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Castillo Velásquez AB, Supervia M, Pelaez Mata D, de Agustín Asensio JC, Arroyo Riaño MO. [Safety and efficacy of a therapeutic exercise program in young adults with repaired congenital diaphragmatic hernia]. Rehabilitacion (Madr) 2024; 58:100859. [PMID: 38905956 DOI: 10.1016/j.rh.2024.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION AND OBJECTIVE Patients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status. MATERIAL AND METHODS Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used. RESULTS 77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in -0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by -7.27±8.26 cmH2O, P=.008; -11.91±10.20 cmH2O, P=.002; -70.63±17.88 m, P=.001; -42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported. CONCLUSIONS A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.
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Affiliation(s)
- A B Castillo Velásquez
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
| | - M Supervia
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, Estados Unidos; Departamento de Salud y Rendimiento Humano, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, España.
| | - D Pelaez Mata
- Servicio de Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - J C de Agustín Asensio
- Servicio de Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M O Arroyo Riaño
- Servicio de Medicina Física y Rehabilitación, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
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Pietruszka-Wałęka E, Rząd M, Rożyńska R, Miklusz P, Zieniuk-Lesiak E, Żabicka M, Jahnz-Różyk K. Quality of Life in Follow-Up up to 9 Months after COVID-19 Hospitalization among the Polish Population-A Prospective Single Center Study. Biomedicines 2024; 12:1282. [PMID: 38927489 PMCID: PMC11201014 DOI: 10.3390/biomedicines12061282] [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: 04/30/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
The consequences of COVID-19 constitute a significant burden to healthcare systems worldwide. Conducting an HRQoL assessment is an important aspect of the evaluation of the impact of the disease. The aim of this study was to investigate the prevalence of persistent symptoms and their impact on HRQoL and health status in COVID-19 convalescents. The study group consists of 46 patients who required hospitalization due to respiratory failure and who were subsequently evaluated 3 and 9 months after hospital discharge. At the follow-up visits, the patients were asked to assess their HRQoL using the EQ-5D-5L questionnaire. The results of chest CT, 6MWT, as well as the severity of the course of COVID-19 were also considered in the analysis. The obtained results have identified fatigue as the most common persistent symptom. The majority of the convalescents reported an impairment of HRQoL in at least one domain (80% and 82% after 3 and 9 months, respectively), of which the most common was that of pain/discomfort. The presence of ongoing symptoms may affect HRQoL in particular domains. The 6MWT outcome correlates with HRQoL 3 months after hospital discharge. Therefore, it may be useful in identifying patients with reduced HRQoL, allowing early interventions aimed at its improvement.
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Affiliation(s)
- Ewa Pietruszka-Wałęka
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Michał Rząd
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Renata Rożyńska
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Piotr Miklusz
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Emilia Zieniuk-Lesiak
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Magdalena Żabicka
- Department of Radiology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Karina Jahnz-Różyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
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Muderis MA, Tan YC, Lu W, Tetsworth K, Axelrod D, Haque R, Akhtar MA, Roberts C, Doshi K, Al-Jawazneh S, Hoellwarth JS. Transtibial osseointegration following unilateral traumatic amputation: An observational study of patients with at least two years follow-up. Injury 2024; 55:111568. [PMID: 38669890 DOI: 10.1016/j.injury.2024.111568] [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: 01/07/2024] [Revised: 03/06/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
IMPORTANCE Most patients use a traditional socket prosthesis (TSP) to ambulate independently following transtibial amputation. However, these patients generally require prosthesis repairs more than twice annually and an entirely new prosthesis every two years. Furthermore, transtibial amputation patients have four times the skin ulceration rate of transfemoral patients, prompting more frequent prosthesis refitting and diminished use. Trans-Tibial osseointegration (TTOI) is a promising technique to address the limitations of TSP, but remains understudied with only four cohorts totaling 41 total procedures reported previously. Continued concerns regarding the risk of infection and questions as to functional capacity postoperatively have slowed adoption of TTOI worldwide. OBJECTIVE This study reports the changes in mobility, quality of life (QOL), and the safety profile of the largest described cohort of patients with unilateral TTOI following traumatic amputation. DESIGN Retrospective observational cohort study. The cohort consisted of patients with data outcomes collected before and after osseointegration intervention. SETTING A large, tertiary referral, major metropolitan center. PARTICIPANTS Twenty-one skeletally mature adults who had failed socket prosthesis rehabilitation, with at least two years of post-osseointegration follow-up. MAIN OUTCOMES AND MEASURES Mobility was evaluated by K-level, Timed Up and Go (TUG), and Six Minute Walk Test (6MWT). QOL was assessed by survey: daily prosthesis wear hours, prosthesis problem experience, general contentment with prosthesis, and Short Form 36 (SF36). Adverse events included any relevant unplanned surgery such as for infection, fracture, implant loosening, or implant failure. RESULTS All patients demonstrated statistically significant improvement post osseointegration surgery with respect to K-level, TUG, 6MWT, prosthesis wear hours, prosthesis problem experience, general prosthesis contentment score, and SF36 Physical Component Score (p < 0.01 for all). Three patients had four unplanned surgeries: two soft tissue refashionings, and one soft tissue debridement followed eventually by implant removal. No deaths, postoperative systemic complications, more proximal amputations, or periprosthetic fractures occurred. CONCLUSIONS AND RELEVANCE TTOI is likely to confer mobility and QOL improvements to patients dissatisfied with TSP rehabilitation following unilateral traumatic transtibial amputation. Adverse events are relatively infrequent and not further disabling. Judicious use of TTOI seems reasonable for properly selected patients. LEVEL OF EVIDENCE 2 (Therapeutic investigation, Observational study with dramatic effect).
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Affiliation(s)
- Munjed Al Muderis
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia
| | - Yao Chang Tan
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - William Lu
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Kevin Tetsworth
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia; Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Queensland, Australia
| | - Daniel Axelrod
- Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Queensland, Australia.
| | - Russel Haque
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia
| | - Muhammad Adeel Akhtar
- NHS Fife, UK; University of Edinburgh College of Medicine & Veterinary Medicine, UK; University of St. Andrews School of Medicine, UK
| | - Claudia Roberts
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia
| | - Karan Doshi
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia
| | - Shakib Al-Jawazneh
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia
| | - Jason Shih Hoellwarth
- Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia; Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY, USA
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Brochu A, Kairy D, Alos N, Laverdière C, Sinnett D, Sultan S, Curnier D, Miron MC, El-Jalbout R, Fiscaletti M, Hébert LJ. Physical impairments, activity limitations, and participation restrictions of childhood acute lymphoblastic leukemia survivors with and without hip osteonecrosis: a PETALE cohort study. J Cancer Surviv 2024:10.1007/s11764-024-01585-4. [PMID: 38787491 DOI: 10.1007/s11764-024-01585-4] [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: 09/24/2023] [Accepted: 04/02/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Long-term musculoskeletal complications represent a growing burden for survivors of childhood acute lymphoblastic leukemia (cALL). This study aimed to describe physical impairments, activity limitations, and participation restrictions in a high-risk subgroup of cALL survivors of the PETALE cohort. METHODS This cross-sectional study, using observational data from the PETALE cohort, included a subgroup of survivors who presented high-risk criteria for late effects. Outcomes measures consisted of hip magnetic resonance imaging, maximal isometric muscle strength (MIMS) or torque (MIMT), range of motion (ROM), Near Tandem Balance (NTB), 6-Minute Walk Test (6MWT), Five Time Sit-to-Stand Test (FTSST), and health-related quality of life. Descriptive statistics and regression analyses were performed. RESULTS Survivors (n = 97, 24.2 ± 6.7 years old) showed limited grip strength, FTSST, and NTB performance compared to reference values (p < 0.001). Thirteen participants (14.6%, 18 hips) had hip osteonecrosis (ON) (53.8% male). Higher severity hip ON was found in female survivors (66.7% vs. 22.2%). Survivors with hip ON had reduced hip external rotation ROM compared to those without (p < 0.05). Relationships were found between MIMS and ROM outcomes (r = 0.32, p < 0.01) and with 6MWT (r = 0.39-0.41, p < 0.001). Our multiple linear regression model explained 27.6% of the variance of the 6MWT. CONCLUSIONS Survivors in our subgroup had clinically significant physical impairments and activity limitations, and those with hip ON showed worst hip impairment outcomes. IMPLICATIONS FOR CANCER SURVIVORS These findings emphasize the importance of long-term follow-up including physical therapy assessment to help early identification and management of physical impairments and activity limitations in survivors of cALL.
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Affiliation(s)
- Annie Brochu
- CHU Sainte-Justine, Montréal, Canada.
- Université de Montréal, Montréal, Canada.
| | - Dahlia Kairy
- Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Nathalie Alos
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Caroline Laverdière
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Daniel Sinnett
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Serge Sultan
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Daniel Curnier
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Marie-Claude Miron
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Ramy El-Jalbout
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Melissa Fiscaletti
- CHU Sainte-Justine, Montréal, Canada
- Université de Montréal, Montréal, Canada
| | - Luc J Hébert
- Université Laval, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, Canada
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O'Sullivan O, Felton J, Mclean S, Bennett AN. Six-minute walk test in healthy British service personnel. BMJ Mil Health 2024:e002720. [PMID: 38754972 DOI: 10.1136/military-2024-002720] [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: 03/06/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION The 6 min walk test (6MWT) is a widely used, safe and effective submaximal exercise test. The primary outcome is the distance walked, but additional physiological and patient-reported metrics can be recorded. It is used to assess function and is commonly used within UK Defence Rehabilitation. However, there are no published British military 6MWT data in a non-injured population. This study reports the 6MWT procedure and results from healthy British service personnel. METHODS A convenience sample of 46 individuals (male n=40) undertook 95 6MWTs over three study visits throughout a year. They were performed on a 20 m straight-line route, administered by an exercise rehabilitation instructor and preceded by anthropometric measurements (height, weight). Physiological measures (HR, oxygen saturations (SpO2)) and patient-reported measures (Borg shortness of breath (SoB), rate of perceived exertion (RPE) and fatigue) were taken before and after the assessment. Statistical tests were performed between pre-test and post-test measures, and sex and body mass, and concurrent cardiopulmonary exercise tests (CPET) with 6MWT distance. RESULTS The mean 6MWT distance was 705.5±86 m; males 709.4±86.9 m and females 685.9±81.9 m (p=0.32), with a median Borg SoB of 1 (IQR: 0-2) and RPE 9 (IQR: 7-11), and a negative correlation between body mass index and 6MWT distance, p=0.007. There were no significant differences between pre-test and post-test measures. Peak workload and VO2 Max correlated weakly with 6MWT distance (0.336, p=0.01 and 0.375, p=0.09, respectively), but submaximal CPET measures did not. CONCLUSION These results provide a benchmark for British military 6MWT data to guide clinical and research use. However, a larger dataset is required for validation and normative values.
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Affiliation(s)
- Oliver O'Sullivan
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK
- Academic Unit of Injury, Recovery and Inflammation Science, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - J Felton
- DMRC Stanford Hall, Loughborough, UK
| | - S Mclean
- DMRC Stanford Hall, Loughborough, UK
| | - A N Bennett
- Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Giugliani R, Gonzalez-Meneses A, Scarpa M, Burton B, Wang R, Martins E, Oussoren E, Hennermann JB, Chabrol B, Grant CL, Sun A, Durand C, Hetzer J, Malkus B, Marsden D, Merritt Ii JL. Disease characteristics, effectiveness, and safety of vestronidase alfa for the treatment of patients with mucopolysaccharidosis VII in a novel, longitudinal, multicenter disease monitoring program. Orphanet J Rare Dis 2024; 19:189. [PMID: 38715031 PMCID: PMC11077874 DOI: 10.1186/s13023-024-03176-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Mucopolysaccharidosis VII (MPS VII) is an ultra-rare, autosomal recessive, debilitating, progressive lysosomal storage disease caused by reduced activity of β-glucuronidase (GUS) enzyme. Vestronidase alfa (recombinant human GUS) intravenous enzyme replacement therapy is an approved treatment for patients with MPS VII. METHODS This disease monitoring program (DMP) is an ongoing, multicenter observational study collecting standardized real-world data from patients with MPS VII (N ≈ 50 planned) treated with vestronidase alfa or any other management approach. Data are monitored and recorded in compliance with Good Clinical Practice guidelines and planned interim analyses of captured data are performed annually. Here we summarize the safety and efficacy outcomes as of 17 November 2022. RESULTS As of the data cutoff date, 35 patients were enrolled: 28 in the Treated Group and seven in the Untreated Group. Mean (SD) age at MPS VII diagnosis was 4.5 (4.0) years (range, 0.0 to 12.4 years), and mean (SD) age at DMP enrollment was 13.9 (11.1) years (range, 1.5 to 50.2 years). Ten patients (29%) had a history of nonimmune hydrops fetalis. In the 23 patients who initiated treatment prior to DMP enrollment, substantial changes in mean excretion from initial baseline to DMP enrollment were observed for the three urinary glycosaminoglycans (uGAGs): dermatan sulfate (DS), -84%; chondroitin sulfate (CS), -55%; heparan sulfate (HS), -42%. Also in this group, mean reduction from initial baseline to months 6, 12, and 24 were maintained for uGAG DS (-84%, -87%, -89%, respectively), CS (-70%, -71%, -76%, respectively), and HS (+ 3%, -32%, and - 41%, respectively). All adverse events (AEs) were consistent with the known vestronidase alfa safety profile. No patients discontinued vestronidase alfa. One patient died. CONCLUSIONS To date, the DMP has collected invaluable MPS VII disease characteristic data. The benefit-risk profile of vestronidase alfa remains unchanged and favorable for its use in the treatment of pediatric and adult patients with MPS VII. Reductions in DS and CS uGAG demonstrate effectiveness of vestronidase alfa to Month 24. Enrollment is ongoing.
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Affiliation(s)
- Roberto Giugliani
- Dep Genetics UFRGS, Casa dos Raros, INAGEMP, Med Genet Serv HCPA, and DASA Genomics, Porto Alegre, Brazil.
| | | | - Maurizio Scarpa
- Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Barbara Burton
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Raymond Wang
- University of California Irvine School of Medicine, Children's Health of Orange County, Orange, CA, USA
| | | | | | | | | | | | - Angela Sun
- Seattle Children's Hospital, Seattle, WA, USA
| | | | - Joel Hetzer
- Ultragenyx Pharmaceutical Inc, Novato, CA, USA
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Simmich J, Andrews NE, Claus A, Murdoch M, Russell TG. Assessing a GPS-Based 6-Minute Walk Test for People With Persistent Pain: Validation Study. JMIR Form Res 2024; 8:e46820. [PMID: 38498031 PMCID: PMC10985605 DOI: 10.2196/46820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 02/06/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The 6-minute walk test (6MWT) is a commonly used method to assess the exercise capacity of people with many health conditions, including persistent pain. However, it is conventionally performed with in-person supervision in a hospital or clinic, therefore requiring staff resources. It may also be difficult when in-person supervision is unavailable, such as during the COVID-19 pandemic, or when the person is geographically remote. A potential solution to these issues could be to use GPS to measure walking distance. OBJECTIVE The primary aim of this study was to assess the validity of a GPS-based smartphone app to measure walking distance as an alternative to the conventional 6MWT in a population with persistent pain. The secondary aim of this study was to estimate the difference between the pain evoked by the 2 test methods. METHODS People with persistent pain (N=36) were recruited to complete a conventional 6MWT on a 30-m shuttle track and a 6MWT assessed by a smartphone app using GPS, performed on outdoor walking circuits. Tests were performed in random order, separated by a 15-minute rest. The 95% limits of agreement were calculated using the Bland-Altman method, with a specified maximum allowable difference of 100 m. Pain was assessed using an 11-point numerical rating scale before and after each walk test. RESULTS The mean 6-minute walk distance measured by the GPS-based smartphone app was 13.2 (SD 46; 95% CI -2.7 to 29.1) m higher than that assessed in the conventional manner. The 95% limits of agreement were 103.9 (95% CI 87.4-134.1) m and -77.6 (95% CI -107.7 to -61) m, which exceeded the maximum allowable difference. Pain increased in the conventional walk test by 1.1 (SD 1.0) points, whereas pain increased in the app test by 0.8 (SD 1.4) points. CONCLUSIONS In individuals with persistent pain, the 2 methods of assessing the 6MWT may not be interchangeable due to limited validity. Potential reasons for the differences between the 2 methods might be attributed to the variation in track layout (shuttle track vs continuous circuit); poor GPS accuracy; deviations from the 30-m shuttle track; human variability in walking speed; and the potential impact of a first test on the second test due to fatigue, pain provocation, or a learning effect. Future research is needed to improve the accuracy of the GPS-based approach. Despite its limitations, the GPS-based 6MWT may still have value as a tool for remote monitoring that could allow individuals with persistent pain to self-administer frequent assessments of their functional capacity in their home environment.
