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1.

Purpose

The purpose of the present review was to use existing, published data to provide an estimate of the amount of change in six-minute walk test distance (Δ6MWT) that represents a clinically meaningful change in individuals with chronic heart failure (CHF).

Methods

The present review included two separate literature searches of the CINAHL and Medline databases for articles that: (1) reported the intraclass correlation coefficient (ICC) of the 6MWT in individuals with CHF, and (2) used the 6MWT along with either aerobic capacity or health-related quality of life (HRQL) as study endpoints in randomized controlled trials (RCTs) of exercise-based intervention for individuals with CHF. The ICCs were used to calculate the minimum detectable difference (MDD) at the 95% confidence interval for each included study. The Δ6MWT associated with aerobic capacity and HRQL within-group effect sizes for the intervention and control groups in each included RCT was analyzed using receiver operating characteristic (ROC) curves.

Results

Thirteen articles reported the ICC for the 6MWT. The mean (standard deviation) MDD calculated based on these data was 43.1(16.8) m. Eighteen RCTs measured the 6MWT and either aerobic capacity and/or HRQL. A Δ6MWT of 40–45 m was associated with at least moderate aerobic capacity and HRQL effect sizes in the intervention groups. The Δ6MWT thresholds that discriminated between intervention and control groups using ROC curves revealed the following sensitivity/specificity for the respective thresholds: 19 m, 94.4/83.3%, 32 m, 83.3/94.4%, and 48 m 44.4/100% (AUC = .935, p = .009, CI95% .855, 1.015).

Conclusions

A Δ6MWT of approximately 45 m appears to exceed measurement error and be associated with significant changes in either aerobic capacity and/or HRQL.Key Words: heart failure, six-minute walk test, clinically meaningful change, minimum detectable difference  相似文献   

2.

PURPOSE

The primary purpose of this study was to investigate 6-minute walk test (6MWT) performance in young children who were normal weight (NW) and overweight (OW).

METHODS

Seventy children, 5-9 years of age, participated in this study. The 6MWT was performed on an indoor walkway. Heart rate (HR), blood pressure (BP), and oxygen saturation (SaO2) were measured. A self-reported physical activity questionnaire was completed by a parent/guardian. Data were analyzed with independent t tests, ANOVA, correlation analyses, and logistic regression.

RESULTS

The systolic BP values were higher in the children who were OW compared with their NW peers (resting mean 104.1 (8.9) mmHg vs. 97.5 (7.8) mmHg, P < 0.05; post-6WMT: mean 118.4 (10.78) mmHg vs. 109.9 (9.1) mmHg, P < 0.05). The SaO2 values were lower in the children who were OW compared to their NW counterparts (resting: mean 97.2 (1.1) % vs. 98.0 (1.0) %, P < 0.05; post-6WMT: mean 96.8 (1.0) % vs. 97.7 (1.0) %, P < 0.05).

CONCLUSIONS

The children who were OW had higher systolic BP and lower SaO2 levels at rest and post-6WMT. More research is needed to determine if these differences contribute to children who are OW having difficulty performing exercise.Key Words: obesity, children, exercise capacity  相似文献   

3.
Purpose: To evaluate the reliability and validity of the six-minute walk test (6MWT) with respect to its ability to predict functional capacity in patients with chronic heart failure. Methods: A systematic review was performed via 8 databases to assess relevant English language full-text articles published from January 1, 1980 to October 31, 2009. Participant characteristics, interventions, reliability, validity, and predictive value for each article with respect to functional capacity as defined by peak VO2 levels were extracted and compared. Quality Assessment of Diagnostic Accuracy Studies (QUADAS) scores were determined for each study. Results: Fourteen studies met the selection criteria. Comparison of the studies investigating reliability shows that the 6MWT has good reproducibility. The 6MWT demonstrates moderate correlation with peak VO2 levels, and ability to predict VO2 (functional capacity) dependent on distance walked. Cut-off distances vary from 300 to 490 meters depending on the study; if total distance walked remains equal or less than these values, the 6MWT retains its strong predictive value. Conclusion: The 6MWT has good reliability, moderate validity, and a significant ability to predict functional capacity in patients with CHF who do not walk greater than 490 meters.Key Words: six-minute walk test, chronic heart failure, functional capacity, peak VO2  相似文献   

