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Ozcan Kahraman B, Tanriverdi A, Sezgin NH, Acar S, Birlik AM, Koken Avsar A, Akdeniz B, Ozpelit E, Savci S. Comparison of physiological responses after incremental shuttle walking test and 6-minute walk test in patients with systemic sclerosis. Wien Klin Wochenschr 2024; 136:169-176. [PMID: 36161531 DOI: 10.1007/s00508-022-02087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 08/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The 6‑minute walk test (6MWT) is a commonly used to evaluate exercise capacity in patients with systemic sclerosis (SSc), but there was no study using the incremental shuttle walking test (ISWT) for assessing exercise capacity and comparing the patient's cardiorespiratory responses to these tests. The aim was to investigate the usability and determinants of the ISWT in patients with SSc and compare the physiological responses after the ISWT and 6MWT. METHODS A total of thirty four female patients with SSc were included. Dyspnea during daily activities and knee extensor muscle strength was assessed, skin fibrosis and disease severity were recorded, and 6MWT and ISWT were carried out for the exercise capacity measurement. Pulmonary function test results were recorded from the individuals' medical records for SSc with interstitial lung disease (SSc-ILD) patients. RESULTS The ISWT distance was significantly correlated with the 6MWT distance (p < 0.001). The 6MWT was correlated with age, modified Rodnan skin score, Medsger severity score, modified British Medical Research Council Questionnaire (mMRC) score, and knee extensor muscle strength (p < 0.05). The 6MWT was correlated with the forced expiratory volume in the first second (FEV1) (lt) and forced vital capacity (FVC) (lt) in patients with SSc-ILD (p < 0.05). The ISWT distance was correlated with age, modified Rodnan skin score, mMRC score, and knee extensor muscle strength (p < 0.05). Age, mMRC, and knee extensor muscle strength explained 33.8% of the variance in 6MWT distance, while age, mMRC, and knee extensor muscle strength explained 51.7% of the variance in the ISWT distance. CONCLUSION Because of the higher cardiopulmonary responses, and having a more standardized procedure, the ISWT may be preferable for investigating symptom-limited exercise capacity in patients with SSc. Age, dyspnea, and knee extensor muscle strength were the determinants of exercise capacity in patients with SSc.
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Affiliation(s)
- Buse Ozcan Kahraman
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Aylin Tanriverdi
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey
| | | | - Serap Acar
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Merih Birlik
- Department of Internal Disease, Rheumotology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Aydan Koken Avsar
- Department of Internal Disease, Rheumotology Department, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Bahri Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Sema Savci
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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Sedaghati P, Alghosi M, Hosseini F. The effect of fatigue on postural control in individuals with multiple sclerosis: a systematic review. BMC Neurol 2023; 23:409. [PMID: 37978449 PMCID: PMC10655337 DOI: 10.1186/s12883-023-03464-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Fatigue is the most disabling symptom for individuals with multiple sclerosis (MS), which can significantly affect postural control (PC) by impairing the ability of the central nervous system to modulate sensory inputs and coordinate motor responses. This systematic review aimed to investigate the effect of fatigue on PC in individuals with MS.. METHODS This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and registered in PROSPERO with ID CRD42022376262. A systematic search was performed in the Web of Science, PubMed, Scopus, and Google Scholar until January 2023, and a manual search was performed using the reference lists of included studies. Two authors independently selected the studies, extracted data, and evaluated their methodological quality using the Downs and Black checklist. The process was later discussed with a third author.. RESULTS Five studies were included in this review, of which consistent evidence investigating a direct relationship between fatigue and PC in individuals with MS. All the studies reported negative effects on PC. Four studies employed walking tests as their primary protocol for inducing fatigue, while one study implemented a strength testing protocol for both legs, serving as a fatigue-inducing activity. CONCLUSIONS The evidence suggests that individuals with MS may experience PC deficits due to fatigue. However, the present body of literature exhibits limitations regarding its quality and methodology. Gender differences, balance, fatigue task, and muscle function are essential factors that need to be considered when investigating the relationship between fatigue and PC deficits in MS. Further high-quality research is necessary to comprehend the complex interplay between MS-related fatigue and PC deficits after physical activity.
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Affiliation(s)
- Parisa Sedaghati
- Department of Sports Injury and Corrective Exercise, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran
| | - Mohammad Alghosi
- Department of Sports Injury and Corrective Exercise, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran.
| | - Freshteh Hosseini
- Department of Sports Injury and Corrective Exercise, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran
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Günther S, Bancal C, Plantier L. [Survey on hygiene practices after the COVID-19 pandemic in EFR departments]. Rev Mal Respir 2023; 40:535-539. [PMID: 37422341 PMCID: PMC10281215 DOI: 10.1016/j.rmr.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
During the COVID-19 pandemic, airborne transmission of lung disease was a cause for major concern, and scientific societies published strict hygiene guidelines for pulmonary function tests (PFT) and cardiopulmonary exercise testing (CPET). These guidelines led to a major decrease in patient access to PFT and CPET, and their relevance in the 2023 post-pandemic context may be called into question. Under the hypothesis that PFT/CPET expert centers have modified their practices in accordance with the applicable guidelines, a survey was conducted from the 8th through the 23rd of February 2023 in 28 French PFT/CPET hospital departments. An overwhelming majority of the centers (96%) did not limit indications for PFT/CPET, and requested neither a vaccination or recovery certificate (93%) nor a negative diagnostic test (89%). While the use by patients and caregivers of surgical masks and antimicrobial filters was unanimously adopted, only 36% of centers declared that FFP2/N95-filtering face masks were worn. Disinfection of caregivers' hands was carried out by 96%, and a majority of centers reported break time (75%) and disinfection of equipment surfaces (89%) between the testing of two patients. In conclusion: aside from a few modifications, the practices reported by PFT/CPET French expert centers in 2023 were close to those in force prior to the COVID-19 epidemic.
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Affiliation(s)
- S Günther
- Unité d'explorations fonctionnelles respiratoires et du sommeil, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris (AP-HP), université Paris Cité, Paris, France
| | - C Bancal
- Service d'explorations fonctionnelle, secteur respiratoire, Hôpital Bichat, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - L Plantier
- Service de pneumologie et explorations respiratoires, CHRU de Tours, CEPR/Inserm UMR1100, Université de Tours, Tours, France.
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Winding S, Shin DGD, Rogers CJ, Ni L, Bay A, Vaughan C, Johnson T, McKay JL, Hackney ME. Referent Values for Commonly Used Clinical Mobility Tests in Black and White Adults Aged 50-95 Years. Arch Phys Med Rehabil 2023; 104:1474-1483. [PMID: 37037292 PMCID: PMC10524633 DOI: 10.1016/j.apmr.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To estimate referent values for performance on clinical mobility tests conducted amongst racially diverse adults aged 50-95 years in the Southeast US. DESIGN This is an observational study of community-dwelling older adults from diverse racial groups who participated in observational and rehabilitative studies conducted from 2011-2019. SETTING Rehabilitation clinics around the greater metropolitan Atlanta, Georgia, region. PARTICIPANTS A total of 314 adults (N=314; 222 women). Individuals were predominantly Black (n=121) or White (n=164), with some participants from other racial groups (n=29). INTERVENTIONS Clinical and demographic data were collected at individual visits for each participant. MAIN OUTCOME MEASURES Four Square Step Test (FSST), timed Up and Go (TUG) test, dual TUG test, 6-minute walk test (6MWT), 30-second chair stand, and gait speed were all used as assessments in each cohort. RESULTS Performance slowly declines with increasing age, with a sharp drop in the ninth decade for preferred forward, backward, and fast gait speed; backward gait cadence; 6MWT, TUG test, dual-task TUG-Cognitive, and the 360° turn test. Declines were also seen in the eighth and ninth decades in the FSST. Among White participants, there were significant overall differences across age groups except in the assessment variable, preferred gait cadence. For Black individuals, there were significant overall differences across age groups for backward gait speed, fast gait speed, TUG-Cognitive, dual task, 6MWT, FSST, and 30-second chair stand. CONCLUSIONS These data enrich current referent values for brief, commonly used clinical tests in a diverse, older Southeast US cohort. These data include representatives of the oldest old cohort. This study will support race- and age-specific fall prevention and mobility-enhancing therapeutic application among older patients in clinical practice.
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Affiliation(s)
- Shamekia Winding
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA
| | - Dong Gun Denny Shin
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA
| | - Casey J Rogers
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL
| | - Liang Ni
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA
| | - Allison Bay
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA
| | - Camille Vaughan
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA; Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL; Atlanta VA Center for Visual & Neurocognitive Rehabilitation, Decatur, GA
| | - Theodore Johnson
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL; Department of Family and Preventative Medicine, Emory University School of Medicine, Atlanta, GA; Department of Medicine, Division of General Internal Medicine, Emory University School of Medicine, Atlanta, GA
| | - J Lucas McKay
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA; Department of Neurology, Emory University School of Medicine, Atlanta, GA; Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA
| | - Madeleine E Hackney
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA; Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL; Atlanta VA Center for Visual & Neurocognitive Rehabilitation, Decatur, GA; Emory School of Nursing, Atlanta, GA; Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA.
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Santos-Martínez LE, Osegueda-Palomera N, Montoya-Landa C, Reséndiz-Herrera R, Ordóñez-Reyna A, Arroyo-González JJ, Quevedo-Paredes J, Moreno-Ruiz LA. [Six minute walk test: From normal to morbid obesity subject]. Arch Cardiol Mex 2023; 93:284-293. [PMID: 36693218 PMCID: PMC10406474 DOI: 10.24875/acm.22000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/13/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Morbid obesity is associated with alterations in the ability to walk, however, the behavior of the 6-minute walk test in subjects with increases in body mass index is unknown. Objective To describe the behavior of the 6-minute walk test in subjects with normal body mass index to morbid obesity. Methods Through an analytical cross-sectional design, subjects of both genders from 18 to 60 years old with body mass index were studied: Normal (BMI:18.5-24.9); overweight (BMI:25-29.9); obesity (BMI:30-39.9); morbid obesity (BMI:>40) kg/m2. A 6-minute walk test was performed, demographic variables and pathological personal history were delimited. BMI categories were analyzed with one-way ANOVA and Bonferroni adjustment, and gender with t-test, both for independent groups, and Pearson's correlations for the various variables. Results 480 subjects of both genders were studied in four groups. Age: men 43 ± 11 and women 45 ± 10 years old. Percentage diabetes mellitus (6.7%), arterial hypertension (18.3%). Meters walked men vs. women by body mass index (normal: 483 ± 56 vs. 449 ± 61; overweight: 471 ± 55 vs. 441 ± 44; obesity: 455 ± 70 vs. 421 ± 47; morbid obesity: 443 ± 49 vs. 403 ± 54, p < 0.05). Correlation body mass index-meters walked: r: -0.446 (p < 0.0001). Conclusions Meters walked in the 6-minute walk test decreased as body mass index increased. The male gender walked more meters in all categories.