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Affiliation(s)
- Joshua Simmich
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Nicole Emma Andrews
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane, Australia
- The Tess Cramond Pain and Research Centre, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
- Occupational Therapy Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Andrew Claus
- The Tess Cramond Pain and Research Centre, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Megan Murdoch
- The Tess Cramond Pain and Research Centre, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Trevor Glen Russell
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane, Australia
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Kavalcı Kol B, Boşnak Güçlü M, Baytok E, Yılmaz Demirci N. Comparison of the muscle oxygenation during submaximal and maximal exercise tests in patients post-coronavirus disease 2019 syndrome with pulmonary involvement. Physiother Theory Pract 2024:1-14. [PMID: 38469863 DOI: 10.1080/09593985.2024.2327534] [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: 09/22/2023] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Pulmonary involvement is prevalent in patients with coronavirus disease 2019 (COVID-19). Arterial hypoxemia may reduce oxygen transferred to the skeletal muscles, possibly leading to impaired exercise capacity. Oxygen uptake may vary depending on the increased oxygen demand of the muscles during submaximal and maximal exercise. OBJECTIVE This study aimed to compare muscle oxygenation during submaximal and maximal exercise tests in patients with post-COVID-19 syndrome with pulmonary involvement. METHODS Thirty-nine patients were included. Pulmonary function (spirometry), peripheral muscle strength (dynamometer), quadriceps femoris (QF) muscle oxygenation (Moxy® device), and submaximal exercise capacity (six-minute walk test (6-MWT)) were tested on the first day, maximal exercise capacity (cardiopulmonary exercise test (CPET)) was tested on the second day. Physical activity level was evaluated using an activity monitor worn for five consecutive days. Cardiopulmonary responses and muscle oxygenation were compared during 6-MWT and CPET. RESULTS Patients' minimum and recovery muscle oxygen saturation were significantly decreased; maximum total hemoglobin increased, heart rate, blood pressure, breathing frequency, dyspnea, fatigue, and leg fatigue at the end-of-test and recovery increased in CPET compared to 6-MWT (p < .050). Peak oxygen consumption (VO2peak) was 18.15 ± 4.75 ml/min/kg, VO2peak; percent predicted < 80% was measured in 51.28% patients. Six-MWT distance and QF muscle strength were less than 80% predicted in 58.9% and 76.9% patients, respectively. CONCLUSIONS In patients with post-COVID-19 syndrome with pulmonary involvement, muscle deoxygenation of QF is greater during maximal exercise than during submaximal exercise. Specifically, patients with lung impairment should be evaluated for deoxygenation and should be taken into consideration during pulmonary rehabilitation.
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Affiliation(s)
- Başak Kavalcı Kol
- Pilot Health Coordinatorship, Kırşehir Ahi Evran University, Kırşehir, Türkiye
| | - Meral Boşnak Güçlü
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Gazi University, Çankaya, Ankara, Türkiye
| | - Ece Baytok
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Gazi University, Çankaya, Ankara, Türkiye
| | - Nilgün Yılmaz Demirci
- Faculty of Medicine, Department of Pulmonology, Gazi University, Yenimahalle, Ankara, Türkiye
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Volckaerts T, Quadflieg K, Burtin C, de Soomer K, Oostveen E, Roelant E, Verhaegen I, Ruttens D, Lapperre TS, Vissers D. Evaluation of the learning effect on the 6-min walk distance in adults with long COVID. ERJ Open Res 2024; 10:00708-2023. [PMID: 38225989 PMCID: PMC10788084 DOI: 10.1183/23120541.00708-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
There was no learning effect found on 6-min walk distance (6MWD) in patients with long COVID, performing a 6-min walk test twice. However, considerable variation in the difference between the two 6MWDs was observed: only 51% showed an increase. https://bit.ly/3H70G1r.
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Affiliation(s)
- Tess Volckaerts
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Department of Pulmonology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Kirsten Quadflieg
- REVAL – Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Chris Burtin
- REVAL – Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kevin de Soomer
- Department of Pulmonology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Ellie Oostveen
- Department of Pulmonology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Ella Roelant
- Clinical Trial Center, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Iris Verhaegen
- Clinical Trial Center, Antwerp University Hospital (UZA), Edegem, Belgium
| | - David Ruttens
- Department of Pulmonary Medicine, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium
- Faculty of Medicine and Life Science, Hasselt University, Hasselt, Belgium
| | - Thérèse S. Lapperre
- Department of Pulmonology, Antwerp University Hospital (UZA), Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
| | - Dirk Vissers
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Department of Pulmonology, Antwerp University Hospital (UZA), Edegem, Belgium
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10
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Francis AR, Sugrue TJ, Dennis AT. Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people. Heliyon 2024; 10:e25863. [PMID: 38404878 PMCID: PMC10884447 DOI: 10.1016/j.heliyon.2024.e25863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/27/2024] Open
Abstract
Background The Six Minute Walk Test (6MWT) is a simple, non-invasive, well-validated test that assesses cardiorespiratory fitness however is rarely used in pregnant people. It may have clinical utilization to assess fitness, breathing and exertion in pregnancy however no reference intervals exist for people 14+0 to 35+6 weeks gestation. We determined the reference intervals for distance walked for the 6MWT, including exertional and breathlessness ratings for this group. Method We conducted a prospective observational cohort study of 196 healthy nulliparous pregnant people in earlier pregnancy (EP) 14+0 to 23+6 weeks, and middle pregnancy (MP) 24+0 to 35+6 gestation, who performed a standardized 6MWT protocol including rating exertion and breathlessness (Rating Perceived Exertion (RPE) scale (1 none -15 maximal) and Modified Borg Dyspnea (MBD) scale (0 none - 10 maximal)). Results The mean ± SD distance walked was 548 ± 80.9 (EP) versus 547 ± 87.3 (MP) meters (m) P = 0.928. 6MWT reference intervals for the distance walked for the 6MWT were 392-704 m (EP) and 376-718 m (MP). Median (IQR) exertion and breathlessness ratings with exercise for the EP and MP group were 6 (4,7) and 0.5 (0,1) and 6 (4,8) and 0.5 (0,1) respectively. There were no adverse events. Conclusion The 6MWT is safe, feasible and acceptable in pregnant people. The reference intervals for the 6MWT are 392-704 m in people 14+0 to 23+6 weeks gestation and 376-718 m for people 24+0 to 35+6 weeks gestation. Exertion was light and breathlessness was just noticeable with the 6MWT.
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Affiliation(s)
- Alaina R. Francis
- Melbourne, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Australia
- The Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia
| | - Tahila J. Sugrue
- Melbourne, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Australia
- The Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia
| | - Alicia T. Dennis
- Melbourne, Australia
- The Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia
- School of Medicine, Faculty of Health, Deakin University, Department of Obstetrics and Gynaecology, and Department of Critical Care (previously Department of Medicine and Radiology), and Department of Pharmacology, The University of Melbourne, Parkville, Australia
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11
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Maqsood R, Schofield S, Bennett AN, Khattab A, Clark C, Bull AMJ, Fear NT, Boos CJ. The Influence of Physical and Mental Health Mediators on the Relationship Between Combat-Related Traumatic Injury and Ultra-Short-Term Heart Rate Variability in a U.K. Military Cohort: A Structural Equation Modeling Approach. Mil Med 2024; 189:e758-e765. [PMID: 37656495 PMCID: PMC10898941 DOI: 10.1093/milmed/usad341] [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] [Received: 04/17/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Combat-related traumatic injury (CRTI) adversely affects heart rate variability (HRV). The mediating effect of mental and physical health factors on the relationship between CRTI, its severity and HRV has not been previously studied and investigated. MATERIALS AND METHODS A cross-sectional mediation analysis of the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study was performed. The sample consisted of injured and uninjured British male servicemen who were frequency-matched based on their age, rank, role-in-theater, and deployment to Afghanistan (2003-2014). CRTI and injury severity (the New Injury Severity Scores [NISS] [NISS < 25 and NISS ≥ 25]) were included as exposure variables. HRV was quantified using the root mean square of successive differences (RMSSD) obtained using pulse waveform analysis. Depression and anxiety mediators were quantified using the Patient Health Questionnaire and Generalized Anxiety Disorder, respectively. Body mass index and the 6-minute walk test (6MWT) represented physical health measures. Two mediation pathways between exposure and outcome variables were examined in comparison with the uninjured group using structural equation modeling. RESULTS Of 862 servicemen, 428 were injured and 434 were uninjured with the mean age at assessment of 33.9 ± 5.4 (range 23-59) years. Structural equation modeling revealed that depression, anxiety, and body mass index did not significantly mediate the relationship between injury/injury severity and RMSSD. However, the 6MWT significantly mediated the relationship between CRTI and RMSSD (27% mediation). The indirect effect of 6MWT on the relationship between injury severity (NISS ≥ 25 vs. uninjured) and RMSSD was -0.06 (95% CI: -0.12, -0.00, P < .05). CONCLUSIONS The findings suggest that greater physical function may improve HRV following CRTI. Longitudinal studies are warranted to further validate these findings.
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Affiliation(s)
- Rabeea Maqsood
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London SW3 6LR, UK
| | - Susie Schofield
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London SW3 6LR, UK
| | - Alexander N Bennett
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London SW3 6LR, UK
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Nottinghamshire LE12 5QW, UK
| | - Ahmed Khattab
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Carol Clark
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Anthony M J Bull
- Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Nicola T Fear
- Academic Department of Military Mental Health and King's Centre for Military Health Research, King's College London, London SE5 9RJ, UK
| | - Christopher J Boos
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
- Department of Cardiology, University Hospitals Dorset, Poole BH15 2JB, UK
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12
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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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13
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Martinez-Marin RJ, Reyes-Leiva D, Nascimento A, Muelas N, Dominguez-González C, Paradas C, Olivé M, García-Romero M, Pascual-Pascual SI, Grau JM, Barba-Romero MA, Gomez-Caravaca MT, de Las Heras J, Casquero P, Mendoza MD, de León JC, Gutierrez A, Morís G, Blanco-Lago R, Ramos-Fransi A, Pintós G, García-Antelo MJ, Rabasa M, Morgado Y, Usón M, Miralles FJ, Bárcena-Llona JE, Gómez-Belda AB, Pedraza-Hueso MI, Hortelano M, Colomé A, Garcia-Martin G, Lopez de Munain A, Jericó I, Galán-Dávila L, Pardo J, Salgueiro-Origlia G, Alonso-Pérez J, Pla-Junca F, Schiava M, Segovia-Simón S, Díaz-Manera J. Description of clinical and genetic features of 122 patients included in the Spanish Pompe registry. Neuromuscul Disord 2024; 34:1-8. [PMID: 38087756 DOI: 10.1016/j.nmd.2023.10.001] [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] [Received: 06/07/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 12/26/2023]
Abstract
Pompe disease is a rare genetic disorder with an estimated prevalence of 1:60.000. The two main phenotypes are Infantile Onset Pompe Disease (IOPD) and Late Onset Pompe Disease (LOPD). There is no published data from Spain regarding the existing number of cases, regional distribution, clinical features or, access and response to the treatment. We created a registry to collect all these data from patients with Pompe in Spain. Here, we report the data of the 122 patients registered including nine IOPD and 113 LOPD patients. There was a high variability in how the diagnosis was obtained and how the follow-up was performed among different centres. Seven IOPD patients were still alive being all treated with enzymatic replacement therapy (ERT) at last visit. Ninety four of the 113 LOPD patients had muscle weakness of which 81 were receiving ERT. We observed a progressive decline in the results of muscle function tests during follow-up. Overall, the Spanish Pompe Registry is a valuable resource for understanding the demographics, patient's journey and clinical characteristics of patients in Spain. Our data supports the development of agreed guidelines to ensure that the care provided to the patients is standardized across the country.
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Affiliation(s)
- Rafael Jenaro Martinez-Marin
- NeuService, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Universidad Autónoma de Madrid, Madrid, Spain
| | - David Reyes-Leiva
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Andrés Nascimento
- Servicio de Neuropediatría, CIBERER, ERN-NMD, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain
| | - Nuria Muelas
- CIBERER, Spain; Neurology Service, Hospital La Fe de Valencia, Valencia, Spain
| | - C Dominguez-González
- CIBERER, Spain; Neurology Service, Hospital 12 de Octubre, imas12 Research Institute, ERN-NMD, Madrid, Spain
| | - Carmen Paradas
- Neurology Service, Hospital Virgen del Rocío, Sevilla, Spain
| | - Montse Olivé
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain; Neuromuscular Diseases Unit, Neurology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mar García-Romero
- Neuropaediatrics Service, Hospital Universitario La Paz, Madrid, Spain
| | | | - Josep Maria Grau
- Internal Medicine Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - Javier de Las Heras
- Division of Pediatric Metabolism at Cruces University Hospital, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), European Reference Network for Hereditary Metabolic Disorders (MetabERN), Biocruces-Bizkaia Health Research Institute and University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - Pilar Casquero
- Neurology Service, Hospital Mateu Orfila, Menorca, Spain
| | | | - Juan Carlos de León
- Neurology Service, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | | | - Germán Morís
- Neurology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Raquel Blanco-Lago
- Paediatrics Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Alba Ramos-Fransi
- Neurology Service, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - Guillem Pintós
- Internal Medicine Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Maria Rabasa
- Neurology Service, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Mercedes Usón
- Neurology Service, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
| | | | | | | | | | - Miryam Hortelano
- Paediatric Service, Hospital Universitario de Segovia, Segovia Spain
| | - Antoni Colomé
- Internal Medicine Service, Hospital de Terrassa, Barcelona, Spain
| | | | - Adolfo Lopez de Munain
- Neurology Service, Instituto Biodonostia-CIBERNED-EHU-UPV, Hospital Universitario Donostia-OSAKIDETZA, Spain
| | - Ivonne Jericó
- Neurology Service, Complejo Hospitalario de Navarra, Spain
| | - Lucía Galán-Dávila
- Neurology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Julio Pardo
- Neurology Service, Hospital Universitario de Santiago de Compostela, Santiago de Compostela. Spain
| | - Giorgina Salgueiro-Origlia
- Internal Medicine Service, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid, Spain
| | - Jorge Alonso-Pérez
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Francesc Pla-Junca
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Marianela Schiava
- John Walton Muscular Distrophy Research Center, Newcastle University, UK
| | - Sonia Segovia-Simón
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain
| | - Jordi Díaz-Manera
- Institut de Recerca Biomedica Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERER, Spain; John Walton Muscular Distrophy Research Center, Newcastle University, UK.
