The reliability of VO2 kinetics during a 6-minute walking test is influenced by walk speed

Background: Sedentary life style lead to obesity which related into deterioration of cardiac function, anddeconditioning on musculoskeletal system, particularly on walking function. Walking is an important activityin human life, that automatically repeated in daily activity. Doing exercise by walking activity is a simple andsafe exercise. However, in walking exercise prescription, we need to establish what is the objective to achieve.The ten thousand steps of Walking Program (10,000 SWP) is pedometer-based walking program begin in Japanfor adult and elderly, thus the effects in obesity adolescent remains unclear. The aimed of this study was to findthe effect of 10,000 SWP in Cardiorespiratory Endurance (CE) on obese adolescent.Methods:This study was pre and post randomly experimental design with control, in 24 high school obeseadolescent. Subjects divided into two groups, the intervention group that received 10,000 steps walking program5 days in a week for 6 weeks, and the control group that number of step walking recorded by a pedometerwithout daily target. The cardiorespiratory endurance (VO2 max) was evaluated by the six minute walking test(6MWT), that measured before and after intervention.Results: The Intervention and control groups each contain 12 obese high school students, that equal in age,body mass index, and the mean number of walking steps per day. There was no differences between VO2max1 (12.45 ml/Kg ) and VO2max 2 (12.38 ml/Kg ) (p=0.852) in control group, while there was the differencesbetween VO2max 1 (12.44 ml/kg) and VO2max 2 (17.06 ml/kg) (p=0.002) in treatment group.Conclusion: The 10,000 SWP has proven increasing the Cardiorespiratory Endurance of Obese Adolescent.Keywords: 10,000 Steps Walking Program, 6 Minute Walking Test, Cardiorespiratory Endurance, Obese Adolescent.

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Effects of lower limb resistance exercise on muscle strength, physical fitness, and metabolism in pre-frail elderly patients: a randomized controlled trial

BMC Geriatrics ◽

10.1186/s12877-021-02386-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaoxing Lai ◽

Lin Bo ◽

Hongwei Zhu ◽

Baoyu Chen ◽

Zhao Wu ◽

...

Keyword(s):

Muscle Strength ◽

Resistance Exercise ◽

Frail Elderly ◽

Lower Limb ◽

Intervention Group ◽

Control Group ◽

Walking Test ◽

Sit To Stand ◽

Femoris Muscle ◽

Activity Energy

Abstract Background Few studies examined interventions in frail elderly in China, while the awareness of applying interventions to prevent frailty in pre-frail elderly is still lacking. This study aimed to explore the effects of lower limb resistance exercise in pre-frail elderly in China. Methods This was a randomized controlled trial of patients with pre-frailty. The control group received routine care, while the exercise group received a 12-week lower limb resistance exercise based on routine care. The muscle strength in the lower limbs, physical fitness, and energy metabolism of the patients was evaluated at admission and after 12 weeks of intervention. Results A total of 60 pre-frail elderly were included in this study. The patients were divided into the exercise group (n = 30) and control group (n = 30) by random grouping. There were 17 men and 13 women aged 65.3 ± 13.4 in the exercise group, and 15 men and 15 women aged 67.6 ± 11.9 years in the control groups. The Barthel index was 80.3 ± 10.6 and 85.1 ± 11.6, respectively. The characteristics of the two groups were not significantly different before intervention (all p > 0.05). The results of repeated measurement ANOVA showed that there was statistically significant in crossover effect of group * time (all p < 0.05), that is, the differences of quadriceps femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent between the intervention group and the control group changed with time, and the variation ranges were different. The main effects of time were statistically significant (all p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent of the intervention group and the control group were significantly different before and after intervention. The main effects of groups were statistically significant (p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, daily activity energy expenditure and metabolic equivalent before and after intervention were significantly different between the intervention group and the control group, while there was no significant differences in 8-ft “up & go” test between groups. Conclusion Lower limb resistance exercise used for the frailty intervention could improve muscle strength, physical fitness, and metabolism in pre-frail elderly. Trial registration ChiCTR, ChiCTR2000031099. Registered 22 March 2020, http://www.chictr.org.cn/edit.aspx?pid=51221&htm=4

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Novel rehabilitation program after left ventricular assist device (LVAD) implantation improves functional tests and reduces levels of prognostic heart failure biomarkers

European Heart Journal ◽

10.1093/ehjci/ehaa946.1079 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Chwyczko ◽

L Zalucka ◽

E Smolis-Bak ◽

I Kowalik ◽

E Noszczak ◽

...

