Gang Hou,
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Home-based and remote functional exercise testing in cardiac conditions, during the covid-19 pandemic and beyond: a systematic review. Physiotherapy 2022; 115:27-35. [PMID: 35180642 PMCID: PMC8694378 DOI: 10.1016/j.physio.2021.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 09/29/2021] [Accepted: 12/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND With the change in healthcare to one that adopts a greater reliance on remote delivery, guidance regarding functional exercise testing, either in-person in the home or performed remotely, is urgently needed for people with cardiac conditions. OBJECTIVES To identify functional exercise tests that have been conducted in the home or remotely in patients with cardiac conditions. DATA SOURCES A search was undertaken across four electronic databases and grey literature for English language publications without time restrictions. STUDY ELIGIBILITY CRITERIA Studies of any designs were selected if they reported an exercise test conducted at home or remotely in patients with cardiac conditions. STUDY APPRAISAL AND SYNTHESIS Studies were independently screened and graded by two reviewers according to the Downs and Black checklist. A narrative synthesis of the included studies was undertaken. RESULTS Five studies (six articles) were included, with a total of 438 patients with cardiac conditions. Tests used at home or remotely were the 6-minute walk test (6MWT, five studies) and the timed up and go test (one study). No studies reported the use of step tests in the home or remotely. The 6MWTs were administered via a smartphone application, rope, videoconferencing and accelerometer and proved to be feasible, valid and reliable. CONCLUSIONS Despite a marked demand for home-based exercise programs, the 6MWT remains the most commonly administered functional exercise test for people with cardiac conditions. Surprisingly few studies have explored alternative tests for this patient population that may be more suitable for home or remote performance. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42020219512.
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Nazir A, Hasri IP. Pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. Ann Thorac Med 2022; 17:87-93. [PMID: 35651896 PMCID: PMC9150663 DOI: 10.4103/atm.atm_357_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This review aimed to explore the pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. METHODS We reviewed articles published in 2019-2021 using PubMed, Google Scholar, and CINAHL databases as an electronic database. Data obtained were pathophysiology and rehabilitation management of exercise intolerance in COVID-19 survivors. Types of the article were original articles and systematic or narrative reviews, both published and preprint articles. Articles that were written in English and freely accessible in pdf or HTML format were included. RESULTS There were 28 articles eligible for this review. Pathophysiology, rehabilitation management, and both pathophysiology and rehabilitation management were explained in 7, 24, and 4 articles, consecutively. DISCUSSION Exercise intolerance is caused by some pathological processes in the respiratory, cardiovascular, and musculoskeletal systems as a result of systemic inflammation. Fatigue and shortness of breath during the activity were the most common symptom in the early phase of COVID-19 and persisted until the follow-up phase. Hospital admission, especially prolonged use of ventilators and immobilization worsen functional impairment resulting in persistent symptoms. Rehabilitation management begins with a functional assessment consisting of symptom assessment and physical examination of the body systems affected. The goals of rehabilitation management are to increase functional capacity, reduce symptoms, improve the ability to perform daily activities, facilitate social reintegration, and improve quality of life. Exercise is an effective intervention to reach these goals. Several studies recommend breathing, and aerobic exercises, as well as resistance exercises for peripheral and respiratory muscles, to improve symptoms and increase functional capacity.
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Affiliation(s)
- Arnengsih Nazir
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Indra Putera Hasri
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
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Kwok MM, Ng SS, Man S, So BC. The effect of aquatic High Intensity Interval Training on cardiometabolic and physical health markers in women: A systematic review and meta-analysis. J Exerc Sci Fit 2022; 20:113-127. [PMID: 35228847 PMCID: PMC8851250 DOI: 10.1016/j.jesf.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/26/2022] [Accepted: 02/05/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We performed a meta-analysis of randomized controlled trials (RCTs) assessing the effect of Aquatic High Intensity Interval Training (AHIIT) on cardiometabolic and physical health markers in women. METHODS Systematic search used 7 databases (MEDLINE, PubMed, SPORTDiscus, Cochrane, Embase, CINAL complete, PsycINFO). The Physiotherapy Evidence Database (PEDro) score was used to evaluate the methodological quality of the studies. Clinical trials compared AHIIT with a control group that receive no exercise training. We integrated randomized controlled trials published in English, and participants were women aged ≥18 years. The outcome of interest was the change in cardiometabolic and physical health markers. RESULTS Among 242 articles screened, 18 articles (13 trials) were included in this meta-analysis comparing AHIIT (n = 261) with a control group (n = 215). The median PEDro score was 5.5 out of 10 (range, 4-8). AHIIT significantly improved peak oxygen uptake (Hedges' g 0.610; 95% CI 0.277-0.943; P < 0.001), reduced resting heart rate (Hedges' g -0.495; 95% CI -0.866 to -0.124; P < 0.05), as well as chair to stand test. (Hedges' g 0.548; 95% CI 0.019 to 1.077; P < 0.05). CONCLUSION AHIIT has a moderate effect in improving cardiometabolic and physical health markers in women.