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14
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Pietruszka-Wałęka E, Rząd M, Żabicka M, Rożyńska R, Miklusz P, Zieniuk-Lesiak E, Jahnz-Różyk K. Impact of Symptomatology, Clinical and Radiological Severity of COVID-19 on Pulmonary Function Test Results and Functional Capacity during Follow-Up among Survivors. J Clin Med 2023; 13:45. [PMID: 38202052 PMCID: PMC10779755 DOI: 10.3390/jcm13010045] [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: 11/17/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
One of the most commonly observed complications after COVID-19 is persistent pulmonary impairment. The aim of this study was to evaluate the impact of individual factors during the acute phase of COVID-19 on subsequent pulmonary function test results. The study involved 46 patients who were admitted to hospital due to respiratory failure caused by SARS-CoV-2 and who were assessed during follow-up visits at 3 and 9 months after discharge. Patients were divided into two subgroups according to the severity of respiratory failure. The severe group included patients requiring mechanical ventilation or HFNOT. The results of the study showed that a severe course of the disease was associated with a lower FVC and a higher FEV1/FVC ratio 3 months after discharge (both p < 0.05). In addition, it has been revealed that the length of hospitalization is a factor that negatively impacts the FEV1, FVC and TLC values measured at follow-up after 3 months. Furthermore, the obtained results identify the presence of cough in the acute phase of the disease as a factor having a positive impact on several PFT parameters (especially the FEV1/FVC ratio) as well as the 6MWT outcome after 3 months. The FVC improved significantly (p < 0.05) between the follow-up visits. The findings may indicate that COVID-19-induced respiratory dysfunction is usually temporary and spontaneously resolves during recovery. Recovery is slower in those who required more intensive oxygenation. The results of this study may be useful in identifying patients who require more intensive and longer rehabilitation after COVID-19.
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Affiliation(s)
- Ewa Pietruszka-Wałęka
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Michał Rząd
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Magdalena Żabicka
- Department of Radiology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Renata Rożyńska
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Piotr Miklusz
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Emilia Zieniuk-Lesiak
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Karina Jahnz-Różyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
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15
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Nierwińska K, Myśliwiec A, Konarska-Rawluk A, Lipowicz A, Małecki A, Knapik A. SMART System in the Assessment of Exercise Tolerance in Adults. SENSORS (BASEL, SWITZERLAND) 2023; 23:9624. [PMID: 38139470 PMCID: PMC10747569 DOI: 10.3390/s23249624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
Health-oriented physical activity should meet two key criteria: safety and an optimal level of exercise. The system of monitoring and rationalization of training (SMART) was designed to meet them. SMART integrates a custom-configured inertial measurement unit (IMU) and a sensor with real-time heart rate measurement (HR) using a proprietary computer application. SMART was used to evaluate the safety and exercise load with 115 study participants: 51 women (44.35%) and 64 men (55.65%) aged 19 to 65 years. The exercise test was the 6MWT test. In 35% of the participants, the mean HR exceeded the recognized safe limit of HR 75% max. Ongoing monitoring of HR allows for optimal exercise and its safety. Step count data were collected from the SMART system. The average step length was calculated by dividing the distance by the number of steps. The aim of the present study was to assess the risk of excessive cardiovascular stress during the 6MWT test using the SMART system.
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Affiliation(s)
- Katarzyna Nierwińska
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Andrzej Myśliwiec
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Anna Konarska-Rawluk
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Anna Lipowicz
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
- Department of Antropology, Wrocław University of Environmental and Life Sciences, 50-375 Wrocław, Poland
| | - Andrzej Małecki
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
| | - Andrzej Knapik
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065 Katowice, Poland; (K.N.); (A.K.-R.); (A.L.); (A.M.); (A.K.)
- Department of Adapted Physical Activity and Sport, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
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16
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Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
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Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
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17
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Koumenidou M, Kotzamanidou MC, Panoutsakopoulos V, Siaperas P, Misailidou V, Tsalis GA. The Long-Term Adaptations of a Combined Swimming and Aquatic Therapy Intervention in an Adult Person with High-Functioning Autism (Asperger's Syndrome): A Case Study. Healthcare (Basel) 2023; 11:2986. [PMID: 37998478 PMCID: PMC10671614 DOI: 10.3390/healthcare11222986] [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: 10/15/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Individuals with High-Functioning Autism present impairments in communication, social interaction, and motor development. A low level of motor skills, namely difficulties in gross and fine mobility, and in motor control, discourage individuals with High-Functioning Autism from being involved in physical activities, resulting in fewer opportunities for social interaction. There is not much evidence available about the effects of regular swimming exercise and/or aquatic therapy on health promotion in adults with High-Functioning Autism. An adult male (22 yrs) diagnosed with High-Functioning Autism participated in a combined 6-month swimming and aquatic therapy program (two sessions/week, 60 min each). The pre- and post-intervention assessments consisted of physical fitness, balance, functional ability, and psychomotor tests. The post-intervention assessments showed improvements in the standing long jump (+100%), hand grip force (+71.7%), bend arm hang test (+123.1%), and the physiological parameters in the 6 min walk test (+10.2%). On the opposite, decrements in the sit-up (-12%) and sit-and-reach test (-6.3%) were observed. It was noted that the participant frequently lost interest and focus quickly, resulting in the abandonment of the exercise. Conclusively, there is a great need for further research on this topic examining a larger adult population.
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Affiliation(s)
- Maria Koumenidou
- Faculty of Health Sciences, Metropolitan College of Thessaloniki, 546 24 Thessaloniki, Greece, (V.M.)
| | - Mariana C. Kotzamanidou
- Faculty of Health Sciences, Metropolitan College of Thessaloniki, 546 24 Thessaloniki, Greece, (V.M.)
- Institute of Occupational Science & Rehabilitation, Metropolitan College, 151 25 Athens, Greece;
| | - Vassilios Panoutsakopoulos
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | - Panagiotis Siaperas
- Institute of Occupational Science & Rehabilitation, Metropolitan College, 151 25 Athens, Greece;
- Occupational Therapy Department, Metropolitan College, 151 25 Athens, Greece
| | - Victoria Misailidou
- Faculty of Health Sciences, Metropolitan College of Thessaloniki, 546 24 Thessaloniki, Greece, (V.M.)
| | - George A. Tsalis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
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Kaya G, Köse N, Salcı Y, Armutlu K, Karakaya J, Tuncer A, Karabudak R. Reliability and validity of the glittre activities of daily living test in fully ambulatory multiple sclerosis patients. Ir J Med Sci 2023; 192:2379-2386. [PMID: 36451004 DOI: 10.1007/s11845-022-03237-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Evaluation of activities of daily living (ADL) and functional exercise capacity in patients with multiple sclerosis (pwMS) is crucial in demonstrating the effectiveness of interventions. AIMS To investigate the reliability and validity of the Glittre ADL Test in pwMS. METHODS Twenty-five pwMS and 26 healthy adults were included in this methodological study. The Glittre ADL Test was applied. Six-Minute Walk Test (6MWT) and Nottingham Extended Activities of Daily Living Index (NEADL) were applied for concurrent validity. Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Mini Balance Evaluation Systems Test (Mini BESTest), Multiple Sclerosis Quality of Life Scale-54 (MSQoL-54), and Five Times Sit-to-Stand Test (5 STST) were applied for construct validity. The Glittre ADL Test was repeated after 3-6 days for test-retest reliability. RESULTS The test-retest reliability of the Glittre ADL Test was excellent (ICC = 0.941). There was strong correlation of the Glittre ADL Test with 6MWT (rho = - 0.710, p < 0.001), NEADL (rho = - 0.841, p < 0.001), EDSS, (rho = 0.836, p = < 0.001), Mini BESTest (rho = 0.792, p < 0.001), and 5 STST scores (rho = 0.720, p < 0.001). There was a moderate correlation between the Glittre ADL Test and the physical health sub-item score of the MSQoL-54 (rho = - 0.591, p = 0.002). No correlation was found between the Glittre ADL Test and FSS (rho = 0.348, p = 0.096). There was a difference in the Glittre ADL Test results between the pwMS and the healthy adults (p = 0.001). CONCLUSIONS The Glittre ADL Test has excellent reliability and strong construct and criterion validity for assessing functional exercise capacity and ADL in fully ambulatory pwMS. TRIAL REGISTRATION TRN: NCT04182269.
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Affiliation(s)
- Gözde Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, İzmir, Turkey.
| | - Nezire Köse
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yeliz Salcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Kadriye Armutlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aslı Tuncer
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rana Karabudak
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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19
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Dimachkie MM, Kishnani PS, Ivanescu C, Flore G, Gwaltney C, van der Beek NAME, Hamed A, An Haack K, Pollissard L, Baranowski E, Sparks SE, DasMahapatra P. Measurement Properties of 2 Novel PROs, the Pompe Disease Symptom Scale and Pompe Disease Impact Scale, in the COMET Study. Neurol Clin Pract 2023; 13:e200181. [PMID: 37559825 PMCID: PMC10409572 DOI: 10.1212/cpj.0000000000200181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND AND OBJECTIVES The Pompe Disease Symptom Scale (PDSS) and Impact Scale (PDIS) were created to measure the severity of symptoms and functional limitations experienced by patients with late-onset Pompe disease (LOPD). The objectives of this analysis were to establish a scoring algorithm and to examine the reliability, validity, and responsiveness of the measures using data from the COMET clinical trial. METHODS The COMET trial was a randomized, double-blind study comparing the efficacy and safety of avalglucosidase alfa and alglucosidase alfa in patients with LOPD aged 16-78 years at baseline. Adult participants (18 years or older) completed the PDSS and PDIS daily for 14 days at baseline and for 2 weeks before quarterly clinic visits for 1 year after randomization using an electronic diary. Data were pooled across treatment groups for the current analyses. Factor analysis and inter-item correlations were used to derive a scoring algorithm. Test-retest and internal consistency analyses examined the reliability of the measures. Correlations with criterion measures were used to evaluate validity and sensitivity to change. Anchor and distribution-based analyses were conducted to estimate thresholds for meaningful change. RESULTS Five multi-item domain scores were derived from the PDSS (Shortness of Breath, Overall Fatigue, Fatigue/Pain, Upper Extremity Weakness, Pain) and 2 from the PDIS (Mood, Difficulty Performing Activities). Internal consistency (Cronbach α > 0.90) and test-retest reliability (intraclass correlation >0.60) of the scores were supported. Cross-sectional and longitudinal correlations with the criterion measures generally supported the validity of the scores (r > 0.40). Within-patient meaningful change estimates ranging from 1.0 to 1.5 points were generated for the PDSS and PDIS domain scores. DISCUSSION The PDSS and PDIS are reliable and valid measures of LOPD symptoms and functional impacts. The measures can be used to evaluate burden of LOPD and effects of treatments in clinical trials, observational research, and clinical practice. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov identifier: NCT02782741.
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Affiliation(s)
- Mazen M Dimachkie
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Priya S Kishnani
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Cristina Ivanescu
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Giulio Flore
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Chad Gwaltney
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Nadine A M E van der Beek
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Alaa Hamed
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Kristina An Haack
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Laurence Pollissard
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Eileen Baranowski
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Susan E Sparks
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
| | - Pronabesh DasMahapatra
- University of Kansas Medical Center (MMD), Kansas City, KS; Duke University Medical Center (PSK), Durham, NC; IQVIA Netherland (CI, GF), Amsterdam-Zuidoost, North Holland Province, The Netherlands; Gwaltney Consulting (CG), Westerly, RI; Center for Lysosomal and Metabolic Diseases (NAMEB), Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Sanofi (AH, EB, SES, PD), Cambridge, MA; and Sanofi (KAH, LP), Chilly-Mazarin, France
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20
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Delbressine JM, Jensen D, Vaes AW, Li PZ, Bourbeau J, Tan WC, Hajian B, van 't Hul AJ, Spruit MA. Reference values for six-minute walk distance and six-minute walk work in Caucasian adults. Pulmonology 2023; 29:399-409. [PMID: 37045743 DOI: 10.1016/j.pulmoe.2023.02.014] [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] [Received: 10/20/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 04/14/2023] Open
Abstract
RATIONALE The six-minute walk test (6MWT) is a practical and simple field-based test to assess physical capacity. Several reference equations for six-minute walking distance (6MWD, m) exist, but have a number of limitations that decrease their clinical utility. In addition, no reference equations exist for the 6MWT-derived outcome six-minute walk work (6MWORK, kg.m). OBJECTIVES To establish new reference equations for 6MWD and 6MWORK on a 20 m course using data from the population-based Canadian Cohort Obstructive Lung Disease study. METHODS AND MEASUREMENTS A total of 335 participants without obstructive or restrictive pulmonary function, with normal self-reported health status, normal exercise capacity, and <30 pack years cigarette smoking history were selected to create a representative sample of Canadian adults aged ≥40 years. All participants performed two 6MWTs. Reference equations were derived using multiple regression analyses. MAIN RESULTS On average, 6MWD and 6MWORK were 541±98 m and 41.3 ± 11.2 kg.m, respectively. All outcomes were significantly greater in males than females. Sex-specific reference equations were derived from the results of 6MWD and 6MWORK with an explained variance of 24 to 35%. CONCLUSIONS This study established reference equations for 6MWD and 6MWORK on a 20 m course in Caucasian males and females aged ≥40 years with normal pulmonary function, self-reported health status and exercise capacity. These newly derived reference equations add value to the assessment of functional capacity in clinical practice.
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Affiliation(s)
- J M Delbressine
- Department of Research and Development, Ciro, 6085 NM Horn, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, Life Sciences, Maastricht University, 6229 HX Maastricht, the Netherlands.
| | - D Jensen
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, Québec, Canada; Research Institute of the McGill University Health Centre, Translational Research in Respiratory Diseases Program and Respiratory Epidemiology and Clinical Research Unit, Montréal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - A W Vaes
- Department of Research and Development, Ciro, 6085 NM Horn, the Netherlands
| | - P Z Li
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - J Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - W C Tan
- The University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | - B Hajian
- Department of Research and Development, Ciro, 6085 NM Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, the Netherlands
| | - A J van 't Hul
- Department of Pulmonary Disease, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - M A Spruit
- Department of Research and Development, Ciro, 6085 NM Horn, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, Life Sciences, Maastricht University, 6229 HX Maastricht, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, the Netherlands
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21
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Sagat P. Reference standards for the 6-min walk test in Croatian older adults. Front Physiol 2023; 14:1226585. [PMID: 37601636 PMCID: PMC10436743 DOI: 10.3389/fphys.2023.1226585] [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: 05/21/2023] [Accepted: 07/26/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction: The 6-min walk test (6MWT) is commonly used to assess the level of functional capacity of individuals with respiratory diseases. Although previous evidence has provided reference standards for the 6MWT in unhealthy older adults, no data have been provided for the Croatian healthy older populations. Therefore, the main purposes of the study were to define sex- and age-specific references for the 6MWT in older adults. Methods: Six-hundred and forty-three older adults (260 men and 383 women) aged 60-80 years were recruited in this observational cross-sectional study. The participants were instructed to walk the maximal distance possible for 6 min. The main outcome was the final score in the 6MWT conducted at a 30-m straight corridor. Results: Men exhibited longer walking distance, compared to women (678.3 ± 59.1 vs. 653.8 ± 49.9 m, p < 0.001) and younger men and women performed better, than their older counterparts (p < 0.001). However, the sex*age interaction effect showed no significant differences between men and women in the same age range (p = 0.865). Discussion: This is the first study with the purpose of providing reference standards for the 6MWT in a large sample of Croatian older adults. Older men and women in lower percentiles may be treated as a "risky group" of individuals with a special attention of implementing interventions to enhance the performance.
