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Loughney L, Murphy K, Tully R, Robb WB, McCaffrey N, Dowd K, Skelly F. The effect of a pre- and post-operative exercise program versus standard care on physical activity and sedentary behavior of patients with esophageal and gastric cancer undergoing neoadjuvant treatment prior to surgery (the PERIOP-OG Trial): a randomized controlled trial†. Dis Esophagus 2024:doae044. [PMID: 38769843 DOI: 10.1093/dote/doae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/18/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024]
Abstract
Neoadjuvant cancer treatment (NCT) reduces both physical fitness and physical activity (PA) levels, which can increase the risk of adverse outcomes in cancer patients. This study aims to determine the effect of exercise prehabilitation on PA and sedentary behavior (SB) in patients undergoing NCT and surgery for esophagogastric malignancies. This study is a randomized pragmatic controlled multi-center trial conducted across three Irish hospitals. Participants were aged ≥18 years scheduled for esophagectomy or gastrectomy and were planned for NCT and surgery. Participants were randomized to an exercise prehabilitation group (EX) that commenced following cancer diagnosis, continued to the point of surgery, and resumed following recovery from surgery for 6 weeks or to usual care (UC) who received routine treatment. The primary outcome measures were PA and SB. Between March 2019 and December 2020, 71 participants were recruited: EX (n = 36) or UC (n = 35). No significant differences were found between the EX group and UC group on levels of PA or SBs across all measured timepoints. Significant decreases in moderate-vigorous physical activity levels (MVPAs) were found between baseline and post-surgery (P = 0.028), pre-surgery and post-surgery (P = 0.001) and pre-surgery and 6-week follow-up (P = 0.022) for all participants. Step count also significantly decreased between pre-surgery and post-surgery (P < 0.001). Baseline aerobic fitness was positively associated to PA levels and negatively associated with SB. Esophagogastric cancer patients have lower than recommended levels of PA at the time of diagnosis and this decreased further following completion of NCT. An optional home- or group-based exercise intervention was not effective in improving PA levels or behaviors across the cancer treatment journey.
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Affiliation(s)
- Lisa Loughney
- ExWell Medical, Dublin, Ireland
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
- The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Kate Murphy
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Roisin Tully
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland
| | - William B Robb
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Upper GI Surgery, Beaumont Hospital, Dublin, Ireland
| | | | - Kieran Dowd
- SHE Research Group, Department of Sports & Health Science, Technological University of the Shannon, Athlone Westmeath, Ireland
| | - Fiona Skelly
- ExWell Medical, Dublin, Ireland
- SHE Research Group, Department of Sports & Health Science, Technological University of the Shannon, Athlone Westmeath, Ireland
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Lai B, Wadsworth D, Spring K, Jones CS, Mintz M, Malone LA, Kim Y, Wilroy J, Lee H. Validity and Reliability of a Telehealth Physical Fitness and Functional Assessment Battery for Ambulatory Youth With and Without Mobility Disabilities: Observational Measurement Study. JMIR Rehabil Assist Technol 2024; 11:e50582. [PMID: 38345838 PMCID: PMC10897795 DOI: 10.2196/50582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/30/2023] [Accepted: 12/28/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Youth (age 15-24 years) with and without disability are not adequately represented enough in exercise research due to a lack of time and transportation. These barriers can be overcome by including accessible web-based assessments that eliminate the need for on-site visitations. There is no simple, low-cost, and psychometrically sound compilation of measures for physical fitness and function that can be applied to youth with and without mobility disabilities. OBJECTIVE The first purpose was to determine the statistical level of agreement of 4 web-modified clinical assessments with how they are typically conducted in person at a laboratory (convergent validity). The second purpose was to determine the level of agreement between a novice and an expert rater (interrater reliability). The third purpose was to explore the feasibility of implementing the assessments via 2 metrics: safety and duration. METHODS The study enrolled 19 ambulatory youth: 9 (47%) with cerebral palsy with various mobility disabilities from a children's hospital and 10 (53%) without disabilities from a university student population. Participants performed a battery of tests via videoconferencing and in person. The test condition (teleassessment and in person) order was randomized. The battery consisted of the hand grip strength test with a dynamometer, the five times sit-to-stand test (FTST), the timed up-and-go (TUG) test, and the 6-minute walk test (6MWT) either around a standard circular track (in person) or around a smaller home-modified track (teleassessment version, home-modified 6-minute walk test [HM6MWT]). Statistical analyses included descriptive data, intraclass correlation coefficients (ICCs), and Bland-Altman plots. RESULTS The mean time to complete the in-person assessment was 16.9 (SD 4.8) minutes and the teleassessment was 21.1 (SD 5.9) minutes. No falls, injuries, or adverse events occurred. Excellent convergent validity was shown for telemeasured hand grip strength (right ICC=0.96, left ICC=0.98, P<.001) and the TUG test (ICC=0.92, P=.01). The FTST demonstrated good agreement (ICC=0.95, 95% CI 0.79-0.98; P=.01). The HM6MWT demonstrated poor absolute agreement with the 6MWT. However, further exploratory analysis revealed a strong positive correlation between the tests (r=0.83, P<.001). The interrater reliability was excellent for all tests (all ICCs>0.9, P<.05). CONCLUSIONS This study suggests that videoconference assessments are convenient and useful measures of fitness and function among youth with and without disabilities. This paper presents operationalized teleassessment procedures that can be replicated by health professionals to produce valid and reliable measurements. This study is a first step toward developing teleassessments that can bypass the need for on-site data collection visitations for this age group. Further research is needed to identify psychometrically sound teleassessment procedures, particularly for measures of cardiorespiratory endurance or walking ability.