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Affiliation(s)
- Luís E. Santos-Martínez
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
- Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Secretaría de Salubridad y Asistencia, Instituto Nacional de Cardiología Ignacio Chávez
| | - Noé Osegueda-Palomera
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Caleb Montoya-Landa
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Raúl Reséndiz-Herrera
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Adriana Ordóñez-Reyna
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
| | - Juan J. Arroyo-González
- Departamento de Hipertensión Pulmonar y Corazón Derecho, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social
| | - Javier Quevedo-Paredes
- Coordinación del Curso Profesional Técnico Universitario en Terapia Respiratoria, Unidad Médica de Alta Especialidad, Hospital de Especialidades Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social
| | - Luís A. Moreno-Ruiz
- Departamento de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de México, México
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Cordeiro ALL, Almeida de Brito J, Rodrigues Pereira L, Duarte Pascoal H, Correia Dos Santos VT, Raimundo Guimarães A, Petto J. Inspiratory muscle training on quality of life and functional capacity after hospital discharge in patients submitted to coronary artery bypass grafting: A controlled clinical trial. J Bodyw Mov Ther 2023; 35:202-207. [PMID: 37330770 DOI: 10.1016/j.jbmt.2023.04.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/12/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION There is a gap in knowledge about functional capacity and quality of life in patients undergoing coronary artery bypass grafting (CABG) after hospital discharge and the contribution of inspiratory muscle training (IMT). OBJECTIVE To evaluate the influence of IMT on functional capacity and quality of life after hospital discharge of patients undergoing CABG. METHODOLOGY Clinical trial. In the preoperative period, patients assessed maximum inspiratory pressure (MIP), quality of life using the SF-36 and functional capacity using the Six-Minute Walk Test (6MWT). On the first postoperative day, they were randomized into: control group (CG) receiving routine assistance from the hospital; intervention group(IG) in addition to conventional physical therapy and submitted to an IMT protocol based on the glycemic threshold. Being reevaluated on the day of hospital discharge and post-discharge month. RESULTS 41 patients were included. In the preoperative period of the MIP assessment of the CG, it was 104 ± 14 cmH2O already in GI it was 103 ± 19cmH2O (p = 0.78) CG at discharge 80 ± 13 cmH2O already in GI it was 92 ± 15cmH2O(p < 0.01), revaluation CG 91 ± 11 cmH2O versus 98 ± 12 cmH2O (p < 0.01) of the IG. In the 6MWT the preoperative of the GC group was 420 ± 70 m already in GI it was 429 ± 71 m (p = 0,89), CG at discharge 326 ± 79 m versus 373 ± 55 m and revaluation of the CG 377 ± 75 m and IG 410 ± 57 m (p < 0.01). Functional capacity, general health status, emotional aspects and limitations due to physical aspects were significant when the three moments were compared. CONCLUSION IMT increases functional capacity, inspiratory muscle strength and quality of life after discharge from patients undergoing CABG.
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Affiliation(s)
- André Luiz Lisboa Cordeiro
- Centro Universitário Nobre, Feira de Santana, Bahia, Brazil; Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
| | | | | | | | | | | | - Jefferson Petto
- Centro Universitário Nobre, Feira de Santana, Bahia, Brazil; Universidade Salvador, Salvador, Bahia, Brazil
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Cartlidge MK, Wilkie H, Li F, Macleod J, Nicol L, Stewart G, Rabinovich RA, Linton K, McNamara S, Przybylski A, Hirani N. A retrospective study of crossover ambulatory oxygen walk testing in patients with fibrotic lung disease. Respir Investig 2023; 61:467-472. [PMID: 37172428 DOI: 10.1016/j.resinv.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Fibrotic interstitial lung disease (ILD) comprises a group of lung conditions that are often progressive, debilitating, and life-shortening. Ambulatory oxygen therapy (AOT) is regularly prescribed to manage symptoms in patients with fibrotic ILD. In our institution, the decision to prescribe portable oxygen is made on the basis of oxygen improving exercise capacity, measured with the single-blinded, crossover ambulatory oxygen walk test (AOWT). This study aimed to investigate the characteristics and survival rates of patients with fibrotic ILD who have either positive or negative results on the AOWT. METHODS This retrospective cohort study compared the data from 99 patients with fibrotic ILD who underwent the AOWT. These patients were classified into two groups based on whether they showed improvement in the AOWT with supplemental oxygen (positive group) or no improvement (negative group). Patient demographics for both groups were compared to determine any significant differences. A multivariate Cox proportional hazards model was used to analyze the survival rates of the two groups. RESULTS Out of the 99 patients, 71 were in the positive group. We compared the measured characteristics between the positive and negative groups and found no significant difference, wherein the adjusted hazard ratio was 1.33 (95% confidence interval 0.69-2.60, P = 0.40). CONCLUSIONS The AOWT can be used to rationalize AOT, but there was no significant difference in baseline characteristics or survival rates between patients whose performance was improved or not in the AOWT.
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Affiliation(s)
- Manjit K Cartlidge
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
| | - Hazel Wilkie
- University of Edinburgh Medical School, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Feng Li
- Centre for Inflammation Research, Queen's Medical Research Institute, 47 Edinburgh, EH16 4TJ, UK
| | - Jill Macleod
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Lisa Nicol
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Gareth Stewart
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Roberto A Rabinovich
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Karen Linton
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Sarah McNamara
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Alex Przybylski
- Centre for Inflammation Research, Queen's Medical Research Institute, 47 Edinburgh, EH16 4TJ, UK
| | - Nik Hirani
- Edinburgh Lung Fibrosis Clinic, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK; Centre for Inflammation Research, Queen's Medical Research Institute, 47 Edinburgh, EH16 4TJ, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Karanfil E, Salcı Y, Balkan AF, Sütçü G, Tuncer A. Reliability and validity of the incremental shuttle walk test in patients with fully ambulatory multiple sclerosis. Mult Scler Relat Disord 2023; 70:104522. [PMID: 36682242 DOI: 10.1016/j.msard.2023.104522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/28/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Functional exercise capacity evaluation is crucial to monitor treatment effects and disease progression in people with multiple sclerosis (pwMS). Compared to other tests, the incremental shuttle walking test (ISWT), which more accurately reflects cardiovascular responses, may be more useful for assessing exercise capacity. The aim of the study is to investigate the reliability and validity of the ISWT. METHODS Thirty-six pwMS with an Expanded Disability Status Scale (EDSS) score<4.5 between the ages of 25 and 65 were included in the study. The subjects underwent practice (ISWT-p) before undergoing the test-retest protocol in order to rule out the ISWT learning effect (ISWT-1 - ISWT-2). ISWT-1 and ISWT-2 were administered with a 3-7 day interval for test-retest reliability. Six-minutes walking test (6MWT) were applied for concurrent validity. The EDSS, pulmonary function tests, Fatigue Impact Scale (FIS), respiratory muscle strength [maximum inspiratory and expiratory pressure (MIP-MEP)] measurements were made for convergent validity. RESULTS ISWT was found to have excellent test-retest reliability with an ICC value of 0.97. The area under the curve value was 0.904 indicating that ISWT has a good performance for predicting disease severity. The moderate correlation between ISWT and 6MWT (rho: 0.68, p<0,001) proved concurrent validity. It was also moderately correlated with EDSS, MEP (rho: -0.58 and 0.47 respectively), weakly correlated with MIP and FIS (rho:0.37 and -0.36, respectively) while not correlated with pulmonary function tests. CONCLUSION The ISWT had excellent test-retest reliability, acceptable criterion and construct validity in ambulatory MS patients.
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Affiliation(s)
- Ecem Karanfil
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Adnan Saygun Caddesi, 06100-Samanpazari, Ankara, Turkey.
| | - Yeliz Salcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Adnan Saygun Caddesi, 06100-Samanpazari, Ankara, Turkey
| | - Ayla Fil Balkan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Adnan Saygun Caddesi, 06100-Samanpazari, Ankara, Turkey
| | - Gülşah Sütçü
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Adnan Saygun Caddesi, 06100-Samanpazari, Ankara, Turkey
| | - Aslı Tuncer
- Faculty of Medicine, Department of Neurology, Hacettepe University, Adnan Saygun Caddesi, 06100-Samanpazari, Ankara, Turkey
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Peniche PDC, Aguiar LT, Ferreira Dos Reis MT, Faria CDCDM. An Equation With Clinical Applicability and Adequate Validity to Predict the Maximum Oxygen Consumption of Individuals Post-stroke. Arch Phys Med Rehabil 2022; 104:769-775. [PMID: 36493868 DOI: 10.1016/j.apmr.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To develop an equation with clinical applicability and adequate validity to predict the maximum oxygen consumption (V̇o2max) of individuals post-stroke. DESIGN A cross-sectional study. SETTING A university laboratory. PARTICIPANTS Individuals post-stroke in the chronic phase (at least 6 months post-stroke). Step-1 (equation development): n=50, aged 55±12 years; Step-2 (validity investigation): n=20, aged 58±8 years (N=50 [step 1], N=20 [step 2]). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) Step-1 (equation development): multiple linear regression analysis was performed. DEPENDENT VARIABLE V̇o2max (mL/kg/min) in the cardiopulmonary exercise test. INDEPENDENT VARIABLES age (years), sex (1-women, 2-men), body mass index (BMI) (kg/m2), and distance (meters) in the Six-Minute Walk Test (6MWT) (6MWT-Equation) or in the Incremental Shuttle Walk Test (ISWT) (ISWT-Equation). Step-2 (validity investigation): agreement between the V̇o2max measured and predicted was evaluated with the intraclass correlation coefficient (ICC) with 95% confidence interval (CI) and the Bland-Altman method (α=5%). RESULTS In step-1 (equation development), the 4 independent variables for each equation were retained (6MWT-Equation: R2=0.68, P<.001; ISWT-Equation: R2=0.58, P<.001). In step-2 (validity investigation), the 6MWT-Equation showed an ICC of 0.73 (95% CI=0.30, 0.89; P=.004) and a mean bias of 0.003 mL/kg/min; and the ISWT-Equation showed an imprecise ICC of 0.55 (95% CI=-0.12, 0.82; P=.045) and a mean bias of 0.971 mL/kg/min. 6MWT-Equation (V̇o2max=22.239+0.02 × distance in the 6MWT+4.039 × sex-0.157 × age-0.265 × BMI) showed adequate validity. CONCLUSIONS An equation with clinical applicability and adequate validity in the investigated sample was developed to predict the V̇o2max of individuals post-stroke in the chronic phase (6MWT-Equation). Future studies with larger sample should investigate its external validity.
