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Chen F, Lin C, Gu X, Ning Y, He H, Qiang G. Exploring the link between walking and lung cancer risk: a two-stage Mendelian randomization analysis. BMC Pulm Med 2024; 24:129. [PMID: 38481241 PMCID: PMC10938705 DOI: 10.1186/s12890-024-02906-0] [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: 11/01/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Previous observational research showed a potential link between physical activities such as walking and the risk of lung cancer. However, Mendelian randomization (MR) studies suggested there was no association between moderate to vigorous physical activity and lung cancer risk. We speculated that specific physical activities may be associated with lung cancer risk. Consequently, we conducted an MR study to examine the potential relationship between walking and the risk of lung cancer. METHODS We collected genetic summary data from UK Biobank. After excluding SNPs with F values less than 10 and those associated with confounding factors, we conducted a MR analysis to assess the causal effects between different types of walk and lung cancer. We also performed sensitivity analysis to validate the robustness of our findings. Finally, we analyzed the possible mediators. RESULTS MR analysis showed number of days/week walked for 10 + minutes was associated with a reduced risk of lung cancer risk (OR = 0.993, 95% CI = 0.987-0.998, P = 0.009). Additionally, usual walking pace was identified as a potentially significant factor in lowering the risk (OR = 0.989, 95% CI = 0.980-0.998, P = 0.015). However, duration of walks alone did not show a significant association with lung cancer risk (OR = 0.991, 95%CI = 0.977-1.005, P = 0.216). The sensitivity analysis confirmed the robustness of these findings. And number of days/week walked for 10 + minutes could affect fed-up feelings and then lung cancer risk. There was a bidirectional relationship between usual walking pace and sedentary behaviors (time spent watching TV). CONCLUSION The study unveiled a genetically predicted causal relationship between number of days/week walked for 10 + minutes, usual walking pace, and the risk of lung cancer. The exploration of potential mediators of walking phenotypes and their impact on lung cancer risk suggests that specific physical activities may reduce the risk of lung cancer.
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Affiliation(s)
- Fangjun Chen
- Department of Thoracic Surgery, China-Japan Friendship Institute of Clinical Medicine, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Chutong Lin
- Department of Thoracic Surgery, Peking University Third Hospital, Haidian District, No.49 Huayuan North Road, Beijing, 100191, China
| | - Xing Gu
- College of Foreign Languages, Chongqing Medical University, Yuzhong District, No.1 Yixueyuan Road, Chongqing, 400016, China
| | - Yingze Ning
- Department of Thoracic Surgery, Peking University Third Hospital, Haidian District, No.49 Huayuan North Road, Beijing, 100191, China
| | - Huayu He
- Department of Thoracic Surgery, Peking University Third Hospital, Haidian District, No.49 Huayuan North Road, Beijing, 100191, China
| | - Guangliang Qiang
- Department of Thoracic Surgery, Peking University Third Hospital, Haidian District, No.49 Huayuan North Road, Beijing, 100191, China.
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Majed L, Ibrahim R, Lock MJ, Jabbour G. Walking around the preferred speed: examination of metabolic, perceptual, spatiotemporal and stability parameters. Front Physiol 2024; 15:1357172. [PMID: 38405123 PMCID: PMC10884095 DOI: 10.3389/fphys.2024.1357172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024] Open
Abstract
Walking is the most accessible and common type of physical activity. Exercising at one's self-selected intensity could provide long-term benefits as compared to following prescribed intensities. The aim of this study was to simultaneously examine metabolic, perceptual, spatiotemporal and stability parameters at an absolute 3 km·h-1 speed range around the individual preferred walking speed (PWS). Thirty-four young sedentary adults (18 women) volunteered to walk at seven speeds relative to their PWS in 3-min trials interspaced with 3-min rest intervals. Results indicated a significant main effect of speed on all studied variables. While metabolic, perceptual and spatiotemporal values were sensitive to the smallest change in speed (i.e., 0.5 km·h-1), a significant increase in the rate of carbohydrate oxidation and decrease in %fat oxidation were only observed at speeds above PWS. Results also revealed significantly higher coefficients of variation for stride characteristics at speeds below PWS only. Moreover, analyses of best fit models showed a quadratic relationship between most variables and speed, with the exceptions of metabolic cost of transport, rating of perceived exertion and stride duration that changed exponentially with speed. PWS coincided with optimized mechanical efficiency, fuel oxidation and gait stability. This indicated that walking below PWS decreased both mechanical efficiency and stability of gait, while walking above PWS increased carbohydrate oxidation. Those factors seem to play an important role as determinants of PWS. We suggest that walking at PWS may provide benefits in terms of fat oxidation while optimizing gait stability.
