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Fasipe G, Goršič M, Zabre EV, Rammer JR. Inertial Measurement Unit and Heart Rate Monitoring to Assess Cardiovascular Fitness of Manual Wheelchair Users during the Six-Minute Push Test. SENSORS (BASEL, SWITZERLAND) 2024; 24:4172. [PMID: 39000952 PMCID: PMC11243937 DOI: 10.3390/s24134172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
Manual wheelchair users (MWUs) are prone to a sedentary life that can negatively affect their physical and cardiovascular health, making regular assessment important to identify appropriate interventions and lifestyle modifications. One mean of assessing MWUs' physical health is the 6 min push test (6MPT), where the user propels themselves as far as they can in six minutes. However, reliance on observer input introduces subjectivity, while limited quantitative data inhibit comprehensive assessment. Incorporating sensors into the 6MPT can address these limitations. Here, ten MWUs performed the 6MPT with additional sensors: two inertial measurement units (IMUs)-one on the wheelchair and one on the wrist together with a heart rate wristwatch. The conventional measurements of distance and laps were recorded by the observer, and the IMU data were used to calculate laps, distance, speed, and cadence. The results demonstrated that the IMU can provide the metrics of the traditional 6MPT with strong significant correlations between calculated laps and observer lap counts (r = 0.947, p < 0.001) and distances (r = 0.970, p < 0.001). Moreover, heart rate during the final minute was significantly correlated with calculated distance (r = 0.762, p = 0.017). Enhanced 6MPT assessment can provide objective, quantitative, and comprehensive data for clinicians to effectively inform interventions in rehabilitation.
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Affiliation(s)
- Grace Fasipe
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Maja Goršič
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53233, USA
| | - Erika V Zabre
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Jacob R Rammer
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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Spicer MG, Dennis AT. Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review. J Clin Med 2024; 13:416. [PMID: 38256550 PMCID: PMC10816516 DOI: 10.3390/jcm13020416] [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: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. METHODS Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. RESULTS The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. CONCLUSION There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.
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Affiliation(s)
- Madeleine G. Spicer
- Department of Obstetrics and Gynaecology, Alice Springs Hospital, Alice Springs, NT 0870, Australia
| | - Alicia T. Dennis
- Department of Anaesthesia, Pain and Perioperative Medicine, Joan Kirner Women’s and Children’s Hospital, Western Health, St Albans, VIC 3021, Australia;
- School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia
- Departments of Critical Care, Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Li D, Shen M, Yang X, Chen D, Zhou C, Qian Q. Effect of weight-bearing Liuzijue Qigong on cardiopulmonary function. Medicine (Baltimore) 2023; 102:e33097. [PMID: 36827027 PMCID: PMC11309644 DOI: 10.1097/md.0000000000033097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Since the outbreak of coronavirus disease 2019, many people have had to reduce their outdoor activities. Therefore, a convenient, simple, at-home training method to improve or maintain cardiopulmonary function is required. This study aimed to explore the therapeutic effect of weight-bearing Liuzijue Qigong on cardiopulmonary function in healthy volunteers. METHODS This study was a longitudinal trial. The health participants completed a 4-week Liuzijue Qigong exercise with 0.25 kg sandbag wore on each wrist. Each training session took 30 minutes to complete 2 consecutive cycles, and 5 times a week. The cardiopulmonary function of participants was evaluated at baseline (T0) and the end of the intervention (T4). Outcomes measures were pulmonary function, diaphragm movement, and cardiac hemodynamic parameters. Paired t test was used to analyze differences within the group. RESULTS After 4 weeks of weight-bearing Liuzijue Qigong exercise intervention, the differences in the forced expiratory volume in the 1st second (P = .006), forced vital capacity rate of 1 second (P = .003), maximal mid-expiratory flow curve (P = .002), forced expiratory flow at 50% of forced vital capacity (P = .003), and maximum ventilatory volume (P < .001) of the participants were statistically significant. The diaphragmatic excursion (P = .009) under the calm breathing mode and the diaphragmatic contraction speed (P = .003) under the deep breathing mode improved significantly. The cardiac output (P = .04), cardiac index (P = .035), contractility index (P = .018), early diastolic filling ratio (P = .042), systemic vascular resistance index (P = .019), systemic vascular resistance (P = .017), and estimated ejection fraction (P = .016) of participants improved significantly in the resting stage. At the end stage of fast walking, that is, the sixth minute of six-minute walk test, the stroke volume index (P = .048), heart rate (P = .019), cardiac output (P = .008), cardiac index (P = .003), and left cardiac work index (P = .028) of participants were significantly increased compared with those before training, and the systemic vascular resistance index (P = .003) and systemic vascular resistance (P = .005) were decreased. CONCLUSION Weight-bearing Liuzijue Qigong training significantly improved cardiopulmonary function in healthy volunteers, thus representing home-based cardiopulmonary rehabilitation training.