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Affiliation(s)
- Paula da Cruz Peniche
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Tavares Aguiar
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Physical Therapy, Faculdade Ciências Médicas de Minas Gerais (FCM-MG), Belo Horizonte, Minas Gerais, Brazil
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Lans C, Cider Å, Nylander E, Brudin L. The relationship between six-minute walked distance and health-related quality of life in patients with chronic heart failure. SCAND CARDIOVASC J 2022; 56:310-315. [PMID: 35929855 DOI: 10.1080/14017431.2022.2107234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Objectives. To assess the relationship between the six-minute walk test (6MWT) and health-related quality of life (HRQL) in patients with chronic heart failure. Methods. Forty-six patients (37 men and 9 women) with chronic heart failure, mean age 68 (SD 9), NYHA II-III and EF 29 (9) % were included. They performed 6MWT and assessed HRQL using two tools, a Swedish version of the 36-item Short Form (SF-36) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). This was performed repeatedly during a study period of one year. Results. Patients with a walking distance lower than median experienced a lower HRQL than the higher performing half of the cohort, in four dimensions of the SF-36 and the summary of physical and mental components, but not in the dimensions of MLHFQ. Conclusion. Patients with heart failure with a short walking distance assessed their quality of life as inferior in half of the dimensions in the SF-36 but not in the dimensions measured with the MLHFQ. Thus, different aspects of the symptomatology are uncovered using the 6MWT and the different HRQL tools.
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Affiliation(s)
- Charlotta Lans
- Department of Physiotherapy in Kalmar, Kalmar County Hospital, Kalmar, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Åsa Cider
- Occupational and Physiotherapy Department, Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Eva Nylander
- Department of Clinical Physiology, and Department of Health, Medicine and Caring Sciences, Linköping University Linköping, Sweden
| | - Lars Brudin
- Department of Clinical Physiology, Kalmar, Region Kalmar County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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12
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Seth M, Pohlig RT, Hicks GE, Sions JM. Clinical mobility metrics estimate and characterize physical activity following lower-limb amputation. BMC Sports Sci Med Rehabil 2022; 14:124. [PMID: 35799260 PMCID: PMC9264684 DOI: 10.1186/s13102-022-00518-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/01/2022] [Indexed: 12/04/2022]
Abstract
Background Regular physical activity following a lower-limb amputation is essential for maintaining health and a high quality of life. Most adults with a lower-limb amputation, however, participate in insufficient daily physical activity, and thus, are predisposed to poor health outcomes. Estimating physical activity after lower-limb amputation via common mobility metrics may aid in clinical decisions regarding treatment prioritization and prosthesis prescription. The objectives of this study were (a) to examine associations between daily physical activity and patient-reported and performance-based mobility metrics among adults with lower-limb amputation, and (b) to determine whether patient-reported and performance-based mobility metrics can distinguish between physical activity status [i.e., sedentary (< 5000 steps/day) or non-sedentary (≥ 5000 steps/day)] of adults with lower-limb amputation. Methods A cross-sectional study involving 35 adults with a unilateral transtibial (N = 23; 63.0 ± 10.4 years) or transfemoral amputation (N = 12; 58.8 ± 9.5 years) was conducted. Participants completed patient-reported (Prosthesis Evaluation Questionnaire-Mobility Subscale) and performance-based mobility metrics (L-Test, 10-m Walk Test, 6-min Walk Test). Physical activity, i.e., average steps/day, was measured with an accelerometer. Results Patient-reported and performance-based mobility metrics were associated with daily physical activity (p < 0.050). Prosthesis Evaluation Questionnaire-Mobility Subscale scores, L-Test time, 10-m Walk Test speed and 6-min Walk Test distance independently explained 11.3%, 31.8%, 37.6% and 30.7% of the total variance in physical activity. Receiver operating characteristic curves revealed patient-reported and performance-based mobility metrics significantly distinguish between physical activity status, i.e., sedentary (< 5000 steps/day) versus non-sedentary (≥ 5000 steps/day). Preliminary cut-points for mobility metrics to classify physical activity status were determined. Conclusions Following a lower-limb amputation, patient-reported and performance-based mobility metrics may estimate daily physical activity, thereby aiding clinical decisions regarding treatment prioritization as well as prosthesis selection.
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Affiliation(s)
- Mayank Seth
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Suite 210JJ, Newark, DE, 19713, USA
| | | | - Gregory Evan Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Jaclyn Megan Sions
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Suite 210JJ, Newark, DE, 19713, USA. .,Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, DE, USA.
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Peniche PDC, Aguiar LT, Reis MTFD, Oliveira DMG, Scalzo PL, Faria CDCDM. The Distance Covered in Field Tests is more Explained by Walking Capacity than by Cardiorespiratory Fitness after Stroke. J Stroke Cerebrovasc Dis 2021; 30:105995. [PMID: 34289432 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/04/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate if the distance covered in the Six-Minute Walk Test (6MWT) and in the Incremental Shuttle Walk Test (ISWT) is most strongly explained by walking capacity or cardiorespiratory fitness (CRF) measures in individuals after chronic stroke. MATERIALS AND METHODS This is a cross-sectional study. Individuals after chronic stroke aged at least 20 years old and able to walk at least 10 minutes independently were included. The distance covered (meters) in the 6 MWT and ISWT (dependent variables), comfortable and fast gait speed obtained by the 10 m walk test (10 mWT) (walking capacity measures; independent variables) and peak oxygen consumption (VO2peak; CRF measure; independent variable) (ml.kg-1.min-1) obtained by the cardiopulmonary exercise test (CPET) were obtained. Linear regression analyses were performed (α = 5%). RESULTS Fifty individuals (mean age of 55±12 years and mean time after stroke of 67±74 months) were included. Comfortable and fast gait speeds were the variables that most strongly explained the distance covered in the field tests: 6MWT (R² = 0.614, β = 0.784, p < 0.001 and R² = 0.615, β = 0.778, p < 0.001, respectively) and ISWT (R² = 0.450, β = 0.671, p < 0.001 and R² = 0.456, β = 0.746, p < 0.001, respectively). On the other hand, for the VO2peak, the following models were generated: 6MWT (R² = 0.280, β = 0.530, p < 0.001) and ISWT (R² = 0.154, β = 0.393, p = 0.005). CONCLUSIONS: The distance covered in the field tests (6MWT and ISWT) is more suitable to support inferences about the walking capacity than about the CRF of individuals after chronic stroke.
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Affiliation(s)
| | - Larissa Tavares Aguiar
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil; Faculdade Ciências Médicas de Minas Gerais (FCM-MG), Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Paula Luciana Scalzo
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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14
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Tanishima S, Weishi L, Jianzhong H, Jie Z, Huilin Y, Nagashima H. Evaluating the Reproducibility of the Walking Test for Intermittent Claudication Associated with Lumbar Spinal Stenosis. Asian Spine J 2021; 16:411-418. [PMID: 33957742 PMCID: PMC9260410 DOI: 10.31616/asj.2020.0505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/11/2021] [Indexed: 11/23/2022] Open
Abstract
Study Design This is a multicenter, prospective study. Purpose This study aimed to evaluate the reproducibility of the walking test for patients with lumbar spinal stenosis (LSS). Overview of Literature Walking test is one of the useful procedures to investigate cauda equina syndrome with lumbar spinal stenosis. One the other hands, there were few studies to investigate the reproducibility of this test. Methods In this study, we prospectively examined 70 LSS patients with intermittent claudication symptoms at a multicenter outpatient clinic. A walking test was administered at baseline and week 4 to assess patients' walking distance and lower limb pain and numbness. Immediately after the walking test, patients were asked to use the Visual Analog Scale (VAS) to rate their pain and numbness in the front, back, outside, inside, and hip of the lower legs. The reproducibility of the walking test was evaluated using Cohen's κ analysis and intraclass correlation coefficients (ICCs). Meanwhile, the Swiss Spinal Stenosis (SSS) Questionnaire was used to evaluate the severity of the stenosis. Results The walking distance ICC at baseline and at week 4 remained unchanged at 0.7, with acceptable interobserver reliabilities for lower limb pain and numbness in both legs. The average VAS score for lower leg pain was 23.2±25.2 mm at baseline and 27.4±28.8 mm at week 4, while the corresponding average VAS score for numbness was 23.4±26.7 mm at baseline and 24.8±25.2 mm at week 4. The ICC score was 0.7 for leg pain and 0.7 for numbness. The mean SSS was 30.2±5.5 at baseline and 29.2±5.2 at week 4, and there was no significant difference in the severity. Conclusions The walking test for LSS has acceptable reproducibility.
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Affiliation(s)
- Shinji Tanishima
- Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Li Weishi
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Hu Jianzhong
- Department of Orthopaedics, Xiangya Hospital Central South University, Changsha, China
| | - Zhao Jie
- Department of Orthopaedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Huilin
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hideki Nagashima
- Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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Nygaard MKE, Langeskov-Christensen M, Dalgas U, Eskildsen SF. Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis. J Neurol 2021; 268:3861-3870. [PMID: 33829319 DOI: 10.1007/s00415-021-10543-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND In multiple sclerosis (MS), pronounced neurodegeneration manifests itself as cerebral gray matter (GM) atrophy, which is associated with cognitive and physical impairments. Microstructural changes in GM estimated by diffusion kurtosis imaging (DKI) may reveal neurodegeneration that is undetectable by conventional structural MRI and thus serve as a more sensitive marker of disease progression. OBJECTIVE The primary objective was to investigate the relationships between morphological and diffusional properties in cerebral GM and physical and cognitive performance in relapsing-remitting MS (RRMS) patients. A secondary objective was to investigate the relationship between GM microstructure and white matter (WM) injury, estimated by the volume of WM lesions. METHODS Sixty-seven RRMS patients performed the brief repeatable battery of neuropsychological tests (BRB-N), the 6-minute walk test (6MWT), the six spot step test (SSST), and underwent MRI scans using structural and DKI protocols. GM volumetrics and DKI measurements were analyzed in the cortex and deep GM structures using a general linear model with demographics, physical- and cognitive performance as covariates. RESULTS Mean diffusivity (MD) in the cortex was associated with the SSST, 6MWT, information processing, global cognitive performance, and volume of WM lesions. In addition, thalamic volume was associated with SSST (r2 = 0.21, 6MWT (r2 = 0.18), information processing (r2 = 0.21), and WM lesion volume (r2 = 0.60). CONCLUSION Cortical diffusion and thalamic volume are associated with walking and cognitive performance in RRMS patients and are highly affected by the presence of WM lesions.
