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Walk Test (walk + test)
Selected AbstractsIsokinetic Leg Muscle Strength in Older Americans and Its Relationship to a Standardized Walk Test: Data from the National Health and Nutrition Examination Survey 1999,2000JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2004Yechiam Ostchega PhD Objectives: To describe isokinetic knee extensor muscle strength in older U.S. men and women by age and race/ethnicity and to ascertain its relationship to a standard, timed walking-speed test. Setting: The U.S. National Health and Nutrition Examination Survey (NHANES) 1999,2000. Design: A cross-sectional nationally representative health examination survey. Participants: All surveyed persons aged 50 and older (N=1,499) who performed muscle strength and timed walk examinations in the NHANES mobile examination center. Measurements: Concentric peak torque (strength) of the knee extensors at 1.05 rads/ s,1 velocity and a 6-m walk timed in seconds. Results: Knee extensor strength was inversely associated with age (P<.01), and women had less knee extensor muscle strength than men (P<.01). After adjustment for standing height, no significant difference in muscle strength was found across the three race/ethnicity groups (Mexican Americans, non-Hispanic blacks, and non-Hispanic whites) for men or women. After adjustment for age, race/ethnicity, weight, and height, increasing knee extensor strength was associated with significant increases in meters walked per second (P<.01). Conclusion: Knee extensor muscle strength is affected by age and sex but not by race/ethnicity and it is significantly associated with timed walk. [source] Development of an activity of daily living scale for patients with COPD: The Activity of Daily Living Dyspnoea scaleRESPIROLOGY, Issue 3 2009Yoshiyasu YOZA ABSTRACT Background and objective: Patients with COPD often experience restriction in their activities of daily living (ADL) due to dyspnoea. This type of restriction is unique to patients with COPD and cannot be adequately evaluated by the generic ADL scales. This study developed an ADL scale (the Activity of Daily Living Dyspnoea scale (ADL-D scale)) for patients with COPD and investigated its validity and internal consistency. Methods: Patients with stable COPD were recruited and completed a pilot 26-item questionnaire. Patients also performed the Incremental Shuttle Walk Test (ISWT), and completed the St. George's Respiratory Questionnaire (SGRQ) and Medical Research Council (MRC) dyspnoea grade. Results: There were 83 male participants who completed the pilot questionnaire. Following the pilot, eight items that were not undertaken by the majority of subjects, and three items judged to be of low clinical importance by physical therapists were removed from the questionnaire. The final ADL-D scale contained 15 items. Scores obtained with the ADL-D scale were significantly correlated with the MRC dyspnoea grades, distance walked on the ISWT and SGRQ scores. The ADL-D scores were significantly different across the five grades of the MRC dyspnoea grade. The ADL-D scale showed high consistency (Chronbach's , coefficient of 0.96). Conclusions: The ADL-D scale is a useful scale for assessing impairments in ADL in Japanese male patients with COPD. [source] Association Between Fitness and Changes in Body Composition and Muscle StrengthJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2010George A. Kuchel, [see editorial comments by Drs. Gustavo Duque, pp 37 OBJECTIVES: To examine the association between physical fitness, assessed according to ability and time to complete a 400-m walk, on changes in body composition and muscle strength over a 7-year period. DESIGN: Prospective observational cohort study. SETTING: Memphis, Tennessee, and Pittsburgh, Pennsylvania. PARTICIPANTS: Two thousand nine hundred forty-nine black and white men and women aged 70 to 79 participating in the Health, Aging and Body Composition Study. MEASUREMENTS: Body composition (fat and bone-free lean mass) was assessed using dual-energy X-ray absorptiometry in Years 1 to 6 and 8. Knee extension strength was measured using isokinetic dynamometry and grip strength using isometric dynamometry in Years 1, 2, 4, 6, and 8. RESULTS: Less fit people weighed more and had a higher total percentage of fat and a lower total percentage of lean mass than very fit men and women at baseline (P<.001). Additionally, the least fit lost significantly more weight, fat mass, and lean mass over time than the very fit (all P<.01). Very fit people had the highest grip strength and knee extensor strength at baseline and follow-up; decline in muscle strength was similar in every fitness group. CONCLUSION: Low fitness in old age was associated with greater weight loss and loss of lean mass than with high fitness. Despite having lower muscle strength, the rate of decline in the least fit persons was similar to that in the most fit. In clinical practice, a long-distance walk test as a measure of fitness might be useful to identify people at risk for these adverse health outcomes. [source] Stopping to Rest During a 400-Meter Walk and Incident Mobility Disability in Older Persons with