4.
Purpose: To describe the benefits of a feasible, outpatient exercise training program on exercise tolerance and health-related quality of life (HRQL) in individuals with pulmonary arterial hypertension (PAH). Methods: Case report on two subjects recruited from a tertiary care pulmonary hypertension clinic. Subject 1 was a 50-year-old male with idiopathic PAH. Subject 2 was a 54-year-old female with a 20+ year history of scleroderma and 6-year history of PAH. Both subjects underwent exercise training 3 times per week for 6 weeks using a cycle ergometer at workloads progressing from 50% to 80% of peak workload. Outcomes were assessed using cardiopulmonary exercise testing, six-minute walk test (6MWT), and HRQL using the Chronic Respiratory Disease Questionnaire (CRQ) and the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR). Results: Both subjects made substantial improvements in oxygen consumption and workload at anaerobic threshold (improvements of 3.8 and 4.2 mL·kg−1·min,−1 26 and 18 W, respectively) and 6MWT distance (from 496 to 586m and 416 to 517m, respectively). Only Subject 1 made substantial improvements in peak oxygen consumption (from 16.0 to 18.3 mL·kg−1·min−1and from 15.0 to 15.6 mL·kg−1·min,−1 respectively) and peak work rate (from 112 to 130W and 66 to 69W, respectively). Both subjects demonstrated improved HRQL. No adverse events were noted. CONCLUSIONS: A short and practical exercise training program can improve measures of workload, aerobic capacity, and HRQL in individuals with PAH with no adverse effects shown in these two case studies.Key Words: pulmonary arterial hypertension, exercise training  相似文献   

5.
ABSTRACT

Purpose: This study aims to analyze changes in Maximum Inspiratory Pressure (MIP), lung function, cardiorespiratory fitness, and blood pressure, in 10 healthy active elderly women, following 7 weeks of inspiratory muscle training (IMT) combined with a multicomponent training program (MCTP). The association among these health parameters, their changes after training (deltas), and the influence of MIP at baseline (MIPpre) are also considered. Methods: IMT involved 30 inspirations at 50% of the MIP, twice daily, 7 days a week, while MCTP was 1 hr, twice a week. MIP, lung function (FVC, FEV1, FEV1/FVC, FEF25-75%, PEF), 6MWT, and blood pressure (SBP, DBP), jointly with body composition, were assessed before and after the intervention. Results: Seven weeks were enough to improved MIP (p = .019; d = 1.397), 6MWT (p = .012; d = .832), SBP (p = .003; d = 1.035) and DBP (p = .024; d = .848). Despite the high physical fitness (VO2 peak: M = 23.38, SD = 3.39 ml·min·Kg?1), MIPpre was low (M = 39.00, SD = 7.63 cmH2O) and displayed a significant negative correlation with ΔMIPpre-post (r = ?.821; p < .004), showing that women who started the intervention with lower MIP achieved higher improvements in inspiratory muscle strength after training. Conclusions: No significant changes in spirometric parameters may signal that lung function is independent of early improvements in inspiratory muscles and cardiorespiratory fitness. Absence of correlation between physical fitness and respiratory outcomes suggests that being fit does not ensure cardiorespiratory health in active elderly women, so IMT might be beneficial and should supplement the MCTP in this population.  相似文献   