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Affiliation(s)
- Mikkel K E Nygaard
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, Building 1A, 8000, Aarhus C, Denmark.
| | | | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Simon F Eskildsen
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Nørrebrogade 44, Building 1A, 8000, Aarhus C, Denmark
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Kang OD. Effects of therapeutic horse-riding program on the walking ability of students with intellectual disabilities. J Anim Sci Technol 2021; 63:440-452. [PMID: 33987617 PMCID: PMC8071744 DOI: 10.5187/jast.2021.e22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 11/19/2020] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to determine if an 8-week therapeutic riding (TR)
program was effective in improving the walking ability of students with
intellectual disabilities. Thirteen students diagnosed with intellectual
disabilities participated in the TR program. TR sessions were conducted twice a
week (30 min per session), with a total of 16 rides taking place over an 8-week
period. A gait measurement analyzer was used to measure progress based on a turn
test (6-m walking and turning test), walk test (10-m walking), and timed up and
go (TUG) test. Measurements were made three times: before horse-riding (P0),
after 4 weeks (8 rides) of horse-riding (P1), and after 8 weeks (16 rides) of
horse-riding (P2). Data analysis was conducted using SPSS software (ver. 22.0).
Descriptive statistics were generated on the general characteristics of the
subjects, and the Kolmogorov-Smirnov test was used to verify the normality of
the data. Because of the lack of normality, the data were analyzed using a
nonparametric method and the significance level was set to 0.05. Measurements of
the duration of the forward gait cycle (s) in the turn test and the forward gait
speed (m/s) in the walk test indicated improved walking ability after the TR
program (p < 0.001); the stride length (% height) also
increased significantly (p < 0.05). The walk test
revealed a significant effect of the program on the duration of the forward gait
cycle (p < 0.05), while there were significant
improvements on the left and right of the elaborated strides (p
< 0.001). No significant improvement in TUG test performance was observed
after the TR program. In this study, an 8-week TR program had positive results
on gait. Therefore, further research is merited, where TR programs are likely to
improve the walking ability of individuals with intellectual disabilities.
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Affiliation(s)
- Ok-Deuk Kang
- Animal Biotechnology, Jeju National University, Jeju 63243, Korea
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Yamamoto A, Shirai T, Hirai K, Tanaka Y, Watanabe H, Endo Y, Shimoda Y, Suzuki T, Noguchi R, Mochizuki E, Sakurai S, Saigusa M, Akamatsu T, Shishido Y, Akita T, Morita S, Asada K. Oscillometry as a Predictor of Exercise Tolerance in COPD. COPD 2020; 17:647-654. [PMID: 33183076 DOI: 10.1080/15412555.2020.1844176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The usefulness of the oscillometry, known as forced oscillation technique, for predicting exercise tolerance in subjects with COPD is unknown. To test the hypothesis, we investigated whether oscillometry could predict a 6-minute walking distance (6MWD) <350 m in the 6-minute walk test (6MWT).This was a prospective, observational study. Fifty-seven subjects with COPD who attended outpatient clinics for routine checkups at Shizuoka General Hospital between April 2015 and April 2016 (54 males; median age, 70 years; and %FEV1, 61.0%). Modified MRC dyspnea scale (mMRC), COPD Assessment Test (CAT), oscillometry, spirometry, and 6MWT were performed in a stable condition. The participants were classified into subjects with 6MWD ≥350 m or 6MWD <350 m, and the predictor of 6MWD <350 m was assessed.Of the 57 total subjects, 43 (75.4%) had a 6MWD ≥350 m, and 14 (24.6%) had a 6MWD <350 m. Between the two groups, there were significant differences in mMRC scale, GOLD stages, CAT scores, FEV1, IC, 6MWD, lowest SpO2, maximum Borg scale, respiratory resistance (Rrs), and reactance (Xrs). In multivariate regression analysis, a 6MWD <350 m was independently predicted by CAT scores (OR 1.15, 95% CI: 1.01-1.30) and inspiratory R5 (OR 6.01, 95% CI: 1.09-33.30). In receiver operating characteristic curves, the area under the curve was 0.76, 0.78, and 0.85 for CAT scores, R5, and CAT scores + R5, respectively, with the best cutoff value of 17 and 2.82 cmH20/L/s. In conclusion, the oscillatory parameter, inspiratory R5, predicted low exercise tolerance in COPD subjects.
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Affiliation(s)
- Akito Yamamoto
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Keita Hirai
- Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yuko Tanaka
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Hirofumi Watanabe
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yoshinari Endo
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yukiko Shimoda
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Takahito Suzuki
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Rie Noguchi
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Eisuke Mochizuki
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Shogo Sakurai
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Mika Saigusa
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Taisuke Akamatsu
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Yuichiro Shishido
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Takefumi Akita
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Satoru Morita
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan
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Macchiavelli A, Giffone A, Ferrarello F, Paci M. Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis. Neurol Sci 2021; 42:81-7. [PMID: 33064231 DOI: 10.1007/s10072-020-04829-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The six-minute walking test (6MWT) is a simple and widely used measure of functional capacity. The aim of this systematic review is to summarize findings on reliability of 6MWT in subjects who have had a stroke. METHODS Two independent investigators conducted an extensive search in multidisciplinary electronic databases from inception to August 2019, and selected complete original studies on the reliability of the 6MWT used to assess individuals with stroke. Two reviewers independently extracted data and evaluated methodological quality. Outcome for meta-analysis was reliability, measured by intraclass correlation coefficient (ICC). In addition, standard error of measurement (SEM) and minimal detectable change (MDC) were recorded. RESULTS Of the 241 potentially relevant articles screened, 6 met inclusion criteria and 5 of them were included in meta-analysis. Combined correlation coefficient of .98 (confidence interval .98-.99) was found for test-retest reliability. Only one study investigated inter-rater and intra-rater reliability. SEM and MDC values were rarely reported. CONCLUSIONS The 6MWT has high test-retest reliability, when used to assess individuals with stroke. Other types of reliability and SEM and MDC need further investigations in populations with a stroke.
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Moisan L, Iannuzzi D, Maranda B, Campeau PM, Mitchell JJ. Clinical characteristics of patients from Quebec, Canada, with Morquio A syndrome: a longitudinal observational study. Orphanet J Rare Dis 2020; 15:270. [PMID: 32993725 PMCID: PMC7526408 DOI: 10.1186/s13023-020-01545-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
Background Morquio A syndrome is a rare, autosomal recessive, progressively debilitating disorder, with multi-system impairments and high medical burden. Quebec, Canada has a large Morquio A population, which is considered unique due to the presence of founder pathogenic variants. The objectives of this study were to document the genetic and clinical heterogeneity of patients with Morquio A in Quebec, to better characterize the phenotype of those with the French Canadian founder pathogenic variant (NM_000512.5: c.1171A>G, p.Met391Val), and to describe the natural history of the patients treated with elosulfase alfa enzyme replacement therapy. Patients with Morquio A were genotyped for pathogenic variants in the lysosomal enzyme N-acetylgalactosamine-6-sulfatase. Clinical data were retrospectively collected from medical charts of patients and included medical history, height, physical examination, respiratory function tests, electrocardiogram, echocardiogram, endurance in the 6-min walk test (6MWT), and activities of daily living (ADL) as assessed by the Mucopolysaccharidosis Health Assessment Questionnaire (MPS-HAQ). Longitudinal data were collected retrospectively and prospectively for patients treated with elosulfase alfa. Results A total of 33 patients, aged 5–63 years, were included in the analysis. Patients with the founder pathogenic variant (n = 17) generally exhibited a non-classical form of Morquio A. As compared with patients with a non-founder pathogenic variant (n = 16), these patients were generally taller, had greater endurance and were better able to perform ADL. However, they still had significant musculoskeletal disease. Most of the 26 patients treated with elosulfase alfa, regardless of pathogenic variant, showed improvements in endurance and ADL. After 5 to 12 months of treatment, the mean improvement from baseline in the 6MWT was 23% and 10 of 14 patients improved in at least one MPS-HAQ domain. Endurance and ADL generally continued to improve or maintained stable in the long term (up to 7 years). Four out of 19 treated patients with echocardiogram data at follow-up showed progression of cardiac disease. Conclusions In Quebec, Canada, Morquio A frequently manifests as a non-classical form of the syndrome due to a founder effect. Patients treated with elosulfase alfa generally show long-term improvement or stability in endurance and function, regardless of pathogenic variant.
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Affiliation(s)
- Lina Moisan
- Division of Medical Genetics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - David Iannuzzi
- Division of Medical Genetics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Bruno Maranda
- Medical Genetics Division, Centre Hospitalier Universitaire Sherbrooke, Sherbrooke, QC, Canada
| | - Philippe M Campeau
- Medical Genetics Division, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - John J Mitchell
- Division of Medical Genetics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada. .,Division of Pediatric Endocrinology, Montreal Children's Hospital, McGill University Health Centre, A04.6309, 1001 Decarie, Montreal, QC, Canada.
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Pattni J, Godfrey R, Chatfield S, Booth S, Quinlivan R. Reference values for the 12 minute walk test in McArdle patients. Neuromuscul Disord 2020; 30:862-865. [PMID: 32962872 DOI: 10.1016/j.nmd.2020.08.361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
The maximum distance achieved on a modified 12 min walk test (12MWT) is a well-established measure in McArdle disease glycogen storage disease type V (GSDV). Age, height, body mass and gender are known predictors of walking distance in other patient groups. Reference values to correct for these predictors are necessary for comparisons between individuals. To date, there has not been a systematic investigation of these predictors in the 12MWT in GSDV. This study explores the contribution of these predictors on distance achieved in GSDV. Data, included maximum distance walked, age, gender, height and body mass, was collected from 103 GSDV patients who underwent 12MWT between 2011 and 2017. Analysis showed a significant correlation between distance achieved and height, age, body mass and gender. Multiple linear regression analysis revealed a model accounting for 29.7% of variance (R = 0.545, R2 0.297, adjusted R2 0.269). Gender was not significant after height, age and body mass were entered into the regression analysis. This is the first study to report the contribution of non-disease related factors on distance achieved on the 12MWT in the GSDV population. The reference values generated will allow for improved monitoring and assessment of GSDV patients in clinical and research settings.