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Affiliation(s)
- Peter Sagat
- GSD/Health and Physical Education Department, Sport Sciences and Diagnostics Research Group, Prince Sultan University, Riyadh, Saudi Arabia
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22
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Qorolli M, Beqaj S, Ibrahimi‐Kaçuri D, Murtezani A, Krasniqi V, Mačak Hadžiomerović A. Functional status and quality of life in post-COVID-19 patients two to three weeks after hospitalization: A cross-sectional study. Health Sci Rep 2023; 6:e1510. [PMID: 37621387 PMCID: PMC10444983 DOI: 10.1002/hsr2.1510] [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: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Background and Aims Extended hospitalization due to coronavirus disease 2019 (COVID-19) is associated with residual musculoskeletal and functional deficits lasting even 6 months after discharge; therefore, it is crucial that post-hospitalized patients are promptly assessed. The aim of this study was to identify post-COVID-19 patients' functional status and quality of life, as well as to investigate their inter-relatedness 2-3 weeks after hospital discharge. Methods The study included 39 post-COVID-19 patients previously hospitalized in the Clinic for Infectious Diseases at the University Clinical Center of Kosovo (UCCK) from August to December 2021. Physiotherapeutic assessment encompassed socio-demographic and clinical data including Short Physical Performance Battery (SPPB) for physical functional performance, hand grip strength, 6-min Walk Test (6MWT) for aerobic capacity and endurance, EuroQol 5-Dimension 5-Level (EQ-5D-5L) for quality of life, Visual Analogue Scale (VAS) for pain, Borg CR10 for dyspnea, peripheral oxygen saturation and heart rate. Descriptive statistics, Pearson correlation, and multiple linear regression analysis were utilized for data processing. Results The median (interquartile range [IQR]) for Borg CR10, VAS pain scale, total SPPB, grip strength, and 6MWT were 1 (0-3), 3 (1-6), 9 (8-10), 30.5 (23.2-43.5) kg, 344.5 (312.7-381.7) m respectively, while the mean (SD) for EQ-5D-5L index value was 0.7 (0.2). The strongest and most significant correlation was depicted between SPPB total score and its subscales, followed by correlation with EQ-5D-5L (r = 0.719, p < 0.001), grip strength (r = 0.612 p < 0.001), Borg CR10 (r = -0.515, p = 0.001), 6MWT (r = 0.416, p = 0.02), and VAS scale (r = -0.343, p = 0.03). Using the multiple regression analysis, the grip strength, Borg-CR10, and 6MWT were found to be strongly predictive of SPPB total score. Conclusion In post-COVID-19 patients' functional status and quality of life were impaired 2-3 weeks following hospitalization. SPPB showed the most frequent and significant correlation with other variables, hence it should be considered as one of the primary screening tools.
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Affiliation(s)
- Merita Qorolli
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Samire Beqaj
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
| | | | - Ardiana Murtezani
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
| | - Valon Krasniqi
- Faculty of Medicine, Physiotherapy BranchUniversity of PrishtinaPrishtinaRepublic of Kosovo
- University Clinical Center of KosovoPrishtinaRepublic of Kosovo
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Tomaç H, Malkoç M, Angın E. A pilot study of the effects of supervised exercise training on body composition, cardiometabolic risk factors, muscle strength and functional capacity in individuals with bariatric surgery. Heliyon 2023; 9:e19032. [PMID: 37649847 PMCID: PMC10462818 DOI: 10.1016/j.heliyon.2023.e19032] [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: 03/23/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023] Open
Abstract
The main objective of this pilot study was to evaluate the effects of functional exercise training (FET) and home exercise training (HET) on body composition, cardiometabolic risk factors, muscle strength, and functional capacity in individuals with bariatric surgery. The sample of the study included 30 individuals who underwent bariatric surgery. The FET group had functional exercise training consisting of stretching, aerobic, strengthening, and balance exercises assigned by a physiotherapist (n = 15), and the HET group had the same exercises under supervision (n = 15). The training sessions were planned as × 3 per week for a period of 8 weeks. Body composition, cardiometabolic risk factors, cardiometabolic risk status, muscle strength, and functional capacity of all individuals were evaluated before and after training. According to the measurements, body weight (BW), body mass index (BMI), body fat mass (BFM), C-reactive protein, glycated hemoglobin, insulin resistance, cardiovascular risk total score, and ten-year cardiovascular percentage risk decreased significantly (p < 0.05), while HDL-C, leg, back, and hand grip strength (right-left), and walking distance increased significantly (p < 0.05) in the FET group. In the HET group, there were significant increases in body fat percentage (BFM %), BFM, and body muscle mass percentage (BMM %) (p < 0.05), while body muscle mass (BMM), right hand grip strength, leg and back muscle strength, and walking distance scores significantly decreased (p < 0.05). It was concluded that personalized and supervised FET has a positive effect on body composition, cardiometabolic risk factors, muscle strength, and functional capacity, and it can be recommended as a safe exercise model for bariatric surgery patients.
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Affiliation(s)
- Hayriye Tomaç
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Northern Cyprus, Mersin 10, Turkey
| | - Mehtap Malkoç
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Northern Cyprus, Mersin 10, Turkey
| | - Ender Angın
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Northern Cyprus, Mersin 10, Turkey
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Honchar O, Ashcheulova T. Spontaneous physical functional recovery after hospitalization for COVID-19: insights from a 1 month follow-up and a model to predict poor trajectory. Front Med (Lausanne) 2023; 10:1212678. [PMID: 37547607 PMCID: PMC10399450 DOI: 10.3389/fmed.2023.1212678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background Long COVID syndrome has emerged as a new global healthcare challenge, with impaired physical performance being a prominent debilitating factor. Cardiopulmonary rehabilitation is a mainstay of management of symptomatic post-COVID patients, and optimization of candidate selection might allow for more effective use of available resources. Methods In order to study the natural dynamics and to identify predictors of physical functional recovery following hospitalization for COVID-19, 6 min walk test was performed pre-discharge in 176 patients (40% hypertensive, 53% female, mean age 53.2 ± 13.5 years) with re-evaluation at 1 month. Results Six min walk distance and the reached percent of predicted distance (6MWD%) were suboptimal at both visits-396 ± 71 m (68.7 ± 12.4%) pre-discharge and 466 ± 65 m (81.8 ± 13.6%) at 1 month. Associated changes included significant oxygen desaturation (2.9 ± 2.5 and 2.3 ± 2.2%, respectively) and insufficient increment of heart rate during the test (24.9 ± 17.5 and 28.2 ± 12.0 bpm) that resulted in low reached percent of individual maximum heart rate (61.1 ± 8.1 and 64.3 ± 8.2%). Automatic clusterization of the study cohort by the 6MWD% changes has allowed to identify the subgroup of patients with poor "low base-low increment" trajectory of spontaneous post-discharge recovery that were characterized by younger age (38.2 ± 11.0 vs. 54.9 ± 12.1, p < 0.001) but more extensive pulmonary involvement by CT (43.7 ± 8.8 vs. 29.6 ± 19.4%, p = 0.029) and higher peak ESR values (36.5 ± 9.7 vs. 25.6 ± 12.8, p < 0.001). Predictors of poor recovery in multivariate logistic regression analysis included age, peak ESR, eGFR, percentage of pulmonary involvement by CT, need for in-hospital oxygen supplementation, SpO2 and mMRC dyspnea score pre-discharge, and history of hypertension. Conclusion COVID-19 survivors were characterized by decreased physical performance pre-discharge as assessed by the 6 min walk test and did not completely restore their functional status after 1 month of spontaneous recovery, with signs of altered blood oxygenation and dysautonomia contributing to the observed changes. Patients with poor "low base-low increment" trajectory of post-discharge recovery were characterized by younger age but more extensive pulmonary involvement and higher peak ESR values. Poor post-discharge recovery in the study cohort was predictable by the means of machine learning-based classification model that used age, history of hypertension, need for oxygen supplementation, and ESR as inputs.
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McCourt O, Fisher A, Ramdharry G, Land J, Roberts AL, Rabin N, Yong K. Exercise prehabilitation for people with myeloma undergoing autologous stem cell transplantation: results from PERCEPT pilot randomised controlled trial. Acta Oncol 2023; 62:696-705. [PMID: 36794394 DOI: 10.1080/0284186x.2023.2178326] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Autologous stem cell transplant (ASCT) is first line treatment for newly diagnosed patients with myeloma but often results in functional deficits and reduced quality of life (QOL). Physically active myeloma patients have better QOL, less fatigue and reduced morbidity. This trial aimed to investigate the feasibility of a physiotherapist-led exercise intervention delivered across the continuum of the myeloma ASCT pathway at a UK centre. Initially designed and delivered as a face-to-face trial, the study protocol was adapted to virtual delivery in response to the COVID-19 pandemic. MATERIAL AND METHODS A pilot randomised controlled trial of a partly supervised exercise intervention with incorporated behaviour change techniques delivered before, during and for 3 months following ASCT compared to usual care. Face-to-face delivery of the pre-ASCT supervised intervention was adapted to virtually-supervised group classes via video conferencing. Primary outcomes related to feasibility; recruitment rate, attrition and adherence. Secondary outcomes included patient reported measures of QOL (EORTC C30, FACT-BMT, EQ5D), and fatigue (FACIT-F), measures of functional capacity (six-minute walk test (6MWT), timed sit-to-stand (TSTS), hand grip strength, self-reported and objective physical activity (PA). RESULTS Over 11 months 50 participants were enrolled and randomised. Overall, uptake to the study was 46%. The attrition rate was 34%, mainly related to failure to undergo ASCT. Loss of follow-up for other reasons was low. Secondary outcomes demonstrate potential for the benefit of exercise prior to, during and after ASCT with improvements in QOL, fatigue, functional capacity and PA evident on admission for ASCT and 3 months post-ASCT. DISCUSSION Results indicate acceptability and feasibility of delivering exercise prehabilitation, in person and virtually within the ASCT pathway in myeloma. The effects of prehabilitation and rehabilitation provision as a component of the ASCT pathway warrants further investigation.
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Affiliation(s)
- Orla McCourt
- Therapies & Rehabilitation, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - Abigail Fisher
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Gita Ramdharry
- Queens Square Centre for Neuromuscular Diseases, National Hospital for Neurology & Neurosurgery, UCLH NHS Trust/UCL Institute of Neurology, University College London, London, UK
| | - Joanne Land
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Anna L Roberts
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Neil Rabin
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kwee Yong
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
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26
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Suzuki N, Mori-Yoshimura M, Katsuno M, Takahashi MP, Yamashita S, Oya Y, Hashizume A, Yamada S, Nakamori M, Izumi R, Kato M, Warita H, Tateyama M, Kuroda H, Asada R, Yamaguchi T, Nishino I, Aoki M. Phase II/III Study of Aceneuramic Acid Administration for GNE Myopathy in Japan. J Neuromuscul Dis 2023:JND230029. [PMID: 37125562 DOI: 10.3233/jnd-230029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND GNE myopathy is an ultra-rare muscle disease characterized by a reduction in the synthesis of sialic acid derived from pathogenic variants in the GNE gene. No treatment has been established so far. OBJECTIVE We evaluated the safety and efficacy of oral supplementation of aceneuramic acid in patients with GNE myopathy. METHODS This multicenter, placebo-controlled, double-blind study comprised genetically confirmed GNE myopathy patients in Japan who were randomly assigned into treatment groups of sialic acid-extended release (SA-ER) tablets (6 g/day for 48 weeks) or placebo groups (4:1). The primary endpoint of effectiveness was set as the change in total upper limb muscle strength (upper extremity composite [UEC] score) from the start of administration to the final evaluation time point. RESULTS Among the 20 enrolled patients (SA-ER group, 16; placebo group, 4), 19 completed this 48-week study. The mean value of change in UEC score (95% confidence interval [CI]) at 48 weeks was -0.1 kg (-2.1 to 2.0) in the SA-ER group and -5.1 kg (-10.4 to 0.3) in the placebo group. The least squares mean difference (95% CI) between the groups in the covariance analysis was 4.8 kg (-0.3 to 9.9; P = 0.0635). The change in UEC score at 48 weeks was significantly higher in the SA-ER group compared with the placebo group (P = 0.0013) in the generalized estimating equation test repeated measurement analysis. In one patient in the SA-ER group, who was found to be pregnant 2 weeks after drug administration fetal death with tangled umbilical cord occurred at 13 weeks after the discontinuation of treatment. No other serious adverse effects were observed. CONCLUSIONS The present study indicates that oral administration of SA-ER tablets is effective and safe in patients with GNE myopathy in Japan.
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Affiliation(s)
- Naoki Suzuki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Hospital, Nagoya, Japan
- Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Satoshi Yamashita
- Department of Neurology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Atsushi Hashizume
- Department of Neurology, Nagoya University Hospital, Nagoya, Japan
- Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Rumiko Izumi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masaaki Kato
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hitoshi Warita
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Maki Tateyama
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Kuroda
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryuta Asada
- Clinical Research Center, Gifu University Hospital, Gifu, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience and Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Kishnani PS, Diaz-Manera J, Toscano A, Clemens PR, Ladha S, Berger KI, Kushlaf H, Straub V, Carvalho G, Mozaffar T, Roberts M, Attarian S, Chien YH, Choi YC, Day JW, Erdem-Ozdamar S, Illarioshkin S, Goker-Alpan O, Kostera-Pruszczyk A, van der Ploeg AT, An Haack K, Huynh-Ba O, Tammireddy S, Thibault N, Zhou T, Dimachkie MM, Schoser B. Efficacy and Safety of Avalglucosidase Alfa in Patients With Late-Onset Pompe Disease After 97 Weeks: A Phase 3 Randomized Clinical Trial. JAMA Neurol 2023:2802973. [PMID: 37036722 PMCID: PMC10087094 DOI: 10.1001/jamaneurol.2023.0552] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Importance In the previously reported Comparative Enzyme Replacement Trial With neoGAA Versus rhGAA (COMET) trial, avalglucosidase alfa treatment for 49 weeks showed clinically meaningful improvements in upright forced vital capacity (FVC) percent predicted and 6-minute walk test (6MWT) compared with alglucosidase alfa. Objective To report avalglucosidase alfa treatment outcomes during the COMET trial extension. Design, Setting, and Participants This phase 3 double-blind randomized clinical trial with crossover in the extension period enrolled patients 3 years and older with previously untreated late-onset Pompe disease (LOPD) between November 2, 2016, and February 10, 2021, with primary analysis after 49 weeks. Patients were treated at 55 referral centers in 20 countries. Efficacy outcomes were assessed at 97 weeks and safety outcomes to last follow-up, with data cutoff at February 10, 2021. Data were analyzed from May to June 2021. Interventions Random assignment (1:1) to receive 20 mg/kg of avalglucosidase alfa or alglucosidase alfa by intravenous infusion every other week for 49 weeks; thereafter, all patients received 20 mg/kg of avalglucosidase alfa every other week. Main Outcomes and Measures The primary outcome was the least squares (LS) mean change from baseline in FVC percent predicted. Secondary outcomes included the LS mean change from baseline in 6MWT, muscle strength, motor function, quality of life, and disease biomarkers. Safety and tolerability were also assessed. Results Of 100 participants from the double-blind treatment period, 95 entered the extension period. Of these, 51 (54%) were men, and the mean (range) age was 48.3 (10-79) years. At the start of this study, mean upright FVC percent predicted was similar between treatment arms, and 6MWT distance was greater in the avalglucosidase alfa arm. From baseline to week 97, LS mean (SE) FVC percent predicted increased by 2.65 (1.05) for those who continued avalglucosidase alfa and 0.36 (1.12) for those who switched to avalglucosidase alfa. The LS mean (SE) 6MWT distance increased by 18.60 (12.01) m and 4.56 (12.44) m, respectively. For participants who switched to avalglucosidase alfa, FVC percent predicted remained stable (LS mean [SE] change from week 49 to 97, 0.09 [0.88]) and 6MWT distance improved (LS mean [SE] change from week 49 to 97, 5.33 [10.81] m). Potentially treatment-related adverse events were reported in 29 patients (56.9%) who continued avalglucosidase alfa and in 25 patients (56.8%) who switched. Conclusions and Relevance In this randomized clinical trial extension, maintenance of positive clinical outcomes was demonstrated for patients continuing avalglucosidase alfa treatment and, to a lesser extent, patients who switched from alglucosidase alfa. No new safety concerns were observed. Trial Registration ClinicalTrials.gov Identifier: NCT02782741.