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Affiliation(s)
- Desheng Li
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
| | - Mei Shen
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
| | - Xiaoyan Yang
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
| | - Desheng Chen
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
| | - Chunxiu Zhou
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
| | - Qiuyang Qian
- Rehabilitation Medicine Department, Shenzhen Longhua District People’s Hospital, Shenzhen City, China
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Stroke volume and cardiac output during 6 minute-walk tests are strong predictors of maximal oxygen uptake in people after stroke. PLoS One 2022; 17:e0273794. [PMID: 36040986 PMCID: PMC9426911 DOI: 10.1371/journal.pone.0273794] [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: 05/03/2022] [Accepted: 08/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objectives
The 6-minute walk test (6MWT) is a field test commonly used to predict peak oxygen consumption (VO2peak) in people after stroke. Inclusion of cardiodynamic variables measured by impedance cardiography (ICG) during a 6MWT has been shown to improve prediction of VO2peak in healthy adults but these data have not been considered in people after stroke. This study investigates whether the prediction of VO2peak can be improved by the inclusion of cardiovascular indices derived by impedance cardiography (ICG) during the 6MWT in people after stroke.
Methods
This was a cross-sectional study. Patients diagnosed with stroke underwent in random order, a maximal cardiopulmonary exercise test (CPET) and 6MWT in separate dates. Heart rate (HR), stroke volume (SV) and cardiac output (CO) were measured by ICG during all tests. Oxygen consumption was recorded by a metabolic cart during the CPET. Recorded data were subjected to multiple regression analyses to generate VO2peak prediction equations.
Results
Fifty-nine patients, mean age 50.0±11.7 years were included in the analysis. The mean distance covered in the 6MWT (6MWD) was 294±13 m, VO2peak was 19.2±3.2 ml/min/kg. Mean peak HR, SV and CO recorded during 6MWT were 109±6 bpm, 86.3±8.8 ml, 9.4±1.2 L/min and during CPET were 135±14 bpm, 86.6±9 ml, 11.7±2 L/min respectively. The prediction equation with inclusion of cardiodynamic variables: 16.855 + (-0.060 x age) + (0.196 x BMI) + (0.01 x 6MWD) + (-0.416 x SV6MWT) + (3.587 x CO 6MWT) has a higher squared multiple correlation (R2) and a lower standard error of estimate (SEE) and SEE% compared to the equation using 6MWD as the only predictor.
Conclusion
Inclusion of SV and CO measured during the 6MWT in stroke patients further improved the VO2peak prediction power compared to using 6MWD as a lone predictor.