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Affiliation(s)
- Jatin Pattni
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
| | - Richard Godfrey
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Brunel University London, Centre for Human Performance, Exercise and Rehabilitation, London, United Kingdom
| | - Sherryl Chatfield
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Suzanne Booth
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Rosaline Quinlivan
- MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Dubowitz Neuromuscular Centre UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, United Kingdom
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21
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Kakitsuka EE, Morita AA, Itakussu EY, Kuwahara RM, Anami EHT, Pitta F, Hernandes NA. Six-minute walk test in burned subjects: Applicability, reproducibility and performance at hospital discharge. Burns 2020; 46:1540-1547. [PMID: 32807543 DOI: 10.1016/j.burns.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/07/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Despite its clinical relevance in several populations, there is no evidence on applicability of the 6-min walk test (6MWT) in burned subjects. OBJECTIVES To verify the applicability and reproducibility of the 6MWT in burned individuals and to analyze patients' performance in this test at hospital discharge. METHODS In a cross-sectional study, burned individuals performed two 6MWT at hospital discharge, according to international standardization. In addition to walked distance, physiological and symptomatic variables were collected. Clinical history and demographic data were also recorded. RESULTS One hundred individuals were evaluated (70 men, 10 [6-18]% total body surface area burned). There was excellent agreement between the two 6MWT (ICC = 0.97). However, 73% of subjects increased the walked distance in the second test (23 [-9-47]m or 5 [-2-10]%; P = 0.001). Considering the best 6MWT, the walked distance was 488 [396-718]m (80 [65-92]%pred), and 51% of the individuals had limited functional exercise capacity. Additionally, participants without lower limb involvement presented better 6MWT than others (P < 0.0001). CONCLUSION The 6MWT was applicable, well tolerated and reproducible at hospital discharge in burned individuals. However, there was considerable learning effect between the first and second test. Finally, the reduced exercise capacity observed reinforces need for early rehabilitation in this population.
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Affiliation(s)
- Emely Emi Kakitsuka
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil; Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Brazil
| | - Andrea Akemi Morita
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil; Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Brazil
| | - Edna Yukimi Itakussu
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil; Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Brazil
| | - Reinaldo Minoru Kuwahara
- Burn Treatment Center, University Hospital of State University of Londrina (HU-UEL), Londrina, Brazil
| | | | - Fabio Pitta
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Nidia Aparecida Hernandes
- Stricto Sensu Graduate Program in Rehabilitation Sciences, State University of Londrina (UEL) and University Pitágoras Unopar (UNOPAR), Londrina, Brazil; Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil.
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Guo S, Song Y, Feng J, Liu S, Li Y, Liu M, Wei L, Zhang X, Xie H, Sun Z. Effects of Qizhukangxian granules on idiopathic pulmonary fibrosis: a randomized, double blind, placebo-controlled and multicenter clinical pilot trial. J TRADIT CHIN MED 2020; 40:674-682. [PMID: 32744035 DOI: 10.19852/j.cnki.jtcm.2020.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the effects of Qizhukangxian granules (QG) on idiopathic pulmonary fibrosis (IPF). METHODS This is a randomized, double blind, placebo-controlled and multicenter clinical pilot trial. Six medical centers in Tianjin, China, participated in the study. A total of 120 IPF patients were enrolled and randomized into two groups, with 60 patients in each group. The treatment group was treated with QG, while the control group received a Qizhukangxian placebo. The pharmacological treatment lasted for 48 weeks from the enrollment date. The indexes of patients were recorded on the admission day and at the end of the 24th and 48th weeks. Data were analyzed to study the effects of QG; forced vital capacity, change in forced vital capacity and maximal 6-min walk test (6MWT) distance were the primary endpoints. Secondary endpoints were percentage of patients with episodes of acute exacerbation of IPF, pulmonary function, changes in pulse oxygen saturation during the 6MWT, dyspnea score, St. George's respiratory questionnaire score, arterial blood gas analyses and the total Traditional Chinese Medicine symptom pattern score. RESULTS After 24 weeks of treatment, QG showed greater efficacy than the placebo in certain parameters, including the dyspnea score, Traditional Chinese Medicine symptom pattern score and some indicators in the St. George's respiratory questionnaire score. Analysis of the indexes obtained from all patients at the end of the 48th week showed that the therapeutic effects in the treatment group were significantly better than those in the control group because remarkable differences were observed in most of the primary and secondary endpoints between the two groups, except for the maximal distance of the 6MWT and arterial blood gas analyses. No adverse reaction was observed in either group during the 48-week trial treatment period. CONCLUSION QG could effectively treat IPF patients by ameliorating pulmonary function, improving the quality of life and lowering the percentage of acute exacerbations.
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Affiliation(s)
- Sijia Guo
- Department of Respiratory Medicine, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Yalin Song
- Department of Respiratory Medicine, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Jihong Feng
- Department of Respiratory Medicine, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Shuang Liu
- Department of Neurology, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China
| | - Yuechuan Li
- Department of Respiratory Medicine, Tianjin Chest Hospital, Tianjin 300300, China
| | - Min Liu
- Department of Respiratory Medicine, the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Luqing Wei
- Department of Respiratory Medicine, the Affiliated Hospital of Tianjin Armed Police Medical College, Tianjin 300162, China
| | - Xian Zhang
- Department of Respiratory Medicine, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Hui Xie
- Department of Respiratory Medicine, Tianjin Dongli Traditional Chinese Medicine Hospital, Tianjin 300300, China
| | - Zengtao Sun
- Department of Hospital Management, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
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Telford D, Vesey RM, Hofman PL, Gusso S. The Effect of Vibration Therapy on Walking Endurance in Children and Young People With Cerebral Palsy: Do Age and Gross Motor Function Classification System Matter? Arch Rehabil Res Clin Transl 2020; 2:100068. [PMID: 33543094 DOI: 10.1016/j.arrct.2020.100068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the effect of age and Gross Motor Function Classification System (GMFCS) level on walking endurance after 20 weeks of vibration therapy in children and young people with cerebral palsy (CP). Design The study was a clinical trial without control group comparing baseline and postintervention outcomes within participants. Setting Vibration therapy was performed at school or at home. Assessments took place in a clinical research unit. Participants Children and young people (N=59) with CP, aged 5-20 years, GMFCS level II, III, or IV, recruited through schools, physiotherapy services, and District Health Board clinics, Auckland, New Zealand. Interventions Participants performed side-alternating whole-body vibration therapy (WBVT) at 20 Hz and 3-mm amplitude, 9 minutes per day, 4 times per week for 20 weeks. Main Outcome Measures Distance walked in the 6-minute walk test (6MWT) was recorded before and after the intervention. Results Participants baseline results for the 6MWT were lower, independent of age or GMFCS, when compared to non-CP literature. On average, participants walked 12% further in the 6MWT after the intervention (P<.001). There was significant improvement in 6MWT distance in all age groups (5-10y: 16%, P<.001; 11-15y: 10%, P=.001; 16-20y: 13%, P<.001) and all GMFCS levels (level II: 10%, P<.001, level III: 40%, P=.013, level IV: 57%, P=.007). There was a greater percentage improvement in the distance walked in those with GMFCS level III and level IV than level II (P=.049 and P<.001, respectively). Conclusions WBVT had a beneficial effect on walking endurance in children and young people with CP, independent of age and GMFCS.
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Selistre LFA, Gonçalves GH, Vasilceac FA, Serrão PRMDS, Nakagawa TH, Petrella M, Jones RK, Mattiello SM. The relationship between urinary C-Telopeptide fragments of type II collagen, knee joint load, pain, and physical function in individuals with medial knee osteoarthritis. Braz J Phys Ther 2020; 25:62-69. [PMID: 32151525 DOI: 10.1016/j.bjpt.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Considering the osteoarthritis (OA) model that integrates the biological, mechanical, and structural components of the disease, the present study aimed to investigate the association between urinary C-Telopeptide fragments of type II collagen (uCTX-II), knee joint moments, pain, and physical function in individuals with medial knee OA. METHODS Twenty-five subjects radiographically diagnosed with knee OA were recruited. Participants were evaluated through three-dimensional gait analysis, uCTX-II level, the WOMAC pain and physical function scores, and the 40m walk test. The association between these variables was investigated using Pearson's product-moment correlation, followed by a hierarchical linear regression, controlled by OA severity and body mass index (BMI). RESULTS No relationship was found between uCTX-II level and knee moments. A significant correlation between uCTX-II level and pain, physical function, and the 40m walk test was found. The hierarchical linear regression controlling for OA severity and BMI showed that uCTX-II level explained 9% of the WOMAC pain score, 27% of the WOMAC physical function score, and 7% of the 40m walk test. CONCLUSION Greater uCTX-II level is associated with higher pain and reduced physical function and 40m walk test performance in individuals with medial knee OA.
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Affiliation(s)
| | - Glaucia Helena Gonçalves
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | | | - Theresa Helissa Nakagawa
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Marina Petrella
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | - Stela Márcia Mattiello
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
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Vancampfort D, Kimbowa S, Basangwa D, Smith L, Stubbs B, Van Damme T, De Hert M, Mugisha J. Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with psychosis. Psychiatry Res 2019; 282:112619. [PMID: 31648142 DOI: 10.1016/j.psychres.2019.112619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 12/30/2022]
Abstract
The aim of this study was to investigate the test-retest reliability of the 2-minute walk test (2MWT) and the concurrent validity with the 6-minute walk test (6MWT) in outpatients with psychosis. We also explored whether there was a practice effect, determined minimal detectable changes (MDC) and assessed which factors are associated with the 2MWT performance. Fifty outpatients [22 women; 33.5 (14.3) years] performed the 2MWT twice and the 6MWT once and completed the Simple Physical Activity Questionnaire (SIMPAQ) and Brief Symptoms Inventory -18. The median (interquartile) 2MWT score on the first and second test were 128.0 (44.0) meters and 128.0 (31.5) meters, without significant difference between the two trials. The intraclass coefficient was 0.94 (95% confidence interval=0.91-0.97). The significant Spearman Rho correlation between the second 2MWT and the 6MWT was 0.69. The MDC was 22 m for men and 21 m for women. There was no evidence for a practice effect. Variability in SIMPAQ sedentary, exercise, incidental physical activity and leg pain following the test explained 54.6% of the variance in 2MWT score. The current study demonstrates that the 2MWT is a reliable, valid and clinically feasible tool for assessing and evaluating the functional exercise capacity in outpatients with psychosis.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Samuel Kimbowa
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - David Basangwa
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium; Antwerp Health Law and Ethics Chair, University of Antwerp, Belgium
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda
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Marjanski T, Badocha M, Wnuk D, Dziedzic R, Ostrowski M, Sawicka W, Rzyman W. Result of the 6-min walk test is an independent prognostic factor of surgically treated non-small-cell lung cancer. Interact Cardiovasc Thorac Surg 2019; 28:368-374. [PMID: 30203070 DOI: 10.1093/icvts/ivy258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Pathological tumour, node and metastasis (TNM) stage remains the most significant prognostic factor of non-small-cell lung cancer (NSCLC). Meanwhile, age, gender, pulmonary function tests, the extent of surgical resection and the presence of concomitant diseases are commonly used to complete the prognostic profile of the patient with early stage of NSCLC. The aim of this study is to assess how the result of a 6-min walk test (6MWT) further assists in predicting the prognosis of NSCLC surgical candidates. METHODS Six hundred and twenty-four patients who underwent surgical treatment for NSCLC between April 2009 and October 2011 were enrolled in this study. All patients were accepted for surgery on the basis of a standard evaluation protocol. Additionally, patients completed the 6MWT on the day before the surgery, and threshold values of the test were assessed based on both the Akaike information criterion and the coefficient of determination R2. Cox proportional hazards regression analysis was used to analyse the effect of important prognostic factors on the overall survival. RESULTS Three hundred and ninety men and 234 women with a mean age of 64 years underwent radical surgical treatment for primary lung cancer. Five hundred and twenty-five lobectomies (84%), 77 pneumonectomies (12%) and 24 (4%) lesser resections were performed. Three hundred and thirty-one patients (53%) were treated for stage I NSCLC, 191 patients (31%) for stage II and 102 patients (16%) for stages IIIA-IV. A distance of 525 m in the 6MWT [hazard ratio (HR) = 0.57, 95% confidence interval (CI) 0.41-0.78, P < 0.001] was the threshold value differentiating the patients' prognoses (P < 0.001). Using the Cox proportional hazards regression analysis, pathological TNM stage (IIA: HR = 1.87, 95% CI 1.95-2.92, P = 0.006; IIB: HR = 2.03, 95% CI 1.23-3.37, P = 0.006; IIIA-IV: HR = 2.37, 95% CI 1.49-3.75, P < 0.001), male gender (HR = 1.88, 95% CI 1.26-2.79, P = 0.001), pneumonectomy (HR = 1.78, 95% CI 1.17-2.70, P < 0.001) and the results of the 6MWT (HR = 0.50, 95% CI 0.36-0.70, P < 0.001) were considered as independent predictive factors of overall survival. CONCLUSIONS The result of a 6MWT is an independent and convenient prognostic factor of surgically treated non-small-cell lung cancer.
