6-minute Walk Research Articles

Sarcopenia, an overlooked diagnosis inkidney transplant recipients.

Most studies of sarcopenia in renal transplant recipients (RTRs) have been hampered by a lack of standardization in the definitions of sarcopenia. In this study, we aimed to investigate the prevalence of sarcopenia and the associated factors in RTRs using the recently proposed criteria of the European Working Group on Sarcopenia in Older People 2018 (EWGSOP2), which included a standardized definition of sarcopenia. We examined 93 consecutive adult RTRs, 46 chronic kidney disease patients, and 46 healthy controls. We assessed the muscle strength with a hand grip test using a dynamometer and with a chair stand test. We used bioimpedance analysis to estimate appendicular skeletal mass using the Sergi formula. Finally, we conducted a 2-minute walking test to assess endurance. Sarcopenia and probable sarcopenia were determined according to the revised criteria of the EWGSOP2. Probable sarcopenia was found in 29 RTR patients (31.2%), of them 14 (15.1%) were diagnosed with sarcopenia. Multivariate logistic regression analysis showed that presence of diabetes mellitus, increased uric acid level, and statin use were risk factors for probable sarcopenia. On the other hand, longer dialysis vintage was a risk factor for sarcopenia in RTRs. We found that probable sarcopenia and sarcopenia were highly prevalent in our relatively young RTRs. We recommend active screening for the presence of sarcopenia in RTRs, especially in the cadaveric ones. Furthermore, caution seems warranted regarding the myopathic side effects in RTRs who use statins.

Assessment of Exercise Capacity in Home Healthcare: Differences in Three Self-Paced Tests.

Submaximal functional tests of endurance are ubiquitous in clinical practice. This investigation compared cardiovascular responses, perceived exertion, and performance measures following the completion of three self-paced, 2-minute, functional tests of endurance. A pilot prospective, observational, cross-sectional design with 16 community-dwelling older participants compared heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), rating of perceived exertion (RPE), and performance measures following the completion of three randomly allocated self-paced activities. The three activities included 2 minutes of stepping in standing (2MSTD), 2 minutes of seated stepping (2MSIT), and a 2-minute walk test (2MWT). A within-subjects repeated measures ANOVA analyzed differences in change scores for cardiovascular and RPE responses. Pearson's correlations assessed associations in performance measures between the three tests. Standing stepping compared to seated stepping produced statistically higher change scores in HR, SBP, DBP, and RPE (p < .05). Further, 2MSTD revealed statistically higher SBP and RPE scores compared to 2MWT (p < .05). Large and moderate correlations were observed between number of steps completed in sitting and standing (r = 0.83, p < .01) and between standing steps and distance walked (r = 0.56, p = .02), respectively. This pilot investigation informs home care physical therapists that 2 minutes of self-paced stepping in standing produced the greatest change scores in all cardiovascular and perceived exertion responses. No significant differences were noted in HR between self-paced walking and standing stepping, and between standing and seated stepping. For patients unable to walk or step in standing, self-paced seated stepping may be a viable alternative.

Walking on Real-world Terrain with an Ankle Exoskeleton in Cerebral Palsy.

Despite medical treatment focused on addressing walking disability, many millions of people with neurological conditions, like cerebral palsy (CP), struggle to maintain independent mobility. Lower limb exoskeletons and exosuits may hold potential for augmenting walking ability. However, it remains unknown whether these wearable robots are safe and beneficial for use outside of highly controlled laboratory environments, the demonstration of which is necessary for clinical translation. Here, we show that a lightweight, portable, ankle exoskeleton with an adaptable one-size-works-for-all assistance controller can improve energy efficiency and walking speed for individuals with CP spanning a wide spectrum of lower limb impairment in a multi-terrain real-world environment. Tested on an outdoor walking route with level, sloped, and stair terrain, robotic assistance resulted in a 15-18% (p = 0.013-0.026) reduction in estimated energy cost and a 7-8% (p = 0.001-0.004) increase in average walking speed across "shorter" 6-minute and "longer" 20-minute walking durations relative to unassisted walking. This study provides evidence that wearable robots may soon improve mobility in neighborhood, school, and community settings for individuals with CP.

