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Brodowski H, Andres N, Gumny M, Eicher C, Steinhagen-Thiessen E, Tannen A, Kiselev J. Reliability of stair-climbing speed in two cohorts of older adults. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims The ability to climb stairs is an important prerequisite for activities of daily living and social participation in older adults, and is therefore an important part of rehabilitation. However, there is no consensus on how to measure stair-climbing ability. The aim of this study was to investigate the test–retest reliability of the measurement of stair-climbing speed (steps per second) as a parameter for functional ability in older adults. Methods A total of 57 participants who were in hospital and 56 participants who were community-dwelling and did not have any limitations in activities in daily living, all aged 60 years and over, ascended and descended a set of 13 stairs twice. The halfway point of the staircase was marked in order to split the time required for both the ascending and the descending actions. Additional measurements consisted of the Functional Reach Test, the Timed Up and Go Test, walking ability using the GAITRite walkway system and the isometric strength of four muscle groups of the lower extremities using a handheld dynamometer. Results Test–retest reliability of the first and second half of the stair-climbing for both ascending and descending showed excellent results for the group of hospitalised participants (intraclass correlation coefficient, [ICC] 0.87, 95% confidence interval [CI] 0.79–0.93 to 0.94, 95% CI 0.9 – 0.97 for comparison of first vs second half of stair climbing; ICC 0.9, 95% CI 0.83-0.94 to ICC 0.95, 95% CI 0.92–0.97 for comparing first vs second measurement)) and moderate to excellent results for the group of community-dwelling participants with no limitations (ICC 0.58, 95% CI 0.37–0.73 to ICC 0.76, 95% 95% CI 0.63-0.85 for comparison of first vs second half of stair climbing; ICC 0.82, 95% CI 0.71-0.89 to 0.92, 95% CI 0.87–0.95 for comparing first vs second measurement). As expected, hospitalised participants took significantly longer descending than ascending stairs (t(56)=6.98, P<0.001, d=0.93). A general and significant trend of increasing speed while descending could be observed in both groups (performing paired sample t-tests). Conclusions The results indicate that stair-climbing speed is not constant and that different patterns exist in older adults who have no limitations and in those who are hospitalised. The use of stair-climbing speed as an assessment tool should include both stair ascent and descent, because differences in these speeds seem to be indicators of stair-climbing ability.
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Affiliation(s)
- Hanna Brodowski
- Institute of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck University of Luebeck, Luebeck, Germany
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Natascha Andres
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Margareta Gumny
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Cornelia Eicher
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Divison of Lipid Metabolism of the Department of Endocrinology and Metabolic Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Antje Tannen
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Joern Kiselev
- Geriatrics Research Group, Charité – Universitätsmedizin Berlin, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Anesthesiology and Intensive Care Medicine, Campus, Charité Mitte, Corporate Member of Function Reacheie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Pehlivan E, Yazar E, Balcı A, Kılıç L. Comparison of Compliance Rates and Treatment Efficiency in Home-Based with Hospital-Based Pulmonary Rehabilitation in COPD. Turk Thorac J 2019; 20:192-197. [PMID: 31479415 DOI: 10.5152/turkthoracj.2019.18060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 12/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of the present study was to compare the home-based pulmonary rehabilitation (PR) with the hospital-based PR with respect to exercise compliance rates and efficiency of therapy in stable chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS Patients with stable severe and very severe COPD who were admitted consequently to our PR clinic were prospectively included in the study. Patients who completed the home-based PR for at least 4 days/week for 2 months as recommended were classified as the study group. Patients who completed the hospital-based PR in our clinic before the present study were classified as the control group. RESULTS Thirty-five patients were included in the home-based PR, but 10 patients were incompatible with the exercise training, and four patients were out of follow-up. Twenty-one patients successfully completed the home-based PR (study group), and compliance rate was 60%. Thirty-seven patients previously underwent the hospital-based PR, and 25 patients completed the exercise program (control group); thus, their compliance rate was 67%. There was no difference between the two groups with respect to treatment compliance rates. The significant improvement in six-minute walking distance, modified Medical Research Council dyspnea, and COPD Assessment Test scores were observed after PR in both groups, and there was no difference with respect to the levels of improvement. CONCLUSION The present study showed that approximately two-thirds of patients with COPD successfully completed the home-based PR, and that this program also provided similar benefits with respect to the quality of life and exercise capacity compared with the hospital-based PR.