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Affiliation(s)
- Manny M.Y. Kwok
- Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shamay S.M. Ng
- Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - S.S. Man
- Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Billy C.L. So
- Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Bernabeu-Mora R, Valera-Novella E, Sánchez-Martínez MP, Medina-Mirapeix F. Improving the Reliability Between the BODE Index and the BODS Index in Which the 6-Min Walk Test Was Replaced with the Five-Repetition Sit-to-Stand Test. Int J Chron Obstruct Pulmon Dis 2022; 17:643-652. [PMID: 35378838 PMCID: PMC8976496 DOI: 10.2147/copd.s347696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/28/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose The BODS index has been confirmed to have predictive properties similar to the original BODE index for mortality in COPD. We evaluated the agreement between the BODS index and the BODE and explored with an updated BODS how this agreement could be improved and its ability to correctly discriminate individual participants’ mortality in a prospective cohort study. Patients and Methods We included prospectively a consecutive sample of 137 patients with COPD, between 40 and 80 years, during 2014 and followed for 5 years (2014–2019) in the Pneumology section of a public university hospital in Spain. They participated in the baseline data collection, which included BODE- and BODS-related measurements and prognostic factors, and were followed up for 5-year mortality. We used Bland–Altman plots and the kappa coefficient to analyze the agreement between both the original and updated BODS and the BODE index, and we used the areas under ROC curves (AUC) to compare their discriminative abilities for 5-year all-cause mortality. Results The original BODS index scores and quartiles had weak agreement with the BODE index, and our updated BODS strengthened these agreements (a small, statistically nonsignificant mean bias [<0.03] with LoAs<2 points, and a substantial Kappa coefficient [k =0.63; IC 95%: 0.53–0.73]). In addition, the updated BODS index scores had better summarized ability than the BODS index in discriminating participants’ mortality during the following 5 years (AUC: 0.768 versus 0.736; p=0.04). Conclusion The updated BODS index scores and quartiles may provide prognostic information similar to that provided by the BODE index in COPD. Future research should focus on index improvement through external validation, as well as the assessment of safety and effectiveness in clinical practice by means of impact studies.
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Affiliation(s)
- Roberto Bernabeu-Mora
- Department of Pneumology, Hospital General Universitario Morales Meseguer, Murcia, Spain
- Department of Internal Medicine, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Correspondence: Roberto Bernabeu-Mora, Department of Pneumology, Hospital General Universitario Morales Meseguer, Avda Marqués de los Vélez s/n, Murcia, 30008, Spain, Tel +34 968 360 900, Fax +34 968 360 994, Email
| | - Elisa Valera-Novella
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
| | - María Piedad Sánchez-Martínez
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
| | - Francesc Medina-Mirapeix
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
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Zeren M, Karci M, Demir R, Gurses HN, Oktay V, Uzunhasan I, Yigit Z. Cut-off values of 6-min walk test and sit-to-stand test for determining symptom burden in atrial fibrillation. Ir J Med Sci 2022; 191:2587-2595. [PMID: 35066793 PMCID: PMC8783771 DOI: 10.1007/s11845-021-02901-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
Background Since symptomatology is a major predictor of quality of life and an endpoint for the management of atrial fibrillation (AF), practical approaches for objectively interpreting symptom burden and functional impairment are needed. Aims We aimed to provide cut-off values for two frequently used field tests to be able to objectively interpret symptom burden in atrial fibrillation. Methods One hundred twenty-five patients with AF were evaluated with European Heart Rhythm Association (EHRA) score, 6-min walk test (6MWT), 30 s sit-to-stand test (30 s-STST), Short-Form 36 (SF-36), International Physical Activity Questionnaire-Short Form (IPAQ-SF), and spirometry. Patients with EHRA 1 were classified as “asymptomatic”, and those with EHRA 2–4 as “symptomatic”. Cut-off values of 6MWT and 30 s-STST for discriminating between these patients were calculated. Results The optimal cut-off value was “450 m” for 6MWT (sensitivity: 0.71; specificity of 0.79) and “11 repetitions” for 30 s-STST (sensitivity 0.77; specificity of 0.70). Area under ROC curve was 0.75 for both tests (p < 0.001). Discriminative properties of the two tests were similar, and they were significantly correlated (r = 0.58; p < 0.001). Subgroup analysis revealed patients below cut-off values also had worse outcomes in SF-36, IPAQ-SF, and spirometry. Conclusions In patients with AF, walking < 450 m in 6MWT or performing < 11 repetitions in 30 s-STST indicates increased symptom burden, as well as impaired exercise capacity, quality of life, physical activity participation, and pulmonary function. These cut-off values may help identifying patients who may require adjustments in their routine treatment or who may benefit from additional rehabilitative approaches.