Predictive Model of the Risk of Fall Based on Physical Fitness Assessment in Older Adults

Falls occurring during activities of daily living pose a major threat and are the third most common cause of death in seniors. In clinical evaluations, mostly single tests are used to assess the risk of fall. However, a complex set of tests would lead to a more comprehensive assessment of the risk of falls. The purpose of this study was to develop a predictive model of the risk of falls in older adults aimed to prevent injuries. This study involved 159 older adults (≥65, 77% women) who underwent laboratory testing consisting of questionnaires, physical tests and basic anthropometric data measurement. The data were processed by a statistical method of regression analysis, the Classification and Regression Tree. Based on the analysis a predictive model of the risk of fall for older adults was created. The most important variables for the predictive model were total % of body fat mass, Timed Up and Go Test and 2 minutes walking test. Based on the predictive model, we can design a targeted intervention program for elderly adults to prevent risk of falling, promoting well-being and increase quality of their life.

Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

BackgroundThe Six Minute Walk Test (6MWT) is a simple, non-invasive, well-validated test that assesses cardiorespiratory fitness however is rarely used in pregnant people. It may have clinical utilization to assess fitness, breathing and exertion in pregnancy however no reference intervals exist for people 14+0 to 35+6 weeks gestation. We determined the reference intervals for distance walked for the 6MWT, including exertional and breathlessness ratings for this group. MethodWe conducted a prospective observational cohort study of 196 healthy nulliparous pregnant people in earlier pregnancy (EP) 14+0 to 23+6 weeks, and middle pregnancy (MP) 24+0 to 35+6 gestation, who performed a standardized 6MWT protocol including rating exertion and breathlessness (Rating Perceived Exertion (RPE) scale (1 none −15 maximal) and Modified Borg Dyspnea (MBD) scale (0 none – 10 maximal)). ResultsThe mean ± SD distance walked was 548 ± 80.9 (EP) versus 547 ± 87.3 (MP) meters (m) P = 0.928. 6MWT reference intervals for the distance walked for the 6MWT were 392–704 m (EP) and 376–718 m (MP). Median (IQR) exertion and breathlessness ratings with exercise for the EP and MP group were 6 (4,7) and 0.5 (0,1) and 6 (4,8) and 0.5 (0,1) respectively. There were no adverse events. ConclusionThe 6MWT is safe, feasible and acceptable in pregnant people. The reference intervals for the 6MWT are 392–704 m in people 14+0 to 23+6 weeks gestation and 376–718 m for people 24+0 to 35+6 weeks gestation. Exertion was light and breathlessness was just noticeable with the 6MWT.

A quantitative study to assess cardiovascular risks among older African American women living in rural black belt areas of Alabama.

Limited information is available regarding the knowledge of Cardiovascular Disease (CVD)risk factors and the actual risk behaviors among African American (AA) older women living in rural areas of Alabama. A pilot study of needs assessment for CVD prevention behaviors was conducted to collect such data from rural AA women. This paper reports the quantitative part of the needs assessment of this pilot study. We recruited participants (N=30) using convenience sampling.Data collection measures included: i) American Heart Association's CVD-related knowledge questionnaire, ii) Five Times Sit to Stand Test to measure dynamic balance and iii) Six minute walk test (6MWT) to assess exercise endurance iv) standard weighing scale to measure body weight and v) standard measurements scale to measure height. Descriptive and inferential statistics were used to analyze the data. The majority (76%) of participants had hypertension (70%), diabetes (60%), poor balance (70%), and low exercise endurance (100%). Most of the participants had low knowledge related to CVD risk factors. This study demonstrated the need to conduct a large-scale study to assess knowledge related to heart health and the actual needs and preferences of these individuals. Conducting such a study would lay the foundation for developing a need-based program for these underserved individuals while incorporating their preferences and the strategies that would help engage them in a heart health intervention.