6.
Supervised exercise has shown benefits for subjects with asthma, but little is known about the effectiveness of unsupervised physical activity on this population. We investigated the effects of a 12-week unsupervised pedometer-based physical activity program on daily steps and on clinical and psychological parameters of adults with asthma. Clinically stable adults with moderate to severe asthma were encouraged to take daily 30-minute walks and were randomized to pedometer and control groups. The pedometer group received pedometers and individualized daily step targets. Changes in daily steps (average of steps taken during six consecutive days), six-minute walk test (6MWT), health-related quality of life, asthma control and anxiety and depression levels were assessed 12 weeks after intervention and 24–28 weeks after randomization. Thirty-seven participants were recruited and 30 completed the intervention. At 12 weeks, the groups differed significantly in daily steps (adjusted average difference, 2488 steps; 95% confidence interval [CI], 803 to 4172; p = 0.005) and in the 6MWT (adjusted average difference, 21.9 m; 95% CI, 6.6 to 37.3; p = 0.006). These differences were not significant 24–28 weeks after randomization. The program was effective in increasing daily steps of adults with moderate to severe asthma 12 weeks after intervention.  相似文献   

7.
This study examined the relationship between sit-to-stand (STS) power and physical function in adults with severe obesity. Thirty-eight adults (age: 44 ± 12 years; body mass index [BMI]: 45.2 ± 7.8 kg/m2) completed evaluations of STS power, strength and functional performance. STS power was measured with a wearable inertial sensor, strength was assessed with the isometric mid-thigh pull, and function was measured with the timed up-and-go (TUG), six-minute walk test (6MWT) and 30-s chair STS. Power and strength (normalised to body mass) entered regression models in addition to age, gender, BMI and physical activity (daily step count). Power displayed large univariate associations with TUG (r = 0.50) and 30-s chair STS (r = 0.67), and a moderate association with 6MWT (r = 0.49). Forward stepwise regression revealed that power independently contributed to TUG (β = ?0.40, p = 0.010), 30-s chair STS (β = 0.67, p < 0.001) and 6MWT performance (β = 0.27, p = 0.007). Power also appeared to be a superior determinant of function compared with strength. Power generated via the STS transfer largely underpins the ability to perform functional tasks in adults with severe obesity, although intervention studies are required to investigate a potentially causal relationship.  相似文献   

8.
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9.
Background & Purpose: Tuberculosis is an infectious disease that affects the lungs and results in poor lung compliance secondary to diffuse fibrotic changes to lung tissue. Consequently, people with pulmonary tuberculosis experience impaired gas exchange resulting in a decline in functional capacity. The purpose of this study was to evaluate the physical functional capacity (VO2max) in a group of older (50 – 65 years) people with pulmonary tuberculosis and to compare them to an age-matched healthy group. A secondary purpose was to develop reference equations that could be used to predict 6 minute walk test (6MWT) distance in older, healthy people in India. Methods: Sixty healthy subjects (30 male and 30 female) and 60 subjects with a diagnosis of pulmonary tuberculosis (30 male and 30 female) participated in the study. All subjects underwent a 6MWT. Walk-work was calculated and used for evaluating functional capacity. Group comparison for functional capacity was done using 2-tailed t-tests. Pearson product correlation was used to examine for significant relationships and regression analysis was used to derive reference equations. Results: There was a significant difference between groups in regard to functional capacity and 6MWT distance (p < 0.001). Reference equations were developed that use age, height, and weight as predictors for 6MWT distance in the healthy group. Conclusion: The sequelae from pulmonary tuberculosis have considerable impact on functional capacity in older people in India.Key Words: six minute walk test, tuberculosis, functional capacity  相似文献   

