Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial

2020 ◽  
Vol 34 (7) ◽  
pp. 916-926
Author(s):  
Mei-Ling Yeh ◽  
Mei-Hua Wang ◽  
Chin-Che Hsu ◽  
Yueh-Min Liu
Keyword(s):  
Muscle Strength ◽  
Functional Performance ◽  
Controlled Trial ◽  
Exercise Group ◽  
Walk Distance ◽  
Cycling Exercise ◽  
Sit To Stand ◽  
Physical Functional Performance ◽  
Minute Walk Distance ◽  
Minute Walk

Objective: To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis. Design: Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise. Setting: A 50-bed haemodialysis centre in a regional hospital in Taiwan. Subjects: Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups. Intervention: The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment. Main measure: Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds. Results: Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 ( P = 0.01) and 12 ( P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes ( P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group ( P < 0.05). Conclusion: Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.

scholarly journals Maximal Strength Training for Breast Cancer Patients Undergoing Adjuvant Treatment

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 102s-102s
Author(s):  
R. Cešeiko ◽  
S. Tomsone ◽  
A. Srebnijs ◽  
A. Vētra ◽  
M. Timofejevs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Muscle Strength ◽  
Strength Training ◽  
Functional Performance ◽  
Maximal Strength ◽  
Walk Distance ◽  
Leg Press ◽  
Walking Performance ◽  
Minute Walk Distance ◽  
Minute Walk

Background: Breast cancer (BC) patients lose muscle strength during adjuvant treatment, thus affecting physical functioning. Maximal strength training (MST), with an emphasis on velocity in the concentric phase, improves maximal strength and walking efficiency. However, the effect of MST for BC patients undergoing treatment remains elusive. Aim: The aim of this study was to examine the feasibility and effects of such training in BC patients during clinical treatment on maximal muscle strength and functional performance. Methods: Thirty patients (46 ± 9 yr) with stage I-III BC were randomized to training group (TG) or control group (CG). TG performed MST twice a week for 3 months and CG followed prescribed BC treatment without strength training. TG performed four sets of four repetitions (4×4) of dynamic leg press with an emphasis on the maximal mobilization of force in the concentric action and with a progressively adjusted intensity corresponding to 85%–90% of one repetition maximum (1RM). Results: After the MST period, TG displayed significant 25 ± 7 kg (23%) increase in leg press 1RM ( P = 0.001). The strength improvements led to a significant increase in 6 minute walk distance (8%), 30-second chair test (23%), stair climb test (17%), and to a significant increase in walking performance of (8%) measured on an incremental treadmill test to exhaustion. In 3 months' posttest CG displayed significant 10 ± 8 kg (9%) decrease in 1RM ( P = 0.006). Reduced muscle strength leg to a significant decrease in 6 minute walk distance (6%), 30-second chair test (14%), stair climb test by (8%), and walking performance reduced significantly by (17%). Significant changes from pre to 3 months' posttest were observed between TG and CG in all functional performance measured variables. Conclusion: Maximal strength training was feasible during treatment and increased maximal muscle strength in BC patients. Increased strength led to improved functional performance after 24 training sessions each lasting only 20 min. Our results suggest that application of MST could accompany clinical training as a part of the treatment of BC patients. This training form showed excellent improvements in physical function tests and, thus should be implemented as a part of the breast cancer rehabilitation programs.

Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial

2021 ◽  
pp. 026921552199291
Author(s):  
Feng-Lien Lin ◽  
Mei-Ling Yeh
Keyword(s):  
Exercise Capacity ◽  
Controlled Trial ◽  
Chronic Obstructive Lung Disease ◽  
Interoceptive Awareness ◽  
Control Group ◽  
Chronic Obstructive ◽  
Walk Distance ◽  
Obstructive Pulmonary Disease ◽  
Minute Walk Distance ◽  
Minute Walk

Objective: To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled trial with four repeated measurements. Setting: Outpatient departments of a medical centre in northern Taiwan. Participants: Patients with mild to severe COPD. Intervention: The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice. Outcome measures: The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors. Results: Compared with the control group ( n = 40), the mindful walking group ( n = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m; P = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 ( P = 0.01), Week 8 ( P = 0.002) and Week 12 ( P = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D ( P  = 0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance ( P = 0.02). Conclusion: The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.