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Affiliation(s)
- Tomasz Marjanski
- Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Michal Badocha
- Department of Probability and Biomathematics, Gdańsk University of Technology, Gdansk, Poland
| | - Damian Wnuk
- Department of Physical Therapy, Medical University of Gdansk, Gdansk, Poland
| | - Robert Dziedzic
- Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Ostrowski
- Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Wioletta Sawicka
- Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Gdansk, Poland
| | - Witold Rzyman
- Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland
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Heinz P, Gulart AA, Klein SR, Venâncio RS, da Silveira JA, Veras TG, Mayer AF. A performance comparison of the 20 and 30 meter six-minute walk tests among middle aged and older adults. Physiother Theory Pract 2019; 37:817-825. [PMID: 31347427 DOI: 10.1080/09593985.2019.1645251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To compare the performance of the Six-Minute Walk Test on 20-meter (6MWT20) and 30-meter (6MWT30) tracks and to test the validity and reliability of the 6MWT20 in middle-aged and older adults.Method: The subjects underwent lung function assessment and performed the 6MWT30 and 6MWT20. Student´s t-tests or Wilcoxon tests were used to compare the variables. The Pearson or Spearman correlation coefficients were used to evaluate the validity of the 6MWT20 and the reliability of the 6MWT20. The 6MWT30 was tested by the two-way mixed model of the Intraclass Correlation Coefficient (ICC 3,1).Results: Twenty-five subjects (age: 60 ± 10 years) walked, on average, 11.0 ± 21.9 m more in the 6MWT30 than in the 6MWT20 (p < .05). The walking distance, the number of steps, the energy expenditure and the movement intensity between the 6MWT20 and 6MWT30 was correlated (r = 0.95; r = 0.81; r = 0.91; r = 0.67; respectively, p < .001). The walking distances showed high reliability and were similar between test and re-test in the 6MWT30 (544 ± 72.1 vs. 551 ± 70.5; p < .05; ICC = 0.97) and in the 6MWT20 (533 ± 73.1 vs. 532 ± 59.1; p < .05; ICC = 0.87).Conclusion: The 6MWT20 performance is lower than the 6MWT30 However, this difference is not clinically relevant. Additionally, the 6MWT20 is a valid and reproducible test to assess the functional capacity of middle-aged and older adults.
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Affiliation(s)
- Pâmela Heinz
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Aline Almeida Gulart
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Suelen Roberta Klein
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Raysa Silva Venâncio
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Jaqueline Aparecida da Silveira
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Fisioterapia da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Talyta Garbelotto Veras
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Anamaria Fleig Mayer
- Núcleo de Assistência, Ensino e Pesquisa em Reabilitação Pulmonar - NuReab, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Ciências do Movimento Humano da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Programa de Pós-Graduação em Fisioterapia da Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.,Physiotherapy Department, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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Abstract
After a stroke, people characteristically experience a loss of function. Reviewers (English et al., 2017) provide evidence-based insights into the value of instigating CCT into post-stroke rehabilitation. The review examines the effectiveness of CCT for people who have experienced stroke. The meta-analysis includes seventeen trials comprising 1297 participants. Results demonstrate that CCT is a worthwhile intervention to establish and support mobility post-stroke. The primary effect of CCT was to improve walking capacity, measured by a walk test. CCT improves gaining independence in activities of daily living.
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Affiliation(s)
- Kim van Wissen
- Graduate School of Nursing, Midwifery and Health, Faculty of Health, Victoria University of Wellington, P O Box 7625 Newtown, Wellington 6242, New Zealand.
| | - Denise Blanchard
- School of Nursing, Midwifery, and Indigenous Health, Faculty of Science, Charles Sturt University, Panorama Ave, Bathurst, NSW 2795, Australia.
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Oliveira MJ, Marçôa R, Moutinho J, Oliveira P, Ladeira I, Lima R, Guimarães M. Reference equations for the 6-minute walk distance in healthy Portuguese subjects 18-70 years old. Pulmonology 2018; 25:83-89. [PMID: 29980459 DOI: 10.1016/j.pulmoe.2018.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/09/2018] [Accepted: 04/14/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Six-minute walk test (6MWT) is used for evaluating functional exercise capacity. To the best of our knowledge, there are no reference equations to predict six-minute walk distance (6MWD) for the Portuguese population. The aims of the present study were to measure anthropometric data and 6MWD in a sample of healthy Portuguese population, to establish reference equations to predict 6MWD and to compare our equations with those obtained by previously published studies. METHODS We conducted an observational prospective study. We consecutively recruited 158 healthy 18-70 years old subjects from Porto district, who performed two 6MWTs using a standardized protocol. The best 6MWD was used for further analysis. RESULTS The mean 6MWD was 627.8m (SD=73.3m). The variables that were significantly associated with the 6MWD were age, sex, BMI and ΔHR (Heart Rateat the end of the test-HRat rest). We found three explanatory models for 6MWD, the best with an explanatory power of 38%: 6MWD=721.7-1.6×Age-4.0×BMI+0.9×ΔHR+58.4×Sex. We verified that 6MWD decreased 1.6m per year of age, and 4.0m per unit of BMI and increased 0.892m per beat per minute. Moreover, on average, males walk 58.4m more than females (p<0.001). Applying equations from other studies to our population resulted in an overestimation or underestimation of the 6MWD. CONCLUSION The present study was the first to describe the 6MWD in healthy Portuguese people aged 18-70 years old and to propose predictive equations. These can contribute to improving the evaluation of Caucasian Mediterranean patients with diseases that affect their functional capacity.
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Affiliation(s)
- M J Oliveira
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal.
| | - R Marçôa
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | | | - P Oliveira
- EPIUnit, Instituto de Saúde Pública, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - I Ladeira
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - R Lima
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - M Guimarães
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
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Harville EW, Chen W, Guralnik J, Bazzano LA. Reproductive history and physical functioning in midlife: The Bogalusa Heart Study. Maturitas 2018; 109:26-31. [PMID: 29452778 DOI: 10.1016/j.maturitas.2017.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/30/2017] [Accepted: 12/06/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the relationship between reproductive history, pregnancy complications, and later physical function. STUDY DESIGN The Bogalusa Heart Study is a long-running study of cardiovascular health in a semirural community. 761 women were interviewed about their pregnancy history and complications, and underwent tests of physical function. Logistic models for dichotomous outcomes and linear models for continuous outcomes were used, adjusted for covariates. MAIN OUTCOME MEASURES Overall scores on the Short Physical Performance Battery (SPPB), which combines scores for balance, gait speed, and chair stands. Additional tests were a 6-min walk, knee extension strength, grip strength, and a pegboard challenge. RESULTS Nulliparity was associated with lower scores on the walking and balance portions of the SPPB, less distance covered in the 6-min walk, less knee and grip strength, and higher pegboard time, especially among pre-menopausal women. A history of gestational diabetes was associated with more problems on the walk portion of the SPPB (aOR 2.44, 1.06-5.65), higher chair stand time, and lower knee strength. Young age at first birth (<16 or 18 years) was associated with a shorter chair stand time and a better pegboard score. CONCLUSIONS Nulliparity was associated with worse physical functioning, while high parity and early pregnancy were not, suggesting that fertility is associated with better health later in life. Pregnancy complications were associated with worse physical functioning, even after controlling for body mass index. Future studies should attempt to establish the pathways by which reproductive health relates to overall physical functioning.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States.
| | - Wei Chen
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Jack Guralnik
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, United States
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
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Randeree L, Eslick GD. Eteplirsen for paediatric patients with Duchenne muscular dystrophy: A pooled-analysis. J Clin Neurosci 2018; 49:1-6. [PMID: 29254734 DOI: 10.1016/j.jocn.2017.10.082] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/23/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Duchenne Muscular Dystrophy is a paediatric disorder resulting from a defective dystrophin gene. It causes progressive loss of muscle fibres, muscle weakness, and eventually loss of ambulation during adolescence, with death due to respiratory or cardiovascular complications soon afterwards. The drug eteplirsen has received support from medical experts and parents of affected children, but the FDA has delayed their decision for approval of this drug. OBJECTIVE This study analysed the results of previous studies to assess the safety and efficacy of the eteplirsen, and is the first pooled-analysis of its kind. METHODS A literature search of electronic databases was performed. Only human studies using eteplirsen were eligible. RESULTS A total of four relevant clinical studies were identified. A pooled-analysis was performed using data relating to percentage dystrophin-positive fibres obtained from muscle biopsy, and the six-minute walk test (6 MWT). The average increase in percentage dystrophin-positive fibres after treatment with eteplirsen was 24.23% (range -4 to 78; SD 24.44%). The average rate of decline in distance walked was 65metres (range -335 to 83; SD 100.08 m). CONCLUSIONS Whether or not this increase in percentage dystrophin-positive fibres and distance walked is clinically significant is unclear, and there is therefore a need for more clinical trials.
