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Lang JE, Carrion VM, Bhammar DM, Howard JB, Armstrong SC. A Randomized Trial of Inspiratory Training in Children and Adolescents With Obesity. Child Obes 2024. [PMID: 38696657 DOI: 10.1089/chi.2023.0183] [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] [Indexed: 05/04/2024]
Abstract
Introduction: Children with obesity suffer excess dyspnea that contributes to sedentariness. Developing innovative strategies to increase exercise tolerance and participation in children with obesity is a high priority. Because inspiratory training (IT) has reduced dyspnea, we sought to assess IT in children with obesity. Methods: We conducted a 6-week randomized IT trial involving 8- to 17-year-olds with obesity. Participants were randomized 1:1 to either high [75% of maximal inspiratory pressure (MIP)] or low resistance control (15% of MIP) three times weekly. Assessments included adherence, patient satisfaction, and changes in inspiratory strength and endurance, dyspnea scores and total activity level. Results: Among 27 randomized, 24 (89%) completed the intervention. Total session adherence was 72% which did not differ between treatment groups. IT was safe, and more than 90% felt IT benefitted breathing and general health. IT led to a mean improvement (95% CI) in inspiratory strength measured by MIP of 10.0 cm H2O (-3.5, 23.6; paired t-test, p = 0.139) and inspiratory endurance of 8.9 (1.0, 16.8; paired t-test, p = 0.028); however, there was no significant difference between high- and low-treatment groups. IT led to significant reductions in dyspnea with daily activity (p < 0.001) and in prospectively reported dyspnea during exercise (p = 0.024). Among the high- versus low-treatment group, we noted a trend for reduced dyspnea with daily activity (p = 0.071) and increased daily steps (865 vs. -51, p = 0.079). Discussion: IT is safe and feasible for children with obesity and holds promise for reducing dyspnea and improving healthy activity in children with obesity. Breathe-Fit trial NCT05412134.
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Affiliation(s)
- Jason E Lang
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Veronica M Carrion
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Dharini M Bhammar
- Center for Tobacco Research, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Janna B Howard
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Sarah C Armstrong
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
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Ishigaki T, Kubo H, Yoshida K, Shimizu N, Ogawa T. Validity and reliability of the 2-min step test in individuals with stroke and lower-limb musculoskeletal disorders. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1384369. [PMID: 38690193 PMCID: PMC11058829 DOI: 10.3389/fresc.2024.1384369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024]
Abstract
Introduction We investigated the reliability and validity of the 2-min step test (2MST) for assessing the exercise endurance of individuals with stroke and lower-limb musculoskeletal disorders. Participants and methods The participants were 39 individuals with stroke and 42 with lower-limb musculoskeletal disorders (mainly hip fractures) from the convalescent rehabilitation wards of four hospitals. The concurrent validity and congruence between the 2MST and the 6-min walk test (6MWT) and construct validity by hypotheses testing, including mobility and lower limb muscle strength, were also confirmed. A subset of participants (stroke-group, n = 15; musculoskeletal-group, n = 19) underwent a retest 2MST for our evaluation of relative and absolute reliability using the intraclass correlation coefficient (ICC1,1) and Bland-Altman plot. Results Both groups showed a moderate correlation between the 2MST and 6MWT (ρ = 0.55-0.60), but the congruence was not sufficient. The 6MWT was correlated with mobility in both groups and with muscle strength in the stroke group, whereas the 2MST did not show a significant correlation with mobility. The relative reliability was excellent in both groups (ICC1,1 > 0.9). In terms of absolute reliability, the width of the limit of agreement was 18.8% for the stroke group and 15.4% for the musculoskeletal group, relative to their respective sample means of 2MST. A fixed bias was identified in the stroke group, in which step counts increased by 6.5 steps upon retesting. Discussion Our analyses revealed that the 2MST is a valid and reliable tool for assessing the exercise endurance of individuals with stroke or lower-limb musculoskeletal disorders. However, it is necessary to validate the absolute reliability observed herein by using a larger sample size. In addition, when assessing the exercise endurance of individuals with stroke, it may be necessary to consider the potential bias of an increased step count during retesting.
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Affiliation(s)
- Tomoya Ishigaki
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Aichi, Japan
| | - Hiroki Kubo
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Hyogo, Japan
| | - Keishi Yoshida
- Department of Rehabilitation, Senri-Chuo Hospital, Osaka, Japan
| | - Natsuki Shimizu
- Department of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan
| | - Tatsuya Ogawa
- Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Nara, Japan
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Santos-de-Araújo AD, da Luz Goulart C, Marinho RS, Dourado IM, Mendes RG, Roscani MG, Bassi-Dibai D, Phillips SA, Arena R, Borghi-Silva A. The six-minute step test can predict COPD exacerbations: a 36-month follow-up study. Sci Rep 2024; 14:3649. [PMID: 38351306 PMCID: PMC10864352 DOI: 10.1038/s41598-024-54338-9] [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: 07/28/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.
