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van Leunen MMCJ, van Hooff M, Meijer R, Wijnands NHM, Post RAJ, Spee RF, Lu Y, Schep G, Kemps HMC. Evaluation of two self-reported questionnaires for assessment of peak exercise capacity in patients with chronic heart failure. Eur J Prev Cardiol 2024; 31:e13-e15. [PMID: 37665954 DOI: 10.1093/eurjpc/zwad266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/21/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023]
Affiliation(s)
- Mayke M C J van Leunen
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Groene Loper 3, 5612 AR Eindhoven, The Netherlands
| | - Martijn van Hooff
- Department of Sports and Exercise, Máxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Renske Meijer
- Department of Sports and Exercise, Máxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Nikki H M Wijnands
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Richard A J Post
- Department of Mathematics & Computer Science, Eindhoven University of Technology, Groene Loper 3, 5612 AR Eindhoven, The Netherlands
| | - Ruud F Spee
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Yuan Lu
- Department of Industrial Design, Eindhoven University of Technology, Groene Loper 3, 5612 AR Eindhoven, The Netherlands
| | - Goof Schep
- Department of Sports and Exercise, Máxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands
| | - Hareld M C Kemps
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Groene Loper 3, 5612 AR Eindhoven, The Netherlands
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Meijer R, Schep G, Regis M, Papen-Botterhuis NE, Savelberg HHCM, van Hooff M. Test-retest reliability of the FitMáx©-questionnaire in a clinical and healthy population. J Patient Rep Outcomes 2024; 8:3. [PMID: 38175456 PMCID: PMC10767039 DOI: 10.1186/s41687-023-00682-9] [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: 07/18/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The FitMáx© was developed as a questionnaire-based instrument to estimate Cardiorespiratory Fitness (CRF) expressed as oxygen uptake at peak exercise (VO2peak). Test-retest reliability is a clinometric measurement property, which defines stability over time if multiple measurements are performed (i.e. reliability). The present study aimed to assess the test-retest reliability of the FitMáx©-questionnaire in different patient groups. PATIENTS AND METHODS A total of 127 cardiac, pulmonary and oncology patients and healthy subjects aged 19-84 years who completed the questionnaire twice within an average of 18 days were included for analysis. Participants were in a stable clinical situation (no acute disease or participating in a training program). To determine the test-retest reliability, the Intraclass Correlation Coefficient (ICC) and Standard Error of the Measurement (SEM) was calculated between the first (T0) and second (T1) administration of the questionnaires. RESULTS An excellent agreement was found between the FitMáx©-questionnaire scores at T0 and T1, with an ICC of 0.97 (SEM 1.91) in the total study population and an ICC ranging from 0.93 to 0.98 (SEM 1.52-2.27) in the individual patient groups. CONCLUSION The FitMáx©-questionnaire proves to be reliable and stable over time to estimate CRF of patients and healthy subjects. Trial registration NTR (Netherlands Trial Register), NL8846. Registered 25 August 2020, https://trialsearch.who.int/Trial2.aspx?TrialID=NL8846.
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Affiliation(s)
- Renske Meijer
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands.
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Goof Schep
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, University of Technology, Eindhoven, The Netherlands
| | | | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martijn van Hooff
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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van Leunen MMCJ, de Lathauwer ILJ, Verstappen CCAG, Visser-Stevelink DMG, Brouwers RWM, Herkert C, Tio RA, Spee RF, Lu Y, Kemps HMC. Telerehabilitation in patients with recent hospitalisation due to acute decompensated heart failure: protocol for the Tele-ADHF randomised controlled trial. BMC Cardiovasc Disord 2023; 23:379. [PMID: 37516829 PMCID: PMC10386674 DOI: 10.1186/s12872-023-03407-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cardiac rehabilitation in patients with chronic heart failure (CHF) has favourable effects on exercise capacity, the risk at hospital (re-)admission and quality of life. Although cardiac rehabilitation is generally recommended it is still under-utilised in daily clinical practice, particularly in frail elderly patients after hospital admission, mainly due to low referral and patient-related barriers. Cardiac telerehabilitation (CTR) has the potential to partially solve these barriers. The purpose of this study is to evaluate the effects of CTR as compared to standard remote care after hospital admission on physical functional capacity in CHF patients. METHODS In this randomised controlled trial, 64 CHF patients will be recruited during hospitalisation for acute decompensated heart failure, and randomised to CTR combined with remote patient management (RPM) or RPM alone (1:1). All participants will start with RPM after hospital discharge for early detection of deterioration, and will be up titrated to optimal medical therapy before being randomised. CTR will start after randomisation and consists of an 18-week multidisciplinary programme with exercise training by physical and occupational therapists, supported by a (remote) technology-assisted dietary intervention and mental health guiding by a physiologist. The training programme consists of three centre-based and two home-based video exercise training sessions followed by weekly video coaching. The mental health and dietary programme are executed using individual and group video sessions. A wrist-worn device enables remote coaching by the physical therapist. The web application is used for promoting self-management by the following modules: 1) goal setting, 2) progress tracking, 3) education, and 4) video and chat communication. The primary outcome measure is physical functional capacity evaluated by the Short Physical Performance Battery (SPPB) score. Secondary outcome measures include frailty scoring, recovery after submaximal exercise, subjective health status, compliance and acceptance to the rehabilitation programme, and readmission rate. DISCUSSION The Tele-ADHF trial is the first prospective randomised controlled trial designed for evaluating the effects of a comprehensive combined RPM and CTR programme in recently hospitalised CHF patients. We hypothesize that this intervention has superior effects on physical functional capacity than RPM alone. TRIAL REGISTRATION Netherlands Trial Registry (NTR) NL9619, registered 21 July 2021.