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Abstract
[Purpose] This meta-analysis was undertaken to establish normative reference values for
the two-minute walk test. [Methods] Three database searches and a hand search were
conducted. Meta-analysis was used to consolidate two-minute walk test data stratified by
gender and age group. [Results] Data from four articles was consolidated. Normative
two-minute walk test distances varied from 150.3 m (women, 70 to 79 years) to 217.9 m
(men, 20 to 29 tears). [Conclusion] Normative reference values derived using meta-analysis
should provide a better standard than individual studies for interpreting the two-minute
walk test performance of adults.
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Affiliation(s)
- Richard W Bohannon
- Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University: Lillington, NC, USA
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Wang X, Hou Y, Mao J, Zhang Y, Li Z, Zhao Y, Niu T, Yuan R, Wang Y, Cui J, Shi L, Jia X, Fan R, Lin Q, Shang H, Wang B, Wang H, Zhang B, Cui X, Soh S, Ruan J. Western medication plus Traditional Chinese Medicine preparations in patients with chronic heart failure: a prospective, single-blind, randomized, controlled, and multicenter clinical trial. J TRADIT CHIN MED 2017; 37:756-766. [PMID: 32188184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the efficacy and safety in patients with chronic heart failure (CHF) of Western medication plus Traditional Chinese Medicine (TCM) preparations. METHODS This prospective, single-blind, randomized, controlled, and multicenter clinical trial began on September 17, 2008, and was completed on June 25, 2011. A total of 340 inpatients, aged 40-79 years, with exacerbating CHF from 10 hospitals were enrolled and randomly allocated within 24 h of admission. The trial included three intervention periods. During hospitalization, the control group received western medication for CHF and the treatment group received Danhong injection with Shenfu injection or Shenmai injection. After discharge, all patients were treated with Qiliqiangxin capsules and Buyiqiangxin tablets or a placebo for 6 months. After the 6-month intervention, both groups received only continuous western medication. The primary endpoint was all-cause mortality. The efficacy assessments were as follows: B-type natriuretic peptide (BNP), Lee's HF score, the 6-minute walking test (6MWT), left ventricular ejection fraction (LVEF), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The safety assessments were as follows: blood and urine routine examination, hepatic and renal function, electrolytes in blood and adverse events. RESULTS Compared with the control group, the treatment group showed a 30.99% reduction in all-cause mortality and an improved survival rate. The treatment group showed greater improvement in 6MWT (P = 0.02) than the control group on discharge, after 12-month follow-up, there was a time-group interaction for MLHFQ (P = 0.03). Incidence rate of adverse events and other relevant safety indexes were not statistically significant between the two groups. CONCLUSION Western medication plus TCM treatment can increase 6-minute walking distance (improve exercise tolerance) and quality of life with heart failure patients.
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Affiliation(s)
- Xianliang Wang
- Cardiovascular Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Yazhu Hou
- Cardiovascular Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Jingyuan Mao
- Cardiovascular Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Yan Zhang
- Cardiovascular Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Zhijun Li
- Cardiovascular Department, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Yingqiang Zhao
- Cardiovascular Department, the Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China
| | - Tianfu Niu
- Cardiovascular Department, Shanxi Traditional Chinese Medicine Institute, Taiyuan 030012, China
| | - Ruyu Yuan
- Cardiovascular Department, the Second Teaching Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Yonggang Wang
- Cardiovascular Department, the Second Teaching Hospital of Shanxi University of Traditional Chinese Medicine, Xianyang 712000, China
| | - Jinrong Cui
- Cardiovascular Department, the Integrated Hospitals of TCM and Western Medicine of Shanxi University of Traditional Chinese Medicine, Taiyuan 030001, China
| | - Le Shi
- Cardiovascular Department, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
| | - Xiuli Jia
- Cardiovascular Department, Tianjin Nankai Traditional Chinese Medicine Hospital, Tianjin 300102, China
| | - Ruihong Fan
- Cardiovascular Department, Tianjin Traditional Chinese Medicine Hospital, Tianjin 300020, China
| | - Qian Lin
- Cardiovascular Department, the Eastern Hospital of Beijing University of Traditional Chinese Medicine, Beijing 100078, China
| | - Hongcai Shang
- Evidence-based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Baohe Wang
- Evidence-based medicine center, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Hongwu Wang
- Statistic Department, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Boli Zhang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Xiaolei Cui
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Shanbin Soh
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Jishou Ruan
- Department of Mathematics, Nankai University, Tianjin 300071, China
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Machado FVC, Bisca GW, Morita AA, Rodrigues A, Probst VS, Furlanetto KC, Pitta F, Hernandes NA. Agreement of different reference equations to classify patients with COPD as having reduced or preserved 6MWD. Pulmonology 2017; 24:S2173-5115(17)30151-3. [PMID: 29191775 DOI: 10.1016/j.rppnen.2017.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/22/2017] [Accepted: 08/31/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Interpretation of the six-minute walk distance (6MWD) is enhanced by using recommended reference equations. Whenever possible, the choice of equation should be region-specific. A potential problem is that different equations for the 6MWD may have been developed for the same population, and it may be complicated to choose the most suitable. OBJECTIVE To verify the agreement of different reference equations in classifying patients with Chronic Obstructive Pulmonary Disease (COPD) as having reduced or preserved 6MWD. METHODS 159 patients with COPD performed the six-minute walk test according to international standardization. They were classified as having reduced 6MWD if it was below the lower limit of normal. Five Brazilian equations (Iwama; Britto1; Britto2; Dourado; Soares) and the two non-Brazilian equations most cited worldwide (Troosters; Enright) were used. The agreement for patients classified as reduced or preserved 6MWD was verified by Cohen's Kappa (pair-to-pair) analysis. The proportion of patients classified as having reduced walked distance was compared by the Chi-squared test. RESULTS Agreement between equations varied largely in classifying subjects as having reduced or preserved 6MWD (Kappa: 0.10-0.82). Brazilian equations with the highest agreement were Iwama, Britto1 and Britto2 (Kappa>0.75). The proportion of patients classified as having reduced 6MWD was statistically similar only between equations in which the agreement was higher than 0.70. CONCLUSION Even reference equations from the same country vary considerably in the classification of reduced or preserved 6MWD, and it is recommended that the region-specific ones be used as they give with higher agreement for similar and comparable interpretation of the patients' functional exercise capacity.
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Affiliation(s)
- F V C Machado
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - G W Bisca
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil; Centro Universitário Filadélfia (UniFil), Av. Juscelino Kubitscheck, 1626, 86020-000 Londrina, Paraná, Brazil
| | - A A Morita
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - A Rodrigues
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - V S Probst
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - K C Furlanetto
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil; Research Centre in Health Sciences (CPCS), University of Northern Paraná (UNOPAR), Londrina, Paraná, Brazil
| | - F Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - N A Hernandes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Paraná, Brazil.
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Gadre A, Ghattas C, Han X, Wang X, Minai O, Highland KB. Six-Minute Walk Test as a Predictor of Diagnosis, Disease Severity, and Clinical Outcomes in Scleroderma-Associated Pulmonary Hypertension: The DIBOSA Study. Lung 2017. [PMID: 28646245 DOI: 10.1007/s00408-017-0034-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is a common complication of scleroderma (SSc) and is a leading cause of morbidity and mortality. OBJECTIVES To explore the utility of the 6MWT in the prediction of SSc-PH and to assess its prognostic implications. METHODS A retrospective review of SSc patients from 2003 to 2013, with 6MWT and echocardiogram (n = 286), was conducted. Presence of PH was defined by right heart catheterization. Patients were randomized into development and validation cohorts. Using regression techniques, we developed a scoring system to predict the presence of SSc-PH and tested it in our validation cohort. Trends of mortality and disease severity were studied for incremental scores. RESULTS The DIBOSA scoring system includes DIstance walked in 6 min, BOrg dyspnea index, and SAturation of oxygen at 6 min. The DIBOSA score in the development cohort ranged from 0 to 3, resulting in an area of 0.858 (P < 0.0001) under the ROC curve. A score of 0 had a NPV of 100% and a score of 3 had a PPV of 86.58%. The validation cohort had an area under the ROC curve of 0.842. The DIBOSA score correlated with both pulmonary artery pressures and mortality. The 3-year survival rates for DIBOSA scores of 0, 1, 2, and 3 were 100, 100, 87.67, and 66.67%, respectively (HR = 3.92, P < 0.0001). CONCLUSIONS DIBOSA score is a sensitive tool for the prediction of SSc-PH. The DIBOSA score is a direct predictor of mortality in SSc-PH and strongly correlates with pulmonary pressures. 6MWT can be used to predict clinical outcomes in SSc-PH.
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Affiliation(s)
- Abhishek Gadre
- Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Christian Ghattas
- Department of Pulmonary and Critical Care, St. Elizabeth Medical Center, Boston, MA, USA
| | - Xiaozhen Han
- Respiratory Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A90, Cleveland, OH, 44195, USA
| | - Xiaofeng Wang
- Respiratory Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A90, Cleveland, OH, 44195, USA
| | - Omar Minai
- Pulmonary and Critical Care Associates, Petersburg, VA, USA
| | - Kristin B Highland
- Respiratory Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, A90, Cleveland, OH, 44195, USA.
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Yao D, Jakubowitz E, Ettinger S, Plaass C, Stukenborg-Colsman C, Daniilidis K. [Foot drop treatment by implantation of a neuroprosthesis (ActiGait®)]. Oper Orthop Traumatol 2017; 29:266-78. [PMID: 28474107 DOI: 10.1007/s00064-017-0494-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Gait improvement by restoring dorsiflexion using a neuroprosthesis implant. INDICATIONS Foot drop with damage to the 1st motor neuron; passive mobility in ankle is possible; adult patients. CONTRAINDICATIONS Foot drop with peripheral damage and injury to the peroneal nerve; already implanted stimulators (e.g., defibrillator, pacemaker, or pain stimulator); severe anesthesia risks in multimorbid patients. SURGICAL TECHNIQUE Surgery in lateral position. Searching for the peroneal nerve after dorsal incision in the popliteal fossa, using the medial edge of the biceps femoris as anatomic landmark. After identification of the motor branch of the peroneal nerve by positive dorsiflexion after using electrostimulation apply the electrode cuff on the nerve. Epifascial implantation of stimulation body lateral at the middle third of the thigh over the tractus iliotibialis. POSTOPERATIVE MANAGEMENT Pain-adapted full weight bearing, no knee flexion more than 90° for 4-6 weeks, activation of neuroprosthesis 3 weeks after surgery, physiotherapy with gait training is required. RESULTS Between 2013 and 2015, implantation of the neuroprosthesis was performed in 21 patients (13 men/8 women) with chronic foot drop due to a central lesion. Significant improvement in walking speed measured with the 10 meter walk test (11.8 ± 5.4 s to 7.9 s ± 3.4; p = 0.007), in gait endurance with 6 min walk test (212.2 ± 75.5 m to 306.4 ± 96.4 m; p ≤ 0.001), and in gait performance using the Emory Functional Ambulation Profile (105.9 ± 49.7 s to 63.2 ± 31. 3 s; p ≤ 0.001). No patient required surgical revision. Postoperative bleeding was recorded in one case (4%). Patient satisfaction and improvement in mobility and quality of life could be achieved (95% and 90%, respectively).