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Affiliation(s)
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Izadora Moraes Dourado
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), Sao Carlos, SP, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Management in Health Programs and Services, Universidade CEUMA, São Luís, MA, Brazil
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil.
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Berlanga LA, Matos-Duarte M, Abdalla P, Alves E, Mota J, Bohn L. Validity of the two-minute step test for healthy older adults. Geriatr Nurs 2023; 51:415-421. [PMID: 37146558 DOI: 10.1016/j.gerinurse.2023.04.009] [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: 02/09/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND In healthy older adults, the two-minute step test (2MST) does not have its concurrent validity tested against the six-minute walk test (6MWT), which is a valid cardiorespiratory fitness test frequently applied in geriatric samples. OBJECTIVE To derive an equation to predict 6MWT from 2MST and to observe the agreement between observed and estimated 6MWT distances. METHODS 6MWT and 2MST were measured in 51 older adults (72.9±4.6 years) from community multicomponent exercise programs. Multiple linear regression derives the predictive equation of 6MWT walked distance (dependent outcome) from steps obtained in 2MST, age, sex, and body mass index (independent outcomes). RESULTS Correlation between 6MWT and 2MST was strong (r=0.696, p<0.001). The regression equation showed good agreement with measured values, when 6MWT was below 600 m. CONCLUSION The equation stands as a novel approach to obtaining a valid 6MWT estimation from the 2MST. 2MST is easier and faster, representing an alternative approach when time and space are limited.
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Affiliation(s)
- Luis A Berlanga
- Department of Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Sevilla, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Pedro Abdalla
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal
| | - Emília Alves
- Departament of Sport, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal; Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Lucimere Bohn
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
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de Jesus SFC, Bassi-Dibai D, Pontes-Silva A, da Silva de Araujo A, de Freitas Faria Silva S, Veneroso CE, de Paula Gomes CAF, Dibai-Filho AV. Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain. BMC Musculoskelet Disord 2022; 23:1062. [PMID: 36471309 PMCID: PMC9721032 DOI: 10.1186/s12891-022-06050-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/01/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Functional tests are important clinical tools, since they are non-invasive methods, with simple applicability, and low cost. However, there are few tests adapted for individuals with chronic low back pain. Thus, our objective was to evaluate the test-retest and inter-rater reliability of the 2-Minute Step Test in individuals with chronic low back pain and to correlate the test score with measures of pain and physical activity. METHODS We included patients aged between 18 and 45 years, of both sexes, and with low back pain. The interval between the test and retest was 7 days. We analyzed the data via intra-class correlation coefficient (ICC), confidence interval at 95%, standard error of measurement, and minimum detectable change for reliability. We used the Spearman's correlation coefficient to verify the correlation between 2-Minute Step Test and measures of pain and physical activity (Numerical Pain Scale, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Baecke Habitual Physical Activity Questionnaire). RESULTS Sample is composed of 37 individuals, most of them female, with overweight and low back pain > 60 months. 2-Minute Step Test showed excellent test-retest (ICC = 0.903) and inter-rater (ICC = 0.925) reliability. Sport domain of the Baecke showed a significant correlation with the 2-Minute Step Test (rho = 0.444). CONCLUSION 2-Minute Step Test is a reliable measure to measure the functional capacity of patients with chronic low back pain considering different times and examiners, as well as being positively correlated with sports practice.