Keyword(s):

Heart Failure ◽

Exercise Test ◽

Cardiopulmonary Exercise Test ◽

Rehabilitation Program ◽

Left Ventricular ◽

Prognostic Biomarkers ◽

Funding Source ◽

Walking Test ◽

Cardiopulmonary Exercise ◽

Galectin 3

Abstract Background Rehabilitation after LVAD implantation is increasingly used. We developed the novel method of comprehensive rehabilitation starting directly after LVAD implantation. Study group 21 recent LVAD (15 Heart Mate III, 6 HeartWare) recipients (56.2±11.7 yrs, 100% men) were included to 5-week rehabilitation program, which included supervised endurance training on cycloergometer (5 times per week), resistance training, general fitness exercises with elements of equivalent and coordination exercises (every day). 6-minute walking test (6MWT), cardiopulmonary exercise test (CPET) and prognostic biomarkers: NT-proBNP, Galectin-3 and ST2 were investigated at the beginning and at the end of rehabilitation program. Results See Table 1. At the end of rehabilitation program, significant increase in 6MWT distance, maximum workload, peak VO2 and upward shift of anaerobic threshold in CPET were observed in all patients. Significant reductions of NTproBNP, ST2 and galectin-3 levels were observed. There were no major adverse events during rehabilitaton. Conclusions Comprehensive novel rehabilitation in LVAD recipients is safe and results in significant improvement of 6-minutes walking test distance and cardiopulmonary exercise test results. Moreover, this novel rehabilitation program reduces levels of prognostic biomarkers of heart failure: NT-proBNP, Galectin-3 and ST2. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Center for Research and Development - STRATEGMED II project

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Physiological Biomarkers Assessed by Low-Tech Exercise Tests Predict Complications and Overall Survival in Patients Undergoing Pneumonectomy Due to Lung Cancer

Cancers ◽

10.3390/cancers13040735 ◽

2021 ◽

Vol 13 (4) ◽

pp. 735

Author(s):

Tomasz Marjanski ◽

Damian Wnuk ◽

Robert Dziedzic ◽

Marcin Ostrowski ◽

Wioletta Sawicka ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

High Risk ◽

Odds Ratio ◽

Cardiac Complications ◽

First Year ◽

Exercise Tests ◽

Walking Test ◽

Increased Risk ◽

Surgery Department

Due to its debilitating character pneumonectomy this is last-resort procedure. Preoperative results of the 6-min walking test (6MWT) help to identify high risk of postoperative complications and increased mortality in patients undergoing lobectomy for lung cancer. The aim of the study was to validate the value of 500 m in 6MWT as an indicator, which differentiates risk of complications in patients undergoing pneumonectomy. 125 patients who underwent pneumonectomy at Thoracic Surgery Department between 2009 and 2018. On the day preceding the surgery, patients underwent 6MWT. The patients were in median age of 63 years. The cut-off value of 500 m identified patients with increased 90-day mortality [17.9% vs. 3.5%, odds ratio (OR) 6.271, 95% confidence interval (CI) 1.528–25.739], first-year mortality (30.7% vs. 11.6%, OR 3.378, 95% CI 1.310–8.709), and overall survival (p = 0.02). Patients who covered a distance ≤ 500 m had an increased risk of atrial fibrillation (35.9% vs. 16.3%, OR 2.880, 95% CI 1.207–6.870) and cardiac complications (38.4% vs. 19.8%, OR 2.537, 95% CI 1.100–5.849). Patients unable to reach 500 m in 6MWT are in a high risk of postoperative death after pneumonectomy, what may be a result of increased frequency of postoperative cardiac complications. Poor result of 6MWT is a predictor of worse overall survival.

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Cardiac Rehabilitation Based on the Walking Test and Telerehabilitation Improved Cardiorespiratory Fitness in People Diagnosed with Coronary Heart Disease during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052241 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2241

Author(s):

Ladislav Batalik ◽

Vladimir Konecny ◽

Filip Dosbaba ◽

Daniela Vlazna ◽

Kristian Brat

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cardiac Rehabilitation ◽

Cardiorespiratory Fitness ◽

Test Time ◽

Target Heart Rate ◽

Walking Test ◽

Novel Approach ◽

Home Based ◽

Study Participants

This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.

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AB0317 ADHERENCE TO MEDITERRANEAN DIET AND NUTRITIONAL STATE IN ITALIAN WOMEN WITH ISOLATED SJÖGREN’S SYNDROME

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2154 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1183.2-1184

Author(s):

R. Izzo ◽

S. Colafrancesco ◽

A. Pinto ◽

A. Gattamelata ◽

F. Giardina ◽

...

