6-min Walk Test Research Articles

Continuous risk monitoring and management of heart failure: Rationale and design of the ALLEVIATE-HF trial.

Early identification and management of worsening heart failure (HF) is necessary to prevent disease progression and hospitalizations. The ALLEVIATE-HF (Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure) trial is a prospective, randomized, controlled, double-blind, multicentre trial that aims to assess the safety and efficacy of using the Reveal LINQ™ insertable cardiac monitor (ICM) in patients with HF to continuously monitor and evaluate HF risk status and guide timely interventions. The ICM algorithm uses parameters derived from electrocardiogram (atrial fibrillation [AF], ventricular rate during AF, heart rate variability, and night heart rate), three-axis accelerometer (patient activity duration), and subcutaneous bioimpedance (fluid volume, respiration rate). The trial will enroll ~760 patients with New York Heart Association class II or III HF with recent hospitalization for HF or needing intravenous diuretics in the outpatient setting or elevated natriuretic peptide levels, who do not have an implanted cardiac implantable electronic device or haemodynamic monitor. Patients are randomized to an observation or an intervention arm, where the latter will receive an intervention pathway with remote nurses implementing individualized pro re nata (PRN or 'as needed') 4-day medication interventions for acute volume management upon high risk. After 13 months of randomized follow-up, all patients enter an unblinded prolonged follow-up phase with PRN interventions upon high risk. The primary hierarchical composite endpoint for the study includes cardiovascular death, HF events, Kansas City Cardiomyopathy Questionnaire score, and 6-min walk test distance. ALLEVIATE-HF will evaluate how ICM-based HF management can impact the outcomes of patients with HF regardless of ejection fraction.

Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials

ObjectiveTo estimate the relative efficacy of individual and combinations of prehabilitation components (exercise, nutrition, cognitive, and psychosocial) on critical outcomes of postoperative complications, length of stay, health related quality of...

Comprehensive analysis of GDF15 as a biomarker in primary mitochondrial myopathies.

Mitochondrial diseases are caused by defects in oxidative phosphorylation, with primary mitochondrial myopathies (PMM) being a subset where muscle involvement is predominant. PMM presents symptoms ranging from exercise intolerance to progressive muscle weakness, often involving ocular muscles, leading to ptosis and progressive external ophthalmoplegia (PEO). PMM can be due to variants in mitochondrial or nuclear DNA. Growth differentiation factor 15 (GDF15) has been identified as an accurate biomarker for mitochondrial dysfunction. This study evaluates the utility of GDF15 as a biomarker for monitoring PMM. This observational study involved 50 adult PMM patients. Clinical data were collected alongside functional motor outcomes measured by the Motor Research Council scale, 6-min walk test, North Star Ambulatory Assessment, and 100-m run test (100MRT). Biomarkers including serum lactate, creatine kinase (CK), creatinine, and plasma GDF15 were assessed. Patients exhibited diverse phenotypes, including exercise intolerance (8%), progressive myopathy (22%), isolated PEO (24%), and PEO plus (42%). Significant correlations were found among motor function tests, with 100MRT being particularly sensitive. Biomarker analysis showed elevated lactate in 32%, elevated CK in 54%, reduced creatinine in 76%, and elevated GDF15 in 86% of cases. GDF15 levels correlated with motor performance, lactate levels, and mtDNA mutation load in muscle. Creatinine levels were strongly linked to disease severity. This study underscores the heterogeneity of PMM and the importance of reliable biomarkers. GDF15 was consistently elevated across all PMM phenotypes and genotypes, correlating well with disease severity. Reduced creatinine also emerged as a potential prognostic marker.

Short- and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years.

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21-37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9-12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults.

