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Butson G, Edbrooke L, Ismail H, Denehy L. Exercise capacity prior to major cancer surgery: A cross-sectional observational study of the validity of the 6-minute walk and 30-second sit-to-stand tests. Asia Pac J Clin Oncol 2024; 20:497-506. [PMID: 38685578 DOI: 10.1111/ajco.14069] [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: 07/24/2023] [Revised: 02/26/2024] [Accepted: 04/06/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Cardiopulmonary exercise testing (CPET) is the gold standard for measuring exercise capacity, however, it is resource intensive and has limited availability. This study aimed to determine: 1) the association between the 6-min walk test (6MWT) and the 30-s sit-to-stand test (30STS) with CPET peak oxygen uptake (VO2peak) and anaerobic threshold (AT) and 2) 6MWT and 30STS cut points associated with a higher risk of postoperative complications. METHODS A cross-sectional study, retrospectively analyzing data collected from a tertiary cancer center over a 23-month period. Measures included CPET VO2peak and AT, 6MWT and 30STS test. Correlations were used to characterize relationships between variables. Receiver operating characteristic curve analyses determined 6MWT and 30STS cut points that aligned with CPET variable cut points. RESULTS Note that, 156 participants were included. The 6MWT and 30STS displayed moderate correlations with VO2peak, rho = 0.65, p = 0.01 and rho = 0.52, p < 0.005 respectively. Fair correlations were observed between AT and 6MWT (rho = 0.36, p = 0.01) and 30STS (rho = 0.41, p < 0.005). The optimal cut points to identify VO2peak < 15 mL/kg/min were 493.5 m on the 6MWT and 12.5 stands on the 30STS test and for AT < 11 mL/kg/min were 506.5 m on the 6MWT and 12.5 stands on the 30STS test. CONCLUSION Both the 6MWT and 30STS test could be used as alternative tools for measuring exercise capacity preoperatively in the cancer setting where CPET is not available. A range of 6MWT and 30STS cut points, according to sensitivity and specificity levels, may be used to evaluate risk of postoperative outcomes.
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Affiliation(s)
- Grace Butson
- Department of Physiotherapy, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Lara Edbrooke
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anesthesia, Perioperative and Pain Medicine, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Linda Denehy
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
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Associations between pretreatment physical performance tests and treatment complications in patients with non-small cell lung cancer: A systematic review. Crit Rev Oncol Hematol 2021; 158:103207. [PMID: 33383208 DOI: 10.1016/j.critrevonc.2020.103207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 12/25/2022] Open
Abstract
This systematic review evaluated which outcome variables and cut-off values of pretreatment exercise tests are associated with treatment complications in patients with stage I-III non-small cell lung cancer (NSCLC). PRISMA and Cochrane guidelines were followed. A total of 38 studies with adult patients undergoing treatment for stage I-III NSCLC who completed pretreatment exercise tests, and of whom treatment-related complications were recorded were included. A lower oxygen uptake at peak exercise amongst several other variables on the cardiopulmonary exercise test and a lower performance on field tests, such as the incremental shuttle walk test, stair-climb test, and 6-minute walk test, were associated with a higher risk for postoperative complications and/or postoperative mortality. Cut-off values were reported in a limited number of studies and were inconsistent. Due to the variety in outcomes, further research is needed to evaluate which outcomes and cut-off values of physical exercise tests are most clinically relevant.
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Oikawa M, Hanada M, Nagura H, Tsuchiya T, Matsumoto K, Miyazaki T, Sawai T, Yamasaki N, Nagayasu T, Kozu R. Factors Influencing Functional Exercise Capacity After Lung Resection for Non-Small Cell Lung Cancer. Integr Cancer Ther 2020; 19:1534735420923389. [PMID: 32493079 PMCID: PMC7273541 DOI: 10.1177/1534735420923389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: We investigated, in patients who underwent lung resection
for non–small cell lung cancer (NSCLC), the magnitude of early limitation in
functional exercise capacity and the associations with pre- and postoperative
factors. Methods: Consecutive patients with preoperative clinical
stage I to IIIA NSCLC who underwent lung resection were prospectively enrolled.