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Affiliation(s)
- Sulamizia Filomena Costa de Jesus
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil ,Specialized Center for Rehabilitation and Health Promotion, São Luís, MA Brazil
| | - Daniela Bassi-Dibai
- grid.442152.40000 0004 0414 7982Postgraduate Program in Environment, Universidade Ceuma, São Luís, MA Brazil ,Department of Physical Therapy, Faculdade Santa Terezinha, São Luís, MA Brazil
| | - André Pontes-Silva
- grid.411247.50000 0001 2163 588XPostgraduate Program in Physical Therapy, Department of Physical Therapy, Universidade Federal de São Carlos, Rod. Washington Luís, Km 235, CEP, São Carlos, SP 13565-905 Brazil
| | | | | | - Christiano Eduardo Veneroso
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil
| | - Cid André Fidelis de Paula Gomes
- grid.412295.90000 0004 0414 8221Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, SP Brazil
| | - Almir Vieira Dibai-Filho
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil
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Batouli-Santos D, Reis-Silva A, Guimarães-Lourenço G, Mendonça-Guimarães R, Moreira-Marconi E, Sonza A, Bernardo-Filho M, Sá-Caputo D. Acute effect of whole body-vibration exercise and osteopathic manipulative treatment on the heart rate variability in individuals with metabolic syndrome: Randomized cross-study protocol. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fagundes CF, Thommazo-Luporini LD, Goulart CL, Braatz D, Ditomaso A, Borghi-Silva A. Reference equations of oxygen uptake for the step test in the obese population. Braz J Med Biol Res 2022; 55:e11864. [PMID: 35319674 PMCID: PMC8939505 DOI: 10.1590/1414-431x2022e11864] [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: 10/17/2021] [Accepted: 02/09/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to establish reference equations for the six-minute
step test (6MST) based on demographic, anthropometric, body composition, and
performance variables able to predict oxygen uptake (V̇O2) in obese
individuals. Seventy-three obese adults (42±14 years old, body mass index >30
kg/m2) from both sexes were included. They underwent anamnesis,
body composition evaluation, and the 6MST with expired gases registered
simultaneously. Three equations were developed for the obese population (n=73;
59% female). The first equation was composed of the up-and-down step cycles
(UDS), sex, and age as predictors; the second equation was composed of the UDS,
age, and lean mass (LM). Both equations collectively explained 68.1% of the
V̇O2 variance in the 6MST, while the third equation, composed of
the UDS, age, and body mass, accounted for 67.7% of the V̇O2
variance. UDS, sex, age, LM, and body mass were important V̇O2
predictors of 6MST in these obese individuals. This study contributes to the
dissemination of a simple, inexpensive, and fast evaluation method that can
provide important indicators of cardiorespiratory fitness and guide strategies
for rehabilitation.
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Affiliation(s)
- C F Fagundes
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L Di Thommazo-Luporini
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C L Goulart
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - D Braatz
- Departamento de Engenharia de Produção, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A Ditomaso
- Instituto Federal de Educação, Ciência e Tecnologia de São Paulo, São Carlos, SP, Brasil
| | - A Borghi-Silva
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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Vrátná E, Husáková J, Jarošíková R, Dubský M, Wosková V, Bém R, Jirkovská A, Králová K, Pyšková B, Lánská V, Fejfarová V. Effects of a 12-Week Interventional Exercise Programme on Muscle Strength, Mobility and Fitness in Patients With Diabetic Foot in Remission: Results From BIONEDIAN Randomised Controlled Trial. Front Endocrinol (Lausanne) 2022; 13:869128. [PMID: 35865313 PMCID: PMC9294221 DOI: 10.3389/fendo.2022.869128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Diabetic foot syndrome (DFS) is a serious late diabetic complication characterised by limited joint mobility and other biomechanical and muscle abnormalities. AIM To evaluate the effect of an interventional exercise programme on anthropometric parameters, muscle strength, mobility and fitness in patients with diabetic foot in remission. DATA SOURCES AND STUDY SELECTION Thirty-eight patients with type 2 diabetes and DFS without active lesions (mean age 65 ± 6.9 years, BMI 32 ± 4.7 kg.m-2, waist-hip ratio (WHR)1.02 ± 0.06) were enrolled in our randomised controlled trial. All subjects were randomised into two groups: an intervention group (I; n=19) and a control group (C; n=19). The 12-week exercise intervention focused on ankle and small-joint mobility in the foot, strengthening and stretching of the lower extremity muscles, and improvements in fitness. Changes (Δ=final minus initial results) in physical activity were assessed using the International Physical Activity Questionnaire (IPAQ), with joint mobility detected by goniometry, muscle strength by dynamometry, and fitness using the Senior Fitness Test (SFT). DATA EXTRACTION Due to reulceration, 15.8% of patients from group I (3/19) and 15.8% of patients from group C were excluded. Based on the IPAQ, group I was more active when it came to heavy (p=0.03) and moderate physical activity (p=0.06) after intervention compared to group C. Group I improved significantly in larger-joint flexibility (p=0.012) compared to controls. In group I, dynamometric parameters increased significantly in both lower limbs (left leg; p=0.013, right leg; p=0.043) compared to group C. We observed a positive trend in the improvement of fitness in group I compared to group C. We also confirmed positive correlations between heavy physical activity and selected parameters of flexibility (r=0.47; p=0.007), SFT (r=0.453; p=0.011) and dynamometry (r=0.58; p<0.0025). Anthropometric parameters, such as BMI and WHR, were not significantly influenced by the intervention programme. CONCLUSION Our 12-week interventional exercise programme proved relatively safe, resulting in improved body flexibility and increased muscle strength in DF patients in remission.