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Affiliation(s)
- Byron Lai
- Division of Pediatric Rehabilitation Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Danielle Wadsworth
- Exercise Adherence and Obesity Prevention Laboratory, School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Katherine Spring
- Exercise Adherence and Obesity Prevention Laboratory, School of Kinesiology, Auburn University, Auburn, AL, United States
- Pennington Biomedical Research Center, Division of Population and Public Health Science, Pediatric Obesity and Health Behavior Laboratory, Baton Rouge, LA, United States
| | - Chloe S Jones
- Exercise Adherence and Obesity Prevention Laboratory, School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Madison Mintz
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Laurie A Malone
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Yumi Kim
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jereme Wilroy
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Holim Lee
- Department of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, United States
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Monsalves-Álvarez M, Solis-Soto MT, Burrone MS, Candia AA, Jofré-Saldía E, Espinoza G, Flores-Opazo M, Puebla C, Valladares-Ide D, Jannas-Vela S. Community strategies for health promotion and prevention of chronic non-communicable diseases with a focus on physical activity and nutrition: the URO/FOCOS study protocol. Front Public Health 2024; 11:1268322. [PMID: 38283289 PMCID: PMC10811261 DOI: 10.3389/fpubh.2023.1268322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024] Open
Abstract
Non-communicable diseases (NCDs) account for 71% of all annual deaths, totaling 41 million people worldwide. The development and progression of these diseases are highly related to the environment and lifestyle choices, among which physical inactivity and excess malnutrition stand out. Currently, in Chile, there is no evidence at the regional and local level on the impact of physical activity and healthy nutrition plans and interventions on health promotion, prevention, and timely treatment of NCDs. The following protocol delineates the URO/FOCOS (Universidad Regional de O'Higgins/FOrtaleciendo COmunidades Saludables- Regional University of O'Higgins/Strengthening Healthy Communities) study, which will assess pilot community intervention strategies using a participatory action research approach by identifying barriers and facilitators on the practice of physical activity and healthy eating habits. In this project, the community from the O'Higgins region will be involved throughout the entire research process to develop strategies that promote regular physical activity and healthy eating practices. We propose three interrelated strategies: (1) Participatory Action Research, (2) Community interventions for promoting physical activity and healthy nutrition practices, and (3) health education. The URO/FOCOS study offers a unique opportunity in the O'Higgins region to develop participatory strategies and interventions based on the community's needs and motivations with regard to physical activity and healthy eating habits. We believe these strategies will help to improve the community's overall health through effective changes in their decision and preferences toward a more active lifestyle and healthier nutrition practices.
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Spicer MG, Dennis AT. Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review. J Clin Med 2024; 13:416. [PMID: 38256550 PMCID: PMC10816516 DOI: 10.3390/jcm13020416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. METHODS Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. RESULTS The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. CONCLUSION There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.
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Affiliation(s)
- Madeleine G. Spicer
- Department of Obstetrics and Gynaecology, Alice Springs Hospital, Alice Springs, NT 0870, Australia
| | - Alicia T. Dennis
- Department of Anaesthesia, Pain and Perioperative Medicine, Joan Kirner Women’s and Children’s Hospital, Western Health, St Albans, VIC 3021, Australia;
- School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia
- Departments of Critical Care, Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Marin-Farrona M, Wipfli B, Thosar SS, García-Unanue J, Gallardo L, Felipe JL, López-Fernández J. UCLMuevete: Increasing the amount of physical activity, work-ability, and cardiorespiratory fitness capacity in university workers through active breaks. Work 2024; 77:263-273. [PMID: 37638465 DOI: 10.3233/wor-230062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Active break programs at the workplace are a promising initiative for increasing workers' physical activity (PA) levels, health, work-ability (WA), and social relationship. OBJECTIVE To determine the impact of an Active Breaks workplace program based on Bandura's Social Cognitive Theory (SCT) aligned with Behavior Change Techniques (BCT) on PA levels, cardiorespiratory fitness (CRF), WA, and social relationships among university workers. METHODS #UCLMuévete is a quasi-experimental, 12-week intervention designed according to the TREND and TIDieR-PHP checklists. Sixty-nine university workers were recruited and placed into 17 teams of 3 to 5 people. Participants were instructed to take a 20-min active break every working day (walking, cycling, and functional training). The following variables were measured before and after the 12-week intervention: (1) Amount of PA with accelerometers, (2) CRF through the 6 Min-Walking Test (m), (3) Body composition (fat mass (gr), muscle mass (gr), and bone mineral content (g/cm3) through densitometry), (4) Stress with the BodyGuard2 device, (5) WA through Work Ability Index (WAI), and (6) Social relationships through an ad-hoc questionnaire. Part-time workers, pregnant women, and workers with physical disability were excluded. RESULTS Significant improvements were observed in the amount of daily moderate-to-vigorous PA (Difference (Dif)., women +8.05 and men +12.31 minutes; p < 0.05; ES = 0.224; 0.379), CRF (Dif., women +52.98 and men +25.53 meters; p < 0.05; ES = 0.578; 0.209), and (Dif., women +2.16 and men +2.39; p < 0.05; ES = 0.150; 0.177). No significant changes were observed in body composition and stress. CONCLUSION 20 min/day of aerobic and strength active breaks, based on SCT aligned to BCTs, improves university workers' amount of PA, CRF, WAI, and social relationships.
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Affiliation(s)
- Maria Marin-Farrona
- Department of Physical Activity and Sport Sciences, IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Brad Wipfli
- OHSU-PSU School of Public Health, Portland State University, Portland, OR, USA
| | - Saurabh S Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Jorge García-Unanue
- Department of Physical Activity and Sport Sciences, IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Leonor Gallardo
- Department of Physical Activity and Sport Sciences, IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Jose Luis Felipe
- Department of Physical Activity and Sport Sciences, IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
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Vargas GO, Neaves S, Pham T, Huang M, Turki AF, Wang C, Bell KR, Juengst SB, Zhang R, Li M, Driver S, Behbehani K, Hynan LS, Ding K. Community-based exercise program, self-reported health-related symptoms, and quality of life in persons with traumatic brain injury 45 + years old. NeuroRehabilitation 2024; 54:373-381. [PMID: 38457158 DOI: 10.3233/nre-230223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Individuals with moderate to severe traumatic brain injury (msTBI) have reported a lack of motivation, lack of time, and fatigue as perceived barriers to exercise. OBJECTIVE To evaluate the effects of an exercise program on self-reported health-related symptoms and quality of life in persons 45-years and older with msTBI. METHODS Post-hoc analysis of a prospective community-based 12-week exercise program of 20 adults, age 45-80 years, with msTBI. Ten were in aerobic exercise training (AET) program and 10 in a stretching and toning (SAT) program. The AET group was instructed to exercise based on their estimated maximal heart rate (HR) for 150 minutes weekly. The SAT group was to stretch for the same target time without significantly increasing HR or level of exertion. Outcome measures were Traumatic Brain Injury Quality of Life (TBI-QOL) for global, cognitive, emotional, and social health, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, and Pittsburgh Sleep Quality Index (PSQI) for sleep quality. RESULTS AET was associated with improved self-reported cognitive health and sleep compared to SAT. Moderate to large, positive effect sizes were also observed in the AET group in the QOL categories of global, emotional, and social health, and depressive symptoms. CONCLUSIONS This study offers preliminary evidence that AET may improve health-related QOL, especially for cognition and sleep, in middle-aged and older adults with msTBI.