We measured functional exercise capacity (6-minute walk distance [6MWD]) and
skeletal muscle strength (handgrip [HF] and quadriceps force [QF]) within 2 days
prior to surgery and on day 7 postoperatively. Results: Two hundred
eighteen participants were recruited (median age 69 years) of whom 49 developed
postoperative complications (POCs). 6MWD was markedly decreased (514 m vs 469 m,
P < .001); HF and QF were slightly decreased following
surgery. Multiple linear regression showed that preoperative vital capacity
(P < .01), QF (P < .05), the
duration of chest tube drainage (P < .001), and presence of
POCs (P < .05) were significant predictors. However,
intraoperative factors were not significantly associated with the decline in
6MWD. Conclusions: These results suggest that patients with
preoperative impairments in pulmonary function and muscle strength, and those
who require prolonged chest tube drainage or develop POCs are likely to have
impaired exercise capacity. Therefore, individual assessment and follow-up of
patients with such factors is indicated.
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Affiliation(s)
- Masato Oikawa
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masatoshi Hanada
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroki Nagura
- Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoshi Tsuchiya
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keitaro Matsumoto
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takuro Miyazaki
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Terumitsu Sawai
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Takeshi Nagayasu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Kozu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Validation of Submaximal Step Tests and the 6-Min Walk Test for Predicting Maximal Oxygen Consumption in Young and Healthy Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234858. [PMID: 31816834 PMCID: PMC6926792 DOI: 10.3390/ijerph16234858] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 01/15/2023]
Abstract
Background: This study aimed to test the validity of three different submaximal tests (i.e., 3-min step test with 20.3-cm step box height (3MST20), 3-min step test with 30-cm step box height (3MST30), and 6-min walk test (6MWT)) in estimating maximal oxygen consumption (VO2max) in young and healthy individuals. Methods: The 3MST20, 3MST30, 6MWT, as well as the cardiopulmonary exercise test (CPET) were performed in 73 participants (37 men and 36 women; mean age: 30.8 ± 9.3 years). All participants visited the clinic three times in a random order for anthropometric measurements, three submaximal tests, and the VO2max test. Multiple linear regression analyses were conducted to construct the VO2max prediction equations for each submaximal test. Results: The prediction equations developed based on multiple regression analyses for each submaximal tests were as follows: 3MST20: VO2max = 86.0 − 10.9 × sex (male = 1, female = 2) − 0.4 × age − 0.1 × weight − 0.1 × heart rate recovery at 30 s (HRR30s); 3MST30: VO2max = 84.5 − 10.2 × sex (male = 1, female = 2) − 0.4 × age − 0.1 × weight − 0.1 × HRR30s; and 6MWT: VO2max = 61.1 − 11.1 × sex (male = 1, female = 2) − 0.4 × age − 0.2 × weight − 0.2 × (distance walked·10−1). The estimated VO2max values based on formulated equations were 37.0 ± 7.9, 37.3 ± 7.6, and 36.9 ± 7.9 mL∙kg−1∙min−1 derived from the 3MST20, 3MST30, and 6MWT, respectively. These estimated VO2max values were not significantly different from the measured VO2max value, 37.3 mL∙kg−1∙min−1. The estimated VO2max based on the 3MST20, 3MST30, and 6MWT results explained 73.4%, 72.2%, and 74.4% of the variances in the measured VO2max (p < 0.001), respectively. Conclusions: The 3MST20, 3MST30, and 6MWT were valid in estimating VO2max in relatively young and healthy Asian individuals.