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Affiliation(s)
- Melih Zeren
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Kaynaklar St, 35665, Izmir, Turkey.
| | - Makbule Karci
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Istanbul Arel University, Istanbul, Turkey
| | - Rengin Demir
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hulya Nilgun Gurses
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
| | - Veysel Oktay
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Isil Uzunhasan
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zerrin Yigit
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Gephine S, Mucci P, Bielmann M, Martin M, Bouyer L, Saey D, Maltais F. Quadriceps physiological response during the 1-min sit-to-stand test in people with severe COPD and healthy controls. Sci Rep 2022; 12:794. [PMID: 35039600 PMCID: PMC8764045 DOI: 10.1038/s41598-022-04820-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
We compared quadriceps oxygenation and surface electromyography (sEMG) responses during the 1-min sit-to-stand (1STS) in 14 people with severe COPD and 12 controls, in whom cardiorespiratory response, near-infrared spectroscopy signals (oxy [Hb-Mb], deoxy [Hb-Mb], total [Hb-Mb], and SmO2) and sEMG signals of the quadriceps were recorded. Time duration of each sit-to-stand cycle and the total work performed during the 1STS were measured. The quadriceps oxygenation parameters were normalized by reporting their values according to the total work during 1STS. The rate of sit-to-stand maneuvers decelerated in people with COPD leading to smaller total work compared with controls. The pattern of quadriceps oxygenation response during 1STS was similar between groups. However, in COPD, the recovery after 1STS was characterized by larger overshoots in oxy [Hb-Mb], total [Hb-Mb], and SmO2. When corrected for the cumulative total work, the increase in muscle O2 extraction (deoxy [Hb-Mb]) during the first 30 s of recovery was greater in people with COPD compared to controls. Quadriceps sEMG changes suggestive of a fatiguing contraction pattern was observed only in people with COPD. All together, these results highlighted physiological misadaptation of people with severe COPD to the 1STS.
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Affiliation(s)
- Sarah Gephine
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Quebec, QC, G1V 4G5, Canada.,Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, F-59000, France
| | - Patrick Mucci
- Univ. Lille, Univ. Artois, Univ. Littoral Côte d'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Lille, F-59000, France
| | - Mathieu Bielmann
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Canada
| | - Mickael Martin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Quebec, QC, G1V 4G5, Canada
| | - Laurent Bouyer
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Canada
| | - Didier Saey
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Quebec, QC, G1V 4G5, Canada
| | - François Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, 2725 Chemin Sainte-Foy, Quebec, QC, G1V 4G5, Canada.
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Hidayati ERN, Suharti A, Suratinoyo AT, Zahra SR, Nusdwinuringtyas N. Feasibility of the modified 30-second sit-to-stand test in an isolation ward of moderate COVID-19. MEDICAL JOURNAL OF INDONESIA 2021. [DOI: 10.13181/mji.bc.215477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The recovery after prolonged immobilization during hospitalization because of COVID-19 is the primary goal of moderate to severe COVID-19 rehabilitation. Lower extremity muscle function assessment after immobilization is needed before starting mobilization. Hence, this study aimed to evaluate the feasibility of the modified 30-second sit-to-stand test (m30STS) as one of the prospective tools of functional capacity assessment in moderate COVID-19.
METHODS This cross-sectional study recruited the subjects consecutively. All eligible subjects with oxygen saturation (SaO2) ≥95% with or without oxygen supplementation performed the m30STS following the Bohannon’s guidelines. The score of m30STS was calculated based on the number of stands completed within 30 sec. A higher score of the m30STS indicated better lower extremity function.
RESULTS Mean score of m30STS was 13.3. No subjects had oxygen desaturation or increased heart rate, and no fall incidents occurred.