Effectiveness of Aerobic Training on Lung Volume, Exercise Capacity and Gait Speed in Individuals with Chronic Kidney Disease

Background: Kidney disease (CKD) is a disorder in which the kidneys have been damaged and are unable tofilter blood as effectively as they should. As a result, extra fluid and waste from the circulation linger in the body,potentially leading to various health issues like heart disease and stroke. This also causes swelling in the lowerlimb causing reduced mobility and altered lung volume. This reduction in mobility can be improved with exercise.Aerobic training has been proved to be one of the most effective treatments for improving lung volume capacity.Aerobic training using cycling exercise can improve both lung volume capacity and mobility together.Purpose: To analyze the Effect of Aerobic training and lung volume and gait speed capacity in individuals withchronic kidney disease.Materials and Methods: Sixty individuals with chronic kidney disease were selected according to inclusionand exclusion criteria in which 48 individuals completed the study and 12 quit. These individuals were treatedwith bed side cycling and spirometry for 8 weeks, 1 session per day. Their Pretreatment Gait speed test scoring,3-minute walk test, were recorded. After the treatment duration the same test was repeated.Results: There is an Improvement in Gait speed and 3-minute walk test after giving incentive spirometry stage ofCKD Individuals. No adverse events were observed during and after the treatment.Conclusion: Individuals with CKD need aerobic training to improve their lung volume capacity. The currentstudy concludes that there is an improvement in Gait speed and 3-minute walk test after the treatment session ofincentive spirometry and Bedside cycle ergometer.Clinical Significance: This study’s clinical significance lies in assessing how aerobic training impacts lung volumecapacity in chronic kidney disease patients. Improved lung function may lead to better cardiovascular health,enhanced quality of life, and reduced complications. These findings could support tailored exercise programs toimprove the well-being and overall health of individuals with chronic kidney disease.

Effects of the Pole Striding Intervention Program on Cardiovascular Fitness among Bronchial Asthma Patients

Background: Chronic inflammatory illnesses of the airways, such as bronchial hyper-reactivity and varyingdegrees of airway blockage, are known as bronchial asthma. Pole walking is a low-impact fitness walking usingspecially designed, light weighted pole. Nordic walking is a common outdoor physical activity.So in this studywe are going to find out the effectiveness of pole striding in bronchial asthma.Aim: The aim of the analysis is to appraise the impact of the pole striding intervention program on bronchialasthma, with regard to the potential improvements in cardiovascular fitness.Method: 40 Individuals who were admitted in IP for bronchial asthma and got discharged were selected randomlybased on inclusion and exclusion criteria from Saveetha Medical College And Hospital. The selected participantswere allocated into 2 groups. Pole striding group was treated with routine treatment along with pole striding.Calisthenic exercise group was treated with only routine treatment. Treatments were given to the groups accordingto the treatment protocol after discharge as home care therapy. Six-Minute Walk Test, Pulmonary Function Testwere the outcome measures used in this study.Result: The improvement was seen in both groups though statistically pole striding group was more significantthan calisthenic exercise group in 6 minute walk test and forced expiratory volume in one second (FEV1) withmean difference of 28.5m, 0.24L, respectively. P- value is &lt;0.0001.Conclusion: Hereby, This study concludes that Pole-striding approach has a better effect in improving in Cardiovascularfitness among Bronchial asthma.

To Study the Effectiveness of Dry Needling on Functional Performance with Plantar Fascitiis

Background: Plantar fasciitis (PF) is a chronic and progressive disease that impairs patients’ quality of life anddaily activities. PF is caused by repeated tissue injury at the origin of the calcaneus’ medial tuberosity. Thesymptoms include Pain expanding from the heel’s medial aspect into the arch of the foot. Pain is frequently worsein the morning, after a period of rest, or after engaging in physical exercise. These signs and symptoms can becomeparalyzing as the illness advances, reducing the individual’s ability to bear weight. According to recent research,the condition should be called fascists because the pathology is more similar to that of tendinosis. The thickness ofthe plantar fascia increases, as does degenerationPurpose: The purpose of the study to determine the effectiveness of dry needling for the subjects with plantarfasciitisMaterials and Methods: 68 subjects in total were chosen based on the inclusion and exclusion criteria. Experimentalgroup (n=34) patients received dry needling of intended sites using a 30 mm needle that was gradually withdrawnafter 15 minutes. The conventional group (n=34) received the Ultrasound therapy was applied at 3.0-MHzfrequency .Patients taken from the five plus hospital. The study period was from December 2022 to March 2023.Results: Statistical analysis of 6 minute Walk test and NPRS examination post values revealed the constantlysignificant differences, With the P value of &lt;0.0001.Conclusion: Dry needling with strengthening exercise was found to be comparatively more effective thanultrasound therapy with strengthening exercise.