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Affiliation(s)
- Mayke M C J van Leunen
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands.
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Ignace L J de Lathauwer
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Cindy C A G Verstappen
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | | | - Rutger W M Brouwers
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Cyrille Herkert
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - René A Tio
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Ruud F Spee
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands
| | - Yuan Lu
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Hareld M C Kemps
- Department of Cardiology, Máxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
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Molenaar CJL, Von Meyenfeldt EM, de Betue CTI, van den Berg R, Ten Cate DWG, Schep G, Youssef-El Soud M, van Thiel E, Rademakers N, Hoornweg SC, Slooter GD, van den Broek F, Marres GMH. Multimodal prehabilitation in patients with non-small cell lung cancer undergoing anatomical resection: protocol of a non-randomised feasibility study. Perioper Med (Lond) 2023; 12:41. [PMID: 37468983 DOI: 10.1186/s13741-023-00326-y] [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: 02/14/2022] [Accepted: 07/03/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The preoperative period can be used to enhance a patient's functional capacity with multimodal prehabilitation and consequently improve and fasten postoperative recovery. Especially, non-small cell lung cancer (NSCLC) surgical patients may benefit from this intervention, since the affected and resected organ is an essential part of the cardiorespiratory fitness. Drafting a prehabilitation programme is challenging, since many disciplines are involved, and time between diagnosis of NSCLC and surgery is limited. We designed a multimodal prehabilitation programme prior to NSCLC surgery and aimed to conduct a study to assess feasibility and indicative evidence of efficacy of this programme. Publication of this protocol may help other healthcare facilities to implement such a programme. METHODS The multimodal prehabilitation programme consists of an exercise programme, nutritional support, psychological support, smoking cessation, patient empowerment and respiratory optimisation. In two Dutch teaching hospitals, 40 adult patients with proven or suspected NSCLC will be included. In a non-randomised fashion, 20 patients follow the multimodal prehabilitation programme, and 20 will be assessed in the control group, according to patient preference. Assessments will take place at four time points: baseline, the week before surgery, 6 weeks postoperatively and 3 months postoperatively. Feasibility and indicative evidence of efficacy of the prehabilitation programme will be assessed as primary outcomes. DISCUSSION Since the time between diagnosis of NSCLC and surgery is limited, it is a challenge to implement a prehabilitation programme. This study will assess whether this is feasible, and evidence of efficacy can be found. The non-randomised fashion of the study might result in a selection and confounding bias. However, the control group may help putting the results of the prehabilitation group in perspective. By publishing this protocol, we aim to facilitate others to evaluate and implement a multimodal prehabilitation programme for surgical NSCLC patients. TRIAL REGISTRATION The current study is registered as NL8080 in the Netherlands Trial Register on the 10th of October 2019, https://www.trialregister.nl/trial/8080 . Secondary identifiers: CCMO (Central Committee on Research Involving Human Subjects) number NL70578.015.19, reference number of the Medical Ethical Review Committee of Máxima MC W19.045.
