scholarly journals Translational Value of Exercise in Routine Care Following Hematopoietic Stem Cell Transplantation: A Retrospective Analysis

2021 ◽  
Author(s):  
Sarah Marvin ◽  
Lois Ross ◽  
Jasmine Yee ◽  
Shelley Kay ◽  
Judith Lacey ◽  
...  
Keyword(s):  
Stem Cell ◽  
Physical Function ◽  
Retrospective Analysis ◽  
Exercise Program ◽  
Walk Distance ◽  
Hematopoietic Stem ◽  
Session Attendance ◽  
Exercise Response ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Purpose: Exercise is an effective adjuvant therapy to address many of the symptoms experienced by Hematopoietic Stem Cell Transplant (HSCT) recipients. However, there is little translational research examining meaningful clinical effects. A retrospective analysis of a community-embedded exercise program based at a large urban comprehensive cancer hospital was conducted, with the aim of establishing the translational value of exercise in a clinical setting. A secondary aim was to determine the impact of baseline function on exercise response. Methods: The Living Well Program is an evidence-based program supervised by Accredited Exercise Physiologists, delivered through the Chris O’Brien Lifehouse. HSCT recipients are prescribed individualised, once-weekly 1-hour aerobic, resistance and balance training. Changes in physical function (6-minute walk distance, strength, and balance), fatigue, and quality of life measures from baseline to post-intervention were analysed, and also assessed in relation to session attendance. Participants were then stratified as low- or high-function for each measure of physical function. Results: Data from 48 participants (male n=27, age=54.3±11.7-years) was included in the analysis. Significant improvements were found for all outcome measures, with improvements exceeding minimal clinically important differences for 6-minute walk distance (6MWD) and 30-second sit-to-stand. Greater session attendance correlated with improvements in 6MWD and strength outcomes. Exercise response was greater among those with lower baseline scores for 6MWD only (p<0.001).Conclusions: An existing exercise program embedded in cancer care was successful in eliciting improvements that are both significant and clinically relevant. Further investigations into key factors that influence the efficacy of these programs are required.

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

scholarly journals Predictors of reduced 6-minute walk distance after COVID-19: a cohort study in Mexico

Pulmonology ◽  
2021 ◽  
Author(s):  
Alyson W. Wong ◽  
Stephanie López-Romero ◽  
Esperanza Figueroa-Hurtado ◽  
Saul Vazquez-Lopez ◽  
Kathryn M. Milne ◽  
...  
Keyword(s):  
Cohort Study ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

scholarly journals 42 Is Mitochondrial Function Measured by 31P Magnetic Resonance Spectroscopy Associated with Physical Performance in Older People with Functional Impairment?

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
R R Chungath ◽  
M D Witham ◽  
C L Clarke ◽  
A Hutcheon ◽  
S Gandy ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Older People ◽  
Physical Performance ◽  
Functional Impairment ◽  
Resonance Spectroscopy ◽  
Walk Distance ◽  
31P Magnetic Resonance Spectroscopy ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Background Mitochondrial dysfunction has been proposed as a therapeutic target to improve muscle strength and endurance, but the contribution that mitochondrial dysfunction makes to impaired skeletal muscle performance in older people remains unclear. We studied the relationship between phosphocreatine recovery rate (a measure of skeletal muscle mitochondrial function) and physical performance in older people. Methods We analysed data from the Allopurinol in Functional Impairment (ALFIE) trial. Participants aged 65 and over, who were unable to walk 400 m in six minutes, underwent 31P magnetic resonance spectroscopy of the calf after exercise at baseline and at 20 weeks follow up. The phosphocreatine recovery half-life time (t-half) was derived as a measure of mitochondrial function. Participants also undertook the 6-minute walk distance, the Short Physical Performance Battery test (SPPB), and had muscle mass measured using bio-impedance analysis. Bivariate correlations and multivariable regression analyses were conducted to determine associations between t-half and baseline factors. Results One hundred and seventeen people underwent baseline 31P magnetic resonance spectroscopy, mean age 80.4 years (SD 6.0); 56 (48%) were female. Mean 6-minute walk was 291 m (SD 80) and mean SPPB score was 8.4 (SD 1.9). T-half was significantly correlated with SPPB score (r = 0.22, p = 0.02) but not with 6-minute walk distance (r = 0.10, p = 0.29). In multivariable linear regression, muscle mass and weight, but not t-half, were independently associated with SPPB score and with 6-minute walk distance. The change in t-half between baseline and 20 weeks was not significantly associated with the change in SPPB (r = 0.03, p = 0.79) or with the change in 6-minute walk distance (r = −0.11, p = 0.28). Conclusion Muscle mass, but not phosphocreatine recovery time, was associated with Short Physical Performance Battery score and 6-minute walk distance in this cohort of older people with functional impairment.

Six-Minute Walk Distance in Healthy Japanese Adults

2010 ◽  
Vol 11 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Neiko Ozasa ◽  
Takeshi Morimoto ◽  
Yutaka Furukawa ◽  
Hiroshi Hamazaki ◽  
Toru Kita ◽  
...  
Keyword(s):  
Walk Distance ◽  
Japanese Adults ◽  
Minute Walk Distance ◽  
Minute Walk
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