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Aguiar KCA, Marson FAL, Gomez CCS, Pereira MC, Paschoal IA, Ribeiro AF, Ribeiro JD. Physical performance, quality of life and sexual satisfaction evaluation in adults with cystic fibrosis: An unexplored correlation. Rev Port Pneumol (2006) 2017; 23:179-192. [PMID: 28438512 DOI: 10.1016/j.rppnen.2017.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/23/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Quality of life (QOL), sexual satisfaction (SS) and physical performance have been assessed in the management of numerous chronic diseases. METHODS In this study, the following tests and surveys were applied: (i) QOL questionnaire [Cystic Fibrosis Questionnaire (CFQ)]; (ii) SS questionnaire (SSQ) [female sexual quotient (FSQ) and male sexual quotient (MSQ)]; (iii) 6-minute walk test (6MWT). Spearman's correlation was used for comparison between the data; the Mann-Whitney test was applied to analyze the difference between genders. A total of 52 adult patients with CF were included in this study. RESULTS There was a positive correlation between CFQ domains and SSQ questions. The CFQ showed a positive correlation with peripheral oxygen saturation of hemoglobin (SpO2) and the distance walked in the 6MWT, and a negative correlation with the Borg scale. The SSQ showed positive correlation with the distance walked and a negative correlation with the Borg scale. For some markers evaluated in the 6MWT, there was sometimes association with the evaluated domains and questions. Male patients showed better scores in the emotional CFQ domain, better performance in SSQ and physical performance. CONCLUSIONS There was a correlation between CFQ, SSQ and 6MWT in CF. Finally; we believe that QOL surveys should assess the domain "sexuality" as well as physical performance tests.
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Affiliation(s)
- K C A Aguiar
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - F A L Marson
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Department of Medical Genetics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - C C S Gomez
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - M C Pereira
- Department of Medical Clinic, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - I A Paschoal
- Department of Medical Clinic, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - A F Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - J D Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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Jeong IC, Bychkov D, Hiser S, Kreif JD, Klein LM, Hoyer EH, Searson PC. Using a Real-Time Location System for Assessment of Patient Ambulation in a Hospital Setting. Arch Phys Med Rehabil 2017; 98:1366-1373.e1. [PMID: 28286202 DOI: 10.1016/j.apmr.2017.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/20/2017] [Accepted: 02/02/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the feasibility of using an infrared-based Real-Time Location System (RTLS) for measuring patient ambulation in a 2-minute walk test (2MWT) by comparing the distance walked and the Johns Hopkins Highest Level of Mobility (JH-HLM) score to clinician observation as a criterion standard. DESIGN Criterion standard validation study. SETTING Inpatient, university hospital. PARTICIPANTS Patients (N=25) in an adult neuroscience/brain rescue unit. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES RTLS and clinician-reported ambulation distance in feet, and JH-HLM score on an 8-point ordinal scale. RESULTS The RTLS ambulation distance for the 25 patients in the 2MWT was between 68 and 516ft. The mean difference between clinician-reported and RTLS ambulation distance was 8.4±11.7ft (2.7%±4.6%). The correlation between clinician-reported and RTLS ambulation distance was 97.9% (P<.01). The clinician-reported ambulation distance for 2 patients was +100ft and -99ft compared with the RTLS distance, implying clinician error in counting the number of laps (98ft). The correlation between the RTLS distance and clinician-reported distance excluding these 2 patients is 99.8% (P<.01). The accuracy of the RTLS for assessment of JH-HLM score for all 25 patients was 96%. The average patient speed obtained from RTLS data varied between 0.4 and 3.0mph. CONCLUSIONS The RTLS is able to accurately measure patient ambulation and calculate JH-HLM for a 2MWT when compared with clinician observation as the criterion standard.
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Affiliation(s)
- In Cheol Jeong
- Measurement Corps, Johns Hopkins Individualized Health Initiative, Johns Hopkins University, Baltimore, MD
| | - David Bychkov
- Measurement Corps, Johns Hopkins Individualized Health Initiative, Johns Hopkins University, Baltimore, MD
| | | | | | | | - Erik H Hoyer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD
| | - Peter C Searson
- Measurement Corps, Johns Hopkins Individualized Health Initiative, Johns Hopkins University, Baltimore, MD.
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Lilja-Maula L, Lappalainen AK, Hyytiäinen HK, Kuusela E, Kaimio M, Schildt K, Mölsä S, Morelius M, Rajamäki MM. Comparison of submaximal exercise test results and severity of brachycephalic obstructive airway syndrome in English bulldogs. Vet J 2016; 219:22-26. [PMID: 28093105 DOI: 10.1016/j.tvjl.2016.11.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/29/2016] [Accepted: 11/27/2016] [Indexed: 11/19/2022]
Abstract
Canine brachycephalic obstructive airway syndrome (BOAS) is a complex respiratory disease related to congenitally flattened facial and skull anatomy. BOAS causes respiratory distress, heat and exercise intolerance, and gastrointestinal signs. English bulldogs (EB) have a high prevalence of BOAS. Currently, the severity of BOAS signs in veterinary practice is assessed subjectively. To reduce BOAS in brachycephalic breeds, an objective and easy-to-use tool could help breeders select healthier animals. Exercise tests, such as the 6 min walk test (distance walked measured) or the 1000 m walk test (duration measured), could be used to assess the severity of BOAS, as exercise intolerance and impaired recovery are key features of BOAS. This study evaluated the severity of signs and anatomic components of BOAS in a group of prospectively recruited young adult EBs (n = 28) and investigated the correlations of the 6 min walk test or the 1000 m walk test with a veterinary assessment of BOAS severity, using an ordinal 4 level scale of respiratory signs. EBs with more severe BOAS walked a shorter distance, more slowly and their recovery from exercise took longer than those with only mild signs of BOAS. Control dogs of different breeds (n = 10) performed the exercise tests significantly better (i.e. longer distance, faster time and recovery) than EBs. Increases in body temperature during exercise were significantly higher in EBs than in controls. The results of this study support the use of exercise tests for objective evaluation of the severity of BOAS in EBs.
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Affiliation(s)
- Liisa Lilja-Maula
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
| | - Anu K Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Heli K Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Erja Kuusela
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Mirja Kaimio
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Kirsti Schildt
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Sari Mölsä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Mikael Morelius
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Minna M Rajamäki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Guessogo WR, Temfemo A, Mandengue SH, Assomo Ndemba PB, Messina Ondoua RT, Hamadou A, Etoundi-Ngoa LS, Ahmaidi S. Effect of 24-week repeated short-time walking based training program on physical fitness of black Cameroonian obese women. J Exerc Rehabil 2016; 12:90-8. [PMID: 27162770 PMCID: PMC4849497 DOI: 10.12965/jer.1630502.251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 04/05/2016] [Indexed: 11/25/2022] Open
Abstract
This study aimed to examine the effects of a training program based on repetition of short-time walk sequences on cardiorespiratory response, physical performance and metabolic parameters in black Cameroonian obese women. One hundred thirty-nine obese women (body mass in-dex [BMI]>30 kg/m2) were divided into three groups: premenopausal (Pre-M; 39.7±7.9 yr; n=48), postmenopausal (Post-M; 55.0±2.5 yr; n=61) and control group (CONT; 48.7±9.4 yr; n=30). Only Pre-M and Post-M completed 24-week repeated short-time walking program. An-thropometric, cardiorespiratory, metabolic parameters, and the 6-min walk distance (6MWD) were measured at baseline (S1), 12 weeks follow-up (S2), and 2 days after the last session (S3). Significant changes were observed in weight, BMI, fatty mass and 6MWD in Pre-M and Post-M after 24 weeks. The waist and hip circumferences, percentages of water, muscle mass and bone mass changed in Post-M. Total cholesterol, triglycerides, low density lipoprotein and forced expiratory volumes in 1 and 6 sec showed significant improvements in Pre-M and Post-M. High density lipoprotein increased only in Post-M (0.5±0.2 g/L vs 0.7±0.1 g/L, P=0.041). In conclusion, this training modality could constitute an option for obese women rehabilitation.
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Affiliation(s)
- Wiliam R Guessogo
- National Institute of Youth and Sports, Yaounde, Cameroon; Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon
| | - Abdou Temfemo
- Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon; Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Samuel H Mandengue
- Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon; Laboratoire EA3300 - APERE: Adaptations Physiologiques à l'Exercice et Réadaptations à l'Effort, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, Cedex, France
| | - Peguy B Assomo Ndemba
- Exercise and Sport Physiology Unit, Faculty of Sciences, University of Douala, Douala, Cameroon
| | | | - André Hamadou
- National Institute of Youth and Sports, Yaounde, Cameroon
| | | | - Said Ahmaidi
- Laboratoire EA3300 - APERE: Adaptations Physiologiques à l'Exercice et Réadaptations à l'Effort, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, Cedex, France
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Lin SJ, Winston KD, Mitchell J, Girlinghouse J, Crochet K. Physical activity, functional capacity, and step variability during walking in people with lower-limb amputation. Gait Posture 2014; 40:140-4. [PMID: 24731451 DOI: 10.1016/j.gaitpost.2014.03.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 03/04/2014] [Accepted: 03/08/2014] [Indexed: 02/02/2023]
Abstract
Physical activity is important for general health. For an individual with amputation to sustain physical activity, certain functional capacity might be needed. Gait variability is related to the incidence of falls. This study explored the relationship between physical activity and a few common performance measures (six-minute walk test, step length variability, step width variability, and comfortable walking speed) in individuals with unilateral lower-limb amputation. Twenty individuals completed the study (age: 50±11yrs). Twelve of them had transtibial amputation, seven had transfemoral amputation, and one had through-knee amputation. Gait data was collected by the GaitRite instrumented walkway while participants performed a 3-min comfortable walking trial followed by a six-minute walk test. Physical activity was indicated by the mean of 7-day step counts via a pedometer. Gait variability was calculated by the coefficient of variation. Pearson correlation analysis was conducted between physical activity level and the 4 performance measures. Significance level was set at 0.05. Physical activity correlates strongly to comfortable walking speed (r=0.76), six-minute walk distance (r=0.67), and correlates fairly to step width variability (r=0.44). On the contrary, physical activity is inversely related to step length variability of the prosthetic leg (r=-0.46) and of the sound leg (r=-0.47). Having better functional capacity and lateral stability might enable an individual with lower-limb amputation to engage in a higher physical activity level, or vise versa. However, our conclusions are only preliminary as limited by the small sample size.
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