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Affiliation(s)
| | | | | | | | | | - Goof Schep
- Department of Sports Medicine, Máxima MC, Veldhoven, the Netherlands
| | | | - Eric van Thiel
- Department of Pulmonology, Albert Schweitzer Hospital, Dordrecht, the Netherlands
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Weemaes ATR, Meijer R, Beelen M, van Hooff M, Weijenberg MP, Lenssen AF, van de Poll-Franse LV, Savelberg HHCM, Schep G. Monitoring aerobic capacity in cancer survivors using self-reported questionnaires: criterion validity and responsiveness. J Patient Rep Outcomes 2023; 7:73. [PMID: 37466784 PMCID: PMC10356721 DOI: 10.1186/s41687-023-00613-8] [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: 12/02/2022] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Evaluating the criterion validity and responsiveness of the self-reported FitMáx©-questionnaire, Duke Activity Status Index (DASI) and Veterans Specific Activity Questionnaire (VSAQ) to monitor aerobic capacity in cancer survivors. METHODS Cancer survivors participating in a 10-week supervised exercise program were included. The FitMáx©-questionnaire, DASI, VSAQ and a cardiopulmonary exercise test (CPET) were completed before (T0) and after (T1) the program. Intraclass correlation coefficients (ICC) were calculated between VO2peak estimated by the questionnaires (questionnaire-VO2peak) and VO2peak measured during CPET (CPET-VO2peak), at T0 to examine criterion validity, and between changes in questionnaire-VO2peak and CPET-VO2peak (ΔT0-T1) to determine responsiveness. Receiver operating characteristic (ROC) analyses were performed to examine the ability of the questionnaires to detect true improvements (≥ 6%) in CPET-VO2peak. RESULTS Seventy participants were included. Outcomes at T1 were available for 58 participants (83%). Mean CPET-VO2peak significantly improved at T1 (Δ1.6 mL·kg- 1·min- 1 or 8%). Agreement between questionnaire-VO2peak and CPET-VO2peak at T0 was moderate for the FitMáx©-questionnaire (ICC = 0.69) and VSAQ (ICC = 0.53), and poor for DASI (ICC = 0.36). Poor agreement was found between ΔCPET-VO2peak and Δquestionnaire-VO2peak for all questionnaires (ICC 0.43, 0.19 and 0.18 for the FitMáx©-questionnaire, VSAQ and DASI, respectively). ROC analysis showed that the FitMáx©-questionnaire was able to detect improvements in CPET-VO2peak (area under the curve, AUC = 0.77), when using a cut-off value of 1.0 mL·kg- 1·min- 1, while VSAQ (AUC = 0.66) and DASI (AUC = 0.64) could not. CONCLUSION The self-reported FitMáx©-questionnaire has sufficient validity to estimate aerobic capacity in cancer survivors at group level. The responsiveness of the FitMáx©-questionnaire for absolute change is limited, but the questionnaire is able to detect whether aerobic capacity improved. The FitMáx©-questionnaire showed substantial better values of validity and responsiveness compared to DASI and VSAQ.
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Affiliation(s)
- Anouk T R Weemaes
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands.
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Renske Meijer
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Milou Beelen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martijn van Hooff
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Antoine F Lenssen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Goof Schep
- Department of Sports and Exercise, Máxima Medical Center, Veldhoven, The Netherlands
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Zhou H, Wang Y, Li W, Yang L, Liao Y, Xu M, Zhang C, Ma H. Usefulness of the Duke Activity Status Index to Assess Exercise Capacity and Predict Risk Stratification in Patients with Pulmonary Arterial Hypertension. J Clin Med 2023; 12:jcm12082761. [PMID: 37109099 PMCID: PMC10142524 DOI: 10.3390/jcm12082761] [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: 02/13/2023] [Revised: 03/19/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Exercise capacity is an important component of risk assessment for pulmonary arterial hypertension (PAH). We investigated the association of the Duke Activity Status Index (DASI) with peak oxygen consumption (peakVO2) and explored whether the DASI can discriminate the high-risk individuals in patients with PAH, according to peakVO2 < 11 mL/min/kg. A total of 89 patients were evaluated using cardiopulmonary exercise testing (CPET) and DASI. The correlation between the DASI and peakVO2 was measured by univariate analysis, and a receiver operating characteristic (ROC) curve analysis was conducted. The DASI was correlated with peakVO2 in the univariate analysis. The ROC curve analysis revealed that the DASI had a discriminative value for identifying the individuals with a high risk in PAH patients (p < 0.001), with an area under ROC curve (AUC) of 0.79 (95% CI: 0.67-0.92). Similar results were observed in patients with PAH associated with congenital heart disease (CHD-PAH), (p = 0.001), with an AUC of 0.80 (95% CI: 0.658-0.947). Therefore, DASI reflects exercise capacity in patients with PAH and has good ability to discriminate patients with a low risk and a high risk, and it may be included in the risk assessment of PAH.
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Affiliation(s)
- Haofeng Zhou
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
| | - Yu Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
| | - Weiya Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
| | - Lifang Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
| | - Yingxue Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
| | - Mingyu Xu
- School of Medicine, South China University of Technology, Guangzhou 510000, China
| | - Caojin Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510000, China
| | - Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510000, China
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