Keyword(s):

Physical Activity ◽

Disease Activity ◽

International Physical Activity Questionnaire ◽

Eating Habits ◽

Nutritional State ◽

Walking Test ◽

Focus Score ◽

Daily Food ◽

Anti Inflammatory ◽

Activity Questionnaire

Background:The Mediterranean Diet (MD) has anti-inflammatory and immunomodulatory effects1,2 suggesting a protective role in rheumatic diseases. There is limited knowledge about the eating habits and the nutritional state in patients with isolated Sjögren Syndrome (SS) living within the Mediterranean area.Objectives:assessment of adherence to the MD and analysis of the nutritional state in women with SS and their correlations with the clinical, laboratory and histological data of the disease.Methods:patients classified as isolated SS according to AECG criteria 20023 who had undergone to minor salivary gland biopsy during the previous twelve months were consecutively enrolled during follow-up visits. The adherence to the MD was assessed by the Med Diet (MDiet)4 which includes eleven groups of foods; to each group is assigned a value ranging between 0 and 5 based on the frequency of monthly intake. The total score spans from 0 (poor adherence) to 55 (maximum adherence). The level of physical activity was measured by the 6-minutes walking test (6MWT) and by the International Physical Activity Questionnaire (IPAQ). Systemic disease activity was evaluated with the EULAR SS disease activity index (ESSDAI); EULAR SS patient-reported index (ESSPRI) was calculated as well. A subgroup of patients was asked to fill a daily food diary processed with FOOD CONS software which allows to study in detail their eating habits. Nutritional state, muscle strength and basal metabolic rate were assessed. Alcoholism or drug abuse, diabetes mellitus, specific dietary models, treatment with drugs and/or food supplements with anti-inflammatory and/or antioxidant activity were considered exclusion criteria. Multivariate linear regression was performed with R project for Statistical Computing.Results:N= 40 N= 26Age, median (range) 53 (25-80) 33 (25-71)BMI, median (range) 21 (19-29.3) 25.1 (19-33.7)MedDiet score, median (range) 33 (26-43) 33 (23-40)ESSDAI, median (range) 2 (0-16) 1 (0-16)ESSPRI, median (range) 6 (0-8.6) 5.3 (1.6-9)ESSPRI dryness, median (range) 6 (0-10) 6 (2-10)Focus score, median (range) 2.5 (0-9.6) 1.7 (0.8-6.24)ASM kg, median (range) - 16.8 (13.3-21.7)IPAQ meters, median (range) - 1386 (99-11865)6MWT meters, median (range) - 595 (536-680)BMI, body mass index; ASM appendicular skeletal mass; IPAQ International Physical Activity Questionnaire; 6MWT, six minute walking test.MDiet was administered to 40 female SS outpatients. Even if not reaching significativity, patients with a higher focus score in their MSG have a lower value of MDiet score (p = 0.058, r = -1.00). The MDiet score is not associated with ESSDAI (p = 0.85, r 0.02), but only with lower serum levels of C3 (p = 0.004, r = - 0.08).In 26 patients, daily food questionnaire shows that their diet consists of 43% of carbohydrates while fats represent 40% of total energy intake, the remaining 17% daily energy comes from proteins. Fat consumption is higher compared to the levels of energy and nutrient intake for the Italian population5. Six patients had a reduction in muscle mass; sarcopenia is not associated to ESSDAI (p = 0.610).The MDiet score and the amount eaten of polyunsaturated fatty acids (PUFA) were reduced in patients with high value of subscale dryness of ESSPRI (p = 0.057, r -1.21; p =0.610, r -1.00).Conclusion:This study highlights a lower degree of glandular lymphocytic infiltration (expressed as focus score) in minor salivary glands in patients following MD, so its anti-inflammatory role of seems to be confirmed. SS patients have an unbalanced diet because of a higher intake of fat foods, likely for their lubricating effect. Despite the absence of correlation with objective parameters, the increased dryness in patients with a reduced intake of PUFA arouses our interest in a future study including omega-3 supplementation.References:[1]Schwingshackl L et al., Nutr Metab Cardiovasc Dis 2014[2]Mena MP et al., Am J Clin Nutr. 2009[3]Vitali C et al, ARD 2002[4]Panagiotakos D et al., J Med Food 2007[5]LARN 2014Disclosure of Interests:None declared

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Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽

10.1159/000515940 ◽

2021 ◽

pp. 1-7

Author(s):

Ram kinker Mishra ◽

Catherine Park ◽

He Zhou ◽

Bijan Najafi ◽

T. Adam Thrasher

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Performance ◽

Pairwise Comparison ◽

Walking Test ◽

Cognitively Normal ◽

Early Results ◽

Trail Making ◽

Changes Over Time

Introduction: Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. Purpose: This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. Method: Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. Results: All participants enabled to complete iTMT with <3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s d = 1.7, p = 0.024) and CN-older versus MCI (d = 1.57, p < 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (r = −0.4, p = 0.011) and MoCA score (r = −0.56, p < 0.01). Conclusion: This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

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