The Utility of the Sit-to-Stand Test for Inpatients in the Acute Hospital Setting After Lung Transplantation

2020 ◽  
Vol 100 (7) ◽  
pp. 1217-1228
Author(s):  
Benjamin J Tarrant ◽  
Rebecca Robinson ◽  
Caitlin Le Maitre ◽  
Megan Poulsen ◽  
Monique Corbett ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Hospital Setting ◽  
Knee Extensor ◽  
Effect Sizes ◽  
Walk Distance ◽  
Sit To Stand ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Objective Measurement of physical function is important to guide physical therapy for patients post-lung transplantation (LTx). The Sit-to-Stand (STS) test has proven utility in chronic disease, but psychometric properties post-LTx are unknown. The study aimed to assess reliability, validity, responsiveness, and feasibility of the 60-second STS post-LTx. Methods This was a measurement study in 62 inpatients post-LTx (31 acute postoperative; 31 medical readmissions). Interrater reliability was assessed with 2 STS tests undertaken by different assessors at baseline. Known group validity was assessed by comparing STS repetitions in postoperative and medical groups. Content validity was assessed using comparisons to knee extensor and grip strength, measured with hand-held dynamometry. Criterion validity was assessed by comparison of STS repetitions and 6-minute walk distance postoperatively. Responsiveness was assessed using effect sizes over inpatient admission. Results Median (interquartile range) age was 62 (56–67) years; time post-LTx was 5 (5–7) days postoperative and 696 (244–1849) days for medical readmissions. Interrater reliability was excellent (intraclass correlation coefficient type 2,1 = 0.96), with a mean learning effect of 2 repetitions. Repetitions were greater for medical at baseline (mean 18 vs 8). More STS repetitions were associated with greater knee extensor strength (postoperative r = 0.57; medical r = 0.47) and 6-minute walk distance (postoperative r = 0.68). Effect sizes were 0.94 and 0.09, with a floor effect of 23% and 3% at baseline (postoperative/medical) improving to 10% at discharge. Patients incapable of attempting a STS test were excluded, reducing generalizability to critical care. Physical rehabilitation was not standardized, possibly reducing responsiveness. Conclusions The 60-second STS demonstrated excellent interrater reliability and moderate validity and was responsive to change postoperatively. Impact The 60-second STS represents a safe, feasible functional performance tool for inpatients post-LTx. Two tests should be completed at each time point.

scholarly journals Peripheral artery disease, calf skeletal muscle mitochondrial DNA copy number, and functional performance

2018 ◽  
Vol 23 (4) ◽  
pp. 340-348 ◽  
Author(s):  
Mary M McDermott ◽  
Charlotte A Peterson ◽  
Robert Sufit ◽  
Luigi Ferrucci ◽  
Jack M Guralnik ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Copy Number ◽  
Functional Performance ◽  
Dna Copy Number ◽  
Walk Distance ◽  
Mitochondrial Dna Copy Number ◽  
Walking Velocity ◽  
Artery Disease ◽  
Minute Walk Distance ◽  
Minute Walk

In people without lower extremity peripheral artery disease (PAD), mitochondrial DNA copy number declines with aging, and this decline is associated with declines in mitochondrial activity and functional performance. However, whether lower extremity ischemia is associated with lower mitochondrial DNA copy number and whether mitochondrial DNA copy number is associated with the degree of functional impairment in people with PAD is unknown. In people with and without PAD, age 65 years and older, we studied associations of the ankle–brachial index (ABI) with mitochondrial DNA copy number and associations of mitochondrial DNA copy number with functional impairment. Calf muscle biopsies were obtained from 34 participants with PAD (mean age: 73.5 years (SD 6.4), mean ABI: 0.67 (SD 0.15), mean 6-minute walk distance: 1191 feet (SD 223)) and 10 controls without PAD (mean age: 73.1 years (SD 4.7), mean ABI: 1.14 (SD 0.07), mean 6-minute walk distance: 1387 feet (SD 488)). Adjusting for age and sex, lower ABI values were associated with higher mitochondrial DNA copy number, measured in relative copy number (ABI<0.60: 914, ABI 0.60–0.90: 731, ABI 0.90–1.50: 593; p trend=0.016). The association of mitochondrial DNA copy number with the 6-minute walk distance and 4-meter walking velocity differed significantly between participants with versus without PAD ( p-value for interaction=0.001 and p=0.015, respectively). The correlation coefficient between mitochondrial DNA copy number and the 6-minute walk distance was 0.653 ( p=0.056) among people without PAD and –0.254 ( p=0.154) among people with PAD and ABI < 0.90. In conclusion, lower ABI values are associated with increased mitochondrial DNA copy number. Associations of mitochondrial DNA copy number with the 6-minute walk distance and 4-meter walking velocity significantly differed between people with versus without PAD, with stronger positive associations observed in people without PAD than in people with PAD. The cross-sectional and exploratory nature of the analyses precludes conclusions regarding causal inferences. ClinicalTrials.gov Identifier: NCT02246660

scholarly journals Characteristics and health status of patients with and without confirmed HFpEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Deaton ◽  
F Forsyth ◽  
J Mant ◽  
D Edwards ◽  
R Hobbs ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Health Status ◽  
Functional Impairment ◽  
Funding Source ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (&gt;5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

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