Gender Differences Are a Leading Factor in 5-Year Survival of Patients with Idiopathic Pulmonary Fibrosis over Antifibrotic Therapy Reduction.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease with a median survival of 3-5 years. Antifibrotic therapies like pirfenidone and nintedanib slow progression, but the outcomes vary. Gender may influence disease presentation, progression, and response to treatment. This study evaluates the impact of gender on the 5-year survival, pharmacological management, and clinical outcomes of patients with IPF. A retrospective cohort study of 254 IPF patients was conducted, with 164 (131 males:33 females) having complete data. Patients underwent spirometry, DLCO, and 6 min walk tests. Data on comorbidities, smoking, antifibrotic therapy type, dosage adjustments, and adverse events were collected. We used Kaplan-Meier survival curves and logistic regression to assess gender-related differences in outcomes. Men had worse lung function at diagnosis (FVC 74.9 ± 18.5 vs. 87.2 ± 20.1% of pred.; p < 0.001) and a higher smoking prevalence (74% vs. 30%; p < 0.001). Women had better survival (51.2 vs. 40.8 ± 19.2 months; p = 0.005) despite more frequent biopsy use (36% vs. 17%; p = 0.013). Women tolerated longer therapy better (p = 0.001). No differences were found between patients receiving reduced antifibrotic dosing and those receiving full dosing. Gender has a significant impact on IPF outcomes, with women demonstrating better survival and tolerance to long-term therapy. In contrast, reducing antifibrotic treatment does not appear to significantly affect survival outcomes. These findings underscore the need for future research on gender-specific management approaches.

Relation between pulmonary function changes and diaphragmatic ultrasound in patients with idiopathic pulmonary fibrosis

BackgroundIPF is a chronic disease with impaired diaphragmatic function. In the vast majority of patients, lung function gradually deteriorates until intractable respiratory failure occurs.Aim of workTo assess diaphragmatic ultrasound in IPF patients and its relation to functional parameters.Subjects and methodsThis study used a case–control design and involved IPF patients who were either attending an outpatient clinic or admitted to a ward at Ain Shams University Hospitals and Abbassia Chest Hospital. Forty-five participants were included and split up into 3 groups: group A: 15 IPF cases suffering from hypoxia. Group B: 15 IPF patients without hypoxia or respiratory failure. Group C: 15 healthy participants as controls.ResultGroups A and B had considerably decreased diaphragm excursion (QB), thickness of diaphragm at the end of inspiration, diaphragm thickness fraction, and diaphragm thickness fraction % when compared to the control group. Patients' diaphragm excursion during deep breathing was significantly smaller in group A than it was in the controls.The diaphragm excursion (QB and DB), the thickness of the diaphragm at the end of inspiration, the thickness fraction, and the fraction % were positively associated with FVC, FEF 25–75, FEV1, 6MWT, the O2 sat before, the O2 sat after, and the O2 at RA, while they were negatively correlated with FEV1/FVC. There was no difference between groups in diaphragm thickness at the end of expiration.ConclusionDiaphragmatic ultrasound parameters demonstrated strong correlations with pulmonary function parameters, 6-min walk test, and oxygen saturation levels.

Comparison Between Water Aerobics and Deep-Water Running on Middle-Aged Adults' Anthropometric, Hemodynamic and Functional Outcomes.

Head-out aquatic training, using modalities such as water-aerobics/hydrogymnastics (HYD) and deep-water running (DWR), has been effective in improving the physical, metabolic and cognitive health of middle-aged adults. However, direct comparisons between these modalities are lacking. The aim of this study was to compare the effects of water aerobics and deep-water running on anthropometric, functional and hemodynamic outcomes in adults and older adults. An uncontrolled pragmatic trial (RBR-2txw8zy) was conducted with participants aged 30 to 80, allocated to HYD and DWR groups. The intervention consisted of 12 weeks of progressive aerobic training with weekly undulating periodization (2× week), divided into three mesocycles (4, 5, and 3 weeks), each lasting 50 min. Intensity was prescribed using the Rate of Perceived Effort (RPE), ranging from RPE 11 to 17. Outcomes assessed included the 30 s chair stand, 30 s arm curl, Timed-Up-and-Go usual (TUG-u) and maximum (TUG-m), 6 min walking test (6MWT), body mass, waist circumference, blood pressure and resting heart rate-HRrest. The analysis was conducted using generalized estimating equations, with per-protocol (PP) and intention-to-treat (ITT) analyses. The study included 104 participants (HYD: n = 63, mean age 59 years, 54 women; DWR: n = 41, mean age 53 years, 33 women). ITT analysis showed improvements in waist circumference, waist-to-height ratio, and TUG-m in the HYD group, and a reduction in HRrest in the DWR group. Both modalities showed significant improvements in the 30 s chair stand, 30 s arm curl, 6MWT, waist circumference, and waist-to-height ratio in the PP analysis. Both modalities promoted functional improvements and favorable changes in anthropometric evaluations, with DWR showing a greater reduction in HRrest.