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Affiliation(s)
- Gary O Vargas
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Stephanie Neaves
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Perot Foundation Neuroscience Translational Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tri Pham
- University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Mu Huang
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Office of Science, Medicine, and Health, American Heart Association, Dallas, TX, USA
| | - Ahmad Fawzi Turki
- Department of Bioengineering, University of Arlington, Arlington, TX, USA
- Electrical and Computer Engineering Department (ECE), King Abdulaziz University, Jeddah, Saudi Arabia
- Center of Excellence in Intelligent Engineering Systems (CEIES), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Chaowei Wang
- Department of Computer Science, University of Arlington, Arlington, TX, USA
| | - Kathleen R Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shannon B Juengst
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Rong Zhang
- Cerebrovascular Laboratory, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ming Li
- Department of Computer Science, University of Arlington, Arlington, TX, USA
| | - Simon Driver
- Traumatic Brain Injury Research, Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Khosrow Behbehani
- Department of Bioengineering, University of Arlington, Arlington, TX, USA
| | - Linda S Hynan
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kan Ding
- Center of Excellence in Intelligent Engineering Systems (CEIES), King Abdulaziz University, Jeddah, Saudi Arabia
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Reina-Gutiérrez S, Meseguer-Henarejos AB, Torres-Costoso A, Álvarez-Bueno C, Cavero-Redondo I, Núñez de Arenas-Arroyo S, Guzmán-Pavón MJ, Sánchez-López M, Martínez-Vizcaíno V. Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta-analysis. Scand J Med Sci Sports 2023; 33:1916-1928. [PMID: 37226414 DOI: 10.1111/sms.14407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness. OBJECTIVE The aim of this network meta-analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity. METHODS MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA). RESULTS We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind-body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise. CONCLUSIONS Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.
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Affiliation(s)
- Sara Reina-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile
| | | | | | - Mairena Sánchez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Cunha EFD, Silveira MS, Milan-Mattos JC, Cavalini HFS, Ferreira ÁA, Batista JDS, Uzumaki LC, Guimarães JPC, Roriz PIL, Dantas FMDNA, Hautala AJ, de Abreu RM, Catai AM, Schwingel PA, Neves VR. Cardiac Autonomic Function and Functional Capacity in Post-COVID-19 Individuals with Systemic Arterial Hypertension. J Pers Med 2023; 13:1391. [PMID: 37763158 PMCID: PMC10533045 DOI: 10.3390/jpm13091391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Individuals diagnosed with systemic arterial hypertension (SAH) are considered risk groups for COVID-19 severity. This study assessed differences in cardiac autonomic function (CAF) and functional capacity (FC) in SAH individuals without COVID-19 infection compared to SAH individuals post-COVID-19. Participants comprised 40 SAH individuals aged 31 to 80 years old, grouped as SAH with COVID-19 (G1; n = 21) and SAH without COVID-19 (G2; n = 19). CAF was assessed via heart rate variability (HRV), measuring R-R intervals during a 10-min supine period. Four HRV indices were analyzed through symbolic analysis: 0V%, 1V%, 2LV%, and 2UV%. FC assessment was performed by a 6-min walk test (6MWT). G1 and G2 showed no significant differences in terms of age, anthropometric parameters, clinical presentation, and medication use. G2 exhibited superior 6MWT performance, covering more distance (522 ± 78 vs. 465 ± 59 m, p < 0.05). Specifically, G2 demonstrated a moderate positive correlation between 6MWT and the 2LV% index (r = 0.58; p < 0.05). Shorter walking distances were observed during 6MWT in SAH individuals post-COVID-19. However, the study did not find impaired cardiac autonomic function in SAH individuals post-COVID-19 compared to those without. This suggests that while COVID-19 impacted FC, CAF remained relatively stable in this population.
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Affiliation(s)
- Edelvita Fernanda Duarte Cunha
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Matheus Sobral Silveira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Juliana Cristina Milan-Mattos
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Postgraduate Program in Physical Therapy (PPGFT), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Heitor Fernandes Silveira Cavalini
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Ádrya Aryelle Ferreira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Joice de Souza Batista
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Lara Cazé Uzumaki
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - João Paulo Coelho Guimarães
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Pedro Igor Lustosa Roriz
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Fabianne Maisa de Novaes Assis Dantas
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Arto J. Hautala
- Faculty of Sport and Health Sciences, University of Jyväskylä, P. O. Box 35, FI-40014 Jyväskylä, Finland;
| | - Raphael Martins de Abreu
- Department of Physiotherapy, LUNEX University—International University of Health, Exercise & Sports SA, 4671 Differdange, Luxembourg;
- LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, 4671 Differdange, Luxembourg
| | - Aparecida Maria Catai
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Postgraduate Program in Physical Therapy (PPGFT), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Paulo Adriano Schwingel
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Victor Ribeiro Neves
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGRDF), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (E.F.D.C.); (M.S.S.); (H.F.S.C.); (Á.A.F.); (P.I.L.R.)
- Grupo de Estudos e Pesquisas em Fisioterapia Cardiorrespiratória (GEFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (J.d.S.B.); (L.C.U.); (J.P.C.G.); (F.M.d.N.A.D.); (A.M.C.)