Effect of Task Oriented Approach on Cancer Related Fatigue and Functional Capacity among Subjects with Blood Leukaemia

Background: Cancer is the second leading cause of mortality worldwide.19.3 million new cases and 10.3 milliondeaths from cancer were reported worldwide. Cancer-related fatigue (CFR) has a complicated aetiology. Fatiguehas a more detrimental influence on daily tasks and quality of life (QoL) than other ailments like pain or grief. Thisstudy aimed to determine the effect of task oriented approach on cancer related fatigue and functional capacityamong subjects with blood leukaemia.Methods: A randomised, clinical trial was conducted with a total of 30 blood cancer survivors. Subjects wererandomised into a radiation therapy group (RT group) (n=15) and non-radiation therapy group (NRT group)(n=15). Both groups included a task oriented approach for 1section/day, 5 days /week for 4 weeks. The mainoutcome was fatigue as assessed by the Brief fatigue inventory, Other evaluated outcomes were functional capacityand Quality of life measured using 6 minute walk test and EORTC QLQ C30 (Version 3) . Data were collected atbaseline and post-intervention.Result: There is a significant improvement in both group in cancer related fatigue after the intervention, twogroups, non-radiation group show much better improvement comparing to participants under radiation with amean difference of 3.4 in Brief Fatigue Inventory, 5.93 in 6 minute walk test, 16.46 in EORTC QLQ C30 (Version 3).Conclusion: It has been concluded that Task oriented approach has better effect on reducing the fatigue caused bycancer and enhancing the functional capacity, quality of life among blood leukaemia individuals. Participants whoare not under radiation therapy have better prognosis than participants under radiation therapy

The Effects of Early Mobilization Protocol on Pre and Post Operative Functional Performance for Individuals with Post Abdominal Surgery

Background: The post surgical period of abdominal incision was accompanied with respiratory muscle dysfunctionand diminished physical capability. Limited upright mobilisation, exhaustion, and restricted lung abnormalities,among other functional issues, are linked to the early postoperative days. Improving pre-operative levels ofphysical functioning in individuals might be beneficial for post operative outcome.Aim: Aim of the study was to find out on which post-operative day the abdominal surgery participants get to thesame functional status as pre-operative status.Method: 40 Individuals hospitalized for abdominal surgery at Saveetha Medical College and Hospital werechosen for the study based on the inclusion and exclusion criteria. The selected participants were treated withdiaphragmatic breathing exercise, Incentive spirometry, thoracic expansion exercise, splinted coughing technique,active range of motion exercise for upper extremity and lower extremity for pre-operative abdominal surgeryparticipants. Post operative participants were treated with physiotherapy from POD 1 till the time their functionalstatus become same as the pre-operative status. Six- minute walk test, hospital anxiety and depression scale wereused in this study. Their scores were calculated and analysed.Result: Similar pre-operative mean (365.25±25.92) was attained at POD-7 (350.75±25.46). Day of POD-5, the HADSscore was normal (0 to7) in depression.Conclusion: This study shows the post-operative status is attained back on POD-7 with using 6MWT. Depressionwas relieved at POD-5 with a value of mean and standard deviation in HADS.

Feasibility of a Child-Friendly 2-Minute Walk Test: A Crossover Randomized Controlled Trial

Aims Most studies that use the NIH Toolbox 2-Minute Walk Test with young children, modify the protocol, compromising the generalizability of outcomes. A standardizable protocol is needed. The purpose of this study was to compare the 2MWT performance of children ages 3–6 years on the standard NIH Toolbox protocol and on a modified protocol designed to support young children. Methods Cross-over randomized controlled trial. Fifteen typically developing children ages 3–6 years were randomly assigned to the performance order of the NIH toolbox 2MWT protocol and the Modified Accessibility Path (MAP) 2MWT protocol. Outcome variables and statistical analyses included test completion (McNemar test), distance walked (Wilcoxon signed-rank test), and accuracy (general estimating equation model with Poisson distribution). Results All children completed 2 min of walking with the MAP protocol. Only 40% of children completed the NIH Toolbox protocol, with 83% of these NIH completers bolstered by previous exposure to the MAP protocol. Collapsed across the order, children also had significantly fewer errors per lap with the MAP protocol (p < 0.0001), despite walking a significantly greater distance (p = 0.006). Conclusions These findings lend preliminary support for standardized application of a 2MWT with young children when the protocol is designed to be child-friendly.