Acupuncture and Kinesitherapy Improve Physical Activity More than Kinesitherapy Alone in Patients with Acute Decompensated Chronic Heart Failure with Reduced Ejection Fraction Who Are Already on Optimal Drug Therapy: A Randomized, Sham-Controlled, Double-Blind Clinical Study.

Background/Objectives: It is unknown how early exercise therapy combined with acupuncture (AP) affects the speed of recovery in patients suffering from heart failure with reduced ejection fraction (HFrEF) who are hospitalized due to worsening HF. Methods: A prospective, sham-procedure-controlled, double-blind, randomized clinical trial with three patient groups was conducted. The study included patients with HFrEF who were hospitalized for worsening HF. After initial stabilization, patients were randomly assigned to three groups, the controls (C) treated with optimal drug therapy (ODT); E1 received ODT with kinesitherapy, and sham AP; E2 received ODT, kinesitherapy, and needle AP aiming to enhance compensation. Improvement in physical activity was measured by the modified Barthel index (A test), 2 or 6 min walking tests, an endurance walking test, and decrease of blood brain natriuretic peptide (BNP). Results: A total of 120 patients completed the study. The average age was 74 years, 73.3% were male, median EF was 32%, and 83.3% were New York Heart Association (NYHA) Class III. After the fifth day of therapy, the E2 group showed the greatest improvement in the A test compared to other groups (p = 0.022). After 5 days, 80%, 50%, and 10% achieved an A test score of 30 or higher, demonstrating functional independence, (p < 0.01) in the E2, E1, and C groups, respectively. At hospital discharge, the E2 group showed significantly better walking endurance compared to the E1 and C groups (p < 0.001). At discharge, BNP decreased significantly more in both E groups, compared to the C group. Conclusions: Short-term early rehabilitation with AP and kinesitherapy significantly improves the functional status of HFrEF decompensated patients when compared to kinesitherapy alone and ODT.

Comparison of Functional Electrical Stimulation Cycle vs. Conservative Rehabilitation on Functional Status and Muscle Features in Stroke Patients

Background Functional Electrical Stimulation (FES) Cycle is used in the rehabilitation of stroke. Objective The aim of this study is to investigate the effects of CR and FES cycle therapy on the functional status and muscle features in stroke patients Methods The 1st Group(n = 15) received only CR for 6 weeks, and the 2nd Group(n = 15) received FES cycle 3 days a week for 4 weeks in addition to the CR treatment. Brunnstrom recovery staging(BRS), Fugl-Meyer lower extremity evaluation(FME); Berg Balance Scale(BBS), Functional Ambulation Classification(FAC), Barthel Index(BI), Fatigue Severity Scale(FSS), 6 min walk test(6mWT), knee extensor and knee flexor muscle strengths(KEMS, KFMS) in both groups were assessed before and after treatment(6th week). Pennate angle(PA) and rectus femoris muscle thickness(RFT) were measured. Results Significant improvement was detected in BBS, FAS, BI, FME, 6mWT, KEMS, RFT scores after intra-group treatment compared to before treatment in both groups. Only the 2nd Group showed a significant difference in KFMS, FSS, BRS lower extremity, PA values after treatment compared to before. No significant superiority of the groups over each other was detected. Conclusions CR and FES Cycle contribute to the improvement of the functional status of the patients, but their superiority over each other was not observed.

