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Walking Test (walking + test)
Selected AbstractsComparison of Short Form-36 Health Survey and Nottingham Health Profile in moderate to severe patients with COPDJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2008Sevgi Ozalevli Abstract Objective, To compare the health-related quality of life (HRQoL) assessed by Short Form-36 Health Survey (SF-36) and Nottingham Health Profile (NHP) on the basis of lung function and exercise capacity parameters in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Methods and materials, The investigation was a prospective, quality-of-life survey and cross-sectional study of 130 consecutive COPD patients. The NHP and SF-36 as generic HRQoL instruments, the Chronic Respiratory Disease questionnaire (CRQ) as a disease-specific HRQoL instrument and 6-minute walking test, severity of dyspnea, leg fatigue and lung function, were the measurements and instruments used in the study. Results, It was determined that the subscales of both questionnaires were generally related with the FEV1, walking distance, CRQ, severity of dyspnea and leg fatigue values (P < 0.05). The much higher correlation coefficient was determined between these parameters and NHP compared with the SF-36. Only NHP was found to be correlated with the age, body mass index and smoking consumption (P < 0.05). Conclusions, The stronger relation of NHP with the clinical and physical parameters of the patients compared with that of SF-36 may be associated with the increased sensitivity of NHP to the clinical state owing to the increasing respiratory symptoms of our old patients with moderate to severe obstruction and/or the more intelligible and easy-to-respond nature of NHP compared with SF-36. [source] Measurement of ischaemia,reperfusion in patients with intermittent claudication using NMR-based metabonomicsNMR IN BIOMEDICINE, Issue 7 2008Stefan A. Coolen Abstract Intermittent claudication has proved to be a good in vivo model for ischaemia,reperfusion. For assessment of ischaemia,reperfusion damage, the known biochemical markers all have disadvantages with respect to sensitivity and interference with other physiological events. In this work, we studied the metabolic effects of ischaemia,reperfusion in patients with intermittent claudication, and the effects of vitamin C and E intervention, using both traditional biochemical measurements and 1H-NMR-based metabonomics on urine and plasma. The 1H-NMR spectra were subjected to multivariate modelling using principal components discriminant analysis, and the observed clusters were validated using joint deployment of univariate analysis of variance and Tukey,Kramer honestly significant difference (HSD) testing. The study involved 14 patients with intermittent claudication and three healthy volunteers, who were monitored during a walking test, before and after a vitamin C/E intervention, and after a washout period. The effect of exercise was only observable for a limited number of biochemical markers, whereas 1H NMR revealed an effect in line with anaerobic ATP production via glycolysis in exercising (ischaemic) muscle of the claudicants. Thus, the beneficial effect of vitamins C and E in claudicants was more pronounced when observed by metabonomics than by traditional biochemical markers. The main effect was more rapid recovery from exercise to resting state metabolism. Furthermore, after intervention, claudicants tended to have lower concentrations of lactate and glucose and several other citric acid cycle metabolites, whereas acetoacetate was increased. The observed metabolic changes in the plasma suggest that intake of vitamin C/E leads to increased muscle oxidative metabolism. Copyright © 2008 John Wiley & Sons, Ltd. [source] Study of peripheral muscle strength and severity indexes in individuals with chronic obstructive pulmonary diseasePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2010Diego Marmorato Marino Abstract Background and Purpose.,Individuals with chronic obstructive pulmonary disease (COPD) present reduced peripheral muscle strength, which leads to impaired mobility and increased mortality risk. However, it is not clear whether there is any relationship between muscle strength, muscle mass and the body mass index, airflow obstruction, dyspnea, exercise performance (BODE) index scale, which is considered to be the best predictor of survival for individuals with COPD. The BODE Index is a multidimensional system that measures body composition (B), airway obstruction (O), dyspnea perception (D) and the ability to exercise (E), and rates the severity of the major changes found in individuals with COPD. The objective of this study was to verify any relationship between the BODE Index, muscle mass and maximum muscle strengths of the upper limb (UL) and lower limb (LL) in subjects with moderate to very severe COPD.,Methods.,Twenty-six individuals with moderate to very severe COPD were evaluated by body composition (body mass index and muscle mass), BODE Index, handgrip strength (HS) and one repetition maximum (1RM) test of the UL and LL.,Results.,There