- Laboratório de Fisioterapia Cardiopulmonar (LAFIC), Universidade de Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
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Higa KC, Mayer K, Quinn C, Jubina L, Suarez-Pierre A, Colborn K, Jolley SE, Enfield K, Zwischenberger J, Sevin CM, Rove JY. Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation. Crit Care Med 2023; 51:1234-1245. [PMID: 37163480 DOI: 10.1097/ccm.0000000000005900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE We summarize the existing data on the occurrence of physical, emotional, and cognitive dysfunction associated with postintensive care syndrome (PICS) in adult survivors of venoarterial extracorporeal membrane oxygenation (VA-ECMO). DATA SOURCES MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases were searched. STUDY SELECTION Peer-reviewed studies of adults receiving VA-ECMO for any reason with at least one measure of health-related quality of life outcomes or PICS at long-term follow-up of at least 6 months were included. DATA EXTRACTION The participant demographics and baseline characteristics, in-hospital outcomes, long-term health outcomes, quality of life outcome measures, and prevalence of PICS were extracted. DATA SYNTHESIS Twenty-seven studies met inclusion criteria encompassing 3,271 patients who were treated with VA-ECMO. The studies were limited to single- or two-center studies. Outcomes variables and follow-up time points evaluated were widely heterogeneous which limits comprehensive analysis of PICS after VA-ECMO. In general, the longer-term PICS-related outcomes of survivors of VA-ECMO were worse than the general population, and approaching that of patients with chronic disease. Available studies identified high rates of abnormal 6-minute walk distance, depression, anxiety, and posttraumatic stress disorder that persisted for years. Half or fewer survivors return to work years after discharge. Only 2 of 27 studies examined cognitive outcomes and no studies evaluated cognitive dysfunction within the first year of recovery. No studies evaluated the impact of targeted interventions on these outcomes. CONCLUSIONS Survivors of VA-ECMO represent a population of critically ill patients at high risk for deficits in physical, emotional, and cognitive function related to PICS. This systematic review highlights the alarming reality that PICS and in particular, neurocognitive outcomes, in survivors of VA-ECMO are understudied, underrecognized, and thus likely undertreated. These results underscore the imperative that we look beyond survival to focus on understanding the burden of survivorship with the goal of optimizing recovery and outcomes after these life-saving interventions. Future prospective, multicenter, longitudinal studies in recovery after VA-ECMO are justified.
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Affiliation(s)
- Kelly C Higa
- Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA
| | - Kirby Mayer
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY
| | - Christopher Quinn
- Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Lindsey Jubina
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY
| | | | - Kathryn Colborn
- Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Sarah E Jolley
- Division of Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Kyle Enfield
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, VA
| | - Joseph Zwischenberger
- Division of Cardiothoracic Surgery, Department of Surgery, College of Medicine, University of Kentucky, Lexington, KY
| | - Carla M Sevin
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, TN
| | - Jessica Y Rove
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO
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10
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Letnes JM, Nes BM, Wisløff U. Age-related decline in peak oxygen uptake: Cross-sectional vs. longitudinal findings. A review. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200171. [PMID: 36874046 PMCID: PMC9975246 DOI: 10.1016/j.ijcrp.2023.200171] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Cardiorespiratory fitness is established as an important prognostic factor for cardiovascular and general health. In clinical settings cardiorespiratory fitness is often measured by cardiopulmonary exercise testing determining the gold-standard peak oxygen uptake (VO2peak). Due to the considerable impact of age and sex on VO2peak, results from cardiopulmonary exercise testing are typically assessed in the context of age- and sex-specific reference values, and multiple studies have been conducted establishing reference materials by age and sex using cross-sectional designs. However, crossectional and longitudinal studies have shown somewhat conflicting results regarding age-related declines of VO2peak, with larger declines reported in longitudinal studies. In this brief review, we compare findings from crossectional and longitudinal studies on age-related trajectories in VO2peak to highlight differences in these estimates which should be acknowledged when clinicians interpret VO2peak measurements repeated over time.
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Affiliation(s)
- Jon Magne Letnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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11
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Vitacca M, Paneroni M, Salvi B, Spanevello A, Ceriana P, Bruschi C, Balbi B, Aliani M, Ambrosino N. Airflow grades, outcome measures and response to pulmonary rehabilitation in individuals after an exacerbation of severe chronic obstructive pulmonary disease. Eur J Intern Med 2023; 107:81-85. [PMID: 36396523 DOI: 10.1016/j.ejim.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/27/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with COPD may be staged according to symptoms and exacerbation history (GOLD groups: A-D) and on airflow obstruction (GOLD grades: 1-4). Guidelines recommend pulmonary rehabilitation (PR) for these individuals, including those recovering from an exacerbation (ECOPD) OBJECTIVE: To evaluate whether in individuals with clinically severe COPD, recovering from an ECOPD, the effect size of an in-hospital PR program would be affected by airflow severity grades and assessed outcome measures. METHODS Retrospective, multicentre study. Participants were compared according to different GOLD airflow grades. In addition to the MRC dyspnoea scale, six-minute walking distance test and COPD assessment test (CAT), Barthel dyspnoea index (Bid), and Short Physical Performance Battery (SPPB) were assessed, evaluating the proportion of individuals reaching the minimum clinically important difference (MCID) (responders). RESULTS Data of 479 individuals, completing the program were evaluated. Most of the participants were allocated in GOLD grades 4, (57.6%) and 3 (22.1%). All outcome measures significantly improved after PR (p < 0.05), without any significant difference in the proportion of responders in any measure. CONCLUSIONS in individuals with severe COPD, recovering from ECOPD the success rate of PR does not depend on airflow severity, or outcome measure assessed. In addition to the most used outcome measures, also Bid and SPPB are sensitive to PR.
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Affiliation(s)
- Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy.
| | - Mara Paneroni
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Beatrice Salvi
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy
| | - Antonio Spanevello
- Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Piero Ceriana
- Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Claudio Bruschi
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Bruno Balbi
- Respiratory Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy
| | - Maria Aliani
- Respiratory Rehabilitation of the Institute of Bari, Istituti Clinici Scientifici Maugeri IRCCS, Bari, Italy
| | - Nicolino Ambrosino
- Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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12
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Houge IS, Hoff M, Halsan O, Videm V. Exercise Self-Efficacy and patient global assessment were associated with 6-min walk test distance in persons with rheumatoid arthritis. Clin Rheumatol 2022; 41:3687-3696. [PMID: 35930120 PMCID: PMC9361983 DOI: 10.1007/s10067-022-06309-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/05/2022] [Accepted: 07/18/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Low functional capacity is related to future loss of daily function and cardiovascular events. The present study explored the associations of patient-reported outcome measures (PROMs) and disease-specific measures with functional capacity as measured by the 6-min walk test (6MWT) in persons with rheumatoid arthritis (RA). METHODS Seventy-nine participants from rheumatology outpatient clinics were included. The distance walked during the 6MWT (6MWD) was the dependent variable in multivariable regression analyses. Model 1 included the independent variables sex, age (in tertiles to improve model fit), and body mass index (BMI). Building on Model 1, Model 2 added smoking, patient global assessment (PGA), Exercise Self-Efficacy, Hospital Anxiety and Depression Scale's Depression score, and Cohen's Perceived Stress Scale score, whereas Model 3 added smoking, disease duration, present use of glucocorticosteroids, seropositivity, Disease Activity Score 28-C-Reactive Protein (DAS28-CRP), and a comorbidity variable. RESULTS Median age was 65 years, 76% were female, and median 6MWD was 493 m. In Model 1, BMI and age were significantly associated with the 6MWD (R2 = 0.42). In Model 2, PGA and Exercise Self-Efficacy were also significantly associated with the 6MWD, with standardized regression coefficients of - 0.21 (p = 0.03) and 0.26 (p = 0.004) respectively (R2 = 0.54). The RA-specific variables in Model 3 were not significantly associated with the 6MWD (R2 = 0.49). CONCLUSION The PROMs PGA and Exercise Self-Efficacy were significantly associated with functional capacity as measured by the 6MWT in persons with RA, whereas disease-specific measures such as DAS28-CRP and disease duration were not. Key Points • Functional capacity measured with the 6-minute walk test was significantly associated with body mass index, age, patient global assessment, and Exercise Self-Efficacy in persons with RA. • Patient-reported outcome measures explained more of the variation in functional capacity than objective or composite measures of disease and are relevant measures in clinical follow-up. • Techniques that enhance self-efficacy for exercise should be incorporated into clinical practice to promote physical activity.