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Affiliation(s)
- Lina Majed
- Exercise Science, Health and Epidemiology Division, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Rony Ibrahim
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Merilyn Jean Lock
- Exercise Science, Health and Epidemiology Division, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
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Palmer T, Obst SJ, Aitken CR, Walsh J, Sabapathy S, Adams L, Morris NR. Fixed-intensity exercise tests to measure exertional dyspnoea in chronic heart and lung populations: a systematic review. Eur Respir Rev 2023; 32:230016. [PMID: 37558262 PMCID: PMC10410401 DOI: 10.1183/16000617.0016-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Exertional dyspnoea is the primary diagnostic symptom for chronic cardiopulmonary disease populations. Whilst a number of exercise tests are used, there remains no gold standard clinical measure of exertional dyspnoea. The aim of this review was to comprehensively describe and evaluate all types of fixed-intensity exercise tests used to assess exertional dyspnoea in chronic cardiopulmonary populations and, where possible, report the reliability and responsiveness of the tests. METHODS A systematic search of five electronic databases identified papers that examined 1) fixed-intensity exercise tests and measured exertional dyspnoea, 2) chronic cardiopulmonary populations, 3) exertional dyspnoea reported at isotime or upon completion of fixed-duration exercise tests, and 4) published in English. RESULTS Searches identified 8785 papers. 123 papers were included, covering exercise tests using a variety of fixed-intensity protocols. Three modes were identified, as follows: 1) cycling (n=87), 2) walking (n=31) and 3) other (step test (n=8) and arm exercise (n=2)). Most studies (98%) were performed on chronic respiratory disease patients. Nearly all studies (88%) used an incremental exercise test. 34% of studies used a fixed duration for the exercise test, with the remaining 66% using an exhaustion protocol recording exertional dyspnoea at isotime. Exertional dyspnoea was measured using the Borg scale (89%). 7% of studies reported reliability. Most studies (72%) examined the change in exertional dyspnoea in response to different interventions. CONCLUSION Considerable methodological variety of fixed-intensity exercise tests exists to assess exertional dyspnoea and most test protocols require incremental exercise tests. There does not appear to be a simple, universal test for measuring exertional dyspnoea in the clinical setting.
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Affiliation(s)
- Tanya Palmer
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Central Queensland University, School of Health, Medical and Applied Sciences, College of Health Sciences, Bundaberg, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Queensland Health, Chermside, Australia
| | - Steven J Obst
- Central Queensland University, School of Health, Medical and Applied Sciences, College of Health Sciences, Bundaberg, Australia
| | - Craig R Aitken
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Queensland Health, Chermside, Australia
- Heart and Lung Institute, The Prince Charles Hospital, Chermside, Australia
| | - James Walsh
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Queensland Health, Chermside, Australia
- Heart and Lung Institute, The Prince Charles Hospital, Chermside, Australia
| | - Surendran Sabapathy
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
| | - Lewis Adams
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
| | - Norman R Morris
- Griffith University, School of Health Sciences and Social Work, Gold Coast, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Queensland Health, Chermside, Australia
- Heart and Lung Institute, The Prince Charles Hospital, Chermside, Australia
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Tomlinson OW, Markham L, Wollerton RL, Knight BA, Duckworth A, Gibbons MA, Scotton CJ, Williams CA. Validity and repeatability of cardiopulmonary exercise testing in interstitial lung disease. BMC Pulm Med 2022; 22:485. [PMID: 36550475 PMCID: PMC9784077 DOI: 10.1186/s12890-022-02289-0] [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: 11/22/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET), and its primary outcome of peak oxygen uptake (VO2peak), are acknowledged as biomarkers in the diagnostic and prognostic management of interstitial lung disease (ILD). However, the validity and repeatability of CPET in those with ILD has yet to be fully characterised, and this study fills this evidence gap. METHODS Twenty-six people with ILD were recruited, and 21 successfully completed three CPETs. Of these, 17 completed two valid CPETs within a 3-month window, and 11 completed two valid CPETs within a 6-month window. Technical standards from the European Respiratory Society established validity, and repeatability was determined using mean change, intraclass correlation coefficient and typical error. RESULTS Every participant (100%) who successfully exercised to volitional exhaustion produced a maximal, and therefore valid, CPET. Approximately 20% of participants presented with a plateau in VO2, the primary criteria for establishing a maximal effort. The majority of participants otherwise presented with secondary criteria of respiratory exchange ratios in excess of 1.05, and maximal heart rates in excess of their predicted values. Repeatability analyses identified that the typical error (expressed as percent of coefficient of variation) was 20% over 3-months in those reaching volitional exhaustion. CONCLUSION This work has, for the first time, fully characterised how patients with ILD respond to CPET in terms of primary and secondary verification criteria, and generated novel repeatability data that will prove useful in the assessment of disease progression, and future evaluation of therapeutic regimens where VO2peak is used as an outcome measure.