The Impact of Photobiomodulation Therapy on Swelling Reduction and Recovery Enhancement in Total Knee Arthroplasty: A Randomized Clinical Trial.

Background: Total knee arthroplasty (TKA) is commonly performed for severe osteoarthritis but often results in significant postoperative swelling and discomfort, impacting early rehabilitation. Photobiomodulation therapy (PBMT), utilizing low-level laser therapy (LLLT), has emerged as a potential adjunctive treatment to alleviate these symptoms. Methods: In this single-center, nonblinded prospective randomized clinical trial, conducted from May to July 2024, 30 patients undergoing primary TKA were enrolled and divided into two groups. Fifteen patients formed the control group receiving standard postoperative care, while the intervention group consisted of another 15 patients who received additional PBMT from the first to the fifth postoperative day (POD). The swelling was assessed using bioimpedance analysis, which offers a noninvasive, safe, and efficient method for assessing postoperative swelling by measuring tissue impedance, and functional outcomes were measured using the 2-min walk test (2MWT) and active range of motion (aROM). The study was registered with ClinicalTrials.gov (NCT06426251). Results: The PBMT group demonstrated significantly lower impedance, reactance, and phase angle ratios by POD6, suggesting reduced swelling compared to the control group. In the 2MWT, the PBMT group achieved a longer walking distance of 27 m, compared to 16 m in the control group. However, there were no significant differences in aROM or Visual Analogue Scale (VAS) pain scores between the groups. Conclusions: The findings indicate that PBMT effectively reduces postoperative swelling and enhances early mobility post-TKA. These benefits suggest that PBMT can be a valuable addition to conventional postoperative care, potentially accelerating functional recovery, and reducing rehabilitation time.

Exercise Training in Heart Failure: Current Evidence and Future Directions.

Heart Failure (HF) is a prevalent condition which places a substantial burden on healthcare systems worldwide. Medical management implemented with exercise training (ET) plays a role in prognostic and functional capacity improvement. The aim of this review is to determine the effect of exercise training (ET) on HFpEF and HFrEF patients as well as exercise modality recommendations in frail and sarcopenic subpopulations. Pharmacological therapy structures the cornerstone of management in HF reduced ejection fraction (HFrEF) and aids improved survival rates. Mortality reduction with pharmacological treatments in HF preserved ejection fraction (HFpEF) are yet to be established. Cardiac rehabilitation (CR) and ET can play an important role in both HFrEF and HFpEF. Preliminary findings suggest that CR significantly improves functional capacity, exercise duration, and quality of life. ET has shown beneficial effects on peak oxygen consumption (pVO2) and 6 min walk test distance in HFrEF and HFpEF patients, as well as a reduction in hospitalisation and mortality rates; however, the limited scope of larger trials reporting on this underscores the need for further research. ET also has been shown to have beneficial effects on depression and anxiety levels. High-intensity training (HIT) and moderate continuous training (MCT) have both shown benefits, while resistance exercise training and ventilatory assistance may also be beneficial. ET adherence rates are higher when enrolled to a supervised programme, but prescription rates remain low worldwide. Larger robust trials are required to determine ET's effects on HF, as well as the most efficacious and personalised exercise prescriptions in HF subtypes.

Exploring Medium- and Long-Term Respiratory and Functional Sequelae in Young Adults Post-COVID-19.