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Affiliation(s)
- Priya S Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Jordi Diaz-Manera
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, Reference Center for Rare Neuromuscular Disorders, University of Messina, Messina, Italy
| | - Paula R Clemens
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania
| | - Shafeeq Ladha
- Gregory W. Fulton ALS and Neuromuscular Center, Barrow Neurological Institute, Phoenix, Arizona
| | - Kenneth I Berger
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, New York
- André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, New York
| | - Hani Kushlaf
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
- Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Volker Straub
- Newcastle University John Walton Muscular Dystrophy Research Centre, Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | | | - Tahseen Mozaffar
- Department of Neurology, University of California, Irvine, Orange
| | - Mark Roberts
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Shahram Attarian
- Referral Centre for Neuromuscular Diseases and ALS, European Reference Network Neuromuscular Diseases, Hôpital La Timone, Marseille, France
| | - Yin-Hsiu Chien
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Young-Chul Choi
- Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - John W Day
- Department of Neurology, Stanford University, Stanford, California
- Department of Pediatrics, Stanford University, Stanford, California
| | - Sevim Erdem-Ozdamar
- Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Ozlem Goker-Alpan
- Lysosomal and Rare Disorders Research and Treatment Center, Fairfax, Virginia
| | | | - Ans T van der Ploeg
- Center for Lysosomal and Metabolic Diseases, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | | | - Mazen M Dimachkie
- University of Kansas Medical Center, Department of Neurology, Kansas City
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, LMU Klinikum, München, München, Germany
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28
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Pepera G, Karanasiou E, Blioumpa C, Antoniou V, Kalatzis K, Lanaras L, Batalik L. Tele-Assessment of Functional Capacity through the Six-Minute Walk Test in Patients with Diabetes Mellitus Type 2: Validity and Reliability of Repeated Measurements. SENSORS (BASEL, SWITZERLAND) 2023; 23:1354. [PMID: 36772396 PMCID: PMC9920804 DOI: 10.3390/s23031354] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/05/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
A tele-assessed 6MWT (TL 6MWT) could be an alternative method of evaluating functional capacity in patients with diabetes mellitus type 2 (DM2). This study aimed to assess the validity and reliability of a TL 6MWT. The functional capacity of 28 patients with DM2 (75% men) aged 61 ± 13 years was evaluated twice via an indoor, center-based 6MWT (CB 6MWT) and twice outside each patient's home via a web-based platform TL 6MWT. The study showed a high statistically significant correlation between the CB and TL 6MWT (Pearson's r = 0.76, p < 0.001). Reliability testing showed no statistically significant differences in the distance covered (CB1: 492 ± 84 m and CB2: 506 ± 86 m versus TL1: 534 ± 87 m and TL2: 542 ± 93 m, respectively) and in the best distance of the TL 6MWT (545 ± 93 m) compared to the best CB distance (521 ± 83 m). Strong internal reliability for both the CB (intraclass correlation coefficient (ICC) = 0.93) and the TL 6MWT (ICC = 0.98) was found. The results indicate that a TL 6MWT performed outdoors can be a highly valid and reliable tool to assess functional capacity in patients with DM2. No learning effect between the TL and CB assessment was found, minimizing the need for repetition.
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Affiliation(s)
- Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Evmorfia Karanasiou
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Christina Blioumpa
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | - Varsamo Antoniou
- Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, GR-35100 Lamia, Greece
| | | | - Leonidas Lanaras
- Department of Internal Medicine, General Hospital of Lamia, GR-35100 Lamia, Greece
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, 62500 Brno, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
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29
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Kupferschmitt A, Langheim E, Tüter H, Etzrodt F, Loew TH, Köllner V. First results from post-COVID inpatient rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2023; 3:1093871. [PMID: 36756465 PMCID: PMC9899863 DOI: 10.3389/fresc.2022.1093871] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023]
Abstract
Background COVID-19 is associated with various symptoms and psychological involvement in the long term. In view of the multifactorial triggering and maintenance of the post-COVID syndrome, a multimodal therapy with somatomedical and psychotherapeutic content is expedient. This paper compares the psychological stress of post-COVID patients and their course in rehabilitation to psychosomatic and psychocardiological patients. Method Observational study with control-groups and clinical, standardized examination: psychological testing (BDI-II, HELATH-49), 6-MWT as somatic parameter, two measurement points (admission, discharge). Sample characteristics, including work related parameters, the general symptom-load and the course of symptoms during rehabilitation are evaluated. Results At admission in all measures post-COVID patients were significantly affected, but less pronounced than psychosomatic or psychocardiological patients (BDI-II post-COVID = 19.29 ± 9.03, BDI-II psychosomatic = 28.93 ± 12.66, BDI-II psychocardiology = 24.47 ± 10.02). During rehabilitation, in all complaint domains and sub-groups, symptom severity was significantly reduced (effect sizes ranging from d = .34 to d = 1.22). Medium positive effects were seen on self-efficacy (d = .69) and large effects on activity and participation (d = 1.06) in post-COVID patients. In the 6-MWT, the walking distance improved by an average of 76.43 ± 63.58 meters (d = 1.22). Not a single patient deteriorated in walking distance, which would have been a possible sign of post exercise malaise (PEM). Conclusion Post-COVID patients have a slighter psychological burden as psychocardiological or psychosomatic patients. Although rehabilitation is not curative, post-COVID patients benefit significantly from the interventions and there were no signs of PEM.
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Affiliation(s)
- Alexa Kupferschmitt
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany,Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – Universitätsmedizin Berlin, Berlin, Germany,Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany,Correspondence: Alexa Kupferschmitt
| | - Eike Langheim
- Department of Cardiology, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
| | - Haris Tüter
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Franziska Etzrodt
- Department of Cardiology, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
| | - Thomas H. Loew
- Department of Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité – Universitätsmedizin Berlin, Berlin, Germany,Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany
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30
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Krasny J, Jozwiak M, Rodby-Bousquet E. Comparison of the six-minute walk test performed over a 15 and 30 m course by children with cerebral palsy. BMC Musculoskelet Disord 2023; 24:34. [PMID: 36650438 PMCID: PMC9843890 DOI: 10.1186/s12891-022-05944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 11/02/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The aim of this study was to compare performance on the six-minute walk test (6MWT) performed over 15 m and 30 m courses by children and youths with cerebral palsy (CP). METHODS Children and youths with CP at Gross Motor Function Classification System levels I-IV performed the 6MWT in a straight 15 m-long corridor (first trial) and 30 m-long corridor (second trial). The intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between the 6MWT results for the two corridor lengths. RESULTS We included 82 children and youths with CP (36 girls, 46 boys), with a mean age of 11.7 years (SD 4.2, range 5-22 years). There was high agreement between the results of the two 6MWTs: ICC 0.93 (95% confidence interval 0.76-0.97). The total walking distance was longer for the 30 m course (median 399 m, range 44-687 m) than the 15 m course (median 357 m, range 24-583 m). CONCLUSIONS We observed good agreement for the performance of the 6MWT in the 15 m and 30 m courses, although the total walking distance was greater for the 30 m course. We recommend that the same distance is used when evaluating changes in walking ability for an individual child. Both distances are appropriate when measuring endurance in children and youths with CP.
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Affiliation(s)
- Joanna Krasny
- grid.22254.330000 0001 2205 0971Department of Pediatric Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznań, Poland
| | - Marek Jozwiak
- grid.22254.330000 0001 2205 0971Department of Pediatric Orthopedics and Traumatology, Poznan University of Medical Sciences, Poznań, Poland
| | - Elisabet Rodby-Bousquet
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden ,grid.8993.b0000 0004 1936 9457Centre for Clinical Research, Uppsala University-Region Västmanland, Västerås, Sweden
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31
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Oosterbos C, Rummens S, Bogaerts K, Hoornaert S, Weyns F, Dubuisson A, Lemmens R, Theys T. Conservative versus surgical treatment of foot drop in peroneal nerve entrapment: rationale and design of a prospective, multi-centre, randomized parallel-group controlled trial. Trials 2022; 23:1065. [PMID: 36581937 PMCID: PMC9801603 DOI: 10.1186/s13063-022-07009-x] [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: 11/10/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND High-quality evidence is lacking to support one treatment strategy over another in patients with foot drop due to peroneal nerve entrapment. This leads to strong variation in daily practice. METHODS/DESIGN The FOOTDROP (Follow-up and Outcome of Operative Treatment with Decompressive Release Of The Peroneal nerve) trial is a randomized, multi-centre study in which patients with peroneal nerve entrapment and persistent foot drop, despite initial conservative treatment, will be randomized 10 (± 4) weeks after onset between non-invasive treatment and surgical decompression. The primary endpoint is the difference in distance covered during the 6-min walk test between randomization and 9 months later. Time to recovery is the key secondary endpoint. Other secondary outcome measures encompass ankle dorsiflexion strength (MRC score and isometric dynamometry), gait assessment (10-m walk test, functional ambulation categories, Stanmore questionnaire), patient-reported outcome measures (EQ5D-5L), surgical complications, neurological deficits (sensory changes, motor scores for ankle eversion and hallux extension), health economic assessment (WPAI) and electrodiagnostic assessment. DISCUSSION The results of this randomized trial may elucidate the role of surgical decompression of the peroneal nerve and aid in clinical decision-making. TRIAL REGISTRATION ClinicalTrials.gov NCT04695834. Registered on 4 January 2021.
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Affiliation(s)
- Christophe Oosterbos
- grid.5596.f0000 0001 0668 7884Research Group experimental Neurosurgery and Neuroanatomy and the Leuven Brain Institute, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Sofie Rummens
- grid.410569.f0000 0004 0626 3338Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Locomotor and Neurological disorders, KU Leuven, Leuven, Belgium
| | - Kris Bogaerts
- grid.12155.320000 0001 0604 5662Department of public health and critical care, I-BioStat, KU Leuven, Belgium and I-BioStat, UHasselt, Hasselt, Belgium
| | - Sophie Hoornaert
- grid.5596.f0000 0001 0668 7884Research Group experimental Neurosurgery and Neuroanatomy and the Leuven Brain Institute, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Frank Weyns
- grid.470040.70000 0004 0612 7379Department of Neurosurgery, Ziekenhuis Oost-Limburg, Genk, Belgium ,grid.12155.320000 0001 0604 5662Neurosciences, Faculty of Medicine and Life Sciences, UHasselt, Hasselt, Belgium
| | - Annie Dubuisson
- Department of Neurosurgery, University Hospitals Liège, Liège, Belgium
| | - Robin Lemmens
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, Experimental Neurology, KU Leuven – University of Leuven, Leuven, Belgium ,grid.11486.3a0000000104788040VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Tom Theys
- grid.5596.f0000 0001 0668 7884Research Group experimental Neurosurgery and Neuroanatomy and the Leuven Brain Institute, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
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32
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Boelens YF, Strookappe B, Vasse E, Mensink M, van Zanten AR. The effect of an intervention of porcine protein versus maltodextrin supplement on CONvalescence of FUnCtional outcomes after IcU Stay (CONFUCIUS): Study protocol for a randomized controlled, single-center, double-blind trial. Clin Nutr ESPEN 2022; 52:86-93. [PMID: 36513490 DOI: 10.1016/j.clnesp.2022.10.008] [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: 06/24/2022] [Revised: 09/22/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients discharged from the Intensive Care Unit (ICU) frequently suffer from ICU-acquired weakness because of immobilization and massive inflammation-induced muscle mass loss. Consequently, rehospitalization, reduced quality of life (QoL), increased disabilities, and higher post-ICU mortality is observed. Exercise rehabilitation and optimal nutrition, particularly protein intake, are pivotal to regaining muscle mass and function. Studies have shown that protein requirements in the post-ICU phase are often unmet. Furthermore, protein supplementation in other patient groups has shown beneficial effects. However, a study on protein supplementation during the post-ICU period is lacking. This study aims to investigate the effect of a six-week intervention of daily porcine protein supplementation versus an isocaloric control (maltodextrin) on functional outcomes in the post-ICU period in patients with moderately severe ICU-acquired weakness. METHODS 72 post-ICU patients with moderately severe ICU-acquired weakness of Hospital Gelderse Vallei will be randomly assigned to either the intervention or the control group (36 per arm). The intervention group receives a porcine protein supplement twice a day. The control group receives a maltodextrin supplement twice a day. The intervention starts on the first day in the general ward and lasts 42 days (6 weeks). The primary outcome is the between-group difference in physical function at hospital discharge (t;=2), the end of the intervention (t;=3, day 42), and the 3-month follow-up (t;=4) expressed as a composite score consisting of handgrip strength, muscle strength leg, muscle strength arm and exercise capacity. Secondary outcomes encompass physical function, QoL, Activity of daily living (ADL), and plasma amino acids concentrations. Lastly, ICU readmission after ICU discharge, hospital readmission after hospital discharge, and overall survival status will be considered. Linear mixed models will be used to test the treatment effect for the primary and secondary outcome measures. DISCUSSION This trial will be the first to investigate porcine protein supplementation compared with carbohydrate supplementation in the post-ICU period aiming to improve functional outcomes of ICU survivors with moderately severe ICU-acquired weakness. TRIAL REGISTRATION The study has been registered at ClinicalTrials.gov. Number: NCT05405764.
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Affiliation(s)
- Yente Fn Boelens
- Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands; Wageningen University & Research, Division of Human Nutrition and Health, Stippenweg 4, 6708 WE Wageningen, the Netherlands.
| | - Bert Strookappe
- Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands; Department of Physiotherapy, Gelderse Vallei Hospital, Ede, the Netherlands.
| | - Emmelyne Vasse
- Department of Nutrition and Dietetic, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands.
| | - Marco Mensink
- Wageningen University & Research, Division of Human Nutrition and Health, Stippenweg 4, 6708 WE Wageningen, the Netherlands.
| | - Arthur Rh van Zanten
- Department of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, the Netherlands; Wageningen University & Research, Division of Human Nutrition and Health, Stippenweg 4, 6708 WE Wageningen, the Netherlands.