10.
Background:Despite the strong evidence of aerobic exercise as a disease-modifying treatment for Alzheimer’s disease(AD)in animal models,its effects on cognition are inconsistent in human studies.A major contributor to these findings is inter-individual differences in the responses to aerobic exercise,which was well documented in the general population but not in those with AD.The purpose of this study was to examine inter-individual differences in aerobic fitness and cognitive responses to a 6-month aerobic exercise intervention in community-dwelling older adults with mild-to-moderate dementia due to AD.Methods:This study was a secondary analysis of the Effects of Aerobic Exercise for Treating Alzheimer’s Disease(FIT-AD)trial data.Aerobic fitness was measured by the shuttle walk test(SWT),the 6-min walk test(6MWT),and the maximal oxygen consumption(VO2max)test,and cognition by the AD Assessment Scale-Cognition(ADAS-Cog).Inter-individual differences were calculated as the differences in the standard deviation of 6-month change(SDR)in the SWT,6MWT,VO2max,and ADAS-Cog between the intervention and control groups.Results:Seventy-eight participants were included in this study(77.4±6.3 years old,mean±SD;15.7±2.8 years of education;41%were female).VO2max was available for 26 participants(77.7±7.1 years old;14.8±2.6 years of education;35%were female).The SDR was 37.0,121.1,1.7,and 2.3 for SWT,6MWT,VO2max,and ADAS-Cog,respectively.Conclusion:There are true inter-individual differences in aerobic fitness and cognitive responses to aerobic exercise in older adults with mild-tomoderate dementia due to AD.These inter-individual differences likely underline the inconsistent cognitive benefits in human studies.  相似文献   

11.

Purpose

To determine if 30 minutes of Nintendo Wii Sports boxing provides cardiorespiratory benefits and contributes to the daily exercise recommendations for healthy young adults.

Methods

Twenty healthy 23- to 27-year-olds participated in two sessions to measure maximum heart rate (HRmax) via a treadmill test and heart rate (HR) response to 30 minutes of Wii Sports boxing. Heart rate in beats per minute (bpm) was measured continuously, and exercise intensity during each minute of play was stratified as a percentage of HRmax. Mixed designs analysis of variance (ANOVA) and Pearson product moment correlations were used to analyze the data.

Results

Mean (SD) HR response to boxing was 143 (15) bpm or 77.5% (10.0%) of HRmax. The mean HR response for experienced participants was significantly lower than inexperienced participants, P = .007. The ANOVA revealed a significant interaction between experience and time spent at various intensities, P = .009. Experienced participants spent more time in light to vigorous intensities, inexperienced participants in moderate to very hard intensities. Fitness was not correlated with mean HR response to boxing, P = .49.

Conclusion

Thirty minutes of Nintendo Wii Sports boxing provides a moderate to vigorous aerobic response in healthy young adults and can contribute to daily recommendations for physical activity.Key Words: exergaming, cardiorespiratory training, active video games  相似文献   

12.

Purpose

Following a cardiac event patients are at risk for deficits in mobility and function. However, measures of physical performance are not commonly used and have not been extensively studied in patients enrolled in cardiac rehabilitation. The purpose of this study was to determine the reliability and the minimal detectable change (MDC) of gait speed, 5 times sit to stand (5 STS) and hand grip strength for individuals enrolled in cardiac rehabilitation.

Methods

Forty-nine individuals enrolled in phase II or III cardiac rehabilitation participated in the study. Gait speed, 5 STS, and hand grip strength were measured over two sessions held on the same day. Intraclass correlation coefficient was used to determine reliability and MDC95 was calculated to measure responsiveness.

Results

All 3 measures showed high reliability (ICC for gait speed = 0.96, 5 STS = 0.87, right hand grip strength = 0.97, left hand grip strength = 0.97). The MDC95 for gait speed was 0.16 meters/second, 3.12 seconds for 5 STS, 5.2 kilograms for right and 5.1 kilograms for left hand grip strength.

Conclusion

Gait speed, 5 STS, and hand grip strength are reliable and responsive measures for patients in cardiac rehabilitation. Findings support their use in clinical practice and future cardiac rehabilitation studies.Key Words: cardiac rehabilitation, gait speed, sit to stand  相似文献   

13.