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Prognostic value of preoperative exercise capacity in patients undergoing thoracoscopic lobectomy for non-small cell lung cancer. Lung Cancer 2019; 128:47-52. [DOI: 10.1016/j.lungcan.2018.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022]
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Twomey R, Bebb G, Culos-Reed SN. Health-related quality of life after curative-intent treatment of non-small cell lung cancer: can exercise lessen the burden? ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:S76. [PMID: 30613651 DOI: 10.21037/atm.2018.10.51] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rosie Twomey
- Faculty of Kinesiology, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Gwyn Bebb
- Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Alberta, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Alberta, Canada
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Andrade-Lima A, Cucato GG, Domingues WJR, Germano-Soares AH, Cavalcante BR, Correia MA, Saes GF, Wolosker N, Gardner AW, Zerati AE, Ritti-Dias RM. Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease. Ann Vasc Surg 2018; 52:147-152. [PMID: 29793014 DOI: 10.1016/j.avsg.2018.03.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/12/2018] [Accepted: 03/25/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. METHODS Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations. RESULTS Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048). CONCLUSIONS In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.
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Affiliation(s)
- Aluísio Andrade-Lima
- Department of Physical Education, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
| | - Gabriel G Cucato
- Albert Einstein Israelite Hospital, São Paulo, São Paulo, Brazil
| | - Wagner J R Domingues
- Associated Graduate Program in Physical Education UEL/UEM, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Bruno R Cavalcante
- School of Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Marilia A Correia
- School of Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
| | - Glauco F Saes
- Division of Vascular and Endovascular Surgery, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Nelson Wolosker
- Albert Einstein Israelite Hospital, São Paulo, São Paulo, Brazil
| | - Andrew W Gardner
- Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA
| | - Antônio E Zerati
- Division of Vascular and Endovascular Surgery, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Raphael M Ritti-Dias
- Postgraduate Program in Rehabilitation Sciences, University Nine of July, São Paulo, São Paulo, Brazil
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Brocki BC, Westerdahl E, Langer D, Souza DSR, Andreasen JJ. Decrease in pulmonary function and oxygenation after lung resection. ERJ Open Res 2018; 4:00055-2017. [PMID: 29362707 PMCID: PMC5773813 DOI: 10.1183/23120541.00055-2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/14/2017] [Indexed: 12/17/2022] Open
Abstract
Respiratory deficits are common following curative intent lung cancer surgery and may reduce the patient's ability to be physically active. We evaluated the influence of surgery on pulmonary function, respiratory muscle strength and physical performance after lung resection. Pulmonary function, respiratory muscle strength (maximal inspiratory/expiratory pressure) and 6-min walk test (6MWT) were assessed pre-operatively, 2 weeks post-operatively and 6 months post-operatively in 80 patients (age 68±9 years). Video-assisted thoracoscopic surgery was performed in 58% of cases. Two weeks post-operatively, we found a significant decline in pulmonary function (forced vital capacity −0.6±0.6 L and forced expiratory volume in 1 s −0.43±0.4 L; both p<0.0001), 6MWT (−37.6±74.8 m; p<0.0001) and oxygenation (−2.9±4.7 units; p<0.001), while maximal inspiratory and maximal expiratory pressure were unaffected. At 6 months post-operatively, pulmonary function and oxygenation remained significantly decreased (p<0.001), whereas 6MWT was recovered. We conclude that lung resection has a significant short- and long-term impact on pulmonary function and oxygenation, but not on respiratory muscle strength. Future research should focus on mechanisms negatively influencing post-operative pulmonary function other than impaired respiratory muscle strength. Lung resection has a significant short- and long-term impact on pulmonary function and oxygenation, but not on respiratory muscle strengthhttp://ow.ly/WTqc30h6j4i
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Affiliation(s)
- Barbara Cristina Brocki
- Dept of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Daniel Langer
- Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Belgium
| | | | - Jan Jesper Andreasen
- Dept of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark.,Dept of Clinical Medicine, Aalborg University, Aalborg, Denmark
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