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Affiliation(s)
- Owen W. Tomlinson
- grid.8391.30000 0004 1936 8024Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK ,Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK ,grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Laura Markham
- Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK ,grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Rebecca L. Wollerton
- Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK ,grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Bridget A. Knight
- grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK ,grid.477603.1NIHR Exeter Clinical Research Facility, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK
| | - Anna Duckworth
- grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Michael A. Gibbons
- Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK ,grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Chris J. Scotton
- grid.8391.30000 0004 1936 8024Department of Clinical and Biomedical Science, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK
| | - Craig A. Williams
- grid.8391.30000 0004 1936 8024Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Heavitree Road, Exeter, EX1 2LU UK ,Academic Department of Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW UK
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Wang Z, Zhang Q, Lan K, Yang Z, Gao X, Wu A, Xin Y, Zhang Z. Enhancing instantaneous oxygen uptake estimation by non-linear model using cardio-pulmonary physiological and motion signals. Front Physiol 2022; 13:897412. [PMID: 36105296 PMCID: PMC9465676 DOI: 10.3389/fphys.2022.897412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
Oxygen uptake (VO2) is an important parameter in sports medicine, health assessment and clinical treatment. At present, more and more wearable devices are used in daily life, clinical treatment and health care. The parameters obtained by wearables have great research potential and application prospect. In this paper, an instantaneous VO2 estimation model based on XGBoost was proposed and verified by using data obtained from a medical-grade wearable device (Beijing SensEcho) at different posture and activity levels. Furthermore, physiological characteristics extracted from single-lead electrocardiogram, thoracic and abdominal respiration signal and tri-axial acceleration signal were studied to optimize the model. There were 29 healthy volunteers recruited for the study to collect data while stationary (lying, sitting, standing), walking, Bruce treadmill test and recuperating with SensEcho and the gas analyzer (Metalyzer 3B). The results show that the VO2 values estimated by the proposed model are in good agreement with the true values measured by the gas analyzer (R2 = 0.94 ± 0.03, n = 72,235), and the mean absolute error (MAE) is 1.83 ± 0.59 ml/kg/min. Compared with the estimation method using a separate heart rate as input, our method reduced MAE by 54.70%. At the same time, other factors affecting the performance of the model were studied, including the influence of different input signals, gender and movement intensity, which provided more enlightenment for the estimation of VO2. The results show that the proposed model based on cardio-pulmonary physiological signals as inputs can effectively improve the accuracy of instantaneous VO2 estimation in various scenarios of activities and was robust between different motion modes and state. The VO2 estimation method proposed in this paper has the potential to be used in daily life covering the scenario of stationary, walking and maximal exercise.
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Affiliation(s)
- Zhao Wang
- Medical School of Chinese PLA, Beijing, China
| | - Qiang Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Ke Lan
- Beijing SensEcho Science and Technology Co Ltd, Beijing, China
| | - Zhicheng Yang
- PAII Inc., Palo Alto, Santa Clara, CA, United States
| | - Xiaolin Gao
- Institute of Sports Science, General Administration of Sport of China, Beijing, China
| | - Anshuo Wu
- The Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | - Yi Xin
- School of Life Science, Beijing Institute of Technology, Beijing, China
- *Correspondence: Yi Xin, ; Zhengbo Zhang,
| | - Zhengbo Zhang
- Center for Artificial Intelligence in Medicine, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yi Xin, ; Zhengbo Zhang,
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Correale L, Montomoli C, Bergamaschi R, Ivaniski-Mello A, Peyré-Tartaruga LA, Buzzachera CF. Bilateral coordination of gait at self-selected and fast speed in patients with multiple sclerosis: a case-control study. Mult Scler Relat Disord 2022; 65:104027. [DOI: 10.1016/j.msard.2022.104027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 07/03/2022] [Indexed: 11/29/2022]
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Vardar-Yagli N, Saglam M, Firat M, Cakmak A, Inal-Ince D, Calik Kutukcu E, Coplu L. Gait and functional balance in non-CF bronchiectasis. Physiother Theory Pract 2022:1-8. [PMID: 35189785 DOI: 10.1080/09593985.2022.2043965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The decline in ambulatory activities and negative alterations in gait characteristics may impair balance and increase fall risk in obstructive lung diseases. Few studies have evaluated balance and gait parameters in individuals with bronchiectasis. PURPOSE This study aimed to compare the gait parameters and functional balance in individuals with non-cystic fibrosis (CF) bronchiectasis and healthy subjects. METHODS This cross-sectional and retrospective study analyzed data from 22 individuals with non-CF bronchiectasis and 32 healthy controls recorded between July 2019 and July 2020. Functional balance was assessed using the Timed Up and Go (TUG) test. Gait parameters were evaluated using the Biodex Gait Trainer. Step cycle (s), gait speed (m/s), the number of steps per minute, and ambulation index were measured for 6 min. Results The TUG time (s) was significantly longer (p = .019, effect size = 0.66), and gait speed (m/s) (p ˂ 0.001, effect size = 2.47), step cycle (s) (p ˂ 0.001, effect size = 2.23), and ambulation index (p ˂ 0.001, effect size = 2.56) were significantly reduced in individuals with non-CF bronchiectasis compared with healthy controls. CONCLUSION Non-CF bronchiectasis is related to unfavorable changes in gait characteristics, such as slower gait speed and the decreased average step cycle. In addition, impairment in functional balance and mobility exists in a small percentage of adults with non-CF bronchiectasis. In comprehensive pulmonary rehabilitation, balance and gait evaluations should be included to prevent falls in adults with non-CF bronchiectasis.
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Affiliation(s)
- Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Firat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aslihan Cakmak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ebru Calik Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Lutfi Coplu
- Faculty of Medicine, Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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