Purpose

Reduced cardiovascular fitness post-stroke may negatively impact recovery. There is little information regarding exercise testing performance and cardiorespiratory response to an aerobic exercise intervention in subacute stroke. The purpose of this study was to examine cardiorespiratory response in subacute stroke after an 8-week aerobic exercise intervention using a total body recumbent stepper (TBRS).

Methods

Nine individuals with mean age 61.2 (SD 4.7) years and mean 66.7 (SD 41.5) days post-stroke completed the exercise intervention. Participants had a mean Fugl-Meyer score of 100.3 (SD 29.3). Outcome measures were obtained at baseline and postintervention. A peak exercise test using a TBRS assessed oxygen consumption, heart rate, and minute ventilation. Participants completed an 8-week exercise intervention on a recumbent stepper 3 times per week at a prescribed heart rate intensity.

Results

Submaximal VO2 was significantly lower from baseline to postintervention with a main effect of Study Visit (F1,8 = 8.5, p = 0.02). Heart rate was not significantly different pre- to postintervention. Minute ventilation exhibited no main effect of Study Visit or Test Minute.

Conclusion

Moderate-high intensity aerobic exercise in subacute stroke appears to be beneficial for improving cardiovascular outcomes during submaximal performance of an exercise test.Key Words: oxygen uptake, cerebrovascular accident, cardiovascular fitness, submaximal exercise  相似文献   

14.
Abstract

In the present study, we assessed the effects of exercise intensity on salivary immunoglobulin A (s-IgA) and salivary lysozyme (s-Lys) and examined how these responses were associated with salivary markers of adrenal activation. Using a randomized design, 10 healthy active men participated in three experimental cycling trials: 50% maximal oxygen uptake ([Vdot]O2max), 75%[Vdot]O2max, and an incremental test to exhaustion. The durations of the trials were the same as for a preliminary incremental test to exhaustion (22.3 min, s x  = 0.8). Timed, unstimulated saliva samples were collected before exercise, immediately after exercise, and 1 h after exercise. In the incremental exhaustion trial, the secretion rates of both s-IgA and s-Lys were increased. An increase in s-Lys secretion rate was also observed at 75%[Vdot]O2max. No significant changes in saliva flow rate were observed in any trial. Cycling at 75%[Vdot]O2max and to exhaustion increased the secretion of α-amylase and chromogranin A immediately after exercise; higher cortisol values at 75%[Vdot]O2max and in the incremental exhaustion trial compared with 50%[Vdot]O2max were observed 1 h immediately after exercise only. These findings suggest that short-duration, high-intensity exercise increases the secretion rate of s-IgA and s-Lys despite no change in the saliva flow rate. These effects appear to be associated with changes in sympathetic activity and not the hypothalamic – pituitary – adrenal axis.  相似文献   

15.

Purpose

The aim of this study was to investigate the effects of mobilization on respiratory and hemodynamic parameters in critically ill obese patients.

Methods

Critically ill obese patients (n = 31) were included in this retrospective study. Data were collected from patients’ files and physiotherapy records of mobilization sessions. Heart rate (HR), systolic/diastolic/mean blood pressure, respiratory rate (RR), and percutaneous oxygen saturation (SpO2) were recorded. Cardiorespiratory parameters were collected just prior to the mobilization, just after the completion of the mobilization and after 5 minutes recovery period. Respiratory reserve was calculated before and after the mobilization.

Results

A total of 37 mobilization sessions in 31 obese patients (mean age: 63.3 years, mean BMI: 32.2 kg/m2) who received physiotherapy were analyzed. Respiratory rate increased significantly after the completion of the mobilization compared to initial values (p < 0.05). SpO2 significantly increased (p < 0.05) and all other parameters remained similar (p > 0.05) compared to initial values after the recovery period. Mobilization resulted in a significant increase in respiratory reserve (p < 0.05).