Background and Objectives: Long COVID-19 syndrome may cause difficulties in functionality during daily life in young people. Our objective was to investigate the respiratory and functional sequelae in young adults with asymptomatic or mild COVID-19 compared with healthy peers 3-6 months and 6-12 months after COVID-19 infection. Materials and Methods: Participants aged 18-25 who had COVID-19 within the last 3-6 months (Post-COVID Group 1, n = 25) and 6-12 months (Post-COVID Group 2, n = 25) and age-gender-matched healthy controls (n = 25) were included in this study. Respiratory functions and muscle strength were measured. Physical function was assessed with 6 min walking test (6MWT) and an Incremental Shuttle Walk Test (ISWT). The 1 min sit-to-stand test (1-MSTST) and hand grip strength (HGS) were used to assess muscle performance. Fatigue and dyspnea severity were questioned. Results: The FVC%pred (p = 0.023) and MEP (p = 0.034) were higher, and 1-MSTST repetitions were lower in Post-COVID Group-1 compared to Post-COVID Group-2 (p = 0.029). The PEF%pred (p = 0.025), MEP (p = 0.001), and ISWT distance were lower in Post-COVID Group-2 compared to healthy controls. The number of 1-MSTST repetitions and 6MWT distance were lower in Post-COVID Group-1 (p = 0.003, p = 0.001) and Post-COVID Group-2 (p = 0.003, p = 0.017) than in healthy controls. Exercise-induced blood lactate change during the ISWT, HGS, fatigue, and dyspnea were not significantly different between post-COVID groups and healthy controls. Conclusions: Young adults who pass asymptomatic or mild SARS-CoV-2 infection exhibit a decline in FVC%pred, PEF%pred, lower extremity muscle performance, and physical function within 3-6 months. In addition, the deterioration in respiratory and physical functions becomes apparent within 6-12 months.

Clinical benefit of chronic non-invasive ventilation in severe stable COPD: a matter of persistent hypercapnia improvement

PurposeIn patients with chronic obstructive pulmonary disease (COPD) treated with chronic non-invasive ventilation (NIV), the relation between improvements in nocturnal transcutaneous partial pressure of CO2 (PtcCO2) and daytime arterial partial...

Effectiveness of Early Versus Late Time-Restricted Eating Combined with Physical Activity in Overweight or Obese Women.

To evaluate the effectiveness of a dual approach involving time-restricted eating (TRE) at different times of the day combined with physical activity (PA) on functional capacity and metabolic health in overweight or obese women. Random allocation of sixty-one participants into four groups: early time-restricted eating plus physical activity (ETRE-PA, n = 15, 31.8 ± 10.76 years, 89.68 ± 13.40 kg, 33.5 ± 5.53 kg/m2), late time-restricted eating with physical activity (LTRE-PA, n = 15, 30.60 ± 7.94 years, 94.45 ± 15.36 kg, 34.37 ± 7.09 kg/m2), late time-restricted eating only (LTRE, n = 15, 27.93 ± 9.79 years, 88.32 ± 10.36 kg, 32.71 ± 5.15 kg/m2) and a control group (CG, n = 15, 36.25 ± 11.52 years, 89.01 ± 11.68 kg, 33.66 ± 6.18 kg/m2). The intervention lasted for 12 weeks in all groups. Both the ETRE-PA and LTRE-PA groups engaged in a rigorous combined aerobic and resistance-training program. Significant reductions in body weight and body mass index were observed in the ETRE-PA and LTRE-PA groups compared to the CG and LTRE groups post-intervention (p < 0.0005). Only the ETRE-PA group exhibited a significant decrease in fat mass (p = 0.02), low-density lipoprotein cholesterol (p = 0.01), and aspartate aminotransferase (p = 0.002). Significant reductions in alanine aminotransferase levels were observed in the ETRE-PA (p = 0.004) and LTRE-PA (p = 0.02) groups. These two latter groups achieved higher performances in the 6-min walking test, bench press, 30-s squat, crunch test, vertical jump (p < 0.0005 for both), and leg extension (p < 0.02 for both) when compared to the LTRE and CG groups. The integration of TRE with PA leads to greater improvements in body composition, lipid profile, and physical performance, with no significant differences between the ETRE-PA and LTRE-PA approaches. This combined strategy offers a promising solution for overweight and obese women.

Rehabilitation Progress in Patients Following Surgery for Acute Stanford Type A Aortic Dissection Extending Beyond the Ascending Aorta.