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Affiliation(s)
- Ingrid Sæther Houge
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, St. Olavs University Hospital, Lab Center 3 East, NO-7006, Trondheim, Norway
| | - Mari Hoff
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway
| | - Oddrun Halsan
- Department of Rheumatology, Levanger Hospital, Levanger, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, St. Olavs University Hospital, Lab Center 3 East, NO-7006, Trondheim, Norway.
- Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, Trondheim, Norway.
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13
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Álvarez C, Guede-Rojas F, Ramírez-Campillo R, Andrade DC, Vásquez-Gómez J, Rodríguez-Rodríguez F, Ciolac EG, Caamaño-Navarrete F, Delgado-Floody P. Characterizing the interindividual postexercise hypotension response for two order groups of concurrent training in patients with morbid obesity. Front Physiol 2022; 13:913645. [PMID: 36299263 PMCID: PMC9589449 DOI: 10.3389/fphys.2022.913645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Postexercise hypotension (PEH) is a common physiological phenomenon occurring immediately after endurance training (ET), resistance training (RT), and ET plus RT, also termed concurrent training (CT); however, there is little knowledge about the interindividual and magnitude response of PEH in morbidly obese patients. Aim: The aims of this study were (1) to investigate the effect of CT order (ET + RT vs. RT + ET) on the blood pressure responses; 2) characterize these responses in responders and nonresponders, and 3) identify potential baseline outcomes for predicting blood pressure decreases as responders. Methods: A quasi-experimental study developed in sedentary morbidly obese men and women (age 43.6 ± 11.3 years; body mass index [BMI] ≥40 kg/m2) was assigned to a CT group of ET plus RT (ET + RT; n = 19; BMI 47.8 ± 16.7) or RT plus ET order group (RT + ET; n = 17; BMI 43.0 ± 8.0). Subjects of both groups received eight exercise sessions over four weeks. Primary outcomes include systolic (SBP), diastolic (DBP), mean arterial pressure [MAP], heart rate at rest [HR], and pulse pressure [PP] measurements before and after 10 min post-exercise. Secondary outcomes were other anthropometric, body composition, metabolic, and physical fitness parameters. Using the delta ∆SBP reduction, quartile categorization (Q) in “high” (Rs: quartile 4), “moderate” (MRs: quartile 3), “low” (LRs: quartile 2), and “nonresponders” (NRs: quartile 1) was reported. Results: Significant pre–post changes were observed in ET + RT in session 2 for SBP (131.6 vs. 123.4 mmHg, p = 0.050) and session 4 (131.1 vs. 125.2 mmHg, p = 0.0002), while the RT + ET group showed significant reductions in session 4 (134.2 vs. 125.3 mmHg, p < 0.001). No significant differences were detected in the sum of the eight sessions for SBP (∑∆SBP) between ET + RT vs. RT + ET (−5.7 vs. −4.3 mmHg, p = 0.552). Interindividual analyses revealed significant differences among frequencies comparing Q1 “NRs” (n = 8; 22.2%), Q2 “LRs” (n = 8; 22.2%), Q3 “MRs” (n = 9; 25.0%), and Q4 “HRs” (n = 11; 30.5%), p < 0.0001. Quartile comparisons showed significant differences in SBP changes (p = 0.035). Linear regression analyses revealed significant association between ∑∆SBP with body fat % (β –3.826, R2 0.211 [21.1%], p = 0.031), skeletal muscle mass [β –2.150, R2 0.125 (12.5%), p = 0.023], fasting glucose [β 1.273, R2 0.078 (7.8%), p = 0.003], triglycerides [β 0.210, R2 0.014 (1.4%), p = 0.008], and the 6-min walking test [β 0.183, R2 0.038 (3.8%), p = 0.044]. Conclusion: The CT order of ET + RT and RT + ET promote a similar ‘magnitude’ in the postexercise hypotensive effects during the eight sessions of both CT orders in 4 weeks of training duration, revealing “nonresponders” and ‘high’ responders that can be predicted from body composition, metabolic, and physical fitness outcomes.