Impact of pulmonary rehabilitation on lung functions and quality of life in chronic respiratory disease patients

Patients with chronic pulmonary disease commonly present with dyspnea, cough, fatigue, physical limitations, and low Quality-of-Life (QoL). With these morbidities and physical limitations, it may be difficult to perform their day-to-day activities. The London Chest Activity Daily Living (LCADL) scale assesses the self-reported dyspnea of patients with chronic respiratory disease during Activities of Daily Living (ADL). The study was designed to assess the impact of pulmonary rehabilitation on the dyspnea grade (mMRC scale), the Quality-of-Life parameters viz LCADL scale, 6 Minute Walk Test (6MWT) and lung functions (FEV1 &amp; FVC).The study is a retrospective observational study conducted over a period of 1 year, at the Department of Pulmonology, Bhakti Vedanta Hospital &amp; Research Institute. Patients with different pulmonary conditions such as Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), Post-covid Lung Dysfunction, etc. were enrolled in the study. A total of 80 patients were referred to Pulmonary Rehabilitation (PR). Out of which, 40 patients completed an 8-week program. The distribution of the study population was as follows: 18 patients with COPD, 13 patients with ILD, 9 patients with other pulmonary diseases. 15 patients required oxygen support where oxygen saturation (SpO2) was &amp;#60; 90% at baseline at room air. The outcome measures were assessed in these patients at the time of enrollment (Week 0) and at the end of the program (Week 8).Overall, the statistically significant difference noted in Quality-of-Life parameters like LCADL score, mMRC, 6MWT, and lung functions (FEV1, FVC) with an 8-week Pulmonary Rehabilitation program.The p-value (&amp;#60; 0.001) was found in London Chest Activity Daily Living (LCADL) score. Domestic, physical activity had better scores with respect to all parameters after completion of the 8-week Pulmonary Rehabilitation (PR) program. The dyspnea grade on the mMRC scale improved from 1.9 ± 0.591 to 0.45 ± 0.50. The p-value was statistically significant (p &amp;#60; 0.001). 6 MWT distance was improved from 169.5 meters to 324.5 meters at the completion of 8-weeks, the mean difference was 155 meters which was found to be statistically significant. The p-value (&amp;#60; 0.001) was found in 6MWT distance. In lung functions, FEV1 improved from 52.30 % to 56.73 % of predicted and FVC improved from 56.20 % to 58.20 % of predicted. The mean difference of FEV1 and FVC was 4.43 to 2.0, respectively. : An 8-week supervised pulmonary rehabilitation program has demonstrated that the inclusion of pulmonary rehabilitation, not only reduces the symptoms but also improves the exercise capacity and add significant positive effect on the quality of life as well as lung functions in patients with chronic respiratory disease.

Load-induced blood marker kinetics in patients with medial knee compartment osteoarthritis are associated with accumulated load and patient reported outcome measures.

This study aimed to quantify the mechanoresponse of 10 blood marker candidates for joint metabolism to a walking stress test in patients with knee osteoarthritis and to determine the association among marker kinetics and with accumulated load and patient reported outcomes. 24 patients with knee osteoarthritis completed questionnaires, and a 30-minute walking stress test with six blood serum samples and gait analysis. Concentrations of cartilage oligomeric matrix protein (COMP), matrix metalloproteinases (MMP)-1, -3, and -9, epitope resulting from cleavage of type II collagen by collagenases (C2C), type II procollagen (CPII), interleukin (IL)-6, proteoglycan (PRG)-4, A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4, and resistin were determined by enzyme-linked immunosorbent assays, Joint load (moments and compartmental forces) was estimated using musculoskeletal modeling using gait analysis data. COMP and MMP-3 showed an immediate increase after the walking stress followed by a decrease. MMP-9 and resistin showed a delayed decrease below pre-stress levels. ∆COMP correlated with ∆MMP-3 for most time points. ∆MMP-9 correlated with ∆resistin for most time points. The load-induced increase in blood marker levels correlated among blood markers and time points. C2C and resistin correlated positively and C2C/CPII and MMP2 correlated negatively with load during gait. Immediate relative ∆CPII and ∆MMP1 and delayed relative ∆COMP, ∆IL6, ∆C2C, ∆CPII, ∆MMP1 and ∆MMP3 correlated with the load accumulated during the walking stress. Baseline C2C levels correlated with Knee Osteoarthritis Outcome Score (KOOS) subscales and load-induced changes in MMP-3 with KOOS and Short Form 36 quality of life subscores (P<0.05). The distinct and differentiated physiological response to the walking stress depends on accumulated load and appears relevant for patient reported osteoarthritis outcome and quality of life and warrants further investigation in the context of disease progression.ClinicalTrials.gov registration: NCT02622204.