Background: The objective of this study was to assess the course of rehabilitation of patients hospitalized in the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection, extending beyond the ascending aorta, and comparing these findings with those for patients who, after the same type of surgery, had no remaining dissection. The aim was to develop an optimal cardiac rehabilitation model for this patient population, given the lack of clear guidelines. Additionally, the study aimed to evaluate their one-year survival. Methods: The study included patients referred to the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection extending beyond the ascending aorta (a total of 25 patients). The study group was compared with a cohort of patients (a total of 58) who underwent similar cardiac surgery. The main difference was the absence of residual aortic dissection. All patients were assessed on admission to the cardiac rehabilitation unit and at discharge using the 6-min walk test and the Tinetti test. All patients underwent 2-3 weeks of rehabilitation following the same protocol; however, the study group had significantly reduced exercise loads. Results: Patients in the study group were admitted to the cardiac rehabilitation unit in a significantly worse functional status compared to the comparison group, but the final assessment showed comparable results for the Tinetti test and the 6-min walk test. There were no differences in one-year survival between the two groups. Conclusions: Early postoperative cardiac rehabilitation in patients after acute aortic dissection significantly improves the functional status of this patient group, and is safe.

Single-centre, double-blinded, randomised placebo-controlled trial to determine the effect of a 12-week home-based programme of footplate neuromuscular electrical stimulation on walking capacity in people with peripheral artery disease: a protocol for the Foot-PAD trial

IntroductionPatients with peripheral artery disease (PAD) can experience intermittent claudication, which limits walking capacity and the ability to undertake daily activities. While exercise therapy is an established way to improve...

Assessment of Bendopnea and Its Association With Clinical and Para-Clinical Findings in Systolic Heart Failure: A Cross-Sectional Study.

Bendopnea is a symptom found in patients with heart failure (HF) defined as shortness of breath when bending forward. The present study examined the correlation between bendopnea with other cardiac symptoms, echocardiographic findings,and cardiac function parameters. This was a single-center prospective cross-sectional study of patients diagnosed with systolic HF. Medical history, bending tests, laboratory tests, electrocardiography (ECG), echocardiography, and 6-min walking test (6-MWT) were evaluated. Patients with reduced ejection fraction were followed to assess the 2-year outcomes for cardiovascular death and rehospitalization. A total of 80 patients were included in this study, of whom 54 (67.5%) were male. Bendopnea was present in 34 (42.5%) and theirmean age was 62.44 years (compared to group without bendopnea, p = 0.869). Symptoms of HF such as dyspnea of exertion (DOE) and orthopnea were significantly related to the presence of bendopnea (p = 0.001, odds ratio (OR): 6.87, and p = 0.016, OR: 3.18, respectively). The bendopnea-positive group had a higher New York Heart Association (NYHA) class (p = 0.005). ECG results showed no significant difference between the two groups. The echocardiographic findings showed that the inferior vena cava (IVC) respiratory collapse was significantly lower in the bendopnea-positive group (p = 0.019, OR: 0.339, 95% CI:0.13-0.85). Moreover, they had a substantially lower performance in 6-MWT (387.39 vs. 325.58 m, p = 0.015). Neither rehospitalization nor death was related to bendopnea after a 2-year follow-up (p = 0.454). Bendopnea was associated with several signs and symptoms of HF, including orthopnea, DOE, NYHA class, lower IVC collapse, and impaired functional capacity measured via 6-MWT. However, there was no association between bendopnea and ECG findings, ejection fraction, and NT-proBNP levels. Further studies with larger sample sizes are needed to assess the associations with long-term outcomes and confirm our findings.

Associations between 6-min walk distance and cardiopulmonary parameter in non-obese older adults: An observational study.