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Affiliation(s)
- Eliška Vrátná
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
- Clinical Rehabilitation Division, Institute for Clinical and Experimental Medicine, Prague, Czechia
- *Correspondence: Eliška Vrátná,
| | - Jitka Husáková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Radka Jarošíková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- Second Faculty of Medicine, Charles University, Prague, Czechia
| | - Michal Dubský
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Veronika Wosková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Robert Bém
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Alexandra Jirkovská
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Kateřina Králová
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Bára Pyšková
- Faculty of Physical Education and Sport, Charles University, Prague, Czechia
| | - Věra Lánská
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Vladimíra Fejfarová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- Second Faculty of Medicine, Charles University, Prague, Czechia
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Responses of different functional tests in candidates for bariatric surgery and the association with body composition, metabolic and lipid profile. Sci Rep 2021; 11:22840. [PMID: 34819543 PMCID: PMC8613230 DOI: 10.1038/s41598-021-02072-x] [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: 05/05/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022] Open
Abstract
Individuals with obesity can have metabolic disorders and may develop impairments that affect the ability to exercise. The maximal incremental cardiopulmonary exercise test is widely used to assess functional capacity. However, submaximal tests such as the two-minute step test (2MST) and the six-minute walk test (6MWT) also allow this assessment. We propose to analyze whether body composition, metabolic and lipid profile influence the maximal and submaximal performance, and investigate these variables in response to different functional tests. Forty-four individuals with obesity, aged 18–50 years, underwent analysis of body composition, metabolic and lipid profile, incremental treadmill test (ITMT), 6MWT, and 2MST. One-way ANOVA, Pearson or Spearman correlation, and Stepwise multiple linear regression analysis were performed. ITMT induced a greater metabolic, ventilatory, cardiovascular, and perceived exertion demand when compared to the 6MWT and 2MST (p < 0.05). In addition, 2MST elicited a higher chronotropic (HR) and metabolic (V̇O2) demand when compared to the 6MWT (p < 0.05). Significant correlations were found between tests and body composition, metabolic and lipid profile. Fat mass and low-density lipoprotein can explain 30% of the V̇O2 variance in the ITMT; and fat mass, glucose, and performance in the 2MST can explain 42% of the variance of the distance walked in the ITMT. Obesity and its metabolic impairments are capable of influencing responses to exercise. ITMT generated greater demand due to the high stress imposed, however, 2MST demanded greater metabolic and chronotropic demand when compared to the 6MWT.
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Castro-Piñero J, Marin-Jimenez N, Fernandez-Santos JR, Martin-Acosta F, Segura-Jimenez V, Izquierdo-Gomez R, Ruiz JR, Cuenca-Garcia M. Criterion-Related Validity of Field-Based Fitness Tests in Adults: A Systematic Review. J Clin Med 2021; 10:jcm10163743. [PMID: 34442050 PMCID: PMC8397016 DOI: 10.3390/jcm10163743] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/23/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022] Open
Abstract
We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19–64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July 2020. Each original study’s methodological quality was classified as high, low and very low, according to the number of participants, the description of the study population, statistical analysis and systematic reviews which were appraised via the AMSTAR rating scale. Three evidence levels were constructed (strong, moderate and limited evidence) according to the number of studies and the consistency of the findings. We identified 101 original studies (50 of high quality) and five systematic reviews examining the criterion-related validity of field-based fitness tests in adults. Strong evidence indicated that the 20 m shuttle run, 1.5-mile, 12 min run/walk, YMCA step, 2 km walk and 6 min walk test are valid for estimating cardiorespiratory fitness; the handgrip strength test is valid for assessing hand maximal isometric strength; and the Biering–Sørensen test to evaluate the endurance strength of hip and back muscles; however, the sit-and reach test, and its different versions, and the toe-to-touch test are not valid for assessing hamstring and lower back flexibility. We found moderate evidence supporting that the 20 m square shuttle run test is a valid test for estimating cardiorespiratory fitness. Other field-based fitness tests presented limited evidence, mainly due to few studies. We developed an evidence-based proposal of the most valid field-based fitness tests in healthy adults aged 19–64 years old.
