Walk performance in Thai men and women: physical activity dependence

Temporal trends in step test performance for Chinese adults between 2000 and 2014

BACKGROUD/OBJECTIVE

Cardiorespiratory endurance is an excellent marker of functional endurance and health among adults. The aim of this study was to estimate temporal trends in step test performance for Chinese adults between 2000 and 2014.

METHODS

Apparently healthy adults aged 20-59 years were included. Nationally representative step test data (n = 603,977) from 2000, 2005, 2010, and 2014 were reported descriptively by the China Physical Fitness Surveillance Center. Temporal trends in means were estimated at the sex-age level for all adults and separate location/occupation groups using sample-weighted linear regression, with trends in distributional characteristics described visually and estimated as the ratio of coefficients of variation (CVs).

RESULTS

Collectively, there was a negligible improvement in mean step test performance of 0.12 standardized effect sizes (95% confidence interval (95%CI): 0.11-0.13). Negligible to small improvements were observed for all age, sex, location, and occupation groups. Variability declined substantially over time (ratio of CVs (95%CI): 0.86 (0.86-0.86)), with negligible to large improvements in those below the 10th percentile, and negligible to moderate declines in those above the 90th percentile.

CONCLUSION

There have been negligible to large improvements in step test performance for low to average performing Chinese adults since 2000, which may be meaningful to public health because low endurance is an important risk factor for all-cause mortality.

Temporal trends in 6-minute walking distance for older Japanese adults between 1998 and 2017

BACKGROUND

The 6-minute walking distance (6MWD) is an excellent measure of both functional endurance and health. The primary aim of this study was to estimate temporal trends in 6MWD for older Japanese adults between 1998 and 2017; the secondary aim was to estimate concurrent trends in body size (i.e., height and mass) and self-reported participation in exercise/sport.

METHODS

Adults aged 65-79 years were included. Annual nationally representative 6MWD data (n = 103,505) for the entire period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in means (and relative frequencies) were estimated at the gender-age level by best-fitting sample-weighted linear/polynomial regression models, with national trends estimated by a post-stratified population-weighting procedure. Temporal trends in distributional variability were estimated as the ratio of coefficients of variation.

RESULTS

Between 1998 and 2017 there was a steady, moderate improvement in mean 6MWD (absolute = 45 m (95% confidence interval (95%CI): 43-47); percent = 8.0% (95%CI: 7.6%-8.4%); effect size = 0.51 (95%CI: 0.48-0.54)). Gender- and age-related temporal differences in means were negligible. Variability in 6MWD declined substantially (ratio of coefficients of variation = 0.89, 95%CI: 0.87-0.92), with declines larger for women compared to men, and for 75-79-year-olds compared to 65-74-year-olds. Correspondingly, there were moderate and negligible increases in mean height and mass, respectively, and negligible increases in the percentage who participated in exercise/sport at least 3 days per week and at least 30 min per session.

CONCLUSION

There has been a steady, moderate improvement in mean 6MWD for older Japanese adults since 1998, which is suggestive of corresponding improvements in both functional endurance and health. The substantial decline in variability indicates that the temporal improvement in mean 6MWD was not uniform across the distribution. Trends in 6MWD are probably influenced by corresponding trends in body size and/or participation in exercise/sport.

Physical activity and sedentary behaviour research in Thailand: a systematic scoping review

BACKGROUND

The number of deaths per year attributed to non-communicable diseases is increasing in low- and middle-income countries, including Thailand. To facilitate the development of evidence-based public health programs and policies in Thailand, research on physical activity (PA) and sedentary behaviour (SB) is needed. The aims of this scoping review were to: (i) map all available evidence on PA and SB in Thailand; (ii) identify research gaps; and (iii) suggest directions for future research.

METHODS

A systematic literature search was conducted through 10 bibliographic databases. Additional articles were identified through secondary searches of reference lists, websites of relevant Thai health organisations, Google, and Google Scholar. Studies written in Thai or English were screened independently by two authors and included if they presented quantitative or qualitative data relevant to public health research on PA and/or SB.

RESULTS

Out of 25,007 screened articles, a total of 564 studies were included in the review. Most studies included PA only (80%), 6.7% included SB only, and 13.3% included both PA and SB. The most common research focus was correlates (58.9%), followed by outcomes of PA/SB (22.2%), prevalence of PA/SB (12.4%), and instrument validation (3.2%). Most PA/SB research was cross-sectional (69.3%), while interventions (19.7%) and longitudinal studies (2.8%) were less represented. Most studies (94%) used self-reports of PA/SB, and few (2.5%) used device-based measures. Both sexes were examined in most studies (82.5%). Adults were the main target population group (51.1%), followed by older adults (26.9%), adolescents (15.7%), and children (6.3%). Clinical populations were investigated in the context of PA/SB in a relatively large number of studies (15.3%), most frequently those with cardiovascular disease, diabetes, and hypertension (22%, 21%, and 21% respectively).

CONCLUSIONS

The number of Thai papers on PA published per year has been increasing, indicating a growing interest in this research area. More studies using population-representative samples are needed, particularly among children and adolescents, and investigating SB as a health risk factor. To provide stronger evidence on determinants and outcomes of PA/SB, longitudinal studies using standardised measures of PA and SB are required.