Functional LimitationsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009Sonja Vestergaard PhD OBJECTIVES: To examine the association between stopping to rest during a 400-m usual-pace walk test (400-MWT) and incident mobility disability in older persons with functional limitations. DESIGN: Prospective cohort study. SETTING: Community based. PARTICIPANTS: Four hundred twenty-four participants in the Lifestyle Intervention and Independence for Elders Pilot (LIFE-P) Study aged 70 to 89 with functional limitations (summary score ,9 on the Short Physical Performance Battery (SPPB)) but able to complete the 400-MWT within 15 minutes. MEASUREMENTS: Rest stops during the 400-MWT were recorded. The onset of mobility disability, defined as being unable to complete the 400-MWT or taking more than 15 minutes to do so, was recorded at Months 6 and 12. RESULTS: Fifty-four (12.7%) participants rested during the 400-MWT at baseline, of whom 37.7% experienced mobility disability during follow-up, versus 8.6% of those not stopping to rest. Performing any rest stop was strongly associated with incident mobility disability at follow-up (odds ratio (OR)=5.4, 95% confidence interval (CI)=2.7,10.9) after adjustment for age, sex, and clinic site. This association was weaker, but remained statistically significant, after further adjusting for SPPB and time to complete the 400-MWT simultaneously (OR=2.6, 95% CI=1.2,5.9). CONCLUSION: Stopping to rest during the 400-MWT is strongly associated with incident mobility disability in nondisabled older persons with functional limitations. Given the prognostic value, rest stops should be recorded as part of the standard assessment protocol for the 400-MWT. [source] Weight Change and Lower Body Disability in Older Mexican AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Soham Al Snih MD Objectives: To examine the association between 2-year weight change and onset of lower body disability over time in older Mexican Americans. Design: Data were from the Hispanic Established Population for the Epidemiological Study of the Elderly (1993,2001). Weight change was examined by comparing baseline weight to weight at 2-year follow-up. Incidence of lower body disability was studied from the end of this period through an additional 5 years. Setting: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. Participants: One thousand seven hundred thirty-seven noninstitutionalized Mexican-American men and women aged 65 and older who reported no limitation in activities of daily living (ADLs) and were able to perform the walk test at 2-year follow-up. Measurements: In-home interviews assessed sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), self-reported ADLs, depressive symptoms, and number of hospitalizations. Cognitive function, handgrip muscle strength, and body mass index (BMI) were obtained. The outcomes were any limitation of lower body ADL (walking across a small room, bathing, transferring from a bed to a chair, and using the toilet) and limitation on the walk test over subsequent 5-year follow-up period. General Estimation Equation (GEE) was used to estimate lower body disability over time. Results: Weight change of 5% or more occurred in 42.3% of the participants; 21.7% lost weight, 20.6% gained weight, and 57.7% had stable weight. Using GEE analysis, with stable weight as the reference, weight loss of 5% or more was associated with greater risk of any lower body ADL limitation (odds ratio (OR)=1.43, 95% confidence interval (CI)=1.06,1.95) and walking limitation (OR=1.35, 95% CI=1.03,1.76) after controlling for sociodemographic variables and BMI at baseline. Weight gain of 5% or more was associated with greater risk of any lower body ADL limitation (OR=1.39, 95% CI=1.02,1.89), after controlling for sociodemographic variables and BMI at baseline. When medical conditions, handgrip muscle strength, high depressive symptomatology, cognitive function, and hospitalization were added to the equation, the relationship between 2-year weight change (>5% loss or >5% gain) and lower body disability decreased. Conclusion: Health conditions and muscle strength partially mediate the association between weight loss or gain and future loss of ability to walk and independently perform ADLs. [source] Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplastyJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2005Ryan L. Mizner Abstract Purpose: Total knee arthroplasty (TKA) successfully reduces pain, but has not achieved comparable improvements in function. We hypothesized that quadriceps strength affects performance by altering loading and movement patterns during functional tasks. Methods: Fourteen subjects with isolated, unilateral TKA were tested three months after surgery. Quadriceps strength was assessed isometrically and kinematics, kinetics, and EMG were collected during level walking and sit-to-stand (STS). Function was assessed using the timed up and go test (TUG), stair climbing test (SCT), and the 6 min walk test (6MW). Results: Functional performance was significantly related to the quadriceps strength of both legs, but was more strongly related to the uninvolved strength (involved rho = ,0.43 with TUG; ,0.65 with SCT; 0.64 with 6MW) (uninvolved rho = ,0.63 with TUG; ,0.68 with SCT; 0.77 with 6MW). During STS, subjects shifted weight away from the operated limb (p <0.01). Quadriceps muscle activity and the extension moments at the knee and hip were smaller in the involved compared to the uninvolved (p <0.05). The amount of asymmetry in knee excursion during weight acceptance in gait, the asymmetry in weight bearing from sit-to-stand, and the uninvolved hip extension moment during STS were related to the amount of asymmetry in quadriceps strength (rho > 0.56, p < 0.05). Conclusions: Quadriceps weakness in patients with TKA has a substantial impact on the movement patterns and performance of the knee during functionally important tasks. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Six-minute walk test in obese children and adolescents: Reproducibility and validity,PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2009Gunilla Morinder Abstract Background and Purpose.,The six-minute walk test (6MWT) is increasingly used in clinical practice. The aims of this study were to determine the reproducibility of the 6MWT in obese children and adolescents, to describe walking capacity in this population and compare the results with values from normal-weight children (known group validity), and, finally, to describe the correlation between distance walked and estimated maximum oxygen uptake (VO2max).,Methods.,Reproducibility was determined by a test,retest design and known group validity by a comparative design. The 6MWT was first test,retested in 49 obese children (30 boys, 19 girls, 8,16 years, body mass index [BMI] 24.9,52.1,kg?m,2). Then, for validation, 250 obese children (126 boys, 124 girls, 8,16 years, BMI 23.2,57,kg/m2) and 97 normal-weight children (48 boys, 49 girls, 8,16 years, BMI 13.3,23.2,kg·m,2) performed the 6MWT. The obese children also performed a sub-maximal bicycle ergometry test.,Results.,In the test,retest, the obese children walked 571,m the first test and 57,m the second (p = 0.578). The measurement error (Sw) was 24,m, coefficient of variation (CV): 4.3% and the intraclass correlation (ICC1:1): 0.84. Repeatability was 68,m, and limits of agreement were +71 and ,65,m. In comparison mean (standard deviation), six-minute walk distance (6MWD) in the obese children was 571,m (65.5), and in the normal-weight children, 663,m (61.1) (p < 0.001). The correlation between 6MWD and estimated VO2max (r = 0.34) was low.,Conclusions.,The 6MWT showed good reproducibility and known group validity, and can be recommended for use in clinical practice in the studied population. To evaluate individual outcomes after intervention, the 6MWD needs to change by >68,m to be statistically significant. The 6MWD performed by obese children averaged 86% of the distance normal-weight children walked. In obese children, the correlation between 6MWD and estimated VO2max was low, hence the 6MWT cannot substitute a bicycle ergometry test. Copyright © 2008 John Wiley & Sons, Ltd. [source] The six-minute walk test in outpatients with obesity: reproducibility and known group validityPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2008Ulla Evers Larsson Abstract Background and Purpose.,To assess the reproducibility and validity of the six-minute walk test (6MWT) in men and women with obesity in order to facilitate evaluation of treatment outcome.,Method.,A test,retest design was used to test reproducibility and a comparative design to test known group validity. Forty-three obese outpatients (16 male), mean age 47 (21,62) years, mean body mass index (BMI) 40 (3,62)kg-m,2 performed the 6MWT twice within one week. Intraclass correlation (ICC1.1) and measurement error (Sw) were calculated from the mean square values derived from a one-way repeated-measures ANOVA (fixed effect model). The reproducibility was also analysed by means of coefficient of variation (CV) and the Bland Altman method including 95% limits of agreement. The variance of the distance walked was analysed by means of regressions. The known group validity of the 6MWT (distance walked and the work of walking) in obese participants was shown by comparisons with 41 lean participants (18 male), mean age 47 (24,65) years, mean BMI 22.7kg-m,2 (19,25).,Results.,The obese group walked 534,m (confidence interval [CI] 508,560 the first and 552,m (CI 523,580) the second walk (p < 0.001). Sw was 25,m, CV 4.7%, ICC1.1 was 0.96. The limits of agreement were ,46,m+80,m. The validity tests showed that they walked 162,m shorter (p < 0.001) and performed much heavier work (p < 0.001) than the lean group. In the obese group, BMI alone explained 38% of the variance of the distance walked.,Conclusions.,The 6MWT showed good reproducibility and known group validity and can be recommended for evaluating walking ability in subjects with obesity. For individual evaluation, however, an improved walking distance of at least 80,m was required to make the difference clinically significant. Despite shorter walking distance the obese participants performed heavier work than the lean. Copyright © 2008 John Wiley & Sons, Ltd. [source] Physical training and testing in patients with chronic obstructive pulmonary diseaseTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2007Ragnheiður Harpa Arnardóttir Abstract Introduction:, The effects of different training modes need to be investigated further in patients with chronic obstructive pulmonary disease (COPD). Both advanced laboratory tests and field tests are used in patients with COPD to evaluate effects of interventions such as pulmonary rehabilitation. Aims:, The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and on health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical field tests used in pulmonary rehabilitation, the 12-min walk test and the incremental shuttle walking test (ISWT). Materials and Methods:, Patients with moderate or severe COPD were included. In study I (n = 57), the 12-min walk test was performed three times within 1 week. Exercise-induced hypoxemia (EIH) was assessed by pulse oximeter and was defined as SpO2 < 90%. In study II (n = 93), performance on ISWT was compared to performance on two different cycle tests. In study III (n = 42), the effects of two different combination training programmes were compared when training twice a week for 8 weeks. One programme was mainly based on endurance training (group A), and the other was based on resistance training and on callisthenics (group B). In study IV (n = 60), endurance training with interval resistance was compared to endurance training with continuous resistance. Results:, In study I, the 12-min walking distance (12MWD) did not increase on retesting in patients with EIH, but increased significantly on retesting in the non-EIH patients. In study II, the ISWT was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) was. In study III, W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post training, 12MWD was back to baseline in group A, but was significantly shorter than at baseline in group B. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, sub-maximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did. Conclusions:, EIH affects the retest effects on 12MWD. W peak can be predicted from an ISWT similarly well as from VO2 peak. A short training programme can improve W peak and 12MWD when based mainly on endurance training. Both patients with moderate and severe COPD respond to training in the same way. A short endurance training intervention can possibly delay decline in 12MWD for 1 year. Both interval and continuous endurance training improves physical performance and HRQoL. Interval training lowers the energy cost of sub-maximal work more than continuous training does. [source] Six-minute walk test is a poor predictor of maximum oxygen uptake in childrenACTA PAEDIATRICA, Issue 7 2010T Takken No abstract is available for this article. [source] Ventilation threshold as a measure of impaired physical performance in adults with growth hormone excessCLINICAL ENDOCRINOLOGY, Issue 3 2002Scott G. Thomas Summary objective Fatigue is a prominent symptom among patients with GH excess and acromegaly. Identifying the physiological basis of such complaints and obtaining objective measures to quantify their severity remains an ongoing challenge. We investigated whether submaximal measures of aerobic performance can be used to assess GH excess-associated fatigue objectively. design and patients To investigate this possibility we examined the relation between physical function and physical capacity in 12 patients with active acromegaly and persistent fatigue before and after 3 and 6 months of treatment with the long-acting somatostatin analogue octreotide (LAR®). measurements Heart rate (HR) and rating of perceived exertion (RPE using Borg's 10-point scale) were measured during a 160-metre self-paced walk test (SPW). Maximum oxygen uptake (VO2max) and ventilation threshold (VeT: a measure of work rate when breathlessness develops) were measured during a progressive treadmill test to fatigue or symptom-limited maximum. The Profile Of Mood States questionnaire (POMS) was used to quantify subjective feelings of fatigue and vigour. Morning fasting levels of GH and IGF-I were measured using immunoassay of serum samples. results SPW speed at a fast pace of 1·69 ± 0·18 m/s was achieved with higher than normal HR (112 ± 15/min; normal = 102) and RPE (2·4 ± 1·2). Similar to GH-deficient adults, VO2max (22·6 ± 6·4 ml.kg,1.min,1; normal ~30 ml.kg,1.min,1) and VeT (13·1 ± 2·9 ml.kg,1.min,1; predicted normal ~16 ml.kg,1(min,1) were low. However, VeT occurred at a normal fraction of VO2max (VeT/VO2max = 0·58). VeT was significantly increased and plasma IGF-I levels reduced following 3 and 6 months of octreotide LAR® treatment. Reduction in circulating IGF-I levels was correlated with improvement in reported vigour (r = 0·85) and VeT (r = 0·65) (P < 0·05). conclusions Our findings demonstrate impairment in physical function and physical capacity consistent with the perception of increased fatigue among acromegalic patients. These objective measures of compromised physical function are similar to the changes that we have reported previously in adults with GH deficiency. Taken together, these data suggest that a narrow window for GH/IGF-I levels is required to maintain optimal physical function. [source] | ||||||||||