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Singhai A, Mallik M, Jain P. Unmasking Hypoxia in Cirrhosis Patients: Six-Minute Walk Test as a Screening Tool for Hepatopulmonary Syndrome. Adv Biomed Res 2022; 11:50. [PMID: 35982866 PMCID: PMC9379911 DOI: 10.4103/abr.abr_150_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/16/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Abstract
Background Hepatopulmonary syndrome (HPS) is one of the complications of advanced cirrhosis which has a serious impact on prognosis of patient. Finding arterial deoxygenation early and initiating higher-level treatment is one of the most critical strategies in the therapy of HPS. In this study, we aimed to assess the utility of six-minute walk test (6MWT) in the diagnosis of HPS. Materials and Methods We have enrolled 100 consecutive cirrhosis patients referred to the Liver Clinic of a tertiary care centre of India for >1 year. The Child-Pugh score and the MELD score were used to determine the severity of cirrhosis. All the patients underwent transthoracic contrast echocardiography, arterial blood gas measurements on room air, 6MWT, and chest imaging. Results A total of 100 patients were included in the study after fulfilling the inclusion criteria. HPS was present in 21 out of 100 patients (21%). Median (twenty fifth to seventy fifth percentile) MELD score in patients with HPS was 29 (26-33), which was significantly higher as compared to patients without HPS 22 (14.5-26); P <.0001. The 6MWT was positive in 20 (95.23%) HPS patients, while only 1 patient (4.77%) of HPS had negative 6MWT. If 6MWT is positive, then there was 76.92% probability of HPS and if 6MWT is negative, then 98.65% chances of no HPS. Conclusion The 6MWT is a simple and effective screening test for HPS, it helps in identifying the patients early who have a potential to deteriorate. This simple intervention would help in prioritizing patients for liver transplantation as liver transplant is the only effective treatment for HPS.
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Affiliation(s)
- Abhishek Singhai
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India,Address for correspondence: Dr. Abhishek Singhai, Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India. E-mail:
| | - Manaswinee Mallik
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Pragya Jain
- Department of Ophthalmology, Peoples College of Medical Sciences, Bhopal, Madhya Pradesh, India
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Kukliński J, Steckiewicz KP, Piwowarczyk SP, Kreczko MJ, Aszkiełowicz A, Owczuk R. Effect of Carbohydrate-Enriched Drink Compared to Fasting on Hemodynamics in Healthy Volunteers. A Randomized Trial. J Clin Med 2022; 11:825. [PMID: 35160276 PMCID: PMC8836957 DOI: 10.3390/jcm11030825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
Abstract
Fasting prior to surgery can cause dehydration and alter hemodynamics. This study aimed to determine the impact of a carbohydrate-enriched drink (NutriciaTM Pre-op®) on selected hemodynamical parameters, measured in a non-invasive manner. We enrolled 100 healthy volunteers and measured their weight, height, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), thoracic fluid content (TFC), thoracic fluid index (TFCI), stroke volume (SV), stroke volume variation (SVV), stroke index (SI), cardiac output (CO), cardiac index (CI), heather index (HI), systolic time ration (STR), systemic time ratio index (STRI), systemic vascular resistance (SVR), and systemic vascular resistance index (SVRI) by a Niccomo™ device, implementing the impedance cardiography (ICG) method. Measurements were performed at the beginning of the study, and after 10 h and 12 h. We randomly allocated participants to the control group and the pre-op group. The pre-op group received 400 mL of Nutricia™ preOp®, as suggested in the ERAS guidelines, within 10 h of the study. Student's t-test or the Mann-Whitney U test were used to compare the two groups, and p < 0.05 was considered significant. We did not observe any changes in hemodynamical parameters, blood pressure, and heart rate between the groups. We have proven that carbohydrate-enriched drink administration did not have a significant impact on the hemodynamical parameters of healthy volunteers.
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Affiliation(s)
- Jakub Kukliński
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (J.K.); (M.J.K.); (A.A.); (R.O.)
| | - Karol P. Steckiewicz
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (J.K.); (M.J.K.); (A.A.); (R.O.)
| | - Sebastian P. Piwowarczyk
- Students Scientific Society, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland;
| | - Mateusz J. Kreczko
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (J.K.); (M.J.K.); (A.A.); (R.O.)
| | - Aleksander Aszkiełowicz
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (J.K.); (M.J.K.); (A.A.); (R.O.)
| | - Radosław Owczuk
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdańsk, Poland; (J.K.); (M.J.K.); (A.A.); (R.O.)
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