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Affiliation(s)
- Esra Pehlivan
- Clinic of Pulmonary Rehabilitation, University of Health Sciences, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Esra Yazar
- Clinic of Pulmonary Rehabilitation, University of Health Sciences, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Arif Balcı
- Clinic of Pulmonary Rehabilitation, University of Health Sciences, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Lütfiye Kılıç
- Clinic of Pulmonary Rehabilitation, University of Health Sciences, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
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Pehlivan E, Mutluay F, Balcı A, Kılıç L. The effects of inspiratory muscle training on exercise capacity, dyspnea and respiratory functions in lung transplantation candidates: a randomized controlled trial. Clin Rehabil 2018; 32:1328-1339. [PMID: 29843525 DOI: 10.1177/0269215518777560] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate whether inspiratory muscle training would contribute to the improvement of exercise capacity, dyspnea perception and respiratory functions in lung transplantation candidates. DESIGN Prospective randomized controlled trial. SETTING Pulmonary Rehabilitation center. SUBJECTS A total of 34 patients with severe lung disease requiring lung transplantation were randomly allocated to either pulmonary rehabilitation plus inspiratory muscle training group (PR + IMT group, n = 17) or pulmonary rehabilitation group (PR group, n = 17) before any lung transplantation operation. METHODS All patients underwent supervised pulmonary rehabilitation program on two days per week for three months. The PR + IMT group received inspiratory muscle training in addition to the standard pulmonary rehabilitation program. The 6-minute walk test, maximal inspiratory pressure, modified Medical Research Concile dyspnea scores and spirometric parameters were measured for each patient. RESULTS The PR + IMT group had statistically significantly increased in walking distance (100 m, P = 0.03), maximum inspiratory pressure (26 cmH2O, P = 0.001) and alveolar volume ratio of carbonmonoxide diffusion capacity (9%, P = 0.02) than PR group. Although both groups demonstrated a statistically significant decrease in the dyspnea score, no significant differences were found between the groups ( P = 0.075). There was no change in spirometric variables in both groups. CONCLUSION A greater increase in exercise capacity was observed in the PR + IMT group. Our study showed that inspiratory muscle training improved exercise capacity even further and increased the benefits provided by pulmonary rehabilitation.
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Affiliation(s)
- Esra Pehlivan
- 1 Department of Pulmonary Rehabilitation, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fatma Mutluay
- 2 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Medipol University, Istanbul, Turkey
| | - Arif Balcı
- 1 Department of Pulmonary Rehabilitation, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Lütfiye Kılıç
- 1 Department of Pulmonary Rehabilitation, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Santos BFA, Souza HCD, Miranda APB, Cipriano FG, Gastaldi AC. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study. Braz J Phys Ther 2016; 20:66-72. [PMID: 26786074 PMCID: PMC4835166 DOI: 10.1590/bjpt-rbf.2014.0119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 07/24/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES: To assess functional capacity in the preoperative phase of pulmonary surgery by
comparing predicted and obtained values for the six-minute walk test (6MWT) in
patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated
using the 6MWT, followed by monitoring of the postoperative evolution of each
participant who underwent the routine treatment. Participants were then divided
into two groups: the group with PPC and the group without PPC. The results were
also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the
odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative
period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC
walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by
the group without PPC was 80% of the predicted value, whereas the group with PPC
averaged less than 70% (p=0.03), with more appropriate predicted values for the
reference equations CONCLUSIONS: The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation
in pulmonary surgery and may indicate patients with a higher chance of developing
PPC.