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Axelsson GT, Halldorsson AB, Jonsson HM, Eythorsson E, Sigurdardottir SE, Hardardottir H, Gudmundsson G, Hansdottir S. Respiratory function and CT abnormalities among survivors of COVID-19 pneumonia: a nationwide follow-up study. BMJ Open Respir Res 2022; 9:9/1/e001347. [PMID: 36216402 PMCID: PMC9556742 DOI: 10.1136/bmjresp-2022-001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Considering the pulmonary burden caused by acute COVID-19, questions remain of respiratory consequences after recovery. The aim of the study was to describe respiratory function of COVID-19 pneumonia survivors at mid-term follow-up (median 68 days) and assess whether impairments were predicted by acute illness severity or residual CT abnormalities. METHODS Residents of Iceland that had COVID-19 and oxygen saturation ≤94% from 28 February 2020 to 30 April 2021 were offered a clinical follow-up visit with an interview, a 6 min walk test (6MWT), spirometry with gas exchange measurement and chest CT. The results of these examinations were described, grouped by the level of care during acute illness. The associations of disease severity and CT abnormalities at follow-up with subjective dyspnoea, 6MWT results and lung function test results were estimated with regression analyses. RESULTS Of 190 eligible patients, 164 (86%) participated in the study. Of those, 32 had never been admitted to hospital, 103 were admitted to hospital without intensive care and 29 had required intensive care. At a follow-up, need for intensive care during acute illness was associated with shorter walking distance on 6MWT, lower oxygen saturation and lower DLCO. Imaging abnormalities at follow-up were observed for most participants (74%) and the magnitude of these changes was associated with decrements in 6MWT distance, oxygen saturation, forced vital capacity and DLCO. CONCLUSIONS The findings show that impaired exercise capacity and lung physiology at follow-up were primarily observed for patients with COVID-19 pneumonia that required intensive care treatment and/or had persistent imaging abnormalities.
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Affiliation(s)
- Gisli Thor Axelsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Internal Medicine, Landspitali, Reykjavik, Iceland
| | | | | | - Elias Eythorsson
- Department of Internal Medicine, Landspitali, Reykjavik, Iceland
| | | | - Hronn Hardardottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine and Sleep, Landspitali, Reykjavik, Iceland
| | - Gunnar Gudmundsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine and Sleep, Landspitali, Reykjavik, Iceland
| | - Sif Hansdottir
- Department of Respiratory Medicine and Sleep, Landspitali, Reykjavik, Iceland
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Functional Performance, Leg Muscle Strength, and Core Muscle Endurance in Multiple Sclerosis Patients With Mild Disability: A Cross-Sectional Study. Motor Control 2022; 26:729-747. [PMID: 36068072 DOI: 10.1123/mc.2021-0129] [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: 11/22/2021] [Revised: 06/20/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate the relationship of sit-to-stand and walking performance with leg muscle strength and core muscle endurance in people with multiple sclerosis (PwMS) with mild disabilities. In this study, 49 PwMS (Expanded Disability Status Scale score = 1.59 ± 0.79) and 26 healthy controls were enrolled. The functional performances, including sit-to-stand and walking performances, were evaluated with the five-repetition sit-to-stand test, timed up and go test, and 6-min walking test. The PwMS finished significantly slower five-repetition sit-to-stand, timed up and go, and 6-min walking test than the healthy controls. In addition, the significant contributors were the weakest trunk lateral flexor endurance for five-repetition sit-to-stand; the Expanded Disability Status Scale score, and the weakest hip adductor muscle for timed up and go; the weakest hip extensor muscles strength for 6-min walking test. The functional performances in PwMS, even with mild disabilities, were lower compared with healthy controls. Decreases in both leg muscle strength and core muscle endurance are associated with lower functional performance in PwMS.
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Dimachkie MM, Barohn RJ, Byrne B, Goker-Alpan O, Kishnani PS, Ladha S, Laforêt P, Mengel KE, Peña LDM, Sacconi S, Straub V, Trivedi J, Van Damme P, van der Ploeg AT, Vissing J, Young P, Haack KA, Foster M, Gilbert JM, Miossec P, Vitse O, Zhou T, Schoser B. Long-term Safety and Efficacy of Avalglucosidase Alfa in Patients With Late-Onset Pompe Disease. Neurology 2022; 99:e536-e548. [PMID: 35618441 PMCID: PMC9421599 DOI: 10.1212/wnl.0000000000200746] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Pompe disease is a rare, progressive neuromuscular disorder caused by deficiency of lysosomal acid α-glucosidase (GAA) and subsequent glycogen accumulation. Avalglucosidase alfa, a recombinant human GAA enzyme replacement therapy designed for increased cellular uptake and glycogen clearance, has been studied for long-term efficacy and safety in patients with late-onset Pompe disease (LOPD). Here, we report up to 6.5 years' experience with avalglucosidase alfa during the NEO1 and NEO-EXT studies. METHODS NEO1 participants with LOPD, either treatment naive (Naive Group) or receiving alglucosidase alfa for ≥9 months (Switch Group), received avalglucosidase alfa (5, 10, or 20 mg/kg every other week [qow]) for 6 months before entering NEO-EXT and continued their NEO1 dose until all proceeded with 20 mg/kg qow. Safety and efficacy, a prespecified exploratory secondary outcome, were assessed; slopes of change for efficacy outcomes were calculated from a repeated mixed-measures model. RESULTS Twenty-four participants enrolled in NEO1 (Naive Group, n = 10; Switch Group, n = 14); 21 completed and 19 entered NEO-EXT; in February 2020, 17 participants remained in NEO-EXT, with data up to 6.5 years. Avalglucosidase alfa was generally well tolerated during NEO-EXT, with a safety profile consistent with that in NEO1. No deaths or treatment-related life-threatening serious adverse events occurred. Eighteen participants developed antidrug antibodies without apparent effect on clinical outcomes. No participants who were tested developed immunoglobulin E antibodies. Upright forced vital capacity %predicted remained stable in most participants, with slope estimates (95% CIs) of -0.473 per year (-1.188 to 0.242) and -0.648 per year (-1.061 to -0.236) in the Naive and Switch Groups, respectively. Six-minute walk test (6MWT) %predicted was also stable for most participants, with slope estimates of -0.701 per year (-1.571 to 0.169) and -0.846 per year (-1.567 to -0.125) for the Naive and Switch Groups, respectively. Improvements in 6MWT distance were observed in most participants aged <45 years at NEO1 enrollment in both the Naive and Switch Groups. DISCUSSION Avalglucosidase alfa was generally well tolerated for up to 6.5 years in adult participants with LOPD either naive to alglucosidase alfa or who had previously received alglucosidase alfa for ≥9 months. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence of long-term tolerability and sustained efficacy of avalglucosidase alfa in patients with LOPD after up to 6.5 years. TRIAL REGISTRATION INFORMATION NCT01898364 (NEO1 first posted: July 12, 2013; clinicaltrials.gov/ct2/show/NCT01898364); NCT02032524 (NEO-EXT first posted: January 10, 2014; clinicaltrials.gov/ct2/show/NCT02032524). First participant enrollment: NEO1-August 19, 2013; NEO-EXT-February 27, 2014.
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Affiliation(s)
- Mazen M Dimachkie
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany.
| | - Richard J Barohn
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Barry Byrne
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Ozlem Goker-Alpan
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Priya S Kishnani
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Shafeeq Ladha
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Pascal Laforêt
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Karl Eugen Mengel
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Loren D M Peña
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Sabrina Sacconi
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Volker Straub
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Jaya Trivedi
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Philip Van Damme
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Ans T van der Ploeg
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - John Vissing
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Peter Young
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Kristina An Haack
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Meredith Foster
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Jane M Gilbert
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Patrick Miossec
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Olivier Vitse
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Tianyue Zhou
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
| | - Benedikt Schoser
- From the University of Kansas Medical Center (M.M.D., R.J.B.), Kansas City; University of Missouri (R.J.B.), Columbia; University of Florida (B.B.), Gainesville; LDRTC (O.G.-A.), Fairfax, VA; Duke University Medical Center (P.S.K., L.D.M.P.), Durham, NC; Barrow Neurological Institute (S.L.), Phoenix, AZ; Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France Service de Neurologie (P.L.), Hôpital Raymond-Poincaré, Garches, AP-HP and INSERM U1179, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux; SphinCS GmbH (K.E.M.), Institute of Clinical Science for LSD, Hochheim, Germany; Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (L.D.M.P.), OH; Neuromuscular Diseases Centre (S.S.), Department of Clinical Neurosciences, University Hospital of Nice (CHU), France; Newcastle University John Walton Muscular Dystrophy Research Centre (V.S.), Newcastle Hospitals NHS Foundation Trust, United Kingdom; University of Texas Southwestern Medical Center (J.T.), Dallas; Department of Neurosciences (P.V.D.), KU Leuven (Catholic University of Leuven), VIB-Center for Brain & Disease Research, and Department of Neurology, University Hospitals Leuven, Belgium; Erasmus MC University Medical Center (A.T.v.d.P.), Pompe Center & Center for Lysosomal and Metabolic Diseases, Rotterdam, the Netherlands; Copenhagen Neuromuscular Center (J.V.), Rigshospitalet, University of Copenhagen, Denmark; Department of Neurology (P.Y.), Medical Park Bad Feilnbach, Germany; Sanofi (K.A.H., P.M.), Chilly-Mazarin, France; Sanofi (M.F., T.Z.), Cambridge, MA; Elevate Medical Affairs (J.M.G.), Horsham, United Kingdom; Sanofi (O.V.), Montpellier, France; and Friedrich-Baur-Institut (B.S.), Department of Neurology Klinikum München, Germany
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Frundi DS, Kettig E, Popp LL, Hoffman M, Dumartin M, Hughes M, Lamy E, Fru YJW, Bano A, Muka T, Wilhelm M. Physical performance and glycemic control under SGLT-2-inhibitors in patients with type 2 diabetes and established atherosclerotic cardiovascular diseases or high cardiovascular risk (PUSH): Design of a 4-week prospective observational study. Front Cardiovasc Med 2022; 9:907385. [PMID: 35935634 PMCID: PMC9354468 DOI: 10.3389/fcvm.2022.907385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background Type 2 diabetes (T2D) is associated with limitation in physical performance. Results from animal studies report enhancement of physical performance in T2D rodents treated with sodium glucose cotransporter 2 inhibitors (SGLT2is). However, in human patients with T2D and established atherosclerotic cardiovascular disease (ASCVD) or high cardiovascular risk, the impact of guideline directed SGLT2i medication on physical performance has not been sufficiently examined. Objectives The main objectives of this study are thus firstly, to assess the changes in physical performance after 4 weeks of exercise therapy in patients with established ASCVD or high cardiovascular risk categorized into three groups according to their glycemic control at baseline. Secondly, to investigate the association of glycemic control at baseline and new guideline directed antidiabetic treatment (inadequate glycemic control and diabetes + new SGLT2i vs. adequate glycemic control and diabetes vs. no diabetes) with change in physical performance. Methods and design This is a 4-week prospective observational study of 450 participants with established ASCVD or high cardiovascular risk with or without T2D and without previous SGLT2i medication undergoing exercise therapy during inpatient rehabilitation in a single center in Switzerland. Upon admission, participants are categorized into 3 groups of 150 participants each according to their glycemic control. Group I consisting of participants with inadequately controlled T2D defined as mean fasting plasma glucose (FPG) of ≥7 mmol/L, who are consequently administered new treatment with an SGLT2i. Group II comprises of participants with adequately controlled T2D with mean FPG of <7 mmol/L requiring no antidiabetic medication change. Group III consists of participants with no diabetes and mean FPG of ≤ 5.5 mmol/L. Primary outcomes are 6-min walk distance and rate of perceived exertion. Secondary outcomes are echocardiographic parameters (left ventricular mass index; global longitudinal strain average; end-diastolic volume), fatigue, muscle, metabolic, and anthropometric measures. Ethics and dissemination This study is conducted in accordance with the Declaration of Helsinki with ethical approval from the Cantonal Ethical Commission of Bern, Switzerland. The results will be published in a peer-reviewed journal. The implementation and reporting will be according to the SPIRIT guidelines. Study protocol registration https://www.clinicaltrials.gov/, identifier: NCT03422263.
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Affiliation(s)
- Devine S. Frundi
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
- Permanence Médicale, Hôpital de Sierre, Sierre, Switzerland
- *Correspondence: Devine S. Frundi
| | - Eva Kettig
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Lena Luise Popp
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Melanie Hoffman
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Marine Dumartin
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Magali Hughes
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | - Edgar Lamy
- Berner Klinik Montana, Zentrum für Medizinische und Neurologische Rehabilitation, Crans-Montana, Switzerland
| | | | - Arjola Bano
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Center for Preventive Cardiology, University Hospital Bern and University of Bern, Bern, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Center for Preventive Cardiology, University Hospital Bern and University of Bern, Bern, Switzerland
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Pant S, Basnet K, Shrestha P, K.C. M. Mean Six Minute Walk Distance of Healthy Healthcare Workers of a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:604-607. [PMID: 36705197 PMCID: PMC9297354 DOI: 10.31729/jnma.7541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/25/2022] [Indexed: 01/31/2023] Open
Abstract
Introduction The six-minute walk test is a sub-maximal exercise test used in clinical populations to determine functional exercise capacity. It is a safe, simple, and inexpensive test. There are a number of reference equations described for estimating six-minute walk distance in healthy subjects in different countries. However, there is a lack of standard reference value for six minute walk distance in healthy Nepalese population. The aim of the study was to find the mean six minute walk distance of healthy healthcare workers of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among healthy health care workers of a tertiary care centre from 1 August 2021 to 30 November 2021 after taking ethical approval from Institutional Review Committee (Reference number: 1507202105). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results The mean six-minute walk distance of the 162 healthy health care workers was 486.74±74.73 (475.23-498.24, 95% Confidence Interval) m. Men walked 519.61±79.19 m and women walked 474.12±75.62 m. The mean age of the participants was 29.25±8.25 years. Conclusions The mean six-minute walk distance was found to be lower when compared to similar studies conducted in similar settings. Keywords exercise test; health personnel; healthy volunteer; walk test.
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Affiliation(s)
- Subash Pant
- Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal,Correspondence: Dr Subash Pant, Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal. , Phone: +977-9851097894
| | - Krity Basnet
- Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Prinsa Shrestha
- Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Mathura K.C.
- Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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Efficacy of Inspiratory Muscle Training on Respiratory Muscle Strength in Hematopoietic Stem Cell Recipients: A Systematic Review and Meta-analysis. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cazzoletti L, Zanolin ME, Dorelli G, Ferrari P, Dalle Carbonare LG, Crisafulli E, Alemayohu MA, Olivieri M, Verlato G, Ferrari M. Six-minute walk distance in healthy subjects: reference standards from a general population sample. Respir Res 2022; 23:83. [PMID: 35382813 PMCID: PMC8985335 DOI: 10.1186/s12931-022-02003-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/23/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The 6-min walking distance (6MWD) test is a useful tool to obtain a measure of functional exercise capacity. However, reference equations have been mainly based on selected populations or small samples. The purpose of this study was to determine the reference equations to predict the 6MWD in a large Italian population sample of healthy adults of a wide age range. Methods In the frame of the multi case–control population-based study Gene Environment Interaction in Respiratory Diseases (GEIRD), we studied 530 healthy subjects: 287 females ranging 21–76 and 243 males ranging 21–78 years of age. We measured 6MWD, demographic and anthropometric data and collected the reported physical activity. A multiple linear regression model for the 6MWD included age, age2, height, weight and physical activity for both sex equations. The two-way interaction age-height and age-weight and the quadratic terms of weight and height were also tested for inclusion separately in each model. Results The mean ± SD for 6MWD was 581.4 ± 66.5 m (range 383–800 m) for females and 608.7 ± 80.1 m (range 410–875 m) for males. The reference equations were 6MWD = 8.10*age + 1.61*heightcm−0.99*weightkg + 22.58*active−0.10*age2 + 222.55 for females (R squared = 0.238) and 6MWD = 26.80*age + 8.46*heightcm−0.45*weightkg−2.54*active−0.06*age2−0.13*age*heightcm−890.18 for males (R squared = 0.159), where “active” is 1 when the subject is physically active, 0 otherwise. Conclusion This study is the first to describe the 6MWD in a large population sample of young, middle aged and elderly healthy Caucasian subjects, and to determine reference equations. These findings will help to improve the evaluation of Italian and European patients with diseases influencing their functional capacity.
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Affiliation(s)
- Lucia Cazzoletti
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy.
| | - Maria Elisabetta Zanolin
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Gianluigi Dorelli
- School of Medicine in Sports and Exercise, Department of Medicine, University of Verona, Verona, Italy
| | - Pietro Ferrari
- School of Medicine in Sports and Exercise, Department of Medicine, University of Verona, Verona, Italy
| | | | - Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Mulubirhan Assefa Alemayohu
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy.,Department of Epidemiology, School of Public Health, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Marcello Ferrari
- School of Medicine in Sports and Exercise, Department of Medicine, University of Verona, Verona, Italy.,Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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40
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Unver B, Sevik K, Karatosun V. Reliability of the Modified Four-Square Step Test in Revision Total
Knee Arthroplasty: A Cross-Sectional Study. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2022. [DOI: 10.1055/a-1750-6149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Abstract
Background The modified four-square step test (mFSST) assesses dynamic
balance by rapid stepping in different directions. This study aimed to evaluate
the reliability of the mFSST in patients who had undergone revision total knee
artroplasty (rTKA).
Methods The study was designed as a cross-sectional study. The mFSST was
administered on 22 patients with a history of rTKA. Two trials were performed
and the patients rested between trials to avoid fatigue.
Results The intraclass correlation coefficient (ICC) for the mFSST was
0.83. The standard error of measurement and the smallest real difference
(95%. confidence level) were 0.67 and 1.85 respectively.
Conclusion The mFSST showed good reliability in patients who had undergone
rTKA. The mFSST is a reliable measure for the assessment of gait variability,
dynamic balance, walking skills and mobility. It can easily detect changes in
rTKA patients with simple equipment.
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Affiliation(s)
- Bayram Unver
- Physical Therapy and Rehabilitation, Dokuz Eylul Universitesi,
İzmir, Turkey
| | - Kevser Sevik
- Physical Therapy and Rehabilitation, Dokuz Eylul Universitesi,
İzmir, Turkey
- Physical Therapy and Rehabilitation, Izmir Katip Celebi University,
Turkey
| | - Vasfi Karatosun
- Orthopaedics and Traumatology, Dokuz Eylul Universitesi,
İZMİR, Turkey
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Celik Z, Boşnak Güçlü M, Özkurt ZN. Exercise capacity, physical activity and quality of life in patients with newly diagnosed hematologic malignancies: a cross-sectional study. Physiother Theory Pract 2022; 39:1152-1162. [DOI: 10.1080/09593985.2022.2035865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Zeliha Celik
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Meral Boşnak Güçlü
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Zübeyde Nur Özkurt
- Department of Hematology, Faculty of Medicine, Gazi University, Ankara, Turkey
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42
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van Gestel T, Groen LCB, Puik JR, van Rooijen SJ, van der Zaag-Loonen HJ, Schoonmade LJ, Danjoux G, Daams F, Schreurs WH, Bruns ERJ. Fit4Surgery for cancer patients during covid-19 lockdown – A systematic review and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2022; 48:1189-1197. [PMID: 35183411 PMCID: PMC8828288 DOI: 10.1016/j.ejso.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 01/18/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022]
Affiliation(s)
- T van Gestel
- Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands.
| | - L C B Groen
- Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands
| | - J R Puik
- Department of Surgery, Amsterdam University Medical Center Location VU, Amsterdam, the Netherlands
| | - S J van Rooijen
- Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | | | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - G Danjoux
- South Tees Hospitals NHS Foundation Trust, UK; Honorary Professor, Hull York Medical School and Teesside University, UK
| | - F Daams
- Department of Surgery, Amsterdam University Medical Center Location VU, Amsterdam, the Netherlands
| | - W H Schreurs
- Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands
| | - E R J Bruns
- Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands
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Timurtas E, Inceer M, Mayo N, Karabacak N, Sertbas Y, Polat MG. Technology-based and supervised exercise interventions for individuals with type 2 diabetes: Randomized controlled trial. Prim Care Diabetes 2022; 16:49-56. [PMID: 34924318 DOI: 10.1016/j.pcd.2021.12.005] [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: 09/13/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/19/2022]
Abstract
AIMS The purpose of this study was to estimate, for people with type 2 diabetes (T2D), the extent to which glycemic control was affected by a 12-week program using mobile app and wearable smartwatch in comparison to supervised exercise training. METHODS This study was a stratified, randomized, assessor-blind, controlled, pragmatic trial with three parallel groups which were supervised, mobile app and wearable smartwatch. Individually tailored exercise regimens delivered through a supervisor, mobile app and wearable smartwatch. Programs consisted of aerobic, resistance exercises, calisthenic, flexibility, balance, and coordination exercises. Primary outcome was change in glycemic control (HbA1c); secondary outcome was Six Minute Walk Test; and explanatory outcomes were exercise behaviour, muscle function, and physical capacity. The groups were contrasted for change in HbA1c and absolute reduction of ≥0.5% (Minimal Important Change). Linear and logistic regressions were used to compare the groups and generalized estimated equations were used to analyze the explanatory outcomes. RESULTS In total, 90 people were randomized, 6 were lost over 12 weeks, leaving 84 with outcome data. The difference in HbA1c did not differ between the supervised and the technology groups combined and between the mobile app and smartwatch group. Proportions of people achieving a clinically meaningful difference on HbA1c between the supervised and technology groups were similar (46% vs 43%) and the associated OR was 0.87 (95%CI:0.34-2.28). Within the two technology groups, proportions of people achieving a clinically meaningful difference in HbA1c were 48% in the mobile app and 38% in the smartwatch groups and the associated OR was 0.65 (95%CI:0.21-2.03). The groups did not differ on secondary and explanatory outcomes. CONCLUSIONS The results of our trial provide evidence that all outcomes have improved in all groups regardless of the exercise delivery method. Considering the supervised programs are not available for everybody, technological options are crucial to implement to help individuals self-manage most aspects of their diabetes.
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Affiliation(s)
- Eren Timurtas
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey.
| | - Mehmet Inceer
- School of Physical and Occupational Therapy, McGill University, Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Center for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
| | - Nancy Mayo
- School of Physical and Occupational Therapy, McGill University, Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Center for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
| | - Neslihan Karabacak
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey.
| | - Yasar Sertbas
- Fatih Sultan Mehmet Education and Research Hospital, Department Of Internal Medicine, Istanbul, Turkey.
| | - Mine Gulden Polat
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey.
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Ferioli M, Prediletto I, Bensai S, Betti S, Daniele F, Di Scioscio V, Modolon C, Rimondi MR, De Molo C, Serra C, Nava S, Fasano L. Spontaneous Evolution of COVID-19 Lung Sequelae: Results from a Double-Step Follow-Up. Respiration 2022; 101:381-393. [PMID: 35042222 PMCID: PMC8805081 DOI: 10.1159/000521316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background Few studies have reported a double-step follow-up of patients after hospitalization for COVID-19. Objectives We designed an observational double-step follow-up study with a clinical, functional, and radiological evaluation at 2 and 6 months after COVID-19. The primary outcome was to describe symptoms, spirometry, and 6-minute walking test (6MWT) at 2 and 6 months. Secondary outcomes were to identify if the lowest PaO<sub>2</sub>/FiO<sub>2</sub> during hospitalization is related with functional and radiological evolution and to assess the correlation between radiological and functional abnormalities at 6 months. Methods Symptoms, spirometry, and 6MWT were assessed at 2 and 6 months; arterial blood gas, chest x-ray, and lung ultrasound were performed at 2 months; body plethysmography, diffusing capacity for carbon monoxide (DLCO), and CT scan were performed at 6 months. Results Sixty-four per cent and 42% of patients reported at least one symptom at 2 and 6 months, respectively. The most common 6-month functional alteration was DLCO impairment (57% of patients). An improvement of FEV1, FVC, and 6MWT was observed between 2 and 6 months (p < 0.001). Patients with PaO<sub>2</sub>/FiO<sub>2</sub> <200 during hospitalization performed worse at 6MWT at 2 and 6 months (p < 0.05) and reported more extended radiological abnormalities at 6 months (p < 0.001) compared with patients with PaO<sub>2</sub>/FiO<sub>2</sub>>200. At 6 months, more extended radiological abnormalities were related with worse 6MWT, DLCO, and total lung capacity (p < 0.05). Discussion DLCO and 6MWT impairment seem to be the functional hallmark of COVID-19 and are related with the severity of acute pneumonia. At 6 months, radiological abnormalities were related to functional impairment.
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Affiliation(s)
- Martina Ferioli
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Irene Prediletto
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Serena Bensai
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Sara Betti
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Federico Daniele
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Valerio Di Scioscio
- Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero Universitaria of Bologna, Bologna, Italy.,Radiology Institute, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
| | - Cecilia Modolon
- Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero Universitaria of Bologna, Bologna, Italy.,Radiology Institute, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
| | - Maria Rita Rimondi
- Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero Universitaria of Bologna, Bologna, Italy.,Radiology Institute, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
| | - Chiara De Molo
- Department of Organ Failure and Transplantation, IRCCS Azienda Ospedaliero Universitaria of Bologna, Bologna, Italy.,Interventional and Diagnostic Ultrasound Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
| | - Carla Serra
- Department of Organ Failure and Transplantation, IRCCS Azienda Ospedaliero Universitaria of Bologna, Bologna, Italy.,Interventional and Diagnostic Ultrasound Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
| | - Stefano Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Luca Fasano
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum University, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
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Diaz-Manera J, Kishnani PS, Kushlaf H, Ladha S, Mozaffar T, Straub V, Toscano A, van der Ploeg AT, Berger KI, Clemens PR, Chien YH, Day JW, Illarioshkin S, Roberts M, Attarian S, Borges JL, Bouhour F, Choi YC, Erdem-Ozdamar S, Goker-Alpan O, Kostera-Pruszczyk A, Haack KA, Hug C, Huynh-Ba O, Johnson J, Thibault N, Zhou T, Dimachkie MM, Schoser B. Safety and efficacy of avalglucosidase alfa versus alglucosidase alfa in patients with late-onset Pompe disease (COMET): a phase 3, randomised, multicentre trial. Lancet Neurol 2021; 20:1012-1026. [PMID: 34800399 DOI: 10.1016/s1474-4422(21)00241-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pompe disease is a rare, progressive neuromuscular disorder caused by deficiency of acid α-glucosidase (GAA) and accumulation of lysosomal glycogen. We assessed the safety and efficacy of avalglucosidase alfa, a recombinant human GAA enzyme replacement therapy specifically designed for enhanced mannose-6-phosphate-receptor targeting and enzyme uptake aimed at increased glycogen clearance, compared with the current approved standard of care, alglucosidase alfa, in patients with late-onset Pompe disease. METHODS We did a randomised, double-blind, phase 3 trial at 55 sites in 20 countries. We enrolled individuals (aged ≥3 years) with enzymatically confirmed late-onset Pompe disease who had never received treatment. We used a centralised treatment allocation system to randomly allocate participants to either avalglucosidase alfa or alglucosidase alfa. Participants and investigators were unaware of their treatment allocation. The primary outcome measure was change from baseline to week 49 in upright forced vital capacity percent (FVC%) predicted. We used a hierarchical fixed sequential testing strategy, whereby non-inferiority of avalglucosidase alfa compared with alglucosidase alfa was assessed first, with a non-inferiority margin of 1·1. If non-inferiority was seen, then superiority was tested with a 5% significance level. The key secondary objective was effect on functional endurance, measured by the 6-minute walk test (6MWT). Safety was assessed, including treatment-emergent adverse events and infusion-associated reactions. The modified intent-to-treat population was the primary analysis population for all efficacy analyses. The safety population was the analysis population for safety analyses. This trial is registered with ClinicalTrials.gov, NCT02782741. We report results of the 49-week primary analysis period. FINDINGS Between Nov 2, 2016, and March 29, 2019, 100 participants were randomly allocated avalglucosidase alfa (n=51) or alglucosidase alfa (n=49). Treatment with avalglucosidase alfa resulted in a least-squares mean improvement in upright FVC% predicted of 2·89% (SE 0·88) compared with 0·46% (0·93) with alglucosidase alfa at week 49 (difference 2·43% [95% CI -0·13 to 4·99]). Non-inferiority was shown because the lower bound of the 95% CI for the difference far exceeded the predefined non-inferiority margin but did not exclude 0 (p=0·0074). Superiority was not reached (p=0·063), so formal testing was stopped, as per the testing hierarchy. Improvements were also seen in the 6MWT with avalglucosidase alfa compared with alglucosidase alfa, with greater increases in distance covered (difference 30·01 m [95% CI 1·33 to 58·69]) and percent predicted (4·71% [0·25 to 9·17]). Treatment-emergent adverse events potentially related to treatment were reported in 23 (45%) of 51 participants in the avalglucosidase alfa group and in 24 (49%) of 49 in the alglucosidase alfa group, and infusion-associated reactions were reported in 13 (26%) participants in the avalglucosidase alfa group and 16 (33%) in the alglucosidase alfa group. Of the five trial withdrawals, all in the alglucosidase alfa group, four were due to adverse events, including two infusion-associated reactions. Serious treatment-emergent adverse events were reported in eight (16%) participants who received avalglucosidase alfa and in 12 (25%) who received alglucosidase alfa. One participant treated with alglucosidase alfa died because of acute myocardial infarction determined to be unrelated to treatment. Antidrug antibody responses were similar in both groups. High and persistent titres (≥12 800) and neutralising antibodies were more common with alglucosidase alfa (in 16 [33%] participants) than with avalglucosidase alfa (ten [20%]). INTERPRETATION We consider that this study provides evidence of clinically meaningful improvement with avalglucosidase alfa therapy over alglucosidase alfa in respiratory function, ambulation, and functional endurance, with no new safety signals reported. An open-label extended-treatment period is ongoing to confirm the long-term safety and efficacy of avalglucosidase alfa, with the aim for this therapy to become the new standard treatment in late-onset Pompe disease. FUNDING Sanofi Genzyme.
