scholarly journals Validating the 6-minute walk test as an indicator of recovery in patients undergoing cardiac surgery

Medicine ◽  
2018 ◽  
Vol 97 (42) ◽  
pp. e12925 ◽  
Author(s):  
Yueh-Chi Chen ◽  
Kun-Chung Chen ◽  
Li-Hua Lu ◽  
Yi-Liang Wu ◽  
Te-Jen Lai ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

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

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

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

2009 ◽  
Vol 96 (S1) ◽  
pp. 5-5
Author(s):  
R. C. F. Sinclair ◽  
V. Goodridge ◽  
A. M. Batterham ◽  
A. D. Parry ◽  
G. R. Danjoux
Keyword(s):  
Risk Assessment ◽  
Cardiac Surgery ◽  
Exercise Capacity ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

Direct Myocardial Implantation of Human Fetal Stem Cells in Heart Failure Patients: Long-term Results

2010 ◽  
Vol 13 (1) ◽  
pp. 31 ◽  
Author(s):  
Federico Benetti ◽  
Ernesto Pe�herrera ◽  
Teodoro Maldonado ◽  
Yan Duarte Vera ◽  
Valvanur Subramanian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cells ◽  
Cardiac Function ◽  
Nyha Class ◽  
Left Ventricular ◽  
Long Term Results ◽  
Walk Test ◽  
The Mean ◽  
6 Minute Walk Test ◽  
Minute Walk

Background: End-stage heart failure (HF) is refractory to current standard medical therapy, and the number of donor hearts is insufficient to meet the demand for transplantation. Recent studies suggest autologous stem cell therapy may regenerate cardiomyocytes, stimulate neovascularization, and improve cardiac function and clinical status. Although human fetal-derived stem cells (HFDSCs) have been studied for the treatment of a variety of conditions, no clinical studies have been reported to date on their use in treating HF. We sought to determine the efficacy and safety of HFDSC treatment in HF patients.Methods and Results: Direct myocardial transplantation of HFDSCs by open-chest surgical procedure was performed in 10 patients with HF due to nonischemic, nonchagasic dilated cardiomyopathy. Before and after the procedure, and with no changes in their preoperative doses of medications (digoxin, furosemide, spironolactone, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, betablockers), patients were assessed for New York Heart Association (NYHA) class, performance in the exercise tolerance test (ETT), ejection fraction (EF), left ventricular end-diastolic dimension (LVEDD) via transthoracic echocardiography, performance in the 6-minute walk test, and performance in the Minnesota congestive HF test. All 10 patients survived the operation. One patient had a stroke 3 days after the procedure, and although she later recovered, she was unable to perform the follow-up tests. Another male patient experienced pericardial effusion 3 weeks after the procedure. Although it resolved spontaneously, the patient abandoned his control tests and died 5 months after the procedure. An autopsy of the myocardium suggested that new young cells were present in the cardiomyocyte mix. At 40 months, the mean (SD) NYHA class decreased from 3.4 0.5 to 1.33 0.5 (P = .001); the mean EF increased 31%, from 26.6% 4% to 34.8% 7.2% (P = .005); and the mean ETT increased 291.3%, from 4.25 minutes to 16.63 minutes (128.9% increase in metabolic equivalents, from 2.46 to 5.63) (P < .0001); the mean LVEDD decreased 15%, from 6.85 0.6 cm to 5.80 0.58 cm (P < .001); mean performance in the 6-minute walk test increased by 43.2%, from 251 113.1 seconds to 360 0 seconds (P = .01); the mean distance increased 64.4%, from 284.4 144.9 m to 468.2 89.8 m (P = .004); and the mean result in the Minnesota test decreased from 71 27.3 to 6 5.9 (P < .001).Conclusion: Although these initial findings suggest direct myocardial implantation of HFDSCs is feasible and improves cardiac function in HF patients at 40 months, more clinical research is required to confirm these observations.

Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure

2020 ◽  
Vol 28 (3) ◽  
pp. 290-299
Author(s):  
Kira A. Ageeva ◽  
Evgenii V. Filippov
Keyword(s):  
Respiratory System ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Walk Test ◽  
Ventricular Ejection Fraction ◽  
6Mwt Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

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