Determination of 6-minute walk test using accelerometer-based ambulatory monitoring device for the assessment of patient’s progress in cardiac rehabilitation

Background Cardiac rehabilitation is an established performance measure for adults with ischemic heart disease, but patient participation is remarkably low. Home‐based cardiac rehabilitation (HBCR) may be more practical and feasible, but evidence regarding its efficacy is limited. We sought to compare the effects of HBCR versus facility‐based cardiac rehabilitation (FBCR) on functional status in patients with ischemic heart disease. Methods and Results This was a pragmatic trial of 237 selected patients with a recent ischemic heart disease event, who enrolled in HBCR or FBCR between August 2015 and September 2017. The primary outcome was 3‐month change in distance completed on a 6‐minute walk test. Secondary outcomes included rehospitalization as well as patient‐reported physical activity, quality of life, and self‐efficacy. Characteristics of the 116 patients enrolled in FBCR and 121 enrolled in HBCR were similar, except the mean time from index event to enrollment was shorter for HBCR (25 versus 77 days; P <0.001). As compared with patients undergoing FBCR, those in HBCR achieved greater 3‐month gains in 6‐minute walk test distance (+95 versus +41 m; P <0.001). After adjusting for demographics, comorbid conditions, and indication, the mean change in 6‐minute walk test distance remained significantly greater for patients enrolled in HBCR (+101 versus +40 m; P <0.001). HBCR participants reported greater improvements in quality of life and physical activity but less improvement in exercise self‐efficacy. There were no deaths or cardiovascular hospitalizations. Conclusions Patients enrolled in HBCR achieved greater 3‐month functional gains than those enrolled in FBCR. Our data suggest that HBCR may safely derive equivalent benefits in exercise capacity and overall program efficacy in selected patients. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02105246.

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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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Determination Of Hemodynamic Parameters During 6-Minute Walk Test In Pulmonary Hypertension

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a4093 ◽

2012 ◽

Author(s):

Vineesha Arelli ◽

Jose Ramos ◽

Kevin McCarthy ◽

Adriano Tonelli ◽

Raed A. Dweik ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Walk Test ◽

Hemodynamic Parameters ◽

6 Minute Walk Test ◽

Minute Walk

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Why to evaluate the functional capacity in PAD patients?

VASA ◽

10.1024/0301-1526/a000852 ◽

2020 ◽

Vol 49 (4) ◽

pp. 275-280

Author(s):

Pavel Poredoš ◽

Mateja K. Jezovnik

Keyword(s):

Quality Of Life ◽

Functional Impairment ◽

Constant Load ◽

Load Test ◽

Walk Test ◽

Treadmill Test ◽

6 Minute Walk Test ◽

Minute Walk

Summary: In patients with peripheral arterial disease (PAD), the ability to perform physical exercise is an essential and most important indicator of a patient’s health and quality of life. In many cases, there exists a discrepancy between lower extremity blood flow, the extent of arterial occlusion shown by morphological investigation and functional impairment. Reversal of lower extremity arterial obstruction with revascularization does not always reverse functional impairment of diseased leg. Further, training exercise and drug treatment can improve functional performance although they are not associated with an improvement in arterial obstruction. Therefore, the determination of functional impairment and its recovery after different therapeutic procedures should be determined using objective tests. The most frequently used functional tests are treadmill exercise testing and a 6-minute walk test. The constant load test, in which results are expressed as a walked distance, does not always permit an accurate assessment of the full range of functional impairment of PAD patients. Recently, as a substitute for a constant-load test, the graded treadmill test is used. With this test, it is possible to identify those individuals with exercise limitations who are not caused only by deterioration of the blood flow of lower limbs. The 6-minute walk test is simple to perform and requires minimal equipment. However, the correlation between the 6-minute walk test and the graded treadmill test is relatively weak, indicating that peak performance on a graded treadmill may reflect different pathophysiological mechanisms of limitations. In conclusion: for the determination of limitations of mobility and quality of life in patients with PAD, objective measures of functional impairment are needed. The determination of functional capacity is related to the quality of life and is a useful tool for investigation of the success of revascularization of peripheral arteries and conservative treatment.

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A REPORT OF CLINICAL OUTCOMES FOR THE FIRST YEAR OF A CARDIAC REHABILITATION PROGRAM UTILIZING THE SF 36 HEALTH STATUS PROFILE AND THE 6 MINUTE WALK TEST AS MEASUREMENT TOOLS.

Cardiopulmonary Physical Therapy Journal ◽

10.1097/01823246-199607040-00021 ◽

1996 ◽

Vol 7 (4) ◽

pp. 25-26

Author(s):

K L Bishop ◽

S Brenneman ◽

P Kelly

Keyword(s):

Health Status ◽

Cardiac Rehabilitation ◽

Rehabilitation Program ◽

First Year ◽

Walk Test ◽

Cardiac Rehabilitation Program ◽

Sf 36 ◽

Measurement Tools ◽

6 Minute Walk Test ◽

Minute Walk

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Subtraction CT angiopulmonographic assessment of the vascular bed and lung perfusion in patients with chronic thromboembolic pulmonary hypertension: A pilot study

Terapevticheskii arkhiv ◽

10.17116/terarkh20178948-14 ◽

2017 ◽

Vol 89 (4) ◽

pp. 8-14 ◽

Cited By ~ 1

Author(s):

T N Veselova ◽

A Yu Demchenkova ◽

T V Martynyuk ◽

N M Danilov ◽

S K Ternovoy ◽

...

Keyword(s):

Chronic Thromboembolic Pulmonary Hypertension ◽

Lung Perfusion ◽

Walk Test ◽

Test Results ◽

Vascular Perfusion ◽

Vascular Bed ◽

Thromboembolic Pulmonary Hypertension ◽

6 Minute Walk Test ◽

Minute Walk

Aim. To evaluate the vascular bed and lung perfusion in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by computed tomography (CT) and to compare the severity of pulmonary arterial (PA) thrombotic lesions concurrent with parenchymal perfusion disorders with angiopulmonographic findings and clinical and hemodynamic characteristics. Subjects and methods. In the period from November 2015 to May 2016, 22 patients (7 men, 15 women) aged 27 to 67 years with a verified diagnosis of CTEPH were examined using an Aquilion ONE VISION Edition 640 (Toshiba Medical Systems, Japan) CT scanner with a 320-row detector. Perfusion defect in this study was evaluated with the new software allowing one to combine contrast and contrast-free images by a subtraction method. CT data analysis included visual assessment of the vascular bed and lung parenchyma and quantitative assessment with perfusion map construction and semi-automatic determination of the obstruction index (OI) and perfusion defect index (PDI). OI was compared with PDI and mean LA pressure according to the data of right heart catheterization and 6-minute walk test. Results. A statistically significant correlation was found between OI and PDI in patients with CTEPH (Pearson r=0.56; p=0.0065). There were no relationships between mean LA pressure and vascular perfusion indices (OI and PDI) or between vascular perfusion parameters and 6-minute walk test results. Conclusion. CT angiopulmonography in conjunction with pulmonary perfusion assessment (within one study) allows evaluation of the severity of vascular lesions and perfusion disorders and determination of the efficiency of treatment in patients with CTEPH.

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