was a positive correlation (Pearson, p < 0.05) of peripheral muscle strength, evaluated by HS and 1RM (pectoral and triceps, round muscles and dorsal section, quadriceps), to muscle mass (0.74, 0.57, 0.74 and 0.62, respectively) and the distance walked in the six-minute walking test (0.52, 0.50, 0.46 and 0.58, respectively), but no correlation of muscle strength was found to forced expiratory volume in one second to dyspnea or the BODE Index.,Conclusion.,In accordance with the results of this study, peripheral muscle strength as measured y HS and 1RM is not related to the severity indexes for COPD, unlike UL and LL muscle strength. Therefore, UL and LL measurements now have an additional importance in COPD evaluation. Copyright © 2010 John Wiley & Sons, Ltd. [source] Correlates of mortality in elderly COPD patients: Focus on health-related quality of lifeRESPIROLOGY, Issue 1 2009Raffaele ANTONELLI-INCALZI ABSTRACT Background and objective: The Saint George Respiratory Questionnaire (SGRQ) is widely used as a measure of health-related quality of life (HRQL) in patients with COPD. This study tested whether the SGRQ predicts the survival of patients with COPD. Methods: The study recruited 238 patients with COPD who were participants in the multicentre Salute Respiratoria nell'Anziano (Sa.R.A.) study. Patients' sociodemographic, clinical and functional characteristics were assessed and the association between the SGRQ and mortality, corrected for potential confounders, was estimated. Results: The mean age of study participants was 72.6 years. Over the 5-year observation period there were 88 deaths. After adjustment for potential confounders, the SGRQ score was associated with an increased risk of dying (hazard ratio (HR): 1.22 for four-point increments; 95% confidence interval (CI): 1.02,1.45). There was no association between mortality and the Symptoms subscale (corrected HR: 1.13; 95% CI: 0.96,1.32), whereas each four-point increment of the Activity (HR: 1.20; 95% CI: 1.00,1.43) and Impact (HR: 1.38; 95% CI: 1.03,1.83) subscale scores were associated with increased mortality. Higher FEV1 relative to predicted (HR: 0.73 for each 5% increment; 95% CI: 0.58,0.91) and better performance at the 6-min walking test relative to predicted (HR: 0.93 for each 5% increment; 95% CI: 0.89,0.97) were associated with lower mortality. Conclusions: In elderly COPD patients, the SGRQ can improve prognostic models based on classical indicators of disease severity. [source] Physical training and testing in patients with chronic obstructive pulmonary diseaseTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2007Ragnheišur 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] Exercise Training During Hemodialysis Reduces Blood Pressure and Increases Physical Functioning and Quality of LifeARTIFICIAL ORGANS, Issue 7 2010Maycon De Moura Reboredo Abstract Hypertension and cardiovascular diseases are highly prevalent in hemodialysis patients and are associated with the reduction of physical functioning and quality of life. We evaluated the effects of supervised aerobic exercise training on physical functioning, blood pressure, quality of life, and laboratory data in hemodialysis patients. Fourteen patients were evaluated at the beginning and after 12 weeks of stretching exercises (control phase) and at the end of 12 weeks of aerobic exercise training performed during hemodialysis sessions (intervention phase). Patients underwent a 6-min walking test (6MWT), 24-h ambulatory blood pressure monitoring, a Medical Outcomes Study 36,Item Short-Form Health Survey (SF-36) quality of life questionnaire, and blood sample collections. After the intervention phase, the 6MWT distance increased from 508.7 ± 91.9 m to 554.9 ± 105.8 m (P = 0.001), systolic and diastolic blood pressure decreased respectively from 150.6 ± 18.4 mm Hg to 143.5 ± 14.7 mm Hg and from 94.6 ± 10.5 mm Hg to 91.4 ± 9.7 mm Hg (P < 0.05), while hemoglobin levels increased from 10.8 ± 1.2 g/dL to 11.6 ± 0.8 g/dL (P < 0.05). Moreover, there was a significant increase in the physical functioning, social functioning, and mental health dimensions of the SF-36. Aerobic exercise training during hemodialysis increased physical functioning, reduced blood pressure levels, and improved the control of anemia and quality of life in patients with end-stage renal disease. [source] Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care,Correlations with food intake, metabolism, exercise capacity, and hormonesCANCER, Issue 10 2005Marita Fouladiun M.D. Abstract BACKGROUND Several investigations that yielded different results in terms of net changes in body composition of weight-losing cancer patients have been reported that employed a variety of methods based on fundamentally different technology. Most of those reports were cross-sectional, whereas to the authors' knowledge there is sparse information available on longitudinal follow-up measurements in relation to other independent methods for the assessment of metabolism and performance. METHODS For the current report, the authors evaluated time course changes in body composition (dual-energy X-ray absorptiometry) with measurements of whole body and regional distribution of fat and lean tissue in relation to food and dietary intake, host metabolism (indirect calorimetry), maximum exercise capacity (walking test), and circulating hormones in cancer patients who were receiving palliative care during 4,62 months of follow-up. The entire cohort comprised 311 patients, ages 68 years ± 3 years who were diagnosed with solid gastrointestinal tumors (84 colorectal tumors, 74 pancreatic tumors, 73 upper gastrointestinal tumors, 51 liver-biliary tumors, 3 breast tumors, 5 melanomas, and 21 other tumor types). RESULTS Decreased body weight was explained by loss of body fat, preferentially from the trunk, followed by leg tissue and arm tissue, respectively. Lean tissue (fat-free mass) was lost from arm tissue, whereas trunk and leg tissue compartments increased, all concomitant with declines in serum albumin, increased systemic inflammation (C-reactive protein, erythrocyte sedimentation rate), increased serum insulin, and elevated daily caloric intake; whereas serum insulin-like growth factor 1 (IGF-1), resting energy expenditure, and maximum exercise capacity remained unchanged in the same patients. Serum albumin levels (P < 0.001), whole body fat (P < 0.02), and caloric intake (P < 0.001) predicted survival, whereas lean tissue mass did not. Daily intake of fat and carbohydrate was more important for predicting survival than protein intake. Survival also was predicted by serum IGF-1, insulin, leptin, and ghrelin levels (P < 0.02 , P < 0.001). Serum insulin, leptin, and ghrelin (total) levels predicted body fat (P < 0.001), whereas IGF-1 and thyroid hormone levels (T3, free T3) predicted lean tissue mass (P < 0.01). Systemic inflammation primarily explained variation in lean tissue and secondarily explained loss in body fat. Depletion of lean arm tissue was related most to short survival compared with the depletion of lean leg and trunk tissue. CONCLUSIONS The current results demonstrated that body fat was lost more rapidly than lean tissue in progressive cancer cachexia, a phenomenon that was related highly to alterations in the levels of circulating classic hormones and food intake, including both caloric amount and diet composition. The results showed importance in the planning of efficient palliative treatment for cancer patients. Cancer 2005. © 2005 American Cancer Society. [source] Intensity of Nordic Walking in young females with different peak O2 consumptionCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 5 2009Toivo Jürimäe Summary The purpose of this cross - sectional study was to determine the physiological reaction to the different intensity Nordic Walking exercise in young females with different aerobic capacity values. Twenty-eight 19,24-year-old female university students participated in the study. Their peak O2 consumption (VO2 peak kg,1) and individual ventilatory threshold (IVT) were measured using a continuous incremental protocol until volitional exhaustion on treadmill. The subjects were analysed as a whole group (n = 28) and were also divided into three groups based on the measured VO2 peak kg,1 (Difference between groups is 1 SD) as follows: 1. >46 ml min,1 kg,1 (n = 8), 2. 41,46 ml min,1 kg,1 (n = 12) and 3. <41 ml min,1 kg,1 (n = 8). The second test consisted of four times 1 km Nordic Walking with increasing speed on the 200 m indoor track, performed as a continuous study (Step 1 , slow walking, Step 2 , usual speed walking, Step 3 , faster speed walking and Step 4 , maximal speed walking). During the walking test expired gas was sampled breath-by-breath and heart rate (HR) was recorded continuously. Ratings of perceived exertion (RPE) were asked using the Borg RPE scale separately for every 1 km of the walking test. No significant differences emerged between groups in HR of IVT (172·4 ± 10·3,176·4 ± 4·9 beats min,1) or maximal HR (190·1 ± 7·3,191·6 ± 7·8 beats min,1) during the treadmill test. During maximal speed walking the speed (7·4 ± 0·4,7·5 ± 0·6 km h,1) and O2 consumption (30·4 ± 3·9,34·0 ± 4·5 ml min,1 kg,1) were relatively similar between groups (P > 0·05). However, during maximal speed walking, the O2 consumption in the second and third groups was similar with the IVT (94·9 ± 17·5% and 99·4 ± 15·5%, respectively) but in the first group it was only 75·5 ± 8·0% from IVT. Mean HR during the maximal speed walking was in the first group 151·6 ± 12·5 beats min,1, in the second (169·7 ± 10·3 beats min,1) and the third (173·1 ± 15·8 beats min,1) groups it was comparable with the calculated IVT level. The Borg RPE was very low in every group (11·9 ± 2·0,14·4 ± 2·3) and the relationship with VO2and HR was not significant during maximal speed Nordic Walking. In summary, the present study indicated that walking is an acceptable exercise for young females independent of their initial VO2 peak level. However, females with low initial VO2 peak can be recommended to exercise with the subjective ,faster speed walking'. In contrast, females with high initial VO2 peak should exercise with maximal speed. [source] | ||||||||||