CONCLUSIONS The m30STS is feasible and safe to evaluate lower extremity for moderate COVID-19 patients with SaO2 >95%. The absence of oxygen desaturation and increase in heart rate showed no increased oxygen consumption during the test.
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Hansen J, Pedersen AR, Sørensen H, Nielsen JF. Analysis of 15 different pelvis marker protocols during sit-to-stand. J Biomech 2021; 130:110875. [PMID: 34871893 DOI: 10.1016/j.jbiomech.2021.110875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
Sit-to-stand (STS) is a common transition movement needed to perform daily tasks. Previously, the kinematics of the STS movement has been investigated using optical motion capture. This method uses cameras and reflective markers on the body to capture movements. During STS, these markers can be difficult to measure due to blocked vision from the chair's arm- and backrest. This can result in poor data quality. The aim of this study was to investigate 15 different marker protocols and compare them in terms of visibility and selected outcome measures: hip flexion mean angle and range of motion (ROM). Fourteen healthy subjects completed five successful trials of STS. Marker protocols consisted of three anterior marker protocols and five posterior marker protocols, combined into a total of 15 marker protocols. For visibility, the traditional pelvis marker protocol proved unsuitable for STS tracking. Marker pins or additional markers anteriorly, and sacrum markers posteriorly, proved to be more suitable alternatives. For hip flexion mean angle and ROM, the estimates had similar tendencies. Hence, marker protocols were not outcome measure specific. Anteriorly, marker pins resulted in similar estimates as the traditional pelvis marker protocol. Posteriorly, sacrum markers estimated a smaller hip flexion angle, compared to the traditional pelvis marker protocol. In conclusion, marker pins can be used instead of regular ASIS markers at anterior pelvis. Posteriorly, sacrum markers can be used instead of PSIS markers.
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Affiliation(s)
- Jakob Hansen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.
| | - Asger R Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | | | - Jørgen F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
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Medina-Mirapeix F, Valera-Novella E, Morera-Balaguer J, Bernabeu-Mora R. Prognostic value of the five-repetition sit-to-stand test for mortality in people with chronic obstructive pulmonary disease. Ann Phys Rehabil Med 2021; 65:101598. [PMID: 34718192 DOI: 10.1016/j.rehab.2021.101598] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 07/09/2021] [Accepted: 07/23/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prognostic studies suggest that some musculoskeletal and functional capacity tests are independently associated with mortality in chronic obstructive pulmonary disease (COPD), but comparing their prognostic value is difficult because of differences in the selected covariates for regression modelling in those studies. OBJECTIVES To assess the prognostic value of five musculoskeletal and functional capacity tests in predicting mortality risk in patients with COPD after adjusting for existing and confounding prognostic factors and to compare their ability to correctly discriminate the mortality of individual participants using the 6-min walk test (6MWT). We hypothesized that the examined tests have different prognostic value. METHODS Prospective and longitudinal study. A total of 137 patients with stable COPD (mean [SD] age 67 [8.33] years; 87% male) were recruited from a hospital in Spain during 2014 and followed for 5 years (2014-2019). No one refused and only one was lost to follow-up. The outcome measure was 5 year all-cause mortality. RESULTS A total of 37 patients died within 5 years. All musculoskeletal tests were associated with 5 year all-cause mortality in Cox proportional-hazards regression models. However, only the five-repetition sit-to-stand test (5-STS) score was an independent prognostic factor (hazard ratio 1.04 per sec, 95% confidence interval 1.01-1.08) after adjusting for history of heart disease, number of previous severe exacerbations, and dyspnoea. This model explained 50.7% of the variance in mortality. This test exhibited similar discriminative ability as the 6MWT for 5 year mortality (area under the receiver operating characteristic curve: 0.741vs 0.722; p = 0.92), and a highly prognostic cut-off for discriminating (15.98 s). This cut-off had higher likelihood ratios (LRs) than the 6MWT cut-off (∼350 m), especially for negative LRs (1/LR-: 7.69vs 2.00). CONCLUSIONS The 5-STS is an objective measure for predicting mortality in patients with COPD and has good discriminative ability, with a cut-off for discriminating survival slight better than the 6MWT. The prognostic value of the other tests remains to be confirmed.
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Affiliation(s)
- Francesc Medina-Mirapeix
- Department of Physiotherapy, University of Murcia, and Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | | | | | - Roberto Bernabeu-Mora
- Department of Pneumology, Hospital General Universitario Morales Meseguer, Murcia, Spain.
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