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Affiliation(s)
- Bruna F A Santos
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Hugo C D Souza
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Aline P B Miranda
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Federico G Cipriano
- Departamento de Clínica Cirúrgica, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Ada C Gastaldi
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Chang NW, Lin KC, Lee SC, Chan JYH, Lee YH, Wang KY. Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy. J Clin Nurs 2014; 23:3391-402. [DOI: 10.1111/jocn.12584] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Nai-Wen Chang
- Graduate Institute of Medical Sciences; National Defense Medical Center; Taipei Taiwan
- School of Nursing; National Defense Medical Center; Taipei Taiwan
| | - Kuan-Chia Lin
- Graduate Institute of Nurse-Midwifery; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Shih-Chun Lee
- Division of Thoracic Surgery; Department of Surgery; Tri-Service General Hospital; Taipei Taiwan
| | - James Yi-Hsin Chan
- Graduate Institute of Medical Sciences; National Defense Medical Center; Taipei Taiwan
| | - Ya-Hsin Lee
- School of Nursing; National Defense Medical Center; Taipei Taiwan
| | - Kwua-Yun Wang
- School of Nursing; National Defense Medical Center; Taipei Taiwan
- Department of Nursing; Taipei Veterans Hospital; Taipei Taiwan
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Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests. ACTA ACUST UNITED AC 2014; 51:335-50. [DOI: 10.1682/jrrd.2013.06.0148] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 10/02/2013] [Indexed: 11/05/2022]
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Functional capacity, physical activity and muscle strength assessment of individuals with non-small cell lung cancer: a systematic review of instruments and their measurement properties. BMC Cancer 2013; 13:135. [PMID: 23514337 PMCID: PMC3623892 DOI: 10.1186/1471-2407-13-135] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 03/07/2013] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The measurement properties of instruments used to assess functional capacity, physical activity and muscle strength in participants with non-small cell lung cancer (NSCLC) have not been systematically reviewed. METHOD OBJECTIVES To identify outcome measures used to assess these outcomes in participants with NSCLC; and to evaluate, synthesise and compare the measurement properties of the outcome measures identified. DATA SOURCES A systematic review of articles using electronic databases MEDLINE (1950-2012), CINAHL (1982-2012), EMBASE (1980-2012), Cochrane Library (2012), Expanded Academic ASAP (1994-2012), Health Collection Informit (1995-2012) and PEDRO (1999-2012). Additional studies were identified by searching personal files and cross referencing. Eligibility Criteria for Study Selection: Search one: studies which assessed functional capacity, physical activity or muscle strength in participants with NSCLC using non-laboratory objective tests were included. Search two: studies which evaluated a measurement property (inter- or intra-rater reliability; measurement error; criterion or construct validity; or responsiveness) in NSCLC for one of the outcome measures identified in search one. Studies published in English from 1980 were eligible. Data Extraction and Methodological Quality Assessment: data collection form was developed and data extracted. Methodological quality of studies was assessed by two independent reviewers using the 4-point COSMIN checklist. RESULTS Thirteen outcome measures were identified. Thirty-one studies evaluating measurement properties of the outcome measures in participants with NSCLC were included. Functional capacity was assessed using the six- and twelve-minute walk tests; incremental- and endurance-shuttle walk tests; and the stair-climbing test. Criterion validity for three of these measures was established in NSCLC but not the reliability or responsiveness. Physical activity was measured using accelerometers and pedometers. Only the construct validity for accelerometers and pedometers was reported. Muscle strength was measured using hand-held dynamometry, hand-grip dynamometry, manual muscle test, one-repetition maximum and the chair-stand test, however only two studies reported reliability and measurement error and one study reported construct validity. CONCLUSION Currently there is a gap in the literature regarding the measurement properties of commonly used outcome measures in NSCLC participants, particularly reliability, measurement error and responsiveness. Further research needs to be conducted to determine the most suitable outcome measures for use in trials involving NSCLC participants.
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Abstract
This article reviews an evidence-based approach to the physiologic evaluation of patients under consideration for surgical resection of lung cancer. Adequate physiologic evaluation often includes a multidisciplinary evaluation, with complete identification of risk factors for perioperative complications and long-term disability including cardiovascular risk, assessment of pulmonary function, and smoking cessation counseling. Consideration of tumor-related anatomic obstruction, atelectasis, or vascular occlusion may alter measurements. Careful preoperative physiologic assessment helps to identify patients at increased risk of morbidity and mortality after lung resection. These evaluations are helpful in identifying patients who may not benefit from surgical management of their lung cancer.
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