Conclusion

Early mobilization in intensive care unit promotes respiratory reserve in obese patients. We found that mobilization can be performed safely in critically ill obese patients if cardiorespiratory parameters are continuously monitored.Key Words: obesity, mobilization, critically ill patients, physiotherapy  相似文献   

16.
In this study the authors examine the test–retest reliability and concurrent validity of the Repeat Ice Skating Test (RIST). This was an on-ice field anaerobic test that measured average peak power and was validated with 3 anaerobic lab tests: (a) vertical jump, (b) the Margaria–Kalamen stair test, and (c) the Wingate Anaerobic Test. The participants (n?=?14) were 11- to 12-year-old males selected from a Peewee “A” level ice hockey team (Thunder Bay, Canada). The results of the test–retest reliability estimation showed that the RIST was a reliable test at measuring average peak power in watts (R = .99, C.I.95% = 0.97 to 0.99) and watts per kilogram (R = .98, C.I.95% = 0.94 to 0.99). The RIST was also a valid test when correlated with the 3 anaerobic lab tests for measuring peak power in watts: vertical jump (r = .86, C.I.95% = 0.72 to 0.94), Margaria–Kalamen stair test (r = .66, C.I.95% = 0.39 to 0.83) and Wingate Anaerobic Test (r = .86, C.I.95% = 0.72 to 0.93). The test is considered promising because it does not require any specific equipment, and is a sport-specific, on-ice test, that can be administered during a regular ice hockey practice session.  相似文献   

17.
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18.
ABSTRACT

Endurance athletes usually achieve performance peaks with 2–4 weeks of overload training followed by 1–3weeks of tapering. With a tight competition schedule, this may not be appropriate. This case investigates the effect of a 7-day overload period including daily high-intensity aerobic training followed by a 5-day step taper between two competitions in an elite cross-country mountain biker. Pre-test peak oxygen consumption was 89 ml·kg?1·min?1, peak aerobic power 6.8 W·kg?1, power output at 2 mmol·L?1 blood lactate concentration 3.9 W·kg?1, maximal isometric force 180 Nm and squat jump 21 cm. During overload, perceived leg well-being went from normal to very heavy. On day 1 after overload, vastus lateralis and vastus medialis EMGmean activity was reduced by 3% and 7%, respectively. Other baseline measurements were reduced by 3–7%. On day 4 of the taper, he felt that his legs were good and all measurements were 3–7% higher than before overload. On day 6 after the taper, his legs felt very good. This case shows that an elite mountain biker (11th in UCI World Cup one week prior to the pre-test) could achieve a rather large supercompensation by using a 12-day performance peaking protocol.  相似文献   

19.
This study presents a worked example of a stepped process to reliably estimate the habitual physical activity and sedentary time of a sample of young children. A total of 299 children (2.9 ± 0.6 years) were recruited. Outcome variables were daily minutes of total physical activity, sedentary time, moderate to vigorous physical activity and proportional values of each variable. In total, 282 (94%) provided 3 h of accelerometer data on ≥1 day and were included in a 6-step process: Step-1: determine minimum wear-time; Step-2: process 7-day-data; Step-3: determine the inclusion of a weekend day; Step-4: examine day-to-day variability; Step-5: calculate single day intraclass correlation (ICC) (2,1); Step-6: calculate number of days required to reach reliability. Following the process the results were, Step-1: 6 h was estimated as minimum wear-time of a standard day. Step-2: 98 (32%) children had ≥6 h wear on 7 days. Step-3: no differences were found between weekdays and weekend days (P ≥ 0.05). Step-4: no differences were found between day-to-day variability (P ≥ 0.05). Step-5: single day ICC’s (2,1) ranged from 0.48 (total physical activity and sedentary time) to 0.53 (proportion of moderate to vigorous physical activity). Step-6: to reach reliability (ICC = 0.7), 3 days were required for all outcomes. In conclusion following a 7 day wear protocol, ≥6 h on any 3 days was found to have acceptable reliability. The stepped-process offers researchers a method to derive sample-specific wear-time criterion.  相似文献   

20.
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