Self-reported physical activity versus physical function capacity: alternatives for energy expenditure estimation

The extent to which self-report activity measured by the International Physical Activity Questionnaire (IPAQ) can substitute performance-based functional capacity measured by the Six-Minute Walk Test (6MWT) remains inconclusive. This study assessed Physical Activity (PA) and Functional Exercise Capacity (FEC); and also determined the relationship between PA and FEC in apparently healthy young adults. A total of 342 (145 males and 197 females) undergraduates of Obafemi Awolowo University, Ile-Ile, Nigeria participated in the study. The IPAQ was used to assess PA, while FEC was assessed using the 6MWT, and expressed in terms of the Six-Minute Walk Distance (6MWD), Six-Minute Walk Work (6MWW), Maximum Oxygen Uptake (VO2max) and Metabolic Equivalent (METS). Anthropometric and cardiovascular parameters were measured following standardized procedures. Data was analyzed using descriptive and inferential statistics. The alpha level was set at 0.05. The mean age of the participants was 22.0±2.87 years. The mean IPAQ score of all participants was 1471.4±1086.93. The percentage for low, moderate and high PA was 19% (65), 41.2% (141) and 39.8% (136), respectively. The mean 6MWD, 6MWW, VO2max and METS were 639.47 ±66.6 m, 41805.0 ±8520.6 kg·m, 28.9 ±1.92 mlO2k-1min-1, 4.05 ±0.32 mL/kg, respectively. There were signifi cant positive correlations between PA and each of the 6MWD (r=0.268; p=0.001), 6MWW (r=0.219; p=0.001), VO2max (r=0.268; p=0.001), METS (r=0.268; p=0.001). Measures of exercise capacity were not signifi cantly correlated with the anthropometric variables (p>0.05). Self-report of physical activity in healthy young adults does not adequately substitute the results of the Six-Minute Walk Test. Mbada Ch.E., Osifeso T.A., Johnson O.E., Okonji A.M., Odeyemi E.A. Self-reported physical activity versus physical function capacity: alternatives for energy expenditure estimation. Med Rehabil 2016; 20(4): 4-12. DOI: 10.5604/01.3001.0009.5479 null

Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications

OBJECTIVES

The objective of this study was to determine the performance of preoperative 6-minute walk test (6MWT) for predicting postoperative pulmonary complications (PPC) in high risk patients undergoing elective surgery under general anesthesia.

METHODS

A prospective cohort study was conducted in patients scheduled to undergo elective thoracic or nonthoracic surgery and indicated for preoperative pulmonary evaluation in Songklanagarind Hospital, Songkhla, Thailand. Preoperative spirometry, 6MWT were done and 30-day PPC were recorded. The multiple regression analysis and receiver operating characteristic (ROC) curves were used to analyze the variables and to compare the performance of 6MWT and spirometry tests.

RESULTS

A total of 78 participants were recruited into the study. 6MWT was done completely in all cases without any complications. Among these tests, 14 cases (17.9%) had contraindications to spirometry and two cases were unable to achieve the criteria for acceptable efforts. PPC developed in 17 cases (21%) with a high mortality (17.7%). A multiple regression analysis showed elderly, poor general health status, smoking history, low level of the mean value of forced expiratory volume in 1 second (FEV1) % predicted (by spirometry) and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. Patients developing PPC had a significantly lower preoperative 6MWD compared with patients without PPC (256.0 ± 48.0 versus 440.0 ± 117.1 meters, p < 0.001). 6MWD of ⩽325 meters was a threshold for predicting PPC with 77% sensitivity and 100% specificity, and had a good predictive value for PPC similar to that for the FEV1 %.

CONCLUSIONS

Preoperative 6MWT is a very useful alternative test for predicting PPC in high risk patients scheduled to undergo surgery under GA.

Reference values for standardized tests of walking speed and distance: a systematic review

OBJECTIVE

To provide an overview of the reference values and methodology used to obtain them for time- and distance-limited walk tests.

METHODS

We performed a systematic review and searched PubMed, MEDLINE (Ovid), EMBASE, CINAHL, Scopus, PEDro, and The Cochrane Library from 1946 to May 2013. Full-text peer-reviewed articles written in English, French or Spanish were considered eligible. Two authors independently screened titles and abstracts. One author determined eligibility of full-text articles, appraised methodological quality, and extracted data. A second author independently verified the accuracy of extracted data.

RESULTS

Of the 41 eligible studies reviewed, 25 failed to describe the method used to select participants and 10 had an inadequate sample size. Twenty-five studies provided reference values for one time-limited walk test (6-min walk test (6 MWT)) and 18 studies provided reference values for 15 distance-limited walk tests. Across studies, walk test distances ranged from 3m to 40m. Descriptive values and reference equations for the 6 MWT were reported in 15 and 20 studies, respectively. Across 43 regression equations (median R(2)=0.46), age (98%) and sex (91%) were most frequently included. The equation yielding the maximum R(2) value (0.78) included age, height, weight and percentage of predicted maximum heart rate. Among six unique regression equations for distance-limited walk tests (median R(2)=0.17), sex (83%), age (67%) and weight (67%) were most frequently included. The equation yielding the maximum R(2) value (0.25) included age and sex.

CONCLUSIONS

Reference values reported for these tests provide a basis for classifying walking capacity as within normal limits, determining the magnitude of deficit, educating clients, setting rehabilitation goals, and planning studies.