A Feasibility Study Investigating an Exercise Program in Metastatic Cancer Based on the Patient-Preferred Delivery Mode.

Feasibility of exercise in patients with metastatic cancer is still a challenge. This study aimed to determine the feasibility and preliminary efficacy of an exercise intervention based on a patient-preferred delivery mode in patients affected by metastatic cancer. Forty-four patients with a confirmed diagnosis of metastatic cancer were recruited in a 3-month exercise program. Whereas the exercise program consisted of aerobic and resistance activities performed twice a week, the participants may choose the mode of delivery: home based, personal training, or group based. The primary endpoint was the feasibility, defined by recruitment rate, attendance, adherence, dropout rate, tolerability (comparing the session RPE with the target RPE), and safety (using the Common Terminology Criteria for Adverse Events, version 5.0). Secondary endpoints included cardiorespiratory fitness (six minutes walking test), muscle strength (handgrip strength test and isometric leg press test), flexibility (the back scratch and chair sit and reach tests), anthropometric parameters (body mass index and waist-hip ratio), quality of life (EORTC QLQ C-30 questionnaire), and amount of physical exercise (Godin's Shepard Leisure Time Exercise Questionnaire). Descriptive statistics, Student t test, and Wilcoxon signed rank test were used to analyze data. The study recruitment rate was 81%. Out of 44 recruited patients, 28 chose the personal training program, 16 chose the home-based program, and none chose the group-based program. Nine dropouts occurred (20%), 6 in the personal training program, and 3 in the home-based intervention. The median attendance rate was 92%, adherence was 88%, tolerability was 100%, and 9 nonsevere adverse events were registered during the exercise sessions. An increase in cardiorespiratory fitness (P < .001) and flexibility (P = .011 for chair sit and reach; P = .040 for back scratch) was observed at the end of the intervention, while no changes in anthropometric values and muscle strength were detected. Different quality-of-life domains were improved following the intervention, including physical (P = .002), emotional (P < .001), and role functioning (P = .018), fatigue (P = .030), and appetite loss (P = .005). A 3-month exercise program based on a patient-preferred delivery mode is feasible in patients with metastatic cancer and may improve physical function and quality of life. NCT04226508.

Prehabilitation in gynecological oncology - are we ready to implement the program in polish oncological centers?

Prehabilitation is a concept of holistic approach to the patient and includes preoperative efforts focused on optimalization of patient's general condition. The idea of prehabilitation started at the beginning of the 21st century. However, prehabilitation programs in gynecological cancer patients are not standardized and are heterogeneous. The aim of the study it to present the concept of prehabilitation and propose prehabilitation protocol to be introduced in Polish oncological centers. A search in PubMed, Medline, EMBASE (Ovid) and PsycINFO databases was conducted using the following keywords: prehabilitation, gynecological, abdominal surgery, and cancer. The primary outcomes were complications, hospitalization stay, intensive care unit transfer rate, blood loss, wound healing, and reoperation rate. The search was performed in July 2022 and covered the period from 1st January 2000 till 30th June 2022. A total number of 1,118 articles have been identified. Out of all eligible papers only 42 fulfilled the research criteria and were included in the study. The analysis showed that there is no standardized prehabilitation protocol for gynecological cancer surgery, although most include three-modal approach - physical activity, nutrition, and psychological intervention. There is no standard model for physical capacity evaluation, however, 1,118 6 Minute Walk Test (6MWT) is the most common. Frailty evaluation is based on different measurements that prevent from direct comparison of obtained results between studies. We are not ready to implement the prehabilitation program in polish oncological centers. The main reason elvicz is: lack of accredited ovarian cancer centers, lack of well-established standardized prehabilitation programs for gynecological malignancies (ovarian cancer especially), and lack of proper information for patients about advantages of adequate preparation elvic expected surgery. Furter studies on different prehabilitation programs and information campaigns both for patients and gynecologist are required to make implementing prehabilitation possible in Poland.

Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review.

Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.

