The 6-minute walk test provides an accurate measure of exercise capacity for risk assessment before major non-cardiac surgery

Abstract Background: The 6-minute walk test (6MWT) and incremental shuttle walk test (ISWT) are valid and reliable measures to assess exercise capacity of patients with chronic obstructive pulmonary disease (COPD). However, the comparison of correlation between peak oxygen uptake (peak VO2) and 6MWT or ISWT distance has not been investigated. We aimed to investigate the correlation between peak VO2 and 6MWT and ISWT distances in patients with COPD through a meta-analysis.Methods: We systematically searched MEDLINE, Scopus, Embase, and the Cochrane Library up to June 30, 2020 for studies comparing the correlation of peak VO2 with either 6MWT or ISWT in patients with COPD. Meta-analysis was performed with R software using a fixed-effect model. We compared the correlation coefficient and measured the heterogeneity using I2 statistics. Results: We identified 12 studies involving 746 patients. Meta-analysis showed a significant correlation between peak VO2 and 6MWT and ISWT distances (6MWT: r = 0.65, 95% CI: 0.61 to 0.70; ISWT: r = 0.81, 95% CI: 0.74 to 0.85; p < 0.0001). The heterogeneity was lower in ISWT than in 6MWT (6MWT: I2 = 56%, p = 0.02; ISWT: I2 = 0%, p = 0.71). Subgroup analysis showed a higher correlation coefficient in the low exercise capacity group than in the high exercise capacity group in both field tests. No risk of publication bias was identified.Conclusions: 6MWT and ISWT were significantly correlated with peak VO2. The findings suggest that ISWT had a stronger correlation with peak VO2 than did 6MWT in patients with COPD.Trial registration: CRD 42020200139 at crd.york.ac.uk/prospero/

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Phase-I cardiac rehabilitation practices among physiotherapists in INDIA - A survey

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v19i2.44998 ◽

2020 ◽

Vol 19 (2) ◽

pp. 214-222

Author(s):

Shruti Chari ◽

Gopala Krishna Alaparthi ◽

Shyam Krishnan K ◽

Ashish Prabhakar ◽

Kalyana Chakravarthy Bairapareddy

Keyword(s):

Cardiac Surgery ◽

Cardiac Rehabilitation ◽

Phase I ◽

Lower Limb ◽

Medical Science ◽

Walk Test ◽

Breathing Exercises ◽

Postural Drainage ◽

6 Minute Walk Test ◽

Minute Walk

Objective: To find out the current practice patterns of Physiotherapists in Phase I Cardiac Rehabilitation of patients following Cardiac Surgery (CABG/Valve Surgery). Materials and Methods: The cross sectional survey included 600 cardio-pulmonary physiotherapists working in Cardiac Care Unit, who filled questionnaires sent to them through e-mail. Results: 252 completed questionnaires were received back, the response rate being of 42 %, with a major portion of responses coming from Maharashtra, Karnataka and Andhra Pradesh. More than 80 % of physiotherapists assess and treat the patient Pre- Operatively. More than 90% of physiotherapists performed Cardiac Rehabilitation Post-Operatively. Cardiac Rehabilitation Treatment Techniques predominantly focused on Breathing Exercises (96.7%), Incentive Spirometry (91.1%), Coughing and Huffing (83.3%), Thoracic Expansion Exercises (82.13%), Positioning (71.16%), Percussion and Vibration (63.6%), Modified Postural Drainage (41.2%), active exercises of the upper limb (89.13%), and lower limb exercises (89.3%). Dangling the lower limb (69%) was started on Post –Operative day 2. Room and corridor mobilisation (73.8%) began on third Post-Operative day. 29.4% Stair case climbing was started on fourth post-operative day. 73.8% of patients practiced 6-minute walk test prior to discharge. Most commonly used sternal precautions were Supported Coughing (96.0%) and Lifting Restrictions (82.5%). Conclusion: Phase I cardiac rehabilitation adopted by physiotherapists for cardiac surgery patients involves treatment which mainly focused on cough and huff techniques, breathing exercises and thoracic expansion exercises. On Post-Operative day 2, dangling the lower limb and room ambulation started on third post-Operative day 3. The training for climbing stairs started on fourthpost-operative day. The most commonly used sternal precautions were supported coughing and lifting restrictions whereas 6-minute walk test was use to assess exercise tolerance,prior to discharge. Bangladesh Journal of Medical Science Vol.19(2) 2020 p.214-222

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