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Affiliation(s)
- Cristian Álvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Francisco Guede-Rojas
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Rodrigo Ramírez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - David C. Andrade
- Exercise Applied Physiology Laboratory, Centro de Investigación en Fisiología y Medicina de Altura, Departamento Biomedico, Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Jaime Vásquez-Gómez
- Centro de Investigación de Estudios Avanzados del Maule (CIEAM), Laboratorio de Rendimiento Humano, Universidad Católica del Maule, Talca, Chile
| | | | - Emmanuel Gomes Ciolac
- Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, Sáo Paulo State University (UNESP), Bauru, Buazil
| | | | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco, Chile
- Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- *Correspondence: Pedro Delgado-Floody,
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14
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Mundada PH, Dadgal RM. Comparison of Dual Task Training Versus Aerobics Training in Improving Cognition in Healthy Elderly Population. Cureus 2022; 14:e29027. [PMID: 36237766 PMCID: PMC9552703 DOI: 10.7759/cureus.29027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
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Kambic T, Šarabon N, Lainscak M, Hadžić V. Combined resistance training with aerobic training improves physical performance in patients with coronary artery disease: A secondary analysis of a randomized controlled clinical trial. Front Cardiovasc Med 2022; 9:909385. [PMID: 36093154 PMCID: PMC9448883 DOI: 10.3389/fcvm.2022.909385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background The efficacy of combined resistance training (RT) and aerobic training (AT) compared with AT alone is well established in cardiac rehabilitation (CR); however, it remains to be elucidated whether RT load (high load [HL] vs. low load [LL]) modifies the outcomes. The aim of our study was to investigate the effects of HL-RT and LL-RT combined with AT in comparison to AT alone on body composition and physical performance in patients with coronary artery disease (CAD) enrolled in phase II CR. Methods We randomized 79 patients with a stable CAD to 12 weeks of lower limb LL-RT + AT (35-40% of one repetition maximum [1-RM]; n = 28), HL-RT + AT (70-80% of 1-RM; n = 26), or AT (n = 25). Fifty-nine patients (75% men) with mean (standard deviation) age 61 (8) years and left ventricular ejection fraction 53 (9)% completed LL-RT (n = 19), HL-RT (n = 21) and AT (n = 19). Body composition and physical performance (upper and lower submaximal muscle strength, flexibility, balance, and mobility) were measured at baseline and post-training. Results Training intervention had no significant impact on time × group interaction in the body composition measures. There was a significant time × group interaction for the gait speed test, chair sit-and-reach test, arm curl test, Stork balance test, up and go test, STS-5, and 6-min walk distance (p-values ≤ 0.001-0.04) following the training intervention. After the training intervention, HL-RT improved gait speed (+12%, p = 0.044), arm curl (+13%, p = 0.037), and time of Up and Go test (+9%, p < 0.001) to a greater extent compared with AT group, while there was a greater improvement in time of Up and Go test (+18%, p < 0.001) and time of five sit-to-stand tests (+14%, p = 0.016) following LL-RT when compared with AT. There were no differences between HL-RT and LL-RT in post-training improvement in any of the physical performance measures. Conclusion The combination of AT with HL-RT or LL-RT promoted similar improvements in physical performance, which were superior to AT. Therefore, both types of combined AT and RT can be applied to patients with CAD. Clinical trial registration [https://clinicaltrials.gov/ct2/show/NCT04638764] Identifier [NCT04638764].
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Affiliation(s)
- Tim Kambic
- Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, Rakičan, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Human Health Department, InnoRenew CoE, Izola, Slovenia
- Laboratory for Motor Control and Motor Behaviour S2P, Science to Practice, Ltd., Ljubljana, Slovenia
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Keats MR, Grandy SA, Blanchard C, Fowles JR, Neyedli HF, Weeks AC, MacNeil MV. The Impact of Resistance Exercise on Muscle Mass in Glioblastoma in Survivors (RESIST): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37709. [PMID: 35507403 PMCID: PMC9118089 DOI: 10.2196/37709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022] Open
Abstract
Background Glioblastoma is the most common primary brain malignancy in adults, accounting for approximately 48% of all brain tumors. Standard treatment includes radiation and temozolomide chemotherapy. Glioblastomas are highly vascular and can cause vasogenic brain edema and mass effect, which can worsen the neurologic symptoms associated with the disease. The steroid dexamethasone (DEX) is the treatment of choice to reduce vasogenic edema and intracranial pressure associated with glioblastoma. However high-dose DEX or long-term use can result in muscle myopathy in 10%-60% of glioblastoma patients, significantly reducing functional fitness and quality of life (QOL). There is a wealth of evidence to support the use of exercise as an adjuvant therapy to improve functional ability as well as help manage treatment-related symptoms. Specifically, resistance training has been shown to increase muscle mass, strength, and functional fitness in aging adults and several cancer populations. Although studies are limited, research has shown that exercise is safe and feasible in glioblastoma populations. However, it is not clear whether resistance training can be successfully used in glioblastoma to prevent or mitigate steroid-induced muscle myopathy and associated loss of function. Objective The primary purpose of this study is to establish whether an individualized circuit-based program will reduce steroid-induced muscle myopathy, as indicated by maintained or improved functional fitness for patients on active treatment and receiving steroids. Methods This is a 2-armed, randomized controlled trial with repeated measures. We will recruit 38 adult (≥18 years) patients diagnosed with either primary or secondary glioblastoma who are scheduled to receive standard radiation and concurrent and adjuvant temozolomide chemotherapy postsurgical debulking and received any dose of DEX through the neurooncology clinic and the Nova Scotia Health Cancer Center. Patients will be randomly allocated to a standard of care waitlist control group or standard of care + circuit-based resistance training exercise group. The exercise group will receive a 12-week individualized, group and home-based exercise program. The control group will be advised to maintain an active lifestyle. The primary outcome, muscle myopathy (functional fitness), will be assessed using the Short Physical Performance Battery and hand grip strength. Secondary outcome measures will include body composition, cardiorespiratory fitness, physical activity, QOL, fatigue, and cognitive function. All measures will be assessed pre- and postintervention. Participant accrual, exercise adherence, and safety will be assessed throughout the study. Results This study has been funded by the Canadian Cancer Society Atlantic Cancer Research Grant and the J.D. Irving Limited–Excellence in Cancer Research Fund (grant number 707182). The protocol was approved by the Nova Scotia Health and Acadia University’s Research Ethics Boards. Enrollment is anticipated to begin in March 2022. Conclusions This study will inform how individualized circuit-based resistance training may improve functional independence and overall QOL of glioblastoma patients. Trial Registration ClinicalTrails.gov NCT05116137; https://www.clinicaltrials.gov/ct2/show/NCT05116137 International Registered Report Identifier (IRRID) DERR1-10.2196/37709
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Affiliation(s)
- Melanie R Keats
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.,Beatrice Hunter Cancer Research Institute, Halifax, NS, Canada
| | - Scott A Grandy
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.,Beatrice Hunter Cancer Research Institute, Halifax, NS, Canada
| | - Christopher Blanchard
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Heather F Neyedli
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Adrienne C Weeks
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Mary V MacNeil
- Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
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17
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Meijer R, van Hooff M, Papen-Botterhuis NE, Molenaar CJL, Regis M, Timmers T, van de Poll-Franse LV, Savelberg HHCM, Schep G. Estimating VO2peak in 18–90 Year-Old Adults: Development and Validation of the FitMáx©-Questionnaire. Int J Gen Med 2022; 15:3727-3737. [PMID: 35411174 PMCID: PMC8994663 DOI: 10.2147/ijgm.s355589] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Cardiorespiratory fitness (CRF) plays an essential role in health outcomes and quality of life. However, it is often not assessed nor estimated. Objective CRF assessment is costly, labour intensive and not widely available. Patient-reported outcome measures estimate CRF more cost-efficiently, but current questionnaires lack accuracy. The aim of this study is to develop a new self-reported questionnaire to estimate CRF. Materials and Methods The FitMáx©-questionnaire, consisting of only three questions assessing walking, stair climbing, and cycling capacity, was compared with the commonly used Duke Activity Status Index (DASI) and Veterans Specific Activity Questionnaire (VSAQ). These questionnaires were compared to peak oxygen uptake (VO2peak) as measured with cardiopulmonary exercise testing. This study included 759 cardiac, pulmonary and oncologic patients and healthy persons aged 18‒90. Results FitMáx© strongly correlated (r = 0.94 (0.92‒0.95) SEE = 4.14 mL∙kg−1∙min−1) with measured VO2peak. Bias between predicted and measured VO2peak was −0.24 (−9.23‒8.75; 95% limits of agreement) mL·kg−1·min−1. The FitMáx© scored superiorly on correlation and SEE compared with the DASI and VSAQ, r = 0.75 (0.68‒0.80) SEE = 4.62 mL∙kg−1∙min−1 and r = 0.87 (0.83‒0.90) SEE = 6.75 mL∙kg−1∙min−1, respectively. Conclusion FitMáx© is a valid and accessible questionnaire to estimate CRF expressed as VO2peak in clinical practice and shows substantial improvement compared to currently used questionnaires.
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Affiliation(s)
- Renske Meijer
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, the Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Correspondence: Renske Meijer, Department of Sports and Exercise, Máxima Medical Center, Veldhoven, the Netherlands, Tel +31 40 8888 000, Email ; ;
| | - Martijn van Hooff
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, the Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | | | | | - Marta Regis
- Academy, Máxima Medical Center, Veldhoven, the Netherlands
- Department of Mathematics and Computer Science, University of Technology, Eindhoven, the Netherlands
| | - Thomas Timmers
- Department of Research & Development, Interactive Studios, Rosmalen, the Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Net
herlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Goof Schep
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, the Netherlands
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18
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Botek M, Krejčí J, Valenta M, McKune A, Sládečková B, Konečný P, Klimešová I, Pastucha D. Molecular Hydrogen Positively Affects Physical and Respiratory Function in Acute Post-COVID-19 Patients: A New Perspective in Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041992. [PMID: 35206179 PMCID: PMC8872486 DOI: 10.3390/ijerph19041992] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/15/2022]
Abstract
Molecular hydrogen (H2) is potentially a novel therapeutic gas for acute post-coronavirus disease 2019 (COVID-19) patients because it has antioxidative, anti-inflammatory, anti-apoptosis, and antifatigue properties. The aim of this study was to determine the effect of 14 days of H2 inhalation on the respiratory and physical fitness status of acute post-COVID-19 patients. This randomized, single-blind, placebo-controlled study included 26 males (44 ± 17 years) and 24 females (38 ± 12 years), who performed a 6-min walking test (6 MWT) and pulmonary function test, specifically forced vital capacity (FVC) and expiratory volume in the first second (FEV1). Symptomatic participants were recruited between 21 and 33 days after a positive polymerase chain reaction test. The experiment consisted of H2/placebo inhalation, 2 × 60 min/day for 14 days. Results showed that H2 therapy, compared with placebo, significantly increased 6 MWT distance by 64 ± 39 m, FVC by 0.19 ± 0.24 L, and, in FEV1, by 0.11 ± 0.28 L (all p ≤ 0.025). In conclusion, H2 inhalation had beneficial health effects in terms of improved physical and respiratory function in acute post-COVID-19 patients. Therefore, H2 inhalation may represent a safe, effective approach for accelerating early function restoration in post-COVID-19 patients.
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Affiliation(s)
- Michal Botek
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Jakub Krejčí
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
- Correspondence:
| | - Michal Valenta
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Andrew McKune
- Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT 2617, Australia;
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Barbora Sládečková
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Petr Konečný
- Faculty of Health Sciences, Palacký University Olomouc, 775 15 Olomouc, Czech Republic;
| | - Iva Klimešová
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (M.B.); (M.V.); (B.S.); (I.K.)
| | - Dalibor Pastucha
- Clinic of Rehabilitation and Physical Medicine, University Hospital Ostrava, 708 52 Ostrava, Czech Republic;
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19
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Self-Administered Six-Minute Walk Test Using a Free Smartphone App in Asymptomatic Adults: Reliability and Reproducibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031118. [PMID: 35162141 PMCID: PMC8834251 DOI: 10.3390/ijerph19031118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Background: The 6-min walk test (6MWT) is a simple, inexpensive, reliable, and reproducible test that provides a reasonable estimate of the cardiorespiratory fitness (CRF). We aimed to assess the reliability and reproducibility of a self-administered 6MWT in asymptomatic adults using a free smartphone app. Methods: In the 1st phase, 93 participants underwent a supervised 6MWT (6MWTsup) in a 30 m indoor corridor, using a triaxial accelerometer and their smartphones to compare the total step counts and to develop a 6-min walk distance (6MWD) prediction equation. In the 2nd phase, 25 participants performed the 6MWTsup and two self-administered 6MWTs outdoors (6MWTsa1 and 6MWTsa2, at least 48 h apart) using a free smartphone app. Results: The agreement between accelerometer- and app-based total step counts was limited (mean difference, −58.7 steps (−8.7%): 95% confidence interval, −326.5 (−46.8%) to 209.1 (29.3%)). The best algorithm for predicting the 6MWTsupm included: 795.456 + (0.815 heightm app-steps) − (1.620 ageyears) − (3.005 weightkg) − (1.155 app-steps), R2 = 0.609). The intraclass correlation coefficient between 6MWTsa2 and 6MWTsa1 was excellent (0.91: 0.81–0.96). The coefficient of variation was 6.4%. The agreement between the two self-administered tests was narrow (−1.9 (0.2%) meters: −57.4 (−9.5%) to 61.3 (9.9%)). Conclusions: The self-administered 6MWT has excellent reliability and reproducibility in asymptomatic adults, being a valuable tool for assessing CRF in community-based interventions.
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20
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The Determination of Step Frequency in 3-min Incremental Step-in-Place Tests for Predicting Maximal Oxygen Uptake from Heart Rate Response in Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010563. [PMID: 35010823 PMCID: PMC8744589 DOI: 10.3390/ijerph19010563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/17/2022]
Abstract
The maximal oxygen uptake (VO2max) prediction models established by step tests are often used for evaluating cardiorespiratory fitness (CRF). However, it is unclear which type of stepping frequency sequence is more suitable for the public to assess the CRF. Therefore, the main purpose of this study was to test the effectiveness of two 3-min incremental step-in-place (3MISP) tests (i.e., 3MISP30s and 3MISP60s) with the same total number of steps but different step-frequency sequences in predicting VO2max. In this cross-sectional study, a total of 200 healthy adults in Taiwan completed 3MISP30s and 3MISP60s tests, as well as cardiopulmonary exercise testing. The 3MISP30s and 3MISP60s models were established through multiple stepwise regression analysis by gender, age, percent body fat, and 3MISP-heart rate. The statistical analysis included Pearson's correlations, the standard errors of estimate, the predicted residual error sum of squares, and the Bland-Altman plot to compare the measured VO2max values and those estimated. The results of the study showed that the exercise intensity of the 3MISP30s test was higher than that of the 3MISP60s test (% heart rate reserve (HRR) during 3MISP30s vs. %HRR during 3MISP60s = 81.00% vs. 76.81%, p < 0.001). Both the 3MISP30s model and the 3MISP60s model explained 64.4% of VO2max, and the standard errors of the estimates were 4.2043 and 4.2090 mL·kg-1·min-1, respectively. The cross-validation results also indicated that the measured VO2max values and those predicted by the 3MISP30s and 3MISP60s models were highly correlated (3MISP30s model: r = 0.804, 3MISP60s model: r = 0.807, both p < 0.001). There was no significant difference between the measured VO2max values and those predicted by the 3MISP30s and 3MISP60s models in the testing group (p > 0.05). The results of the study showed that when the 3MISP60s test was used, the exercise intensity was significantly reduced, but the predictive effectiveness of VO2max did not change. We concluded that the 3MISP60s test was physiologically less stressful than the 3MISP30s test, and it could be a better choice for CRF evaluation.
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21
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Qu J, Shi H, Guo Y, Chen X, Xiao X, Zheng X, Cui Y. Is the six-minute walk test still reliable compared to cardiopulmonary exercise test for exercise capacity in children with congenital heart disease? Front Pediatr 2022; 10:965739. [PMID: 36452347 PMCID: PMC9702990 DOI: 10.3389/fped.2022.965739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We aimed to assess the validity of the six-minute walk test (6MWT) to reflect the functional capacity of children with congenital heart disease (CHD), evaluate a possible correlation between the 6MWT distance with cardiopulmonary exercise test (CPET) variables, as well as to find a cutoff value to stratification the physical fitness in this population. METHODS We enrolled 459 children with CHD, 6-18 years old, who performed a complete CPET and 6MWT on the same day in a cross-sectional observational study. Correlations between variables of CPET and six-minute walking distance (6MWD) were analyzed and cutoff values of 6MWD were identified for the classification of the physical fitness in the population. RESULTS The mean distance ambulated during the 6MWT was 578 ± 65 m, 590 ± 65 m for boys, and 562 ± 62 m for girls (p < 0.001). Both VO2max and %predicted VO2max showed a correlation with the 6MWT distance (r = 0.35, p < 0.001 and r = 0.51, p < 0.001, respectively), and an inverse correlation was found between VE/VCO2 slope and the 6MWT distance (r = -0.31; p < 0.001). There appeared to be a linear association between 6MWD and VO2max up to a 6MWD of approximately 600 m. We divided the population into 4 subgroups (boys <130 cm; boys ≥130 cm; girls <130 cm; girls ≥130 cm), and get the cutoff values (554 m, 617 m, 549 m, 587 m) respectively equivalent to 80% of predicted VO2max. The 6MWT distances of another 102 patients were applied for external verification of the cutoff values. CONCLUSIONS Our study provided evidence on when a 6MWT should be considered as a convincing complementary test in the pediatric population with CHD and explored the classification of exercise tolerance using a 6MWD value. The cut-off values for 6MWD may be qualified as an intervention target for exercise rehabilitation.
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Affiliation(s)
- Jiangbo Qu
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hui Shi
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yugong Guo
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xinxin Chen
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xuwen Xiao
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaojuan Zheng
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanqin Cui
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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22
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Reijneveld EAE, Bor P, Dronkers JJ, Argudo N, Ruurda JP, Veenhof C. Impact of curative treatment on the physical fitness of patients with esophageal cancer: A systematic review and meta-analysis. Eur J Surg Oncol 2021; 48:391-402. [PMID: 34426032 DOI: 10.1016/j.ejso.2021.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Esophageal cancer and curative treatment have a significant impact on the physical fitness of patients. Knowledge about the course of physical fitness during neoadjuvant therapy and esophagectomy is helpful to determine the needs for interventions during and after curative treatment. This study aims to review the current evidence on the impact of curative treatment on the physical fitness of patients with esophageal cancer. METHODS A systematic literature search of PubMed, Embase, Cinahl and the Cochrane Library was conducted up to March 29, 2021. We included observational studies investigating the change of physical fitness (including exercise capacity, muscle strength, physical activity and activities of daily living) from pre-to post-neoadjuvant therapy and/or from pre-to post-esophagectomy. Quality of the studies was assessed and a meta-analysis was performed using standardized mean differences. RESULTS Twenty-seven articles were included. After neoadjuvant therapy, physical fitness decreased significantly. In the first three months after surgery, physical fitness was also significantly decreased compared to preoperative values. Subgroup analysis showed a restore in exercise capacity three months after surgery in patients who followed an exercise program. Six months after surgery, there was limited evidence that exercise capacity restored to preoperative values. CONCLUSION Curative treatment seems to result in a decrease of physical fitness in patients with esophageal cancer, up to three months postoperatively. Six months postoperatively, results were conflicting. In patients who followed a pre- or postoperative exercise program, the postoperative impact of curative treatment seems to be less.
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Affiliation(s)
- Elja A E Reijneveld
- Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands.
| | - Petra Bor
- Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jaap J Dronkers
- Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Núria Argudo
- Department of Surgery, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, Spain
| | - Jelle P Ruurda
- Department of Surgery, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Cindy Veenhof
- Expertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht, Utrecht, the Netherlands
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