The 6-min walk test (6MWT) has established itself as a classical field-test for assessing exercise capacity across diverse populations, including older adults. Despite its widespread use, the specific contribution of cardiopulmonary factors to the 6-min walk distance (6MWD) remains relatively unexplored. The primary objective of this investigation was to examine any potential associations between 6MWD and various cardiopulmonary parameters in older adults. Ninety-two non-obese older adults (66.9±4.1 years) were recruited for this study. Real-time assessments of cardiohemodynamic parameters were conducted using impedance cardiography, while cardiopulmonary parameters were evaluated using a gas analyzer during the administration of the 6MWT. Our findings revealed mild-to-strong positive correlations between 6MWD and several cardiohemodynamic parameters, including left cardiac work index, heart rate, cardiac output, and cardiac index, as well as cardiopulmonary parameters such as oxygen consumption (V˙˙O2), carbon dioxide consumption (V˙˙CO2), minute ventilation, oxygen pulse, tidal volume, respiratory exchange ratio (RER), and breath frequency at the end of walking task (p<0.05). Additionally, a negative moderate association was observed between 6MWD and systemic vascular resistance index (SVRi), while no significant correlation was found between stroke volume and 6MWD. Furthermore, a combination of SVRi, V˙˙O2, V˙˙CO2, and RER appeared to predict 6MWD with reasonable accuracy (R2=0.567, p<0.001). Our investigation highlights a robust association between cardiopulmonary parameters and 6MWD among non-obese older adults. These results also emphasize the potential impact of systemic vascular health on submaximal exercise capacity evaluation within the community-dwelling older adults.

Progression of Spinal Cord Disease in Adult Men With Adrenoleukodystrophy.

This study presents the longest systematic prospective follow-up of spinal cord disease in adult male ALD patients to date. Standardized yearly quantitative data collection included scoring of the EDSS, SSPROM, 6-min walking test (6MWT), urological and quality of life questionnaires and vibration sense of the hallux. Progression rates were compared between patients with mild (EDSS ≤ 2.5) and moderate to severe (EDSS > 2.5) disability over a period of 7 years. Data from 79 patients was included. EDSS, SSPROM and 6MWT showed significant disease progression over time. The general progression pattern was linear. Stratified by disease severity, the increase in EDSS was 0.1 points per year in the low EDSS group and 0.2 points per year in the higher EDSS group. SSPROM decreased by -0.7 points per year in the low EDSS group and by -1.9 points per year in the higher EDSS group. 6MWT decreased by -9.3 m/year in the low EDSS group and by -18.2 m/year in the higher EDSS group. The rate of progression in patients with relatively severe disability was higher than in patients with mild disability. Clinical trials will therefore observe effects more rapidly in patients with more advanced disease.

Glittre-ADL tests in three laps as an alternative to the five laps test.

The Glittre-ADL test is a comprehensive test to evaluate functional capacity in patients with chronic obstructive pulmonary disease (COPD). The primary aim was to validate the Glittre-ADL test with and without the backpack performed in three laps as an alternative to five laps in people with COPD. Forty-eight participants with mild to severe COPD (mean±SD age: 71±7 years; FEV1: 46±17 %predicted) were recruited and performed two 6-min walk tests (visit 1); two Glittre-ADL tests with backpack (visit 2), and the Glittre-ADL test with and without the backpack, in random order (visit 3). The Glittre-ADL tests were performed in five laps and symptoms, heart rate and oxygen saturation were recorded for three and five laps. The Glittre-ADL test performed in three laps provoked the same oxygen desaturation [mean±SD oxygen saturation (SpO2): 90±6 vs 90±6, p=0.249] and rate of perceived exertion (RPE) [RPE legs: 2.91±2.23 vs 3.08±2.56, p=0.380; RPE arms: 1.91±1.77 vs 2.16±1.92, p=0.306] to the Glittre-ADL test performed in five laps for both Glittre with the backpack and without the backpack SpO2 [mean±SD: 90±6 vs 90±7, p=0.249], and RPE [legs: 3.02±2.28 vs 3.25±2.37, p=0.380; arms: 2.13±1.91 vs 2.03±1.84, p=0.306]. The heart rate and dyspnoea were significantly lower for both Glittre-ADL tests performed in three laps. The 3-lap Glittre-ADL test may be a more practical alternative to the 5-lap test, while still remaining a good test of functional capacity for activities of daily living.