The six minute walk test in healthy young women

ObjectivesThe Six Minute Walk Test (6MWT) assesses functional capacity. We determined the reference range distance walked, heart rate change, and breathlessness in healthy women. DesignProspective observational study. Methods100 nulliparous women aged 18–40 performed two 6MWTs, with the second performed after heart rate returned to baseline. Borg scales compared expected and true breathlessness. ResultsReference range was 472–758 ​m, with distance mean (SD) of 615 (73.0) metres. Heart rate increase during exercise was 11 (11.8) beats per minute, recovering to baseline in 4.5 (3.9) minutes. 63 ​% of women overestimated breathlessness. ConclusionsThese data represent reference values for functional evaluation of healthy young women.

Movement-evoked pain is not associated with pain at rest or physical function in knee osteoarthritis.

Knee Osteoarthritis (KOA) is mainly characterized by pain. The assessment of KOA-related pain frequently focuses on different constructs subject to sources of bias or drawbacks, as the classical Pain at Rest (PAR). Movement-evoked pain (MEP), recently defined as 'pain during walking', emerges as a differential concept, since PAR and MEP are driven by different underlying mechanisms. Given the novelty of the MEP approach, its association with PAR or with different performance-based tests has not been studied in KOA yet. A cross sectional study was conducted. PAR was measured, alongside the performance of four mobility tests and their corresponding MEP: Timed Up and Go Test, 10-metre Walk Test, 2-Minute Walk Test, and 6-Minute Walk Test. Association and agreement were explored for MEP versus PAR, while the correlation of the tests versus each corresponding MEP-measure was assessed. Neither association nor agreement were found in the duality MEP versus PAR. Also, the lack of association between the performance of a mobility test and the perceived level of pain during the development of the test was stated. Movement-evoked pain is neither related to pain at rest nor to functional performance in subjects affected by knee osteoarthritis. The results from our study suggest that MEP and pain at rest measure and refer to different constructs in knee osteoarthritis. The implementation of MEP as an outcome in exercise-therapy could enhance the tracking of results, as well as the development of tailored interventions under different conditions. This research elucidates the relevance of MEP, recently defined as 'pain during walking', through the analysis of its association with PAR and with functional performance (measured through four mobility tests) in knee osteoarthritis. The results from our study highlight the absence of either association or agreement between MEP and PAR, fact that supports and endorses the idea that both concepts measure and refer to different constructs in knee osteoarthritis.

Tibiotalocalcaneal arthrodesis with an intramedullary nail: The functional and clinical outcome of a challenging patient group and its comparison to a below knee amputation

BackgroundTibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure to fuse the ankle and subtalar joints to treat severe ankle and hindfoot disease. Patients often have multiple operations before a TTCA. A below knee amputation (BKA) has major physical and psychological impacts. Our aim is to investigate the outcomes of these treatments in salvage situations, with a focus on objective functional measurements and patient reported outcome measures (PROMs). Methods52 patients underwent TTCA with a retrograde intramedullary nail and contacted for clinical and functional assessments and compared to patients who underwent traumatic BKA. PROMS such as AOFAS score, SF-36 and foot function index (FFI), and objective functional outcome measures were used. ResultsOf the 52 TTCA patients, 28 patients were recruited for follow-up. 35.7% of patients had postoperative complications. Mean postoperative AOFAS score was 63.9 ± 8.4 (range, 47–81), FFI 48.8 ± 15.8 (range, 22.2–75.2). 11 BKA patients (mean age 46.4 years) were included as control group. BKA patients scored higher than the TTCA patients on SF-36 physical functioning (p < 0.01) and SF-36 mental health (p < 0.05) subscales. The flat-surface functional tests (timed up and go test, 2-minute walk test, 10-meter walk test) showed significantly (p < 0.05) better outcomes for the BKA compared to TTCA. ConclusionsA TTCA is a salvage procedure with high complication rates. Functional and psychometric results are reduced compared to the normal population. Patients after a BKA had significantly better scores on SF-36 functional and mental health subscales and better functional outcomes for flat ground activities compared to TTCA. Heterogeneity of the TTCA and BKA patient cohorts is a limitation of this study. With these results in mind, the outlook of a BKA is not necessarily a grim one. They may be used by surgeons to counsel patients preoperatively when managing complex ankle and hindfoot disease. Level of evidenceLevel III, retrospective cohort study