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Affiliation(s)
- Jose Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
| | - Nuria Marin-Jimenez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-956-016-253
| | - Jorge R. Fernandez-Santos
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
| | - Fatima Martin-Acosta
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
| | - Victor Segura-Jimenez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
| | - Rocio Izquierdo-Gomez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
| | - Jonatan R. Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, School of Sports Science, University of Granada, 18007 Granada, Spain;
| | - Magdalena Cuenca-Garcia
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avenida República Saharaui s/n, Puerto Real, 11519 Cádiz, Spain; (J.C.-P.); (J.R.F.-S.); (F.M.-A.); (V.S.-J.); (R.I.-G.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), 11009 Cádiz, Spain
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Marinho R, Jürgensen S, Arcuri J, Goulart C, dos Santos P, Roscani M, Mendes R, de Oliveira C, Caruso F, Borghi-Silva A. Reliability and validity of six-minute step test in patients with heart failure. Braz J Med Biol Res 2021; 54:e10514. [PMID: 34287574 PMCID: PMC8289340 DOI: 10.1590/1414-431x2020e10514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 06/02/2021] [Indexed: 01/28/2023] Open
Abstract
Exercise intolerance is the hallmark consequence of advanced chronic heart failure (HF). The six-minute step test (6MST) has been considered an option for the six-minute walk test because it is safe, inexpensive, and can be applied in small places. However, its reliability and concurrent validity has still not been investigated in participants with HF with reduced ejection fraction (HFrEF). Clinically stable HFrEF participants were included. Reliability and error measurement were calculated by comparing the first with the second 6MST result. Forty-eight hours after participants underwent the 6MST, they were invited to perform a cardiopulmonary exercise test (CPET) on a cycle ergometer. Concurrent validity was assessed by correlation between number of steps and peak oxygen uptake (V̇O2 peak) at CPET. Twenty-seven participants with HFrEF (60±8 years old and left ventricle ejection fraction of 41±6%) undertook a mean of 94±30 steps in the 6MST. Intra-rater reliability was excellent for 6MST (ICC=0.9), with mean error of 4.85 steps and superior and inferior limits of agreement of 30.6 and -20.9 steps, respectively. In addition, strong correlations between number of steps and CPET workload (r=0.76, P<0.01) and peak V̇O2 (r=0.71, P<0.01) were observed. From simple linear regression the following predictive equations were obtained with 6MST results: V̇O2 peak (mL/min) = 350.22 + (7.333 × number of steps), with R2=0.51, and peak workload (W) = 4.044 + (0.772 × number of steps), with R2=0.58. The 6MST was a reliable and valid tool to assess functional capacity in HFrEF participants and may moderately predict peak workload and oxygen uptake of a CPET.
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Affiliation(s)
- R.S. Marinho
- Programa de Pós-Graduação Interunidades de Bioengenharia, Universidade de São Paulo, São Carlos, SP, Brasil
| | - S.P. Jürgensen
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - J.F. Arcuri
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C.L. Goulart
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - P.B. dos Santos
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - M.G. Roscani
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - R.G. Mendes
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C.R. de Oliveira
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F.R. Caruso
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - A. Borghi-Silva
- Programa de Pós-Graduação Interunidades de Bioengenharia, Universidade de São Paulo, São Carlos, SP, Brasil
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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12
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Gerke O. Reporting Standards for a Bland-Altman Agreement Analysis: A Review of Methodological Reviews. Diagnostics (Basel) 2020; 10:E334. [PMID: 32456091 PMCID: PMC7278016 DOI: 10.3390/diagnostics10050334] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022] Open
Abstract
The Bland-Altman Limits of Agreement is a popular and widespread means of analyzing the agreement of two methods, instruments, or raters in quantitative outcomes. An agreement analysis could be reported as a stand-alone research article but it is more often conducted as a minor quality assurance project in a subgroup of patients, as a part of a larger diagnostic accuracy study, clinical trial, or epidemiological survey. Consequently, such an analysis is often limited to brief descriptions in the main report. Therefore, in several medical fields, it has been recommended to report specific items related to the Bland-Altman analysis. The present study aimed to identify the most comprehensive and appropriate list of items for such an analysis. Seven proposals were identified from a MEDLINE/PubMed search, three of which were derived by reviewing anesthesia journals. Broad consensus was seen for the a priori establishment of acceptability benchmarks, estimation of repeatability of measurements, description of the data structure, visual assessment of the normality and homogeneity assumption, and plotting and numerically reporting both bias and the Bland-Altman Limits of Agreement, including respective 95% confidence intervals. Abu-Arafeh et al. provided the most comprehensive and prudent list, identifying 13 key items for reporting (Br. J. Anaesth. 2016, 117, 569-575). An exemplification with interrater data from a local study accentuated the straightforwardness of transparent reporting of the Bland-Altman analysis. The 13 key items should be applied by researchers, journal editors, and reviewers in the future, to increase the quality of reporting Bland-Altman agreement analyses.
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Affiliation(s)
- Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 47, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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