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Affiliation(s)
- Jordi Diaz-Manera
- John Walton Muscular Dystrophy Research Centre, Newcastle University Centre for Life, Newcastle upon Tyne, UK; Neuromuscular Diseases Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Spain.
| | - Priya S Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
| | - Hani Kushlaf
- Department of Neurology and Rehabilitation Medicine, and Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Shafeeq Ladha
- Gregory W Fulton ALS and Neuromuscular Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Tahseen Mozaffar
- Department of Neurology, University of California, Irvine, Orange, CA, USA
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University Centre for Life, Newcastle upon Tyne, UK
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, Reference Centre for Rare Neuromuscular Disorders, University of Messina, Messina, Italy
| | - Ans T van der Ploeg
- Center for Lysosomal and Metabolic Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Kenneth I Berger
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine, New York, NY, USA; André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA
| | - Paula R Clemens
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Veterans Affairs Medical Center, Pittsburgh, PA, USA
| | - Yin-Hsiu Chien
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - John W Day
- Department of Neurology, and Department of Pediatrics, Stanford University, Stanford, CA, USA
| | | | | | - Shahram Attarian
- Referral Centre for Neuromuscular Diseases and ALS, Hôpital La Timone, Marseille, France
| | | | - Francoise Bouhour
- Referral Centre for Neuromuscular Diseases, Hopîtal Neurologique, Lyon-Bron, France
| | - Young Chul Choi
- Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | | | - Ozlem Goker-Alpan
- Lysosomal and Rare Disorders Research and Treatment Center (LDRTC), Fairfax, VA, USA
| | | | | | | | | | | | | | | | - Mazen M Dimachkie
- University of Kansas Medical Center, Department of Neurology, Kansas City, KS, USA
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, LMU Klinikum München, Munich, Germany
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You DS, Ziadni MS, Cooley CE, Talavera DC, Mackey SC, Poupore-King H. Effectiveness of a multidisciplinary rehabilitation program in real-world patients with chronic back pain: A pilot cohort data analysis. J Back Musculoskelet Rehabil 2021; 34:965-973. [PMID: 34151829 PMCID: PMC8673504 DOI: 10.3233/bmr-200305] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Randomized clinical trials (RCT) suggest a multidisciplinary approach to pain rehabilitation is superior to other active treatments in improving pain intensity, function, disability, and pain interference for patients with chronic pain, with small effect size (ds= 0.20-0.36) but its effectiveness remains unknown in real-world practice. OBJECTIVE The current study examined the effectiveness of a multidisciplinary program to a cognitive and behavioral therapy (pain-CBT) in real-world patients with chronic back pain. METHODS Twenty-eight patients (M𝑎𝑔𝑒= 57.6, 82.1% Female) completed a multidisciplinary program that included pain psychology and physical therapy. Eighteen patients (M𝑎𝑔𝑒= 58.9, 77.8% Female) completed a CBT-alone program. Using a learning healthcare system, the Pain Catastrophizing Scale, 0-10 Numerical Pain Rating Scale, and Patient-Reported Outcomes Measurement Information System® measures were administered before and after the programs. RESULTS We found significant improvement in mobility and pain behavior only after a multidisciplinary program (p's < 0.031; d= 0.69 and 0.55). We also found significant improvement in pain interference, fatigue, depression, anxiety, social role satisfaction, and pain catastrophizing after pain-CBT or multidisciplinary programs (p's < 0.037; ds = 0.29-0.73). Pain ratings were not significantly changed by either program (p's > 0.207). CONCLUSIONS The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice.
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Affiliation(s)
- Dokyoung S. You
- Corresponding author: Dokyoung S. You, Department Anesthesiology, Perioperative and Pain Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA 94304, USA. Tel.: +1 650 724 9320; E-mail:
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47
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Crowe J, Francis JJ, Edbrooke L, Loeliger J, Joyce T, Prickett C, Martin A, Khot A, Denehy L. Impact of an allied health prehabilitation service for haematologic patients receiving high-dose chemotherapy in a large cancer centre. Support Care Cancer 2021; 30:1841-1852. [PMID: 34609585 PMCID: PMC8491182 DOI: 10.1007/s00520-021-06607-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022]
Abstract
Purpose Evaluate the impact of a new multidisciplinary allied health prehabilitation service in haematologic cancer patients receiving high-dose chemotherapy with autologous stem cell transplant (AuSCT). Methods In a tertiary cancer centre, 12 months of prospectively collected data was retrospectively analysed. Patients were referred to an allied health service for individualised exercise prescription, nutrition intervention and, if indicated through screening, psychological intervention. Impact and operational success were investigated using the RE-AIM framework: patient uptake of the service and sample representativeness (reach); effectiveness in terms of changes in outcomes from initial to pre-transplant assessment; adoption of the service by key stakeholders; fidelity of the prescribed exercise program (implementation); and the extent to which the new service had become routine practice (maintenance). Results One hundred and eighty-three patients were referred to the AuSCT service over 12 months, of whom 133 (73%) were referred into the prehabilitation service, 128 (96%) were eligible and 116 (91%) participated. Patients were representative of Australian AuSCT patients. Eighty-nine patients reached pre-transplant assessment by data censoring; 6-min walk distance (n = 45/89, 51%) improved a mean (95% CI) of 39.9 m (18.8 to 61.0, p = < 0.005) from baseline. Fidelity of exercise prescription was moderate with 72% of eligible patients receiving the intended exercise interventions. The referral trend over time (maintenance) was high after the initiation period. Conclusion The prehabilitation service was well adopted by clinicians. Clinically relevant improvements in outcomes were demonstrated. Recommendations, including development of well-integrated discipline-specific assessment intervention and measurement protocols, are highlighted for service improvement. Prehabilitation should be routinely considered to support patients undergoing AuSCT. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06607-w.
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Affiliation(s)
- Jessica Crowe
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. .,Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.
| | - Jill J Francis
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lara Edbrooke
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
| | - Jenelle Loeliger
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Trish Joyce
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Christina Prickett
- Department of Clinical Psychology, Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Alicia Martin
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Amit Khot
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Linda Denehy
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Izquierdo-Alventosa R, Inglés M, Cortés-Amador S, Gimeno-Mallench L, Sempere-Rubio N, Serra-Añó P. Effectiveness of High-Frequency Transcranial Magnetic Stimulation and Physical Exercise in Women With Fibromyalgia: A Randomized Controlled Trial. Phys Ther 2021; 101:6312574. [PMID: 34216139 DOI: 10.1093/ptj/pzab159] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/19/2021] [Accepted: 05/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) is characterized by chronic widespread pain and both physical and emotional alterations, which in turn may affect the individual's quality of life. Thus, interventions aimed at treating such symptoms, without increasing fatigue, are needed. The aim of this study was to explore the effect of high-frequency transcranial magnetic stimulation (HF-TMS) and physical exercise (PE) on pain, impact of FM, physical conditioning, and emotional status in women with FM. METHODS Forty-nine women with FM were randomly allocated to: (1) a PE group (PEG, n = 16), who underwent an 8-week (two 60-minute sessions/wk) low-intensity PE program; (2) a TMS group (TMSG, n = 17) receiving a 2-week (five 20-minute sessions/wk) HF-TMS intervention; and (3) a control group (CG, n = 16). Pain (ie, perceived pain and average pressure pain threshold), perceived impact of FM (ie, overall impact, symptoms, and perceived physical function), physical conditioning (ie, endurance and functional capacity, fatigue, gait velocity, and power), and emotional status (ie, anxiety, depression, stress, and satisfaction) were assessed at baseline (T0) and after the intervention (T1, at 2 weeks for TMSG and at 8 weeks for PEG and CG). RESULTS The TMSG showed significant improvement in all studied variables after the intervention except for satisfaction, whereas the PEG showed improved average pressure pain threshold, perceived overall impact of FM and total score, endurance and functional capacity, velocity and power, anxiety, depression, and stress. In contrast, the CG showed no improvements in any variable. CONCLUSION Both PE and HF-TMS are effective in improving pain, impact of FM, physical conditioning, and emotional status in people with FM; HF-TMS achieved larger improvements in emotional status than PE. IMPACT TMS and PE have similar benefits for physical status, whereas TMS has greater benefits than PE for emotional status in women with FM.
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Affiliation(s)
- Ruth Izquierdo-Alventosa
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Sara Cortés-Amador
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Lucia Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
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49
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Gillis C, Fenton TR, Gramlich L, Keller HH, Sajobi TT, Culos-Reed N, Richer L, Awasthi R, Carli F. Malnutrition modifies the response to multimodal prehabilitation: A pooled analysis of prehabilitation trials. Appl Physiol Nutr Metab 2021; 47:141-150. [PMID: 34587460 DOI: 10.1139/apnm-2021-0299] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Patients with colorectal cancer are at risk of malnutrition before surgery. Multimodal prehabilitation (nutrition, exercise, stress reduction) readies patients physically and mentally for their operation. However, it is unclear whether extent of malnutrition influences prehabilitation outcomes. METHODS We conducted a pooled analysis from five 4-week multimodal prehabilitation trials in colorectal cancer surgery (prehabilitation: n=195; control: n=71). Each patient's nutritional status was evaluated at baseline using the Patient-Generated Subjective Global Assessment (PG-SGA; higher score, greater need for treatment of malnutrition). Functional walking capacity was measured with the six-minute walk test (6MWD) at baseline and before surgery. A multivariable mixed effects logistic regression model evaluated the potential modifying effect of PG-SGA on a clinically meaningful change of >=19m in 6MWD before surgery. RESULTS Multimodal prehabilitation increased the odds by 3.4 times that colorectal cancer patients improved their 6MWD before surgery as compared to control (95%CI:1.6 to 7.3; P=0.001, n=220). Nutritional status significantly modified this outcome (P=0.007): Neither those patients with PG-SGA>=9 (adjusted odds ratio:1.3; 95% CI: 0.23 to 7.2, P=0.771, n=39) nor PG-SGA <4 (adjusted odds ratio:1.3; 95% CI: 0.5 to 3.8, P=0.574, n=87) improved in 6MWD with prehabilitation. CONCLUSION Baseline nutritional status modifies prehabilitation effectiveness before colorectal cancer surgery. Patients with a PG-SGA score 4-8 appear to benefit most (physically) from 4 weeks of multimodal prehabilitation. Novelty bullets: 1) Nutritional status is an effect modifier of prehabilitation physical function outcomes; 2) Patients with a PG-SGA score 4-8 benefited physically from 4 weeks of multimodal prehabilitation.
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Affiliation(s)
| | - Tanis R Fenton
- University of Calgary, 2129, Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, 1403 29th Street NW, Calgary, Alberta, Canada, T2N 2T9.,Alberta Health Services, Nutrition Services, Calgary, Alberta, Canada;
| | - Leah Gramlich
- University of Alberta, Gastroenterology, 214 csc RAH, Edmonton, Alberta, Canada, T5H 3V9.,ualberta, medicine;
| | | | | | - Nicole Culos-Reed
- University of Calgary, Department of Kinesiology, Calgary, Alberta, Canada;
| | | | - Rashami Awasthi
- McGill University, Department of Anesthesia, Montreal General Hospital, Montreal, Quebec, Canada;
| | - Francesco Carli
- McGill University, Department of Anesthesia, Montreal General Hospital, Montreal, Quebec, Canada, H4B1R6;
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50
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Briot K, Portale AA, Brandi ML, Carpenter TO, Cheong HI, Cohen-Solal M, Crowley RK, Eastell R, Imanishi Y, Ing S, Insogna K, Ito N, Jan de Beur S, Javaid MK, Kamenicky P, Keen R, Kubota T, Lachmann RH, Perwad F, Pitukcheewanont P, Ralston SH, Takeuchi Y, Tanaka H, Weber TJ, Yoo HW, Nixon A, Nixon M, Sun W, Williams A, Imel EA. Burosumab treatment in adults with X-linked hypophosphataemia: 96-week patient-reported outcomes and ambulatory function from a randomised phase 3 trial and open-label extension. RMD Open 2021; 7:rmdopen-2021-001714. [PMID: 34548383 PMCID: PMC8458321 DOI: 10.1136/rmdopen-2021-001714] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To report the impact of burosumab on patient-reported outcomes (PROs) and ambulatory function in adults with X-linked hypophosphataemia (XLH) through 96 weeks. Methods Adults diagnosed with XLH were randomised 1:1 in a double-blinded trial to receive subcutaneous burosumab 1 mg/kg or placebo every 4 weeks for 24 weeks (NCT02526160). Thereafter, all subjects received burosumab every 4 weeks until week 96. PROs were measured using the Western Ontario and the McMaster Universities Osteoarthritis Index (WOMAC), Brief Pain Inventory-Short Form (BPI-SF) and Brief Fatigue Inventory (BFI), and ambulatory function was measured with the 6 min walk test (6MWT). Results Subjects (N=134) were randomised to burosumab (n=68) or placebo (n=66) for 24 weeks. At baseline, subjects experienced pain, stiffness, and impaired physical and ambulatory function. At week 24, subjects receiving burosumab achieved statistically significant improvement in some BPI-SF scores, BFI worst fatigue (average and greatest) and WOMAC stiffness. At week 48, all WOMAC and BPI-SF scores achieved statistically significant improvement, with some WOMAC and BFI scores achieving meaningful and significant change from baseline. At week 96, all WOMAC, BPI-SF and BFI achieved statistically significant improvement, with selected scores in all measures also achieving meaningful change. Improvement in 6MWT distance and percent predicted were statistically significant at all time points from 24 weeks. Conclusions Adults with XLH have substantial burden of disease as assessed by PROs and 6MWT. Burosumab treatment improved phosphate homoeostasis and was associated with a steady and consistent improvement in PROs and ambulatory function. Trial registration number NCT02526160.
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Affiliation(s)
- Karine Briot
- Department of Rheumatology, Hôpital Cochin, Paris, France
| | - Anthony A Portale
- Department of Pediatrics, Division of Nephrology, University of California, San Francisco, California, USA
| | | | - Thomas O Carpenter
- Department of Pediatrics and Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hae Ii Cheong
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Martine Cohen-Solal
- Department of Rheumatology, Hôpital Lariboisière, Paris, France.,INSERM U1132 BIOSCAR, University of Paris, Paris, France
| | - Rachel K Crowley
- Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland.,University College Dublin School of Medicine, Dublin, Ireland
| | - Richard Eastell
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Steven Ing
- Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Karl Insogna
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nobuaki Ito
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan
| | - Suzanne Jan de Beur
- Division of Endocrinology and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Peter Kamenicky
- Endocrine Physiology and Pathophysiology, INSERM, Paris-Saclay University, Paris, France.,Hospital Bicetre, Paris, France
| | - Richard Keen
- Metabolic Bone Disease Unit, Royal National Orthopaedic Hospital NHS Trust, London, UK
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Robin H Lachmann
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Farzana Perwad
- Department of Pediatrics, Division of Nephrology, University of California, San Francisco, California, USA
| | - Pisit Pitukcheewanont
- Department of Pediatric Endocrinology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Stuart H Ralston
- Rheumatology and Bone Diseases Unit, Medical Research Council Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | | | - Hiroyuki Tanaka
- Department of Pediatrics, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Thomas J Weber
- Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Han-Wook Yoo
- Department of Pediatrics, Asan Medical Center Children's Hospital, Seoul, Republic of Korea
| | | | | | - Wei Sun
- Biostatistics Department, Kyowa Kirin Pharmaceutical Development, Inc, Princeton, New Jersey, USA
| | - Angela Williams
- Health Economics and Outcomes Research Department, Kyowa Kirin International PLC, Marlow, UK
